The following text is based on the document published in Eur J Clin Chem Clin Biochem 1997; 35: 805-31. Clin Chim Acta 1997; 268: S5-73.
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The present document is part of a series on properties and units in the clinical laboratory sciences initiated in 1987.
The series will comprise: | |
---|---|
I | Syntax and semantic rules [Ref. 1] |
II | Kinds-of-property [Ref. 2] |
III | Elements and their code values |
IV | Properties and code values |
V | Properties and units in Thrombosis and Haemostasis |
VI | Properties and units in IOC prohibited Drugs (This document) |
VII | Properties and units in Inborn Errors of Metabolism |
VIII | Properties and units in Microbiology |
IX | Properties and units in Trace Elements |
X | Properties and units in General Clinical Chemistry |
XI | Coding systems - Structure and Guidelines |
XII | Properties and units in Clinical Pharmacology and Toxicology |
XIII | Properties and units in Reproduction and Fertility |
XIV | Properties and units in Tumor markers |
XVI | Properties and units in Allergology |
The size and complexity of parts III and IV are such that they will be presented in
electronic format. This is for ease of handling and to facilitate expression of concepts
in different languages.
The overall aim is access by electronic media (Internet) of: 'Compendium of terminology
and nomenclature of properties in clinical laboratory sciences' [Ref. 3].
'Glossary of terms in quantities and units in clinical chemistry' [Ref. 4].
'Properties and units in the clinical laboratory sciences'. At the end, standard
systematic names, elaborated according to international standards and recommendations
should be available in the different domains of clinical laboratory sciences. The core of
the series is code value strings representing concepts, that in combination delineate and
define each property regardless of linguistic expression, thus avoiding errors prone to
incur on translation between languages.
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Clinical Laboratory Sciences are characterised by the exacting nature of the work
performed and the demand for a precise presentation of the outcome.
In drugs of abuse the parent compound is usually named in a report although the
metabolites are often the components determined by the laboratory. Further the domain is
transnational, international or "global".
The adherent informatics system therefore needs to identify the findings accurately and to
present them with the degree of detail required. At the same time it has to facilitate the
transfer over linguistic and cultural barriers without distortion or loss of clarity, in
order to promote clear, unambiguous, meaningful and fully informative communication in
different terminologies.
The degree to which a message (such as a laboratory report) needs to be expressed in a
formal, systematic language depends on the geographical, linguistic, social or
professional distance between the communicating parties. The greater the distance, the
greater the risk of misunderstanding.
Within one laboratory, local jargon terms may be used which are usually well understood
between colleagues, but which would not be sufficiently widely known for communication
with the outside world. Likewise, a laboratory and its local community of users, such as
hospital or community physicians, may use a "local dialect" of the language of
laboratory medicine which is well understood by all concerned; but when the communication
possibilities are wider, even transnational, risks of serious misunderstanding arise.
The purpose is to apply the IFCCIUPAC recommended syntax structures for request and
report and to create a standard systematic terminology which can be used as the basis for
encoding laboratory messages in the domain of drugs of abuse. This is to facilitate
communication of messages about such properties through computing and telecommu- nication
between databases, messages that contain sufficient information to allow translation from
and to the required "local dialect" at each end.
Only drugs of abuse as defined by the International Olympic Committee Medical Code are
dealt with. This is because the delineation in other domains is variable depending on
legal requirements, culture, guidelines, attitude, etc.
Essential is, that the structure used in IOC defined drugs of abuse, can be applied also
to the domain "drugs" in general as a paradigma.
The number of entries is 326, but the list is not exhaustive in that "related
substances" for practical reasons is incomplete.
The standard systematic names recommended here are for the purpose of electronic
transmission and are not intended for standardisation of the language used by clinicians
or laboratory practitioners.
