WHO releases ICD-11 Beta drafting platform

WHO releases ICD-11 Beta drafting platform

Post #170 Shortlink: http://wp.me/pKrrB-28K

Yesterday, May 14, the World Health Organization (WHO) announced the launch of the ICD-11 Beta drafting platform.

Press Release here and below.

This publicly viewable platform replaces the Alpha drafting platform that has been viewable since mid 2011. ICD-11 Revision Topic Advisory Groups are using a separate drafting platform with greater functionality than the platform launched yesterday.

Interested stakeholders can register for increased access and to interact with the Beta drafting platform.

In terms of functionality, the Beta platform does not appear to incorporate any additional features over the Alpha. 

In terms of population of content, some entities have text populated for Definitions, others are still waiting for provisional definitions. Some entities have very few “Content Model” parameters listed, others have the following: Parents; Definition; Synonyms; Exclusions; Narrower Terms; Causal Mechanisms; Body Site.

It’s not evident how many of the proposed 13 “Content Model” parameters that describe an ICD-11 entity term will eventually be populated for any given entity. The original list of 13 “Content Model” parameters has been modified since early 2011, but no new documentation has been publicly released that sets out the new parameters.

More information on the Beta drafting platform here:

http://www.who.int/classifications/icd/revision/en/

The International Classification of Diseases 11th Revision is due by 2015

Participate in the ICD Revision

Beta phase participants will have the opportunity to:

• Make Comments
• Make Proposals
• Propose definitions of diseases in a structured way
• Participate in Field Trials
• Assist in translating ICD into other languages

Video invitation to participate
Frequently Asked Questions About ICD-11
ICD Information Sheet

WHO video invitation from Dr Marie-Paule Kieny on ICD-11

For the first time, experts in the public health community who work with patient diagnosis and treatment have an opportunity to contribute to the development of the next version of the ICD. This is WHO’s publication that ensures all aspects of the health community refer to diseases and health conditions in a consistent way.

WHO is calling on experts, health providers and stakeholders from around the world to participate in the 11th revision process. The final ICD-11 will be released in 2015.

With your help, this classification will be more comprehensive than ever before.

 

The Beta drafting platform can be found here:

Linearizations:

http://apps.who.int/classifications/icd11/browse/l-m/en

Foundation Component:

http://apps.who.int/classifications/icd11/browse/f/en#

User Guide:

http://apps.who.int/classifications/icd11/browse/Help/en

Listing for Chronic fatigue syndrome:

http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%23G93.3

WHO Press Release

May 2102

http://www.who.int/features/2012/international_classification_disease/en/

WHO seeks health experts’ input for 11th International Classification of Diseases

For the first time, experts in the public health community who work with patient diagnosis and treatment have an opportunity to contribute to the development of the next version of the International Classification of Diseases (ICD), which is WHO’s publication that ensures all members of the health community refer to diseases and health conditions in a consistent way.

WHO/Jim Holmes

WHO is releasing the beta version of what will be ICD-11 on a wiki-type platform that allows stakeholder comments to be added after peer review. The final ICD-11 will be released in 2015.

WHO encourages anyone interested to comment to develop a more comprehensive classification.

Foundation for reliable health data

The ICD is the foundation for the identification of health trends and statistics globally. Receiving input from health experts will greatly improve the representation from current medical practice and create insight from a broader diversity of medicine.

“Literally this is what doctors use to diagnose a patient,” says Tevfik Bedirhan Ustun, coordinator in the Department of Health Statistics and Information Systems. “It is how we define the cause of death when a person dies. In research, it is how we classify health problems based on evidence.”

The ICD is the gold standard for defining and reporting diseases and health conditions. It allows the world to compare and share health information using a common language.

In addition to health providers, the ICD is a key tool used by epidemiologists to study disease patterns, insurers, national health programme managers, data collection specialists, and others who track global health progress and how health resources are spent.

ICD-11 innovations

Using advances in information technology, this ICD revision will allow users to collect data on cause of death, advances in science and medicine, emerging diseases and health conditions, and compare information across the globe with more ease and diversity in the service of public health and clinical reporting.

Some of the key new features of the 11th version will include:

• a new chapter on traditional medicine, which constitutes a significant part of health care in many parts of the world;
• it will be ready to use with electronic health records and applications;
• it will updated through the development phase to reflect new knowledge as it is added to the classification; and
• it will be produced in multiple languages through the development phase.

