THis presentation gives the background of WHO's work on health information including the compilation of data from different sources using ICD; as well as revision of ICD with modern ontological methods.
This document provides an overview of the International Classification of Diseases (ICD) and the development of ICD-11. It discusses the historical evolution of the ICD, the features of ICD-11 including its internet-based platform, input from stakeholders, content model, and definitions. It also describes new elements of ICD-11 like new chapters and coding schemes, as well as the field trials and multilingual representations that are part of the ICD-11 revision process.
Utility and Added Value of Classifications in Health Information SystemsBedirhan Ustun
Health Information Systems; ICD, ICD11, SNOMED-CT, Use Cases showing benefits of use of classification- terminology systems; avoid and e-tower of Babel; electronic health record, Enhance Patient Care, Decision Support, Safety & Quality
State of the WHO Family of International Classifications -2015Bedirhan Ustun
The document discusses the history and development of the International Classification of Diseases (ICD) over 150 years from its origins in William Farr's work in the mid-19th century to the current revision process for ICD-11. It notes that ICD-11 aims to evolve as a multi-purpose classification that can serve various uses in an electronic environment and be linked to other clinical terminologies and ontologies. The development includes creating a foundation component with detailed disease descriptions and linearizations tailored for specific uses such as mortality statistics and primary care.
The presentation multiple code sets ( aka linearizations) that are used in ICD11 and its different use cases: Primary Care, Mortality statistics, Morbidity Statistics. Use for Primary Care should be simple short and user friendly. It should have incentives for the providers and compatible with ICD11 Joint Linearizations.
ICF provides domains of functioning as body functions, personal activities and societal participation to classifiy what a person can do in a certain environment. It provides a common language for communication and meaningful exchange of data.
DSM5 has changed the requirements for describing the clinical significance of a DSM category. Now there it is required that "impairment" criteria is specified in accordance with the ICF ( International Classification of Functioning Disability and Health ) and operationally measured with the WHODAS 2.0;
The document summarizes a seminar on ICD-10 classification of mental disorders. It provides an overview of the layout and topics covered in the seminar, including the history and development of ICD, principles and structure of ICD-10 coding, categories of mental disorders, controversies, and comparisons to DSM. The seminar speaker discussed challenges in classifying psychiatric disorders and evaluating ICD-10.
This document provides an overview of the International Classification of Diseases (ICD) and the development of ICD-11. It discusses the historical evolution of the ICD, the features of ICD-11 including its internet-based platform, input from stakeholders, content model, and definitions. It also describes new elements of ICD-11 like new chapters and coding schemes, as well as the field trials and multilingual representations that are part of the ICD-11 revision process.
Utility and Added Value of Classifications in Health Information SystemsBedirhan Ustun
Health Information Systems; ICD, ICD11, SNOMED-CT, Use Cases showing benefits of use of classification- terminology systems; avoid and e-tower of Babel; electronic health record, Enhance Patient Care, Decision Support, Safety & Quality
State of the WHO Family of International Classifications -2015Bedirhan Ustun
The document discusses the history and development of the International Classification of Diseases (ICD) over 150 years from its origins in William Farr's work in the mid-19th century to the current revision process for ICD-11. It notes that ICD-11 aims to evolve as a multi-purpose classification that can serve various uses in an electronic environment and be linked to other clinical terminologies and ontologies. The development includes creating a foundation component with detailed disease descriptions and linearizations tailored for specific uses such as mortality statistics and primary care.
The presentation multiple code sets ( aka linearizations) that are used in ICD11 and its different use cases: Primary Care, Mortality statistics, Morbidity Statistics. Use for Primary Care should be simple short and user friendly. It should have incentives for the providers and compatible with ICD11 Joint Linearizations.
ICF provides domains of functioning as body functions, personal activities and societal participation to classifiy what a person can do in a certain environment. It provides a common language for communication and meaningful exchange of data.