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component
definable part of a system [Ref. 1; Ref. 5]
NOTE: In the domain of drugs of abuse, the name of the component usually refers to the
parent compound
EXAMPLE: Acebutolol
difference scale
set of values, each being the product of a number and a unit, arranged according to
magnitude, and with arithmetic meaning such that equal differences in scale numbers
correspond to equal differences in magnitude [Ref. 14]
NOTE: The principle of equality of differences is not violated by changing the size of the
unit or the zero point; consequently, both are chosen arbitrarily, but should be
conventional
EXAMPLE: Testosterone/Epitestosterone substance ratio increment
drug
any substance which when absorbed into a living organism may modify one or more of its
functions [Ref. 12]
NOTE: The term is generally accepted for a substance taken for a therapeutic purpose, but
is also commonly used for abused substances
drug of abuse
drug used for non-therapeutic purpose
kind-of-property
attribute of phenomena, bodies or substances that may distinguished qualitatively [Ref. 1; Ref. 5]
NOTE: In Ref. 5 the term property (in a general sense) is used as
synonym for kind-of-property
EXAMPLE: colour (value: green; blue; ..), transparency, length (value: long; short; 2 m; 5
m; ..), amount-of-substance (value: 2 mol; 5 mol; ..)
NOTE: Kind-of-property includes the concept kind-of-quantity . All kinds-of-property may
be related to nominal scale (ex. green; blue) or ordinal scales (ex. small; large), but
kinds-of-quantity are generally related to difference scales (ex. 10 �C (i.e. 10 �C more
than an arbitrary zero)) or ratio scales (length 2 m or 5 m)
nominal scale
set of values, each having a unique name (la nomen) or symbol listed in arbitrary order
according to practical considerations [Ref. 14]
EXAMPLE: list of names of drugs of abuse
ordinal scale
set of values, each symbolised by words or a combination of numbers and words indicating
magnitude and used for ranking [Ref. 14]
EXAMPLE: arbitrary concentration of anabolic steroids in urine
("negative" "non-negative" or 0 1)
property
set of data elements comprising information on system, component and kind-of-property and
their adherent specifications
NOTE: Information about identification, time and result is not considered
EXAMPLE: substance concentration of caffeine in urine
particular property
property of a given object (phenomenon, body or substance) [Ref. 1; Ref. 5]
NOTE 1: 'Particular property' includes the concept of particular quantity
NOTE 2: The adjective 'particular' may be omitted, if no ambiguity is caused
EXAMPLE: substance concentration of caffeine in urine of NN at time xx
ratio scale
set of values, each being the product of a number and a unit, arranged according to
magnitude and having its zero corresponding to the natural zero value [Ref.
14]
EXAMPLE: 0 0,1 0,2 - - - 31 32 �mol/l
system
demarcated arrangement of a set of elements and a set of relationships between these
elements [Ref. 1; Ref. 5]
EXAMPLE: Urine
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The main parts of a request and a report are presented in Table 1.
Table 1. Standard systematic description and some recommended sources of names and symbols | |||
---|---|---|---|
Elements | Sources of recommended terms | ||
Particular property | |||
1 | Identification and time | ||
1.1 | identification of patient | ||
1.2 | date and time(s) of sampling | ||
2 | Property | ||
2.1 | system | Nomina Anatomica | |
2.2 | component | WHO, IUPAC, IFCC, IUBMB | |
2.3 | kind-of-property | ISO, IUPAC, IFCC | |
3 | Result | ||
3.1 | equality, inequality or other operator | ||
3.2 | numerical value | ||
3.3 | prefix | SI | |
3.4 | unit | SI, WHO, IUPAC, IFCC, IUBMB | |
4 | Note(s) |
Essential for a request (Table 1) is parts 1 and 2, that is
information on patient identification, time or time interval for sampling, and information
on the property requested.
The laboratory report on a particular property comprises the three parts 1, 2 and 3. To
each element in part 2 may be added a specification as a parenthetic suffix for
clarification, identification and to avoid ambiguity.
Note(s) (part 4) relating to diagnosis, medication, haemolysis or hardware breakdown are
not included, except when needed for the interpretation of results such as pretreatment of
patient or subject.
Thus the elements of a property comprise:
System(specification)Component(specification); kind-of-property(specification)
EXAMPLE [NPU01008]
UrineAcetazolamide; arbitrary concentration(IOC 95 Confirm; 0 1)
The elements of a result comprise: an operator (=; <; <=; >; >=; etc.), a value, a prefix and a coherent unit.
