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There are benefits in comparing the change of certain laboratory test result values over a period of time, better known as Trending. Most EMR’s are capable of choosing particular tests and evaluating the change in the test result value over a period of time. Until recently, this has been relatively straight forward because the results in the EMR have typically come from one laboratory system.

In recent years, with the advancement of provincially based lab repositories, which store lab results from a variety of disparate lab systems, the process of trending laboratory tests needs to be re-evaluated. Laboratory providers need to ensure that similar tests are available to be trended together and similar sounding tests which are clinically different are not available to be trended together. There are many ways to resolve this issue technically; this paper does not address those resolutions.

The following table contains a list of commonly trended lab tests that was gathered from data that was collected in British Columbia, Saskatchewan, Manitoba, Ontario and New Brunswick. These tests can be represented in a lab repository by several different LOINC codes. The list includes those LOINC codes that can be safely trended together. Where there is only one LOINC code present, it is the most commonly used code for that test. Multiple codes indicate a variety of different means to obtain the test result value, but all can safely be trended together. In the case of the ALT, there are different commonly used codes available, but none should be trended together.

 

Lab Test

LOINC Codes included in Trend

Hemoglobin A1c

4548-4, 17856-6, 17855-8

Hemoglobin

718-7, 30350-3, 20509-6, 30352-9

Leukocytes

26464-8, 12227-5, 6690-2, 804-5

Platelets

26515-7, 777-3, 778-1

INR

6301-6

Sodium

2951-2, 39791-9

Potassium

2823-3

Chloride

2075-0

Glucose Fasting

14771-0, 14770-2

Lab Test

LOINC Codes included in Trend

Total Cholesterol

14647-2

HDL

14646-4

Chloride

2075-0

Glucose Fasting

14771-0, 14770-2

Total Cholesterol

14647-2

HDL

14646-4

LDL

22748-8, 39469-2

Triglyceride

14927-8

Triglyceride Fasting

47210-0

Alanine Aminotransferase (ALT)

NA

Bilirubin

14631-6

Alkaline Phosphatase

6768-6

Gamma Glutamyl Transferase (GGT)

2324-2

Aspartate Aminotransferase (AST)

1920-8

Creatinine

14682-9

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