DSM5 has changed the requirements for describing the clinical significance of a DSM category. Now there it is required that "impairment" criteria is specified in accordance with the ICF ( International Classification of Functioning Disability and Health ) and operationally measured with the WHODAS 2.0;
The document summarizes a seminar on ICD-10 classification of mental disorders. It provides an overview of the layout and topics covered in the seminar, including the history and development of ICD, principles and structure of ICD-10 coding, categories of mental disorders, controversies, and comparisons to DSM. The seminar speaker discussed challenges in classifying psychiatric disorders and evaluating ICD-10.
AHIMA ICD-10 ICD-11 switch to ICD-10-CM in the USA; Bedirhan Ustun
Switching to ICD-10-CM and ICD revision in the USA. This presentation was made at AHIMA conference in 2011. Now ICD 11 is scheduled in 2017 and ICD-10-CM can be made as a National Linearization.
How can ICD-11 possibly help you enhancing your casemix ?
What Can ICD11 offer systematically?
A systematic meaningful integrated system of clinical conditions - (not only for DRGs … )
Better clinical description
Better severity grading
Better coding of co-morbidity
Inherent functional information (key ICF classes)
Integrated information system between ICD, ICF, ICHI
Deconstructing Diagnosis into subgroups
Computerized information processing
This document provides an overview of the International Classification of Diseases (ICD) and discusses updates to the 11th revision of ICD (ICD-11). It describes the historical evolution of ICD, key features of ICD-11 including its internet-based platform, content model, definitions, field trials and multi-lingual representations. New elements in ICD-11 include new chapters, concepts, coding schemes and terminology. The World Health Organization is leading the ICD-11 revision process with input from various expert advisory groups.
This document provides an overview of the International Classification of Diseases (ICD) and the development of ICD-11. It discusses the historical evolution of the ICD, the features of ICD-11 including its internet-based platform, input from stakeholders, content model, definitions, and field trials. It also describes ICD revisions, the governance structure for ICD-11 development, and how ICD-11 is designed to work with electronic health records.
The document discusses the progress of the ICD-11 revision. It notes that the beta version is currently frozen for review and field trials, with over 75% of top-level categories defined and errors reduced. Field trials will assess the applicability, reliability and utility of ICD-11 for purposes like mortality and morbidity coding. The revision aims to create an electronic, multilingual classification to facilitate health information exchange.
The document discusses the International Classification of Diseases (ICD), which is managed by the World Health Organization (WHO) and used globally for diagnostic and health management purposes. ICD-11, released in 2018, provides major improvements including more clinically relevant classifications that reflect advances in medicine, easier coding, and a digital format. Key changes include new chapters on disorders of the immune system, blood, sexual health, and traditional medicine. ICD-11 also has enhanced functionality for research, policymaking, and clinical practice.
International classification of diseases (ICD) is managed by world health organization (WHO). It is globally used diagnostic tool for epidemiology, health management and clinical purposes.
International Classification of Health Interventions - development phase 2014...Bedirhan Ustun
The document discusses plans for a collaboration between the American Medical Association (AMA) and the World Health Organization (WHO) to develop an integrated international classification of health interventions (ICHI). The goals are to improve interoperability of clinical data globally and enable cross-border data analysis. Key points discussed include establishing an expert group jointly appointed by AMA and WHO, developing ICHI using existing AMA and WHO source materials, and providing financial support for the project over 5 years.
The document provides an overview of ICD-11 and ICHI (International Classification of Health Interventions). ICD-11 is the International Classification of Diseases published by the World Health Organization (WHO) for statistical purposes. ICHI classifies health interventions and includes medical, nursing, rehabilitation and other interventions. Both ICD-11 and ICHI use a common conceptual framework and terminology system. They provide standardized classifications to allow for analysis and comparison of health data globally.
introduction to ICD 10 course ,presented according to the health offices computerization under the supervision of the national information center -Ministry of health and population.
Classificatory systems - Advantages & DisadvantagesHemangi Narvekar
Classification of Diseases/Disorders are important to improve treatment and prevention efforts. Two important classification system used in the field of Mental Disorders are DSM -V and ICD -10. Here we will discuss Strengths and Weaknesses of both.
Introduction to ICD /health care code set naolgonfa
The document provides information about the International Classification of Diseases (ICD) including:
ICD is the global standard for diagnostic classification and coding of diseases, injuries, and causes of death. It allows for consistent recording and comparison of health data worldwide. ICD-10 provides greater specificity than previous versions with over 68,000 codes to capture detailed clinical information. The document outlines the purpose, history, and structure of ICD codes as well as differences between ICD-9 and ICD-10.
The document discusses the classification of diseases. It begins by defining what a disease is and describing the main types. The most widely used system for classifying diseases is the World Health Organization's International Classification of Diseases (ICD). The ICD uses codes to map diseases and health conditions into broad diagnostic categories. It has gone through several revisions over time to ICD-10 to reflect advances in healthcare. The ICD classification system is used globally to facilitate disease tracking, epidemiology research, and clinical care.
The document discusses the role of terminologies and ontologies in the context of electronic health records (EHRs). It describes how terminologies are used to standardize language for communication purposes, while ontologies aim to formally represent the structure of reality to enable machine reasoning. EHRs document information about specific patients and populations. Terminologies play an important role in making EHR data intelligible to other users, while respecting the distinctions between language, conceptualization, and reality.
The document provides an overview of the International Classification of Diseases (ICD) including:
1) A brief history of disease classification systems leading to the development of the ICD by the World Health Organization.
2) An explanation that the ICD-10 is the current international standard for morbidity and mortality statistics and coding of diseases and health problems.
3) A summary of the structure of ICD-10 including its 3 volumes, 22 chapters and alphanumeric coding system.
The document provides an overview of the International Classification of Diseases (ICD) including:
1) A brief history of disease classification systems leading to the development of the ICD by the World Health Organization.
2) An explanation that the ICD-10 is the current international standard for morbidity and mortality statistics and coding of diseases and health problems.
3) A summary of the structure of ICD-10 including its 3 volumes, 22 chapters and alphanumeric coding system.
ICD-10 is a statistical classification, which means that it contains a limited number of mutually exclusive code categories, which describe all disease concepts.
How do we define Health? Is WHO definition sufficient to operationalize and measure health domains? How do we compare data across health domains? Can we set up a "stock exchange" type of conversion utility to make use of different sources of data?
JPI Conference Dublin - Edvard Beem - Evaluation and Monitoring Frameworkjpndresearch
The document discusses the Joint Programme - Neurodegenerative Diseases Research (JPND), which aims to increase coordinated investment in neurodegenerative disease research across Europe. It outlines JPND's goals of finding disease causes, developing cures, and improving care. A monitoring and evaluation framework was developed using logical framework analysis to track JPND's impact on research funding, policy, and the scientific and societal benefits of funded projects. Key performance indicators focus on outputs like collaborative studies and outcomes like policy influence. Challenges include developing and aligning the framework with JPND's evolving strategy.
Operational research- main techniques PERT and CPMvckg1987
this presentation mainly deals with operational research giving more focus on pERT and CPM techniques. this two methods are very useful and very confusing while reading but the examples in this presentation makes it very easy to understand this methods and for more study the end slide is provided with references.
Arastirmaci tarafindan Baslatilan Arastirmalarda larda ortak veri standartlar...Bedirhan Ustun
Araştırmacı tarafından Başlatılan Araştırma (ABA)lar bilimsel bir sistematik içerisinde bir tanı grubundaki deneklere yapılan girişimlerin etkinliklerini değerlendirmek için kullanılabilir: ‘Bu tedavi yöntemi başka yöntemlere göre daha mı iyi’, ‘yan etkileri var mı’ gibi soruları yanıtlamak; ve araştırmalar arasında karşılaştırma yapmak amacıyla yapılabilir. Bu bağlamda, ABAlarda tanı ve girişim etkinliğini ölçmek ve değerlendirmek için bilimsel standartların kullanılması zorunludur. Araştırmacılar genellikle kendi alanlarında daha önce belirlenmiş (1) tanı ve (2) çıktı (outcome) ölçeklerini kullanmaktadırlar.
(1)Bu tür tanı ölçekleri belirli bir tanı grubunu homojen olarak tanımlamak için yararlıdırlar. Ancak her araştırmacı kendi ölçeğini kullanırsa araştırmaların karşılaştırılması sorun yaratır. Örneğin bir araştırmacı depresif bozukluk tanısını DSMIV diğeri ICD10, bir diğeri başka bir klinik tanı sistemi ile koymuşsa bu çalışmaların aynı hastalık grubuna ait bulguları ortaya koyduğunu söyleyebilmek zordur. Yapılması gereken tıpkı EURO, Dolar vb para birimlerinin birbirine denk eşdeğerlik tablolarını çıkarmak; ya da her tanıyı tek bir sistem üzerinden ele almaktır.
(2) Bu alanda daha önemli olarak ikinci sorun tanıdan çok çıktı (outcome) karşılaştırmalarıdır. Çıktı olarak değişik tanı, belirti sayısı, hastalık şiddeti, yetiyitimi (disability) ve işlevsellik, yaşam kalitesi (quality of life) ve iyilik hali gibi veriler birbiri ile iç içe ve birbiri yerine kullanılmaktadır. Böyle durumlarda tedavi sonuçlarının karşılaştırılması olanaksız olmaktadır. Çözüm çıktı olarak neyin ölçüldüğünün net olarak belirlenmesi ve bunun belirli bir standart ölçek üzerinden derecelendirilmesidir.
Bu sunuda depresyon, alkol bağımlılığı, bel ağrısı, diz ve kalça protezleri üzerinden örnekleri üzerinden tanı ve çıktılar adına standart ölçümlerin nasıl karşılaştırılabileceği anlatılacaktır.
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Switching to ICD-10-CM and ICD revision in the USA. This presentation was made at AHIMA conference in 2011. Now ICD 11 is scheduled in 2017 and ICD-10-CM can be made as a National Linearization.
How can ICD-11 possibly help you enhancing your casemix ?
What Can ICD11 offer systematically?
A systematic meaningful integrated system of clinical conditions - (not only for DRGs … )
Better clinical description
Better severity grading
Better coding of co-morbidity
Inherent functional information (key ICF classes)
Integrated information system between ICD, ICF, ICHI
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This document provides an overview of the International Classification of Diseases (ICD) and discusses updates to the 11th revision of ICD (ICD-11). It describes the historical evolution of ICD, key features of ICD-11 including its internet-based platform, content model, definitions, field trials and multi-lingual representations. New elements in ICD-11 include new chapters, concepts, coding schemes and terminology. The World Health Organization is leading the ICD-11 revision process with input from various expert advisory groups.
This document provides an overview of the International Classification of Diseases (ICD) and the development of ICD-11. It discusses the historical evolution of the ICD, the features of ICD-11 including its internet-based platform, input from stakeholders, content model, definitions, and field trials. It also describes ICD revisions, the governance structure for ICD-11 development, and how ICD-11 is designed to work with electronic health records.
The document discusses the progress of the ICD-11 revision. It notes that the beta version is currently frozen for review and field trials, with over 75% of top-level categories defined and errors reduced. Field trials will assess the applicability, reliability and utility of ICD-11 for purposes like mortality and morbidity coding. The revision aims to create an electronic, multilingual classification to facilitate health information exchange.
The document discusses the International Classification of Diseases (ICD), which is managed by the World Health Organization (WHO) and used globally for diagnostic and health management purposes. ICD-11, released in 2018, provides major improvements including more clinically relevant classifications that reflect advances in medicine, easier coding, and a digital format. Key changes include new chapters on disorders of the immune system, blood, sexual health, and traditional medicine. ICD-11 also has enhanced functionality for research, policymaking, and clinical practice.
International classification of diseases (ICD) is managed by world health organization (WHO). It is globally used diagnostic tool for epidemiology, health management and clinical purposes.
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The document discusses plans for a collaboration between the American Medical Association (AMA) and the World Health Organization (WHO) to develop an integrated international classification of health interventions (ICHI). The goals are to improve interoperability of clinical data globally and enable cross-border data analysis. Key points discussed include establishing an expert group jointly appointed by AMA and WHO, developing ICHI using existing AMA and WHO source materials, and providing financial support for the project over 5 years.
The document provides an overview of ICD-11 and ICHI (International Classification of Health Interventions). ICD-11 is the International Classification of Diseases published by the World Health Organization (WHO) for statistical purposes. ICHI classifies health interventions and includes medical, nursing, rehabilitation and other interventions. Both ICD-11 and ICHI use a common conceptual framework and terminology system. They provide standardized classifications to allow for analysis and comparison of health data globally.
introduction to ICD 10 course ,presented according to the health offices computerization under the supervision of the national information center -Ministry of health and population.
Classificatory systems - Advantages & DisadvantagesHemangi Narvekar
Classification of Diseases/Disorders are important to improve treatment and prevention efforts. Two important classification system used in the field of Mental Disorders are DSM -V and ICD -10. Here we will discuss Strengths and Weaknesses of both.
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The document provides information about the International Classification of Diseases (ICD) including:
ICD is the global standard for diagnostic classification and coding of diseases, injuries, and causes of death. It allows for consistent recording and comparison of health data worldwide. ICD-10 provides greater specificity than previous versions with over 68,000 codes to capture detailed clinical information. The document outlines the purpose, history, and structure of ICD codes as well as differences between ICD-9 and ICD-10.
The document discusses the classification of diseases. It begins by defining what a disease is and describing the main types. The most widely used system for classifying diseases is the World Health Organization's International Classification of Diseases (ICD). The ICD uses codes to map diseases and health conditions into broad diagnostic categories. It has gone through several revisions over time to ICD-10 to reflect advances in healthcare. The ICD classification system is used globally to facilitate disease tracking, epidemiology research, and clinical care.
The document discusses the role of terminologies and ontologies in the context of electronic health records (EHRs). It describes how terminologies are used to standardize language for communication purposes, while ontologies aim to formally represent the structure of reality to enable machine reasoning. EHRs document information about specific patients and populations. Terminologies play an important role in making EHR data intelligible to other users, while respecting the distinctions between language, conceptualization, and reality.
The document provides an overview of the International Classification of Diseases (ICD) including:
1) A brief history of disease classification systems leading to the development of the ICD by the World Health Organization.
2) An explanation that the ICD-10 is the current international standard for morbidity and mortality statistics and coding of diseases and health problems.
3) A summary of the structure of ICD-10 including its 3 volumes, 22 chapters and alphanumeric coding system.
The document provides an overview of the International Classification of Diseases (ICD) including:
1) A brief history of disease classification systems leading to the development of the ICD by the World Health Organization.
2) An explanation that the ICD-10 is the current international standard for morbidity and mortality statistics and coding of diseases and health problems.
3) A summary of the structure of ICD-10 including its 3 volumes, 22 chapters and alphanumeric coding system.
ICD-10 is a statistical classification, which means that it contains a limited number of mutually exclusive code categories, which describe all disease concepts.
How do we define Health? Is WHO definition sufficient to operationalize and measure health domains? How do we compare data across health domains? Can we set up a "stock exchange" type of conversion utility to make use of different sources of data?
JPI Conference Dublin - Edvard Beem - Evaluation and Monitoring Frameworkjpndresearch
The document discusses the Joint Programme - Neurodegenerative Diseases Research (JPND), which aims to increase coordinated investment in neurodegenerative disease research across Europe. It outlines JPND's goals of finding disease causes, developing cures, and improving care. A monitoring and evaluation framework was developed using logical framework analysis to track JPND's impact on research funding, policy, and the scientific and societal benefits of funded projects. Key performance indicators focus on outputs like collaborative studies and outcomes like policy influence. Challenges include developing and aligning the framework with JPND's evolving strategy.
Operational research- main techniques PERT and CPMvckg1987
this presentation mainly deals with operational research giving more focus on pERT and CPM techniques. this two methods are very useful and very confusing while reading but the examples in this presentation makes it very easy to understand this methods and for more study the end slide is provided with references.
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Araştırmacı tarafından Başlatılan Araştırma (ABA)lar bilimsel bir sistematik içerisinde bir tanı grubundaki deneklere yapılan girişimlerin etkinliklerini değerlendirmek için kullanılabilir: ‘Bu tedavi yöntemi başka yöntemlere göre daha mı iyi’, ‘yan etkileri var mı’ gibi soruları yanıtlamak; ve araştırmalar arasında karşılaştırma yapmak amacıyla yapılabilir. Bu bağlamda, ABAlarda tanı ve girişim etkinliğini ölçmek ve değerlendirmek için bilimsel standartların kullanılması zorunludur. Araştırmacılar genellikle kendi alanlarında daha önce belirlenmiş (1) tanı ve (2) çıktı (outcome) ölçeklerini kullanmaktadırlar.
(1)Bu tür tanı ölçekleri belirli bir tanı grubunu homojen olarak tanımlamak için yararlıdırlar. Ancak her araştırmacı kendi ölçeğini kullanırsa araştırmaların karşılaştırılması sorun yaratır. Örneğin bir araştırmacı depresif bozukluk tanısını DSMIV diğeri ICD10, bir diğeri başka bir klinik tanı sistemi ile koymuşsa bu çalışmaların aynı hastalık grubuna ait bulguları ortaya koyduğunu söyleyebilmek zordur. Yapılması gereken tıpkı EURO, Dolar vb para birimlerinin birbirine denk eşdeğerlik tablolarını çıkarmak; ya da her tanıyı tek bir sistem üzerinden ele almaktır.
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3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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1. Dr. T. Bedirhan Üstün
World Health Organization
Classifications , Terminologies, Standards
WHO on
Health Information
2. • Views expressed in this presentation are those of B.
Üstün
• They do not necessarily represent the policies of
conflict of interests declared:
• Presenter believes in: Scientific Methods, Ontologies,
Caveat
4. History of Disease & Health
in the World
• 243 BC: plague in China
• 800 s : smallpox in Japan
• 1090s: dysentery in Palestine
• 1340s: "Black Death" in Europe
• 1830s: cholera worldwide
• 1917–19: influenza worldwide
• …
• …
• 1976-2015 Ebola
5. William Farr to
• Farr developed the first national vital statistics system as a
instrument for epidemiologic studies.
• to crafted a disease nosology usable by vital statisticians and
epidemiologists led to the creation of the ICD
• The structure of the ICD derives from Farr's 1860 proposal.
