Hi!
I have some questions about Nucleic Acid Amplification test in microbiology.
As you know, the LOINC codes differentiate the NAA test according to the method of detection. While this granularity may be useful in certain situations, there are others where we prefer less detail. But there are no detection-agnostic NAA codes.
For example, consider that in my laboratory we are using the FilmArray ME panel for the diagnosis of meningoencephalitis. One day, we changed supplier and started using the Qiastat Dx ME panel for the same purpose. The FilmArray ME panel uses high-resolution melting analysis as the detection method, so all tests on the panel belong to the non-probe NAA methods. Qiastat Dx ME, on the other hand, is RT-PCR, with Taqman probes as detection method. This test should be coded as NAA.probe. This change forces me to change all the tests coded in the LIS, although for me this methodological change is less important than changing my colorimetric ELISAs to CLIAs in serology, which all have the same codes (Immunoassay method).
I have read the LOINC Lab Committee Proposal regarding: PCR-Related Methods in Loinc, of 8 June 2017 (available here), but I do not agree that the creation of a NAA method would cause the deprecation of NAA.probe and NAA.non.probe. The two philosophies could coexist with a suitable ontology. The NAA (agnostic detection) method could be a kind of archetype that encompasses itself and the other two.
Another element of confusion is the fact that molecular methods to identify carbapenemases and other resistance genes are all grouped under the ‘Molecular method’, regardless of whether they are probe or non-probe methods.
In relation to this, I would like to ask about NAA rapid tests. At least as far as I know, there are no codes for NAA Point-Of-Care Rapid methods.
Thanks you for everything
Regards,
Ivan