Comparison of the international terminologies SNOMED CT, LOINC and ICD-11: Applicability in a guideline-conform pathology vocabulary for urothelial carcinoma in Germany
Abstract Objective With almost 30,000 new cases per year, urothelial carcinomas account for a significant proportion of cancer cases in Germany. Respective guidelines serve to help pathologists evaluate tumor material according to international classification standards, but to ensure interoperability, further regulations are required. Therefore, the study presented in this work aimed at improving the informational situation by evaluating the applicability of the international terminologies in the scope of urothelial carcinoma in Germany. Methods Based on the S1-guideline "Urothelkarzinom", a collection of terms recommended for a pathology vocabulary was compiled and mapped to SNOMED CT (Systematic Nomenclature of Medical Terms), LOINC (Logical Observation Identifiers Names and Codes) and ICD-11 (International Classification of Diseases 11th Revision), respectively. Results Of the 168 terms required, 163 (97.02%) could be mapped to SNOMED CT, 66 (39.29%) to LOINC and 70 (41.67%) to ICD-11. However, considering the equivalence of each coding and restricting the mapping accordingly resulted in significantly lower coverage. When aiming at absolute equivalence, even combining all three terminologies resulted in only 138 (82.14%) terms being mappable adequately. Discussion Results prove that currently even combining established terminologies does not cover the terms required for a standardized documentation of urothelial findings completely. They also highlight the importance of SNOMED CT, as within this study it provided the largest proportion of mappable terms. Results also clearly demonstrated that especially SNOMED CT and LOINC require extensive knowledge on the respective terminology itself as well as on the respective medical field to ensure reliable mappings.