Answer list constraints

Legacy clinical-loinc surveys-forms-and-patient-assessment-instruments
1

Some questions have different answer lists in different contexts. Does the establishment of a question list at the general level, without an instrument context, constrain assignment to new lists in specific contexts?

E.g., https://loinc.org/95400-8/ has a “preferred” list with no context, and a “normative” list in context of panel 95403-2. This seems legitimate, because the “root” does not assert a normative expectation.

https://loinc.org/88122-7/, on the other hand, asserts a normative list without a context. Does this prohibit the assignment of a different list within the context of an instrument?

Would it be permitted to assign a new answer list if the new list were a subset of the Normative list?

2

Actually, this example suggests you can switch to a list that drops answers (and scores), even if there is a normative root binding.

Immediate question answered.

But still curious about whether you can change answers in ways other than narrowing them.

3

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LOINC_NUM ApplicableContext AnswerListName DisplayText AnswerListLinkType Score AnswerStringId
88122-7 Often true | Sometimes true | Never true | DK DK or Refused NORMATIVE 0 LA30968-4
88122-7 Often true | Sometimes true | Never true | DK Often true NORMATIVE 1 LA28397-0
88122-7 Often true | Sometimes true | Never true | DK Sometimes true NORMATIVE 1 LA6729-3
88122-7 Often true | Sometimes true | Never true | DK Never true NORMATIVE 0 LA28398-8
88122-7 99595-1 Often|Sometimes|Never true Often true NORMATIVE LA28397-0
88122-7 99595-1 Often|Sometimes|Never true Sometimes true NORMATIVE LA6729-3
88122-7 99595-1 Often|Sometimes|Never true Never true NORMATIVE LA28398-8
88122-7 99593-6 Often|Sometimes|Never true Often true NORMATIVE LA28397-0
88122-7 99593-6 Often|Sometimes|Never true Sometimes true NORMATIVE LA6729-3
88122-7 99593-6 Often|Sometimes|Never true Never true NORMATIVE LA28398-8
88122-7 96777-8 Often|Sometimes|Never true Often true NORMATIVE LA28397-0
88122-7 96777-8 Often|Sometimes|Never true Sometimes true NORMATIVE LA6729-3
88122-7 96777-8 Often|Sometimes|Never true Never true NORMATIVE LA28398-8
4

Jay,

Good question. It depends. Are you asking about clinical LOINC codes/survey instruments or laboratory LOINC codes related to instruments?

Suspect it’s the former, but if the latter, there are regulatory impacts related to your question. For laboratory results reporting, CLIA lab regulations in the US and some of ministries of health, require laboratories to report in accord with the instrument/manufacturer’s package insert, including result values. For example, if a vendor’s test indicates values are detected, not detected, a laboratory is unable to report positive or negative. Caution is urged with use of LOINCs that have LOINC Answer Lists as some vendors have different result values than those listed with the LOINC. Other vendor qualitative result values may be included in LOINC Answer Lists.

Cordially,