Digital metrology in laboratory medicine: a call for bringing order to chaos to facilitate precision diagnostics

Laboratory medicine is faced with rapid developments in data exchange, secondary use of data and artificial intelligence. Safe exchange of laboratory data requires a suitable terminology standard. NPU, LOINC and SNOMED CT are increasingly used for this purpose, but none of these terminology standards can currently accommodate safe exchange across the full spectrum of conventional laboratory data. Furthermore, rapid technological advances in, amongst others, the 'omics' area will enforce a shift towards precision diagnostics. These emerging technologies demand an appropriate and future-proof terminology standard. Given the current and future challenges in laboratory terminologies, we here present a concept for digital metrology in laboratory medicine. Terminology standards used in laboratory medicine should be adjusted to the current state of science to allow safe data exchange and interpretation. Essential test information entails the full spectrum of pre-pre-analysis to post-post-analysis. Major improvements needed include sufficient coding detail for the molecular form of the measurand and information on metrological traceability. Furthermore, especially given the advances in precision diagnostics, it will become essential to indicate interrelationships between measurands. Herefore, integration with established taxonomies would allow improved identification of interrelationships between measurands and linkage with scientific information for multidisciplinary data science. Hence, laboratory data can further gain in specificity and value. The time has come to lay the basis for safe data exchange in the era of precision diagnostics, with a global focus. A consensus for digital metrology in laboratory medicine will be essential to move forward with health data exchange within Europe and beyond.