NPU terminology


NPU terminology is a patient centered clinical laboratory terminology for use in the clinical laboratory sciences. Its function is to enable results of clinical laboratory examinations to be used safely across technology, time and geography. To achieve this, the NPU terminology supplies:
The purpose of the NPU terminology is to enable patient examination data to be safely transmitted between laboratory information systems, recognized, compared, reused in calculations, extracted for research or statistics, and stored for documentation, without loss of meaning. It does not cover sampling procedures or methodologies used for determining these data, which may both vary over time.
The terminology adheres to international standards of metrology, terminology, and health informatics, in particular the International System of Quantities and the International Systems of Units. It currently includes over 17 000 entries widely covering multiple disciplines in the field of clinical laboratory science including:
The NPU terminology is supported by a joint committee of the and Laboratory Medicine and a subcommittee of the .
The terminology is freely available for download in its generic version and various language versions. The specific syntax and the references to international terminologies, classifications and nomenclatures make the terminology definitions language-independent.

Utility and benefits

Most countries currently strive to implement eHealth systems for electronic management and communication of healthcare information. The primary drivers for adoption of Electronic Health Records and supporting infrastructure include:
Before health records can be successfully communicated and stored there must be a fundamental agreement on the definition for each individual piece of information. Terminology solutions for describing such "concepts" currently include SNOMED CT, LOINC and the NPU. Key benefits conferred by the NPU terminology include:
The NPU Terminology is owned by both the IFCC and IUPAC. It is governed by the , which consists of representatives from key NPU stakeholders including IFCC, IUPAC, C-SC-NPU, and countries with recognized national release centers.

Terminology structure

Each NPU entry holds a structured definition of the 'result type' it identifies.
The definitions are expressed using well established concepts and terms from the field of laboratory medicine. References to internationally acknowledged classifications, nomenclatures and terminologies are filed where possible. This ensures that the definitions are unambiguous, and that the meaning of each concept will remain stable and accessible over time.
The definition structure is based on the scientific concept of 'examination' – an examination studies one or more properties of a system. In a clinical laboratory terminology such as the NPU terminology the system of interest is assumed to be the patient or the environment, and the NPU definition structure states:
These statements are ordered in a fixed syntax:


System—Component; kind of property

Examples

Body temperature of a patient
NPU08676 Patient—Body; Celsius temperature = ? degree Celsius


Erythrocyte cell count in patient blood
NPU01960 Blood—Erythrocytes; number concentration = ? x 1012 per litre


Concentration of 'Glycoprotein hormones alpha chain' in patient blood plasma
NPU28109 Plasma—Glycoprotein hormones alpha chain; mass concentration = ? microgram per litre


The identifying NPU codes may be used as identifiers with local terms, but a systematically shortened form of the NPU definition is available and is frequently used as a "name" in laboratory reports, for example:
Pt—Body; temp. = ? °C


B—Erythrocytes; num.c. = ? × 1012/L


P—Glycoprotein hormones alpha chain; mass c. = ? μg/L

External referencing for NPU concepts

A key benefit of the NPU terminology is clear definition of terms. Codes are generally only applied where a clear external database reference is available for unequivocal definition of terms.


Example 1: In the items listed above, the reference for 'Blood' is ', ID D001769' which gives the definition:
"The body fluid that circulates in the vascular system. Whole blood includes and ."


Example 2: The reference for 'Glycoprotein hormones alpha chain' is Protein Knowledgebase, , which besides a set of synonyms and a reference to the corresponding gene gives the full sequence of the protein.

Translation of NPU definitions

The English NPU definition structure allows for easy and reliable translation of the NPU definitions into other languages; translating each term in the structured NPU definition into another language will produce a valid definition in that language. The concept behind each term in the definition can be determined and agreed on by accessing the international code assigned to that term. The place of the concept in the syntax assigns the specific meaning of the concept in relation to the examination result.
Translations of the NPU terminology are directly available in Danish and Swedish. The terminology has been structured such that translations into other languages is straightforward.

NPU foundations

C-NPU has been managing the development of structured definitions for laboratory result information for the IFCC and IUPAC and making recommendations through papers, recommendations, and technical reports. These mostly joint documents are available from the old IUPAC website .
PublicationType of Publication
Compendium of Terminology and Nomenclature
of Properties in Clinical Laboratory Sciences		"The Silver Book", a volume in the IUPAC Nomenclature Books series
Glossary of Terms in quantities and units in clinical chemistryRecommendation 1996


Properties and Units in the Clinical Laboratory Sciences, comprising the following series of documents:
I. IUPAC Recommendation 1995
II. IUPAC Recommendation 1997
III. Technical report 1997
IV. Technical report 1997
V. Technical report 1997
VI. Technical report 1997
VIII. Technical report 1999
IX. Technical report 1997
X. Technical report 1999
XI. Technical report 1997
XII. Technical report 1999
XIII. Technical report/recommendation 1997
XVI. Technical report 1999
XVIII. Technical report 2004
XIX. Technical report 2003
XX. Technical report 2007
XXIII. Technical report 2011

While these documents formed the foundation for NPU entries applying to each scientific discipline, subsequent additions in the last decade have consisted primarily of "User driven" requests. The day-to-day administration of the NPU Terminology has for many years been carried out by representatives from the Danish Board of Health with input from the advising NPU committee. The NPU terminology is in nationwide use in laboratories, messages and national registers in Denmark and Sweden, and in sporadic use in several other European countries. In 2014, Norway declared the NPU terminology mandatory on a national scale for most clinical laboratory fields.