Please see the following email for DRONC’s response regarding our concerns and questions with the CDM lab normal range table.
Thanks, Mei From: Keith Marsolo <[email protected]> Sent: Thursday, July 30, 2020 12:10 PM To: Mei Liu <[email protected]> Subject: Re: Follow up on the Data WG Meeting 7/17 Importance: High Hi Mei. We ask for all labs for a couple of reasons. The first is that it allows us to get a sense of the “universe” of lab data across the PCORnet, and allows us to track the network’s improvement in mapping labs to LOINC. The second reason is that we get requests from outside investigators / sponsors about potential projects that require lab data. Through the data curation results, we can determine which sites have records using LOINC codes, and having all labs allows us to look at the RAW_NAME to determine if the records are potentially available and just not mapped. Going forward, we’ve been working with the NLM on queries to better assess the quality of lab data mappings, which will be more effective if applied to all labs. For the 2nd question, it’s really about normal ranges and units. We can’t really query lab data without units, because while we could potentially guess at the unit, we’d have to trust that the LOINC code is correct, and we still discover instances where labs have incorrect LOINC codes. With normal ranges, we haven’t done a ton of work with them yet because we’re still relatively new at querying labs, but they can be very helpful in assigning thresholds or cut points. Many vary by age/race/gender, so understanding that site-level variation is helpful during analysis. Hope that helps. Let me know if there are other questions. Keith On Jul 27, 2020, at 10:54 AM, Mei Liu <[email protected]<mailto:[email protected]>> wrote: Hi Keith, After the Data WG meeting on 7/17, GPC sites had an internal discussion on the feasibility of creating a reference range look-up table for labs. Our major concern is that it may not be feasible for sites like Intermountain Health and IU/Regenstrief in our network to create such table because they have numerous hospitals that use different lab facilities resulting in inconsistent lab normal ranges. Intermountain had a unique case where their central lab lost a section of historic normal range data when they upgraded software, resulting in 78% complete on normal ranges whereas their usual coverage of Lab Normal ranges for quantitative labs is ~95%. So, that gap will fill in and completeness should be back above 80% over time. GPC sites would like the DRNOC to clarify the following two questions: 1. Since we have been asked to dump all lab data into CDM, it would be useful if the DRNOC could articulate why it seems useful – or have they found it useful in practice – to ask for every site’s entire lab data holdings. 2. Why are these Lab Normal tables in the CDM needed? Thank you! Mei ------------------------------------------------- Mei Liu, PhD Associate Professor Department of Internal Medicine Division of Medical Informatics University of Kansas Medical Center Office: 913-945-6446 Fax: 913-588-4880
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