Further coverage:

http://www.dailypioneer.com/nation/65415-who-seeks-inputs-for-key-disease-database.html

WHO seeks inputs for key disease database

Tuesday, 15 May 2012 00:29
Pioneer News Service | New Delhi

The World Health Organisation (WHO) in a maiden initiative has invited experts and users to contribute online to the development of its next version of the International Classification of Diseases (ICD) capturing mortality and morbidity data.

The world’s standard tool provides a picture of the general health of countries and populations and its 11th version is now being developed through an innovative, collaborative process to be released in 2015.

“This is for the first time WHO is calling on experts and users to participate in the revision process through a web-based platform. The outcome will be a classification that is based on user input and needs,” a WHO official said.

Users include physicians, nurses, other providers, researchers, health information managers and coders, health information technology workers, policy-makers, insurers and patient organisations.

WHO will soon be releasing the beta version of what will be ICD-11 on a wiki-type platform that allows stakeholder comments to be added after peer review.

All Member States are expected to use the most current version of the ICD for reporting death and disease statistics (according to the WHO Nomenclature Regulations adopted by the World Health Assembly in 1967), the official added.

Regarding the steps for participating, he elaborated that experts and stakeholders will have to register for a participant account on the web portal which will be open for comments over the next three years and accepted changes will be reflected immediately.

Some of the key new features of the 11th version will include a new chapter on traditional medicine, which constitutes a significant part of health care in many parts of the world and ready to use with electronic health records and applications.

The ICD is translated into 43 languages and is used by all 117 member countries. The ICD holds importance as it provides a common language for reporting and monitoring diseases. This allows the world to compare and share data in a consistent and standard way – between hospitals, regions and countries and over periods of time. It facilitates the collection and storage of data for analysis and evidence-based decision-making, the official said.

DSM-5 Somatic Symptom Disorders: Differences between second and third draft for CSSD

DSM-5 Somatic Symptom Disorders: Differences between second and third draft for CSSD

Post #168 Shortlink: http://wp.me/pKrrB-27y

A reminder that the third and final DSM-5 comment period closes on June 15 and that I am collating submissions on this site.

Comments are open to professional and lay stakeholders. Please alert clinicians, researchers, allied health professionals, social workers, lawyers, educationalists, therapists, patient advocacy groups to these proposals.

Full proposals, criteria and rationales for the Somatic Symptom Disorders are set out in this post:

DSM-5 proposals for Somatoform Disorders revised on April 27, 2012

According to DSM-5 Task Force Chair, David Kupfer, MD, “After the comment period closes, visitors will no longer be able to submit feedback through the site, and the site will not reflect any further revisions to the draft manual in anticipation of its publication in May 2013. However, the site will remain live and viewable.”

 

Somatic Symptom Disorders Work Group proposals:

Two PDF Disorder Descriptions and Rationale/Validity Propositions PDF documents had accompanied the first and second drafts. There are no revised PDFs reflecting the most recent proposals available on the DSM-5 Development website and the documents published with the second draft have been removed.

I have asked the APA’s Media and Communications Office to clarify whether the Somatic Symptom Disorder Work Group intends to publish revised Disorder Descriptions or Rationale/Validity Propositions documents during the life of the stakeholder review period or whether these documents are being dispensed with for this third draft.

Should updated documents be added to the site during the comment period I will post links.

 

Notes on differences between the second and third draft proposals for CSSD

As with the first and second drafts, the intention remains to rename the Somatoform Disorders section to Somatic Symptom Disorders.

The proposal continues to combine the existing DSM-IV categories:

Somatization Disorder
Hypochondriasis
Undifferentiated Somatoform Disorder
Pain Disorder

into a single new category, Somatic Symptom Disorder.

For the second draft, the work group had suggested two separate diagnoses, Complex Somatic Symptom Disorder CSSD) and Simple Somatic Symptom Disorder (SSSD).

Following evaluation of the results of the DSM-5 field trials, the Somatic Symptom Disorders Work Group has decided that Simple Somatic Symptom Disorder  is “a less severe variant of CSSD.”