EXAMPLE [NPU01432]
= 60 �mol/l (prefix (: micro = 10-6)
Nominal and ordinal scale values carry no unit. In difference and ratio scales the unit
must never be omitted in reporting results, except for the unit 1.
It is further recommended that the result includes a measure of uncertainty [Ref. 13].
The names of components are from the International Nonproprietary Names (INN) of WHO [Ref. 6] for pharmaceutical substances (English, French, Russian and
Spanish). If not recorded in INN, preference is for CAS [Ref. 7], USAN
[Ref. 8], BAN [Ref. 9], Martindale [Ref. 10], in that sequence.
In addition to the systematic name of the property, an example and other useful
information is given.
For details, see IUPACIFCC Recommendations 1995 - Syntax and semantic rules [Ref. 1].
Most drugs are metabolised by the organism. Therefore the analytical findings pertain to
the drug administered and to its metabolites. Often the non-modified drug is hardly or not
detectable. If so, the result given to the requester is on the parent compound, a result
deduced from the presence of specific metabolites. Information on metabolites found is
part of the report and is given after a "deduced from".
Entries relating to IOC screening procedures are given in two forms:
In short form with the result of a screening for a set of compounds on a nomimal scale
listing the names of parent compounds, or if none are detected, the outcome as
"none". See NPU04763, NPU04764, NPU04765, NPU04767, NPU04768, NPU04833.
In extended form with the list of compounds screened for with an ordinal scale. See
NPU04559, NPU04560, NPU04561, NPU04562, NPU04572, NPU04832.
The confirmatory outcome is in only one form comprising the standard systematic name for a
property on a parent compound, the scale values "0" (negative) or "1"
(non-negative) and if "1" a "deduced from" followed by systematic
names of metabolites found.
Furthermore it should assist in the collation of data in databases and knowledge bases and
facilitate improvement of procedures f.ex. in delineating the metabolites that are the
more reliable in confirmation tests.
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The terms recommended (elements 1-6) are given in bold, that is: the code value, the standard systematic name, and the unit.
EXAMPLES
a. Nominal scale | |
---|---|
1 | Urine |
3 | Anabolic steroid; |
4 | taxon(IOC 95 Screen) |
10 | Authority: IOC; IFCC/C-LDA |
11 | Note: Report is on parent compounds, based on specific metabolites for each compound. These are reported with the outcome of the confirmation study. |
12 | [NPU04763] |
13 | UAnabolic steroid; taxon(IOC 95 Screen) = Metandienone, Nandrolone, Oxymetholone |
b. Ordinal scale | |
---|---|
1 | Urine |
3 | Anabolic steroid; |
4 | arbitrary concentration(list; IOC 95 Screen) |
10 | Authority: IOC; IFCC/C-LDA |
12 | [NPU04560] |
13 | [NPU04560]UAnabolic steroid; arb.c.(list; IOC 95 Screen) |
[NPU3811] UAndrostanolone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU1394] UBolasterone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU1397] UBoldenone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU1623] UClostebol; arb.c.(IOC 95 Screen; 0 1) = ? [NPU4301] UDanazol; arb.c.(IOC 95 Screen; 0 1) = ? [NPU1849] UDehydrochloromethyl testosterone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU4325] UDrostanolone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU2064] UFluoxymesterone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU4321] UFormebolone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU4408] UMestanolone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU2706] UMesterolone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU2712] UMetandienone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU2716] UMetenolone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU4309] UMethandriol; arb.c.