1. Public Health Case Reporting - CSTE TIG Lab Vocabulary Review May 4th Week – Viral, Parasitic and Non-Infectious Diseases CRSWg, LMCoP, VMCoP May 27 th, 2010 10/20/20151

2. Archive of - 1 st,2 nd and 3rd Meeting Lab Vocabulary Review 10/20/20152 Hyperlink: http://www.phconnect.org/profiles/blogs/call-for-volunteers-reviewhttp://www.phconnect.org/profiles/blogs/call-for-volunteers-review

3. Scope for 4 th Week of CSTE TIG - Lab Vocabulary Review 10/20/20153

4. Spreadsheet Overview 10/20/20154 Note: Includes only the 2 nd Week Bacterial Diseases Lab Vocabulary

5. CSTE Position Statement  CSTE Position Statement not published in the CSTE website for the following conditions: –St.Louis Encephalitis Virus  Eastern Equine Encephalitis Virus CSTE position statement did not have its accompanying CSTE TIG.  Post the above mentioned CSTE position statements in www.phconnect.org www.phconnect.org  Need more detailed review of the following CSTE TIG: –Acute Pesticide Poisoning –Cancer 10/20/20155

6. Cyclosporiasis  “Cyclospora organisms or DNA in intestinal fluid/aspirate or intestinal biopsy specimens” –Test Results (SNOMED) – Non-specific as well as specific. –Need to add the following in non-condition specific nominal results value set - “Protozoa, Protozoal spore, Trophozoite, etc..  l 10/20/20156

7. Giardiasis  “Giardia trophozoites in stool, duodenal fluid or small bowel biopsy “  Two SNOMED results for a single lab test (LOINC). Need to be formatted and map them appropriately. 10/20/20157

8. Malaria  No LOINC or SNOMED mapping in CSTE TIG 10/20/20158 Riki: RELMA codes: 41447-4; 41448-2; 41449-0; 47085-6 all are ord in BLD and 47260-5 (nom)

9. Malaria 10/20/20159 * Need to validate the SNOMED as well as LOINC concepts for its status and find the superseded concept.

10. Malaria 10/20/201510 Could include the Plasmodium hierarchy for more specificity May need to filter the hierarchy and include only the agents that causes Malaria such as Pl. Vivax, Pl. Malariae, Pl. Ovale, Pl. Falciparum

11. Small Pox  polymerase chain reaction (PCR) identification of variola DNA in a clinical specimen  polymerase chain reaction (PCR) identification of variola DNA in an isolate from a clinical specimen 10/20/201511 CSTE Criteria mapped to the same LOINC and SNOMED codes. CSTE criteria has detailed information about specimen which may need to obtained outside LOINC code such as SPM segment, specimen source.

12. Small Pox 10/20/201512

13. Varicella  Combination tests –HSV & VZV “HSV+VZV DNA XXX PCR”  A significant rise in serum varicella immunoglobulin G (IgG) antibody level by any standard serologic assay –Specimen 1 & 2 –Panel has been included in CSTE TIG which may not be in OBX-3 10/20/201513

14. Viral Hemorrhagic Fever (VHF)  Reconcile the CSTE TIG lab criteria with CSTE position statement –Proteinuria –Platelet count  Need to create a value set with a list of viral agents that was specified in CSTE position statement for VHF: –Junin virus –Machupo virus –Sabia virus –Lassa virus –Guanarito virus –ebolavirus –marburgvirus –Crimean-Congo haemorrhagic fever virus 10/20/201514

15. West Nile Virus  Stable (less than or equal to a two-fold change) but elevated titer of WNV virus-specific serum antibodies –No LOINC / SNOMED code, but may repeat the LOINC and SNOMED code from the criteria “Four-fold or greater change in WNV -specific serum antibody titer “ –Riki: - would be a complex method type - might need more than 1 LOINC, if decision is made after report, oterwise need to get IMP code 10/20/201515

16. Waterborne Disease  No Lab Criteria in CSTE position statement as well as in CSTE TIG.  No NND Codes 10/20/201516

17. Neuroinvasive & Non-Neuroinvasive diseases  CSTE position statements does not differentiate between Neuroinvasive and Non-neuroinvasive disease but case notification NND codes differentiate between these too. –West Nile Virus –Western Equine Encephalitis Virus –St.Louis Encephalitis Virus –? Eastern Equine Encephalitis Virus 10/20/201517