The Work Group now proposes merging CSSD and SSSD into a single category called Somatic Symptom Disorder (SSD) and is suggesting dropping the word “Complex” from the category term.

The latest proposed category names for the revision of the DSM-IV’s Somatoform Disorders now look like this:

Somatic Symptom Disorders

J 00 Somatic Symptom Disorder – with the option for specifying:

Mild Somatic Symptom Disorder
Moderate Somatic Symptom Disorder
Severe Somatic Symptom Disorder

J 01 Illness Anxiety Disorder |
J 02 Conversion Disorder (Functional Neurological Symptom Disorder) |
J 03 Psychological Factors Affecting Medical Condition |
J 04 Factitious Disorder |
J 05 Somatic Symptom Disorder Not Elsewhere Classified |

Revised Criteria, Rationale and Severity texts for the above can be found at the links above or on this webpage:

http://www.dsm5.org/ProposedRevision/Pages/SomaticSymptomDisorders.aspx

These are the criteria for J00 Somatic Symptom Disorder

http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=368

J 00 Somatic Symptom Disorder

Updated April-27-2012

Proposed Revision

Somatic Symptom Disorder

Note that the criteria for CSSD in the previous draft, released in May 2011, had read:

“B. Excessive thoughts, feelings, and behaviors related to these somatic symptoms or associated health concerns: At least two of the following must be present.”

But for the third draft, this has been reduced to

“B. Excessive thoughts, feelings, and behaviors related to these somatic symptoms or associated health concerns: At least one of the following must be present.”

This is presumably to accommodate Simple Somatic Symptom Disorder within what had been the criteria for CSSD.

(Last year, for the second draft, the criteria for CSSD had required two from (1), (2) and (3) and a symptom duration of greater than 6 months, whereas the criteria for SSSD had required only one from (1), (2) and (3) and a symptom duration of greater than one month.)

 

Note also that the option for three Severity Specifiers for J00 Somatic Symptom Disorder category: Mild, Moderate, Severe, might potentially be intended to correspond to three newly proposed categories in the ICD-11 Chapter 5: Somatoform Disorders section.

In the ICD-11 Alpha drafting platform (which is a work in progress and comes with caveats), the Somatoform Disorders categories are currently proposed to be renamed to Bodily Distress Disorders. There are three new categories listed:

6R0 Mild bodily distress disorder
6R1 Moderate bodily distress disorder
6R2 Severe bodily distress disorder

These three new category suggestions have no definitions or descriptive parameters visible in the ICD-11 Alpha draft so it isn’t possible to determine at this stage what disorders these newly suggested terms might be intended to capture; nor how they would relate to the existing somatoform disorders categories that still remain listed beneath them in this section of the Alpha draft.

For comparison, this is how the corresponding section of ICD-11 categories currently displays:

ICD-11 Alpha draft:

BODILY DISTRESS DISORDERS [Formerly Somatoform Disorders]

6R0 Mild bodily distress disorder
6R1 Moderate bodily distress disorder
6R2 Severe bodily distress disorder
6R3 Somatization disorder
6R4 Undifferentiated somatoform disorder
6R5 Somatoform autonomic dysfunction
6R6 Persistent somatoform pain disorder
     6R6.1 Persistent somatoform pain disorder
     6R6.2 Chronic pain disorder with somatic and psychological factors [not in ICD-10]
6R7 Other somatoform disorders
6R8 Somatoform disorder, unspecified

Hypochondriacal disorder [ICD-10: F45.2] is currently listed in ICD-11 Chapter 5 as Illness Anxiety Disorder under 6L5 ANXIETY AND FEAR-RELATED DISORDERS > 6L5.6 Illness Anxiety Disorder.

Dissociative (Conversion disorders) [ICD-10: F44] is currently listed in ICD-11 Chapter 5 under Neurotic, stress-related and somatoform disorders > 7A5 Dissociative [conversion] disorders.

There had been discussions by the SSD and Dissociative Disorders work groups for potentially locating Conversion Disorder under the DSM-5 Dissociative Disorders section, for congruency with its location within ICD-10.

For the third draft, it appears that the groups with oversight of the revision of conversion disorder have decided that this category should be renamed to Conversion Disorder (Functional Neurological Symptom Disorder) and classified as a Somatic Symptom Disorder.

In a future post, for ease of comparison, I will post a table comparing DSM-5 third draft proposals with current listings for ICD-11.

 

Links:

1] Somatic Symptom Disorders Third draft proposals:
http://www.dsm5.org/ProposedRevision/Pages/SomaticSymptomDisorders.aspx

2] Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?
http://wp.me/pKrrB-1Vx

3] DSM-5 proposals for Somatoform Disorders revised on April 27, 2012
http://wp.me/pKrrB-24D

4] Submissions to SSD Work Group May 2011 are archived here:
http://wp.me/PKrrB-19a

5] Submissions to SSD Work Group May 2012 are being collated here:
http://wp.me/PKrrB-1Ol

What’s new in the ICD-11 Alpha drafting platform? (CFS, PVFS, ME)

What’s new in the ICD-11 Alpha drafting platform? (CFS, PVFS, ME)

Post #157 Shortlink: http://wp.me/pKrrB-22h

 

Screenshot: ICD-11 Alpha Browser Foundation view selected, logged in at April 10, 2012:

Chapter 6: Diseases of the nervous system

http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%23G93.3

Apr 09 – 11:02 UTC


 

ICD-11 Beta drafting platform to launch in May?

As reported in previous posts, according to the timeline, the ICD-11 Beta drafting platform is supposed to be launching this May.

ICD-11 Revision Steering Group has yet to announce whether the Beta platform remains on target for a May release and if so, on what date it will be launched – so I cannot give you a date yet.

Like the Alpha Drafting Browser, the Beta drafting platform will be a work in progress – not a final Beta draft. The final Beta isn’t scheduled until 2014, after the ICD-11 field trials have been undertaken.

When it does launch, the Beta platform is intended to be accessible to professionals and the public for viewing.

Registered or logged in users will have greater access to content and will be able to interact with the platform to read comments, comment on proposals and make suggestions, as part of the ongoing drafting process.  

In the meantime, the publicly viewable version of the Alpha drafting platform (known as the ICD-11 Alpha Browser) can still be accessed here:

http://apps.who.int/classifications/icd11/browse/f/en

The various ICD-11 Revision Topic Advisory Groups are carrying out their draft preparation work on a separate, more complex multi-author drafting platform that is accessible only to WHO and ICD Revision personnel.

 

Alpha drafting platform

As before, the publicly viewable version of the Alpha Browser should be viewed with the following caveats in mind:

the Alpha draft is a work in progress; it is incomplete; it may contain errors and omissions; it is in a state of flux and updated daily; textual content, codes and “Sorting labels” are subject to change as chapters are reorganized and content populated; the content has not been approved by Topic Advisory Groups, Revision Steering Group or WHO.

It is possible to register, or sign into the platform using existing accounts with several third party account providers such as Google, Yahoo and myOpenID, for increased access and functionality. Once signed in, Comments and Questions can be read and PDFs of the drafts of the top level linearizations can be downloaded from the Linearization tab.

See the Alpha Browser User Guide for information on how the Alpha Browser functions:

http://apps.who.int/classifications/icd11/browse/Help/en

 

The ICD-11 “Content Model”

ICD-11 will be available in both print and online versions and unlike most chapters of ICD-10, will include descriptive content for ICD terms.

For the online version of ICD-11, all ICD entities will include a definition and a number of additional key descriptive fields – between 7 and 13 pre-defined parameters, populated according to a common “Content Model” (Content Model Reference Guide January 2011).

For example, ICD entity Title, Definition, Synonyms, Narrower Terms, Exclusions, Body Site, Body System, Signs and Symptoms, Causal Mechanisms, and possibly Diagnostic Criteria for some entities.*

*According to the iCAT User Google Group message board, these fields may have been revised since the January 2011 Content Model Reference Guide was published; Content Model parameters in the Beta draft may therefore differ from those currently displaying in the public Alpha drafting platform.

The print version will use a concise version of Definition due to space constraints.

In the Alpha Browser, not all these Content Model parameters display in the Foundation and Linearization views and not all of the parameters that have been listed for individual entities have had their draft text added yet, as some chapters are more advanced for the population of proposed content than others.

So the Alpha draft is still very patchy and many entities have no Definition and little or no other proposed content filled in.

With no “Category Discussion Notes” or “Change history” pop-up windows visible in the public version of the Alpha, the viewer cannot determine the rationales behind the reorganization of terms and hierarchies within the various chapters.

 

Chapter location and hierarchy for CFS, PVFS and (Benign) ME in ICD-11

I have been reporting since June 2010 that the proposals for ICD-11 Alpha Draft, as far as one could determine, appeared to be:

1] That a change of hierarchy had been recorded in a “Category Discussion Note”, dated May 1, 2010, between ICD-10 Title term “Postviral fatigue syndrome” and “Chronic fatigue syndrome”. (“Category Discussion Notes” and “Change History” pop-ups did display in the earlier iCAT version of the Alpha drafting platform.)

You can view a screenshot from June 2010 of that “Change history” record here:

http://dxrevisionwatch.files.wordpress.com/2010/06/change-history-gj92-cfs.png

The Definition field on the “Chronic fatigue syndrome” description panel in the current Alpha Browser is currently blank but in June 2010, the Definition had stood as in this contemporaneous screenshot:

http://dxrevisionwatch.files.wordpress.com/2010/05/2icatgj92cfsdef.png

2] That “Chronic fatigue syndrome” had been designated as an ICD-11 Title term within ICD-11 Chapter 6: Diseases of the nervous system, with the capacity for a Definition and up to 10 additional descriptive parameters.

3] That “Benign myalgic encephalomyelitis” had been specified as an Inclusion term to ICD-11 Title term “Chronic fatigue syndrome” but that the relationships between the three terms, PVFS, (B) ME and CFS had yet to be specified, as in this screenshot from June 2010:

http://dxrevisionwatch.files.wordpress.com/2010/05/2icatgj92cfsterms.png

 

What is currently showing in the Chapter 6 Foundation Component?

It isn’t possible to bring up a discrete ICD Title listing for either “Benign myalgic encephalomyelitis” or “Postviral fatigue syndrome” in either the Foundation Component or the Linearization.

In the Foundation view only, for Chapter 6: Diseases of the nervous system, “Chronic fatigue syndrome” is listed as a Title term with the ICD-10 legacy ID “ID:http://who.int/icd#G93.3″;

the Definition field is currently blank;

a list of terms has recently been added under “Synonyms”;

one term has recently been added under “Narrower Terms”.

(Note: there is a small asterisk at the end of term “Benign myalgic encephalomyelitis” which is listed at the top of the “Synonyms” list. The asterisk “Hover text” reads “This term is an inclusion term in the linearizations.”)

If you want to view the listing directly on the Browser site (note the “Comment” and “Questions” icons which open up pop-up windows next to terms for reading/commenting won’t display unless you have already registered and logged in) go here:

ICD-11 Alpha Browser Foundation view:

http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%23G93.3

ID:http://who.int/icd#G93.3

Chronic fatigue syndrome

Parent(s)

Selected cause is Remainder of diseases of the nervous system in Condensed and selected Infant and child mortality lists
Selected Cause is All other diseases in the Selected General mortality list
Selected cause is Diseases of the nervous system

Definition

This entity does not have a definition at the moment.

Synonyms

Benign myalgic encephalomyelitis *  [Ed: Hover text over asterisk reads: "This term is an inclusion term in the linearizations."]
akureyri
akureyri disease
cfs – chronic fatigue syndrome
chronic fatigue syndrome nos   [Ed: from current proposals for ICD-10-CM, Chapter 18, R53.82]
chronic fatigue, unspecified   [Ed: from current proposals for ICD-10-CM, Chapter 18, R53.82]
epidemic neuromyasthenia
iceland disease
icelandic disease
me – myalgic encephalomyelitis
myalgic encephalomyelitis
myalgic encephalomyelitis syndrome
postviral fatigue syndrome
pvfs – postviral fatigue syndrome

Narrower Terms

neuromyasthenia

Body Site

Entire brain (body structure)
Brain structure (body structure)

Causal Mechanisms

Virus (organism)

 

What’s new in Chapter 5: Mental and behavioural disorders?

As reported in Dx Revision Watch post: http://wp.me/pKrrB-1Vx,  the category “Somatoform Disorders” in Chapter 5, Mental and behavioural disorders is currently renamed to “BODILY DISTRESS DISORDERS”, under which currently sit three new child categories:

5M0 Mild bodily distress disorder
5M1 Moderate bodily distress disorder
5M2 Severe bodily distress disorder.

Chapter 5 Linearization view:

http://apps.who.int/classifications/icd11/browse/l-m/en#/http%3a%2f%2fwho.int%2ficd%23F45

Chapter 5 Foundation view:

http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%23F45

(Click on the little grey arrows to display the child categories):

Child categories to parent “BODILY DISTRESS DISORDERS”:

http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%231905_dd0250d2_e8cd_4c48_a93f_7997cc1c8b07

BODILY DISTRESS DISORDERS

5M0 Mild bodily distress disorder
5M1 Moderate bodily distress disorder
5M2 Severe bodily distress disorder
5M3 Somatization disorder
5M4 Undifferentiated somatoform disorder
5M5 Somatoform autonomic dysfunction
5M6 Persistent somatoform pain disorder
      > 5M6.0 Persistent somatoform pain disorder
      > 5M6.1 Chronic pain disorder with somatic and psycological [sic] factors
5M7 Other somatoform disorders
5M8 Somatoform disorder, unspecified

None of these three new (proposed) categories have had any Definitions or other textual content added to the description panels on the right hand side of the Alpha Browser page since I first reported this change in February.

It is still not possible to determine what disorders ICD-11 intends might be captured by these three new (proposed) terms, should ICD-11 Revision Steering Group and WHO classification experts consider these terms to be valid constructs and approve their progression through to the Beta draft.

Because no “Change Notes” or “Change history” pop-up windows display in this version of the Alpha Drafting browser, it is not possible to determine:

whether ICD-11 is proposing to introduce three new terms – 5M0 Mild bodily distress disorder; 5M1 Moderate bodily distress disorder; 5M2 Severe bodily distress disorder, in addition to retaining existing ICD-10 terms, 5M3 thru 5M8;

how ICD Revision intends to define these (proposed) new terms at 5M0, 5M1, 5M2;

how these three (proposed) new terms would relate to the existing ICD-10 “Somatoform Disorders” categories which remain listed as child categories to “BODILY DISTRESS DISORDERS” (apart from “Hypochondriacal disorder” [ICD-10: F45.2], which is now listed as “5H0.5 Illness Anxiety Disorder” in the ICD-11 Alpha Draft).

(See Page 1 and 2 of my report: “Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?: http://wp.me/pKrrB-1Vx  )

 

References:

ICD-11 Revision: http://www.who.int/classifications/icd/revision/en/

ICD-11 Alpha Browser User Guide: http://www.who.int/classifications/icd/revision/caveat/en/index.html
Alpha Browser Foundation view: http://apps.who.int/classifications/icd11/browse/f/en#
Alpha Browser Linearization view: http://apps.who.int/classifications/icd11/browse/l-m/en#
“Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?: http://wp.me/pKrrB-1Vx

Update on timelines: DSM-5, ICD-11, ICD-10-CM

Update on timelines: DSM-5, ICD-11, ICD-10-CM

Post #155 Shortlink: http://wp.me/pKrrB-21N

Update @ April 10, 2012: CMS issues press release – proposes one year delay for ICD-10-CM compliance

See: http://wp.me/pKrrB-22q for press release and full Proposal document

I will update as more information becomes available.

DSM-5

The DSM-5 clinical settings field trials, scheduled to complete by December, last year, but extended in order that more participants might be recruited, were expected to conclude this March. (Source: DSM-5 Disorganization, Disarray, and Delays, Dr Dayle Jones, American Counseling Association, January 3, 2012)

In November, DSM-5 Task Force Vice-chair, Darrel Regier, MD, predicted the pushing back of the final public review and comment period for revised draft diagnostic criteria from January-February to “no later than May 2012,” in response to DSM-5 timeline slippage and delays in completion of the field trials. (Source: APA Answers DSM-5 Critics, Deborah Brauser, November 9, 2011)

The timeline on the DSM-5 Development site was updated to reflect a “Spring” posting of draft diagnostic criteria but thus far, APA has released no firm date for a final public review and feedback exercise in May.

The second release of draft proposals was posted on May 4, last year, with no prior announcement or news release by APA and caught professional bodies, patient organizations and advocates unprepared.

It is hoped that APA will give reasonable notice before releasing their third and final draft – though how much influence professional and public feedback might have at this late stage in the DSM-5 development process is moot.

DSM-5 is slated for publication in May 2013.

Extract from revised Timeline

Spring 2012: Revised draft diagnostic criteria will be posted on http://www.dsm5.org and open to a third public feedback period for 2 months. Feedback will be shared directly with work group members, and further edits to proposals will be made as needed.

The full DSM-5 Timeline (as it stands at April 8, 2012) can be found here.

 

ICD-11

The current timeline schedules presentation of the ICD-11 to the World Health Assembly in May 2015 – a year later than the 2009 timeline.

According to a paper published by Christopher Chute, MD, (Chair, ICD-11 Revision Steering Group) et al, implementation of ICD-11 is now expected around 2016. (Source: Chute CG, Huff SM, Ferguson JA, Walker JM, Halamka JD. There Are Important Reasons For Delaying Implementation Of The New ICD-10 Coding System. Health Aff March 2012 DOI: 10.1377/hlthaff.2011.1258) 

The ICD-11 Beta drafting platform is scheduled to be launched and open to the public this May for comment and interaction. It will be a work in progress – not a final Beta draft. The final Beta draft isn’t scheduled until 2014.

No announcement that the Beta platform remains on target for a May release has been issued by WHO or ICD-11 Revision Steering Group and no date is given on the ICD Revision website for the launch.

The publicly viewable version of the Alpha drafting platform (the ICD-11 Alpha Browser) can be accessed here. The various ICD-11 Revision Topic Advisory Groups work on a separate, more layered multi-author drafting platform.

NB: The Alpha drafting platform is a work in progress. It is incomplete, in a state of flux, updated daily and subject to WHO Caveats.

ICD-11 Alpha Browser User Guide here.

Foundation view here.

Linearization view here.

PDFs of Draft Print versions of the Linearization are available from the Linearization tab to logged in users.

The ICD-11 timeline (as it stands at April 8, 2012) can be found on the WHO website here.

 

ICD-10-CM

Note: ICD-10-CM is the forthcoming US specific “Clinical Modification” of the WHO’s ICD-10. Following implementation of ICD-10-CM, the US is not anticipated to move on to ICD-11, or a Clinical Modification of ICD-11, for a number of years after global transition to ICD-11.

On February 16, Health and Human Services Secretary, Kathleen G. Sebelius, announced HHS’s intent to initiate a process to postpone the date by which certain health care entities have to comply with ICD-10-CM diagnosis and procedure codes. (Source: CMS Public Affairs/HHS Press Release, February 16, 2012)

The final rule adopting ICD-10-CM as a standard was published in January 2009, when a compliance date of October 1, 2013 had been set – a delay of two years from the compliance date initially specified in the 2008 proposed rule.

CMS plans to announce a new ICD-10 implementation date sometime this April, according to CMS Regional Office, Boston. (Source: Healthcare News: CMS targets April for release of new ICD-10-CM/PCS implementation date, March 20, 2012)

It is anticipated that CMS will make an announcement in the Federal Register, take public comment for 60 days, consider feedback on its proposed ruling, then issue a final rule.

For developments on the new ICD-10-CM compliance date, watch the CMS site or sign up for CMS email alerts: http://www.cms.hhs.gov/Medicare/Coding/ICD10/Latest_News.html

 

Related information:

DSM-5 Development

ICD-11 Revision

ICD10 Watch

Federal Register

CMS Latest News

DHHS Newsroom

ICD-10-CM CDC Site

“Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?

“Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?

Post #145 Shortlink: http://wp.me/pKrrB-1Vx

The information in this report relates only to proposals for the WHO’s forthcoming ICD-11; it does not relate to ICD-10 or to the forthcoming US specific “clinical modification” of ICD-10, known as ICD-10-CM.

Codes assigned to ICD-11 Beta draft categories are subject to change as chapter reorganization progresses. Images and text in this posting may not reflect the most recently assigned codes. This post has been updated to reflect the launch of the Beta drafting platform and revisions to codes assigned during the drafting process as they stand at June 24, 2012.

Part One

 

This report contains an important update on proposals for ICD-11 Chapter 5: Mental and behavioural disorders.

In a February 16, 2012 report by Tom Sullivan for Health Care Finance News, Christopher Chute, MD, who chairs the ICD Revision Steering Group, warned of a possible delay for completion of ICD-11 from 2015 to 2016.

The ICD-11 Beta drafting platform was launched in May 2012.

The Beta drafting platform is a publicly viewable browser similar to the Alpha drafting platform that had been in the public domain since May, 2011.

You can view the Beta Drafting Browser here:

Foundation Component view:

http://apps.who.int/classifications/icd11/browse/f/en

Morbidity Linearization view:

http://apps.who.int/classifications/icd11/browse/l-m/en

The Morbidity Linearization is the view that includes (what may be temporarily assigned) sorting codes. These codes are likely to change as chapter organization progresses. Click on the small grey arrows next to the chapters and categories to display parent > child > grandchildren hierarchies. Click on individual terms to display descriptive content in the right hand frame of the Beta Browser.

Textual content for ICD-11 is in the process of being drafted and the population of content for some chapters is more advanced than others. Content for some of the “ICD-11 Content Model” parameters may display: ID legacy code from ICD-10 (where applicable); Parent(s); Definition; Synonyms; Inclusions; Narrower Terms; Exclusions; Body Site; Causal Mechanism; Signs and Symptoms.

(For ICD-11, entities will be defined across all chapters through up to 13 “Content Model” parameters – considerably more descriptive content than in ICD-10 and a significant workload for the Topic Advisory Group members and managers who are generating the content for ICD-11.)

The Beta Browser User Guide is here:

http://apps.who.int/classifications/icd11/browse/Help/en

This page of the User Guide sets out differences between Foundation view and Morbidity Linearization view.

The various ICD Revision Topic Advisory Groups (TAGs) are carrying out their work on a separate, more complex, multi-author drafting platform. On their platform, editing histories and “Category and Discussion Notes” are recorded so the progress of proposals and reorganization of ICD entities can be tracked, as the draft evolves.

For the Beta drafting platform, interested stakeholders may register for increased access and interaction with the drafting process by submitting comments and suggestions on draft content and proposals.

For those registered for increased access, it is possible to download PDFs of drafts for the “Print Versions for the ICD-11 Beta Morbidity Linearization” for all 25 chapters of ICD-11. These are obtainable, once registered and logged in, from the Linearization > Print Versions tab.

Caveats

I’m going to reiterate the ICD-11 Alpha Browser Caveats because it’s important to understand that the ICD-11 Beta draft is a work in progress – not a static document – and is subject to change.

The draft is updated on a (usually) daily basis; when you view the Beta Browser, you are viewing a “snapshot” of how the publicly viewable draft stood at the end of the previous day; not all chapters are as advanced as others for reorganization or population of content; the draft is incomplete and may contain errors and omissions.

The codes and “sorting labels” assigned to ICD parent classes, child and grandchildren terms are subject to change as reorganization of the chapters progresses. The Beta draft has not yet been approved by the Topic Advisory Groups, Revision Steering Group or WHO and proposals for, and content in the draft may not progress to the Beta drafting stage; field trials have not yet been completed – so be mindful of the fact that the draft is in a state of flux.

As it currently stands, the Beta draft lacks clarity; not all textual content will have been generated and uploaded for terms imported from ICD-10 and there may be no definitions or other textual content displaying for proposed new terms.

Two chapters that are a focus of this site are Chapter 5: Mental and behavioural disorders and Chapter 6: Disorders of the nervous system (the Neurology chapter). (ICD-11 is dropping the use of Roman numerals.)

I won’t be reporting on specific categories in Chapter 6 in this post but will do a follow up post for Chapter 6 in a forthcoming post; again, there is a lack of clarity for Chapter 6 and requests for specific clarifications, last year, from the chair of Topic Advisory Group Neurology and the lead WHO Secretariat for TAG Neurology have met with no response.

Continued on Page 2: Somatoform Disorders in ICD-10; Somatoform Disorders to Bodily Distress Disorders for ICD-11?

Practice Central on ICD-10-CM transition; APA Monitor and WHO Reed on ICD-11

Two articles on forthcoming classification systems: the first on ICD-10-CM from Practice Central; the second on ICD-11 from the February 2012 edition of the American Psychological Association’s “Monitor on Psychology”

Post #140 Shortlink: http://wp.me/pKrrB-1Tt

Update: Medicare could delay burdensome rules on doctors | Julian