(IOC 95 Screen; 0 1) = ? [NPU2801] UMethyltestosterone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU4305] UMibolerone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU2885] UNandrolone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU2918] UNorethandrolone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU2972] UOxandrolone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU3015] UOxymesterone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU3018] UOxymetholone; arb.c.(IOC 95 Screen; 0 1) = ? [NPU3469] UStanozolol; arb.c.(IOC 95 Screen; 0 1) = ? [NPU4410] UTrenbolone; arb.c.(IOC 95 Screen; 0 1) = ? |
1 | Urine |
3 | Metandienone; |
4 | arbitrary concentration(IOC 95 Confirm; 0 1) |
6 | M = 300,42 g/mol |
9 | Other term(s): Methandrostenolone |
10 | Authority: IOC; IFCC/C-LDA; INN88; CAS72-63-9 |
12 | [NPU02713] |
13 | UMetandienone; arb.c.(IOC 95 Confirm; 0 1) = 1 |
deduced from 6[[beta]]-Hydroxymetandienone 3'-Hydroxystanozolol |
1 | Urine |
3 | Nandrolone; |
4 | arbitrary concentration(IOC 95 Confirm; 0 1) |
6 | M = 274,39 g/mol |
10 | Authority: IOC; IFCC/C-LDA; INN88; CAS434-22-0 |
12 | [NPU02886] |
13 | UNandrolone; arb.c.(IOC 95 Confirm; 0 1) = 1 |
deduced from 19-Norandrosterone 19-Noretiocholanolone |
1 | Urine |
3 | Oxymetholone; |
4 | arbitrary concentration(IOC 95 Confirm; 0 1) |
6 | M = 332,47 g/mol |
10 | Authority: IOC; IFCC/C-LDA; INN88; CAS434-07-1 |
12 | [NPU03019] |
13 | UOxymetholone; arb.c.(IOC 95 Confirm; 0 1) = 1 |
deduced from 17[[alpha]]-Methyl-5[[alpha]]-androstane-2-hydroxymethylene-3[[alpha]],4,17[[beta]]-triol 17[[alpha]]-Methyl-5[[alpha]]-androstane-3[[alpha]],17[[beta]]-diol |
d. Difference scale | |
---|---|
1 | Urine |
3 | Testosterone/Epitestosterone; |
4 | substance ratio increment(IOC 95; dates) |
10 | Authority: IOC; IFCC/C-LDA |
12 | [NPU04402] |
13 | UTestosterone/Epitestosterone; subst. ratio incr.(IOC 95; 1995-03-21 1995-02-21) = 8,3 |
e. Ratio scale | |
---|---|
1 | Urine |
3 | Ephedrine; |
4 | substance concentration(IOC 95 Screen; (< 30 >= 30) micromole/litre) |
5 | micromole/litre |
6 | M = 165,23 g/mol |
10 | Authority: IOC; IFCC/C-LDA; BAN; CAS299-42-3 |
11 | Note: IOC decision limit 30 �mol/l |
12 | [NPU01936] |
13 | UEphedrine; subst.c.(IOC 95 Screen; (< 30 >= 30) �mol/l) = < 30 �mol/l |
1 | Urine |
3 | Caffeine; |
4 | substance concentration(IOC 95 Confirm) |
5 | micromole/litre |
6 | M = 194,19 g/mol |
10 | Authority: IOC; IFCC/C-LDA; BAN; CAS58-08-2 |
11 | Note: IOC decision limit 60 �mol/l |
12 | [NPU01433] |
13 | UCaffeine; subst.c.(IOC 95 Confirm) = ? �mol/l |
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Note: An asterisk before INN88 signifies that an objection has been raised to the proposed name by a WHO Member State.
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David Cowan: Drug Control Centre, London University, King's College, London SW3 6LX, United Kingdom
Gilbert Hill: Department of Clinical Chemistry, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
Henrik Olesen, Ivan Bruunshuus,
Karina Klempel: Department of Clinical Pharmacology Q 7642, Copenhagen University
Hospital (Rigshospitalet), 20 Tagensvej, DK-2200 Copenhagen, Denmark
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Membership of C-LDA:
Chairman: H. Catlin (USA). Members: D. Cowan (United Kingdom); R. de la
Torre (Spain); M. Donike (Germany)+ ; D. Fraisse (France); H. Oftebro (Norway).
+Deceased 1995-08
The combined Memberships of the Committee and the Commission (C-NPU) during the
preparation of this report (1994 to 1996) were as follows:
Chairman: 1989-1995 H. Olesen (Denmark); 1996 - D Kenny (Ireland). Members:
X. Fuentes-Arderiu (Spain; 1991-1997); J.G. Hill (Canada; 1987-1997); D. Kenny (Ireland;
1994-1997); H. Olesen (Denmark; 1985-1995); PL Storring (United Kingdom; 1989-1995); P
Soares de Araujo (Brazil; 1994-1997); Clem McDonald (USA; 1996-1997).