18. Western Equine Encephalitis Virus  “Demonstration of WEEV- specific nucleic acid by PCR in a clinical specimen“ –LOINC codes have been requested. –Riki: use LOINC: 54036-9? 10/20/201518

19. Yellow Fever  cross-reactions to other flaviviruses –Negative results –Need to check the Flavivirus Hierrarchy in SNOMED / LOINC browsers and include those tests in the CSTE TIG. 10/20/201519

20. Yellow Fever  ?? Any tests for Yellow Fever antigens 10/20/201520

21. Yellow Fever  Antibody Titers with specific values and different methods 10/20/201521

22. Lead Poisoning 10/20/201522 Different CSTE criteria with specific Qn values, but same LOINC tests.

23. Silicosis 10/20/201523 Imaging & Pathology tests

24. Acute Pesticide - related illness and Injury 10/20/201524 Riki: SNOMED Herbicide Value Sets - Why not include all pesticide children under concept 59545008^Pesticide (substance) in the possible results? This list should be reviewed for completeness by SME.

25. Cancer (1) 10/20/201525

26. Cancer (2) 10/20/201526

27. LIMSi Feedback - Cindy 10/20/201527

28. Common Core Data Elements for Case Reporting and Laboratory Result Reporting  First iteration of common core data element list appears in CSTE position statement 09-SI-01 “Common Core Data Elements for Case Reporting and Laboratory Result Reporting” –Actions: provide a process for updating/maintaining common core data set  CRSWg has undergone a review to update the initial list –Consolidated case reporting and laboratory result reporting data elements –Addressed feedback from CSTE  Scope for the common core data set: –Initial case report from a provider to public health (case reporting) –Data elements can be applied across all nationally notifiable conditions 10/20/201528

29. Category Data element * = complex data elementDefinitionCase Reporting NotesLaboratory Result Reporting Notes Test/resultSpecimen collection date/time Test/resultStudy identifier* useful identifier related to test performed; common term --- lab TIG review Accession number: may be specimen ID or the order number in the message Test/resultSpecimen received date/time Test/resultSpecimen type [coded]common term -- lab TIG reviewspecimen origin in PHLIP? Specimen origin should be an additional data element in the report – coding system / values et is still TBD, will be sent as OBX following SPM segment in a message Coding system for specimen type either HL70487 or SNOMED CT in specimen hierarchy Test/resultSpecimen source site [coded]common term -- lab TIG reviewspecimen origin in PHLIP? Specimen origin should be an additional data element in the report – coding system / values et is still TBD, will be sent as OBX following SPM segment in a message Coding system for specimen source site could be either HL7 or SNOMED CT in anatomical structure hierarchy (prefer terms using the “structure of” Test/resultTest ordered [coded] The name of the laboratory test. Test/resultTest performed [coded] Test/resultTest result [coded]The result of the laboratory test. Test/resultTest result, not codedThe result of the laboratory test. Result that cannot be coded, e.g., a number, a ratio, a text report from a radiologic study, an image Test/resultResult date Test/resultResult status Test/resultReference range Test/resultUnits Test/resultPerforming lab identifier* Test/resultPerforming lab name Test/resultPerforming person name* Test/resultSpecimen sent to PHL 10/20/2015 29

30. Additional Data Elements Considered for Inclusion in Common Core  Quantitative/Qualitative  Abnormal flags  Paired serology result

31. Paired Serology Result (1) 10/20/201531 Review the e-mail thread

32. Paired Serology Result (2) 10/20/201532

33. Recommendation Letter to CSTE about CSTE TIG Lab Vocabulary  Include Changes that needs to be made in CSTE position Statements  Mention the issues that are related to lab domain which would be addressed by the lab community of practice and SDO (LOINC, SNOMED).  CSTE lab Criteria Interpretation issues  Maintenance of the CSTE lab Criteria –?? Unique identifier for the lab criteria –Centralized repository of data elements – Maintained by CSTE 10/20/201533