Issues in mapping LOINC laboratory tests to SNOMED CT

Comprehensive clinical terminologies such as SNOMED CT tend to overlap with specialized terminologies such as LOINC (e.g., for the domain of laboratory procedures). Terminological systems such as the UMLS are often used to bridge between terminologies. However, the integration of LOINC in the UMLS and with other terminologies remains suboptimal. We mapped concepts for laboratory tests from LOINC to pre-coordinated SNOMED CT concepts, based on shared relations to other concepts. As LOINC is finer-grained than SNOMED CT, several LOINC codes tend to map to the same SNOMED CT concept. However, a large proportion of LOINC codes could not be mapped to SNOMED CT through this approach, because of underspecified definitions in SNOMED CT and a lack of fine-grained, pre-coordinated concepts in SNOMED CT.