LOINC

LOINC primarily focuses on laboratory tests and clinical observations, making it less suitable for capturing the detailed clinical semantics of psychiatric tools.

While LOINC can represent entire instruments or test panels, it lacks the ability to describe the clinical context or interpretive elements specific to psychiatric assessments. Additionally, integrating PROMs into LOINC requires collaboration with PROM developers to ensure copyright compliance and accurate representation of validated tools. This process can be slow due to varying levels of cooperation, licensing restrictions, and the complexity of adapting subjective patient-reported data into a standardized format.

The PHQ-9 is one of the few psychiatric instruments represented as a panel in LOINC. Each question (or item) in the PHQ-9 is mapped to an individual LOINC code, allowing for granular data capture, while the panel code represents the full instrument.

LOINC PHQ9 Fig. LOINC-Panel for PHQ-9 (Source: LOINC browser)

Normative answer lists in LOINC are standardized sets of predefined answers associated with specific LOINC codes, designed to ensure consistency and interoperability when recording responses. Normative answer lists in LOINC can potentially be used across different questionnaires, but this depends on the context and design of the questions. Normative lists are strictly defined by a validated instrument or an authoritative source, meaning that when using a LOINC term associated with a normative list, one must adhere to the exact set of specified answers. Preferred lists, on the other hand, provide a recommended set of answers that users are strongly encouraged to follow. While these are not mandatory, they represent the preferred options, although users may substitute or expand them with alternate values if needed. Example lists serve as illustrative or suggestive sets of potential answers. They are designed as a starting point and can be customized by users, allowing them to add or remove answers to suit their specific use case.

LOINC PHQ9 Normative Answer List Fig. Normative Answer List for PHQ-9 (Source: LOINC browser)

For a comprehensive list of widely used PROMs in Germany that are part of the LOINC data base and their official German translation, visit the ongoing project on Art-Decor: