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ICD Revision (Ustun) 2014

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This is the current status of ICD Revision Process. A stable computer infrastructure is built; 24 Expert Advisory Groups in different segments have given their proposals. Crosswalks between ICD 10 and ICD 11 have been built using 5 different sources. Proposals can NOW be made by interested stakeholders and the PUBLIC. A scientific peer review for the current and future proposals is set up. YOU can comment, make proposals, review or translate the ICD11 BETA NOW...

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ICD Revision (Ustun) 2014

  1. 1. ICD Revision: Where Are We? World Health Organization Classifications, Terminologies, Standards
  2. 2. Overview • ICD Revision progress – Current status – Stability: how similar to ICD10 – ICD10AM – Next Steps: • Collaborative Authoring Tool improvements • Proposals • Peer Review • Field Trials • Other Products • …
  3. 3. 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
  4. 4. Current Status • Frozen September 30 – iCAT continues real time – JLMMS is frozen for review – A new freeze is expected in Dec 2014. • Definitions – Top level > 75 % > 10,000 definitions • Linearization errors < 465 (from 10K) • Duplicates < 105 (from 3K)
  5. 5. 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.
  6. 6. 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
  7. 7. 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 Morbidity Mortality Primary Care
  8. 8. Linearizations: Zoom-in Zoom-Out
  9. 9. Example of Telescope Title Primary C. Joint Lin. Ophthalm. Cataract code code code Age-related cataract code code code Cortical age-related cataract other other code Nuclear age-related cataract other other code Cataracta brunescens other other code Nuclear sclerosis cataract other other code Capsular and Subcapsular age-related cataract other other code Capsular age-related cataract other other code Anterior subcapsular polar age-related cataract other other code Posterior subcapsular polar age-related cataract other other code Incipient age-related cataract other other code Coronary age-related cataract other code code Punctate age-related cataract other code code Water clefts other other code Advanced or mature age-related cataract other other code Mature age-related cataract other code code Subtotal advanced or mature age-related cataract other other code Advanced or mature age-related cataract, total cataract other other code Morgagnian age-related cataract other other code Calcified age-related cataract other other code Combined forms of age-related cataract other other code
  10. 10. ICD Organization • Pre-coordination - fixed names V12.24 Pedal cyclist injured in collision with two- or three-wheeled motor vehicle, unspecified pedal cyclist, nontraffic accident, while resting, sleeping, eating or engaging in other vital activities • Post- Coordination - extensions • Bicycle Accident • Hit • Role • Context • Activity
  11. 11. X – Chapter: Extension Codes Type 1 Type 2 Type 3 Severity Main Condition (types) History of Temporality (course of the condition) Reason for encounter/admission Family History of Temporality (Time in Life) Main Resource Condition Screening/Evaluation Etiology Present on Admission Anatomic detail Topology Specific Anatomic Location Provisional diagnosis Histopathology Diagnosis confirmed by Biological Indicators Rule out / Differential Consciousness External Causes (detail) Injury Specific (detail)
  12. 12. POST COORDINATION MECHANISM • Extension codes are implemented in iCAT • Sanctioning tables are being generated – REQUIRED – ALLOWED – DISALLOWED • First target group is the REQUIRED a. ICD-10 categories which have equivalence with ICD11 STEM + X codes (around 1000 codes) b. other
  13. 13. • 2014 : Beta version & Field Trials Version – +2 YR : Field trials • 2017 : Final version for WHA Approval – 2018+ implementation – Continuous Annual Cycles • ICD 2018 • ICD 2019 • ICD 2020 ICD-11 Timeline
  14. 14. 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
  15. 15. ICD-11 Browser
  16. 16. Visualization
  17. 17. Print Versions
  18. 18. ICD 2014 September release • Print version release includes: • Frozen “Joint Linearization for Mortality and Morbidity Statistics” ( Vol. 1 Equivalent). • The ongoing work on iCAT will go ahead in further completing the ICD definitions and improvements. • A future release is also planned in December. Thereafter the releases will be made whenever necessary. • Incremental changes from August Release are given in a separate document to enable tracking which parts remained stable – which parts changed.
  19. 19. Diff Files
  20. 20. Diff Files
  21. 21. Taxonomic Check • Taxonomic check includes the aggregation equivalence: • with the Primary Care versions – PC Intermediate Resource version  renamed: Intermediate Version – PC Low Resource version  renamed: Short Version • With Specialty Versions – see whether the specialty extensions roll up to JLMMS ( if this was the chosen option)
  22. 22. Annotation Document & Reviews • An updated Annotation Document identifies the architecture, principles and known issues. • Reviews by Mortality and Morbidity TAGs included for common reference and guiding future work
  23. 23. STABILITY ANALYSIS • A Foundation based equivalence programme identifies equivalences between ICD-10 and ICD-11. • a TRANSCODING table between ICD-10 and ICD-11 in excel format • A CROSSWALK gives the detailed output in excel format • The ICD11 Beta Browser will display the ICD-10 equivalents accordingly.
  24. 24. Mapping Tool
  25. 25. Transcoding tables ICD-10 to ICD-11 in excel
  26. 26. ICD-10 ICD-11 correspondence • 3 character – 1183 (w/o ECI & Residuals) – 951 Equivalent – 191 mapped to a larger entity in 11 • with post coordination many have equivalent maps – 41 not mapped • 4 character - 6635 – 4343 Equivalent – 2207 mapped to a larger entity in 11 • with post coordination many have equivalent maps – 85 not mapped
  27. 27. ICD Index • Print Index is about 1900 pages with some lead terms running several pages. • About 3000 ICD10 Index terms are “missing”. A human judgement is being made as to whether they are necessary and once included they point to the right code. • Sublead terms missing • Improvements planned
  28. 28. Translation Platform
  29. 29. ICD Revision: Where Are We? World Health Organization Classifications, Terminologies, Standards

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