150 year later WHO and the FARR Institute
share the vision of Farr to implement it further
in the digital health space
15. the information YOU -
₋ have is not what you want
₋ want is not what you need
₋ need is not what you can have
Finagle's Law of Information
have
want
need
In other words there is always a gap
between what you have, need or want
16. Health Information needs Health Informatics
Computational
Processing
Knowledge
INPUTS
Analytical process OUTPUT
• Mechanisms
• Interventions
• Policies
• Statistics
• Aggregation
• Ontologies
• Data
• Information
20. Sharing Meaning
YOU
• Think
• wish to express
• think you have just
expressed
• you expressed
• …
OTHER ONE
• wants to hear
• Actually hears
• wishes to understand
• understands
• …
21. How do we
optimize our
health
services
E-he@lth
Health Information Systems: Analog to Digital
22. Placing WHO Classifications in HIS & IT
Population Health
• Births
• Deaths
• Diseases
• Disability
• Risk factors
e-Health Record
Systems
ICD
ICF
ICHI
Classifications
KRs
Terminologies
Clinical
• Decision Support
• Integration of care
• Outcome
Administration
• Scheduling
• Resources
• Billing
Reporting
• Cost
• Needs
• Outcome
23. ICD-11 Revision Goals
1. Evolve a multi-purpose and coherent classification
• Mortality, morbidity, primary care, clinical care, research, public health…
• Consistency & interoperability across different uses
2. Serve as an international and multilingual reference standard for
scientific comparability and communication purposes
3. Ensure that ICD-11 will function in an electronic environment.
• ICD-11 will be a digital product
• Support electronic health records and information systems
• Link ICD logically to underpinning terminologies and ontologies (e.g. SNOMED, GO, …)
• ICD Categories “defined” by "logical operational rules" on their associations and details
24. Ontology (philosophy)
the Organization of Reality !!!
Ontology (computer science)
– the explicit – operational description of
the conceptualization of a domain
• Entities
• Atributes
• Values
• An ontology defines:
– a common vocabulary
– a shared understanding/exchange:
• among people
• among software agents
• between people and software
– to reuse data - information
– to introduce standards to allow
interoperability
What is “NOntology” ?
26. THE CONTENT MODEL
Any Category in ICD is represented by:
1. ICD Concept Title
1.1. Fully Specified Name
2. Classification Properties
2.1. Parents
2.2 Type
2.3. Use and Linearization(s)
3. Textual Definition(s)
4. Terms
4.1. Base Index Terms
4.2. Inclusion Terms
4.3. Exclusions
5. Body Structure Description
5.1. Body System(s)
5.2. Body Part(s) [Anatomical Site(s)]
5.3. Morphological Properties
6. Manifestation Properties
6.1. Signs & Symptoms
6.2. Investigation findings
7. Causal Properties
7.1. Etiology Type
7.2. Causal Properties - Agents
7.3. Causal Properties - Causal Mechanisms
7.4. Genomic Linkages
7.5. Risk Factors
8. Temporal Properties
8.1. Age of Occurrence & Occurrence Frequency
8.2. Development Course/Stage
9. Severity of Subtypes Properties
10. Functioning Properties
10.1. Impact on Activities and Participation
10.2. Contextual factors
10.3. Body functions
11. Specific Condition Properties
11.1 Biological Sex
11.2. Life-Cycle Properties
12. Treatment Properties
13. Diagnostic Criteria
27. The ICD Foundation Component
• is a collection of ALL ICD
entities like diseases,
disorders...
• It represents the whole ICD
universe.
• In a simple way, the foundation component is similar to a “store” of
books or songs.
• From these elements we build a selection as a linearization.
• This analogy may however be misleading because there are many links
between the ICD entities (like parent-child relations and other).
• The ICD entities in the Foundation Component:
• are not necessarily mutually exclusive
• allow multiple parenting ( i. e. an entity may be in more
than one branch, for example tuberculosis meningitis is
both an infection and a brain disease)
28. The ICD Linearizations
• A linearization is a subset of the
foundation component, that is:
• Fit for a particular purpose: reporting mortality,
morbidity, or other uses
• Jointly Exhaustive of ICD Universe (Foundation
Component)
• Composed of entities that are Mutually Exclusive of
each other
• Each entity is given a single parent
29. 30
Foundation: ICD
categories with
- Definitions, synonyms
- Clinical descriptions
- Diagnostic criteria
- Causal mechanism
- Functional Properties
Find Term
SNOMED-CT,
International Classification of Functioning,
Disability and Health (ICF)…
Linearizations
Mortality
Morbidity
Primary Care
30. • Open and Collaborative Platform
• Web based
• Like WIKIPEDIA
• But
• by the Content Model
• with
• by the TAGs , and scientific peers
31. ICD11 βeta
• http://www.who.int/classifications/icd/revision
• Beta – Browser & Print
10 look & feel + descriptions – code structure !
• ICD-11 Beta draft is NOT FINAL
• updated on a daily basis
•NOT TO BE USED for CODING except
for agreed FIELD TRIALS
βeta
32. ICD-11 Features
Internet Based
Platform
Content Model
Multi Lingual Representations
Definitions
Input from
all Stakeholders
لعربية Arabic
官话 Chinese
English English
Français French
Русский язык Russian
Español Spanish
Deutsch German
Português Portuguese
Field Trials for
Use Cases
Electronic Health Record
Ready
35. ICD-11 Timeline
• 2014 : Beta : Field Trials Version
• Systematic/scientific reviews
• Vigorous crowdsourcing
• Field Trials
• 2017 : Final version for WHA Approval
• 2018+ implementation
Perpetual DIGITAL editing – review cycles
36. • Essential for EHR
• Enhance Care
• Decision Support
• Safety & Quality
• Better Collaboration
• Monitoring & Evaluation
• Better Health Information
• Less Administration
37. SNOMED : Old and Current
Former
SNOMED
Enterprise
College
American
Pathologists
Global
Network
Overall Health Care
38. Why work together?
– WHO & IHTSDO
– Coverage & Adequacy
– Quality – Reliability - Utility
– MultiLingual Applicability
– Interoperability
– Sustainability
– Member States:
Enable health care delivery and
compile health information
SNOMED & WHO Classifications
are synergistic and not antagonistic
39. The «Common Ontology»
Purpose
• To provide a common formal knowledge representation structure to
enable interoperability between:
• ICD-11 and SNOMED CT.
• a shared semantics
42. Rewriting ICD Using SNOMED
example of Depressive Disorder F32.0
A. Low mood {41006004}
Loss of interest {417523004 }
Low energy {248274002}
1. Appetite (decrease, increase) {64379006, 72405004}
2. Body weight (decrease, increase) {89362005, 8943002}
3. Sleep (decrease, increase) {59050008, 77692006}
4. Psychomotor (decrease, increase) {398991009, 47295007}
5. Libido loss {8357008}
6. Low self esteem {286647002, 162220005}
7. Guilt, self blame {7571003}
8. Thoughts of death …
9. Suicide Ideation {102911000, 6471006}
B.
43. Beyond GoogleTM
Semantic Interoperability for HIS
• Search using Concepts above Words
• How many patients do have diabetes mellitus type II?
• Extraction of Concepts from Health Records
• Automated extraction of Hb1Ac results of selected patients with DM type II from lab
reports within last year
• Statistical Index on Community Collections
• Calculation of coverage gap for treatment need for diabetes mellitus
• Concept Navigation across Collections
• Comparison of region A with region B etc
45
44. Real Time Public Health
Rule-based Aggregation @ Individual, Facility, Population levels
Public Health,
Epi & Surveillance
Findings InterventionsEvents
Clinical Information
Reimbursement
Resource Management
45. Clinical Use Case:
Exploration of Cough
Fever
386661006
COUGH
49727002
WET COUGH
sputum
28743005
Hemoptisia
Blood in Sputum
207069003
• X-ray : Tbc?
• Culture
399208008
104184002
• Diagnosis: Tuberculosis 154283005
A 15.0
• Treatment: DOTs { 324453004 }
47. Future Steps
1. Linking individual data to public health indicators
2. Standards for public health indicators
• Entities – relations ( n-ontology?: scientific compilation)
• Architecture
• Flow
• Aggregation process
48. Uniform Resource Identifiers
URI: //id.who.int/….
• enable links to other established terminology,
ontologies
• allow impact analysis possible via W3C
• e.g. where on the world these are used or not used
• Useful for translations:
• the concepts will indicate a language-independent construct
and translations will refer to the unique source concept.
49.
50. … BUILDING BLOCKS OF HEALTH INFORMATION …
Avoiding an e-tower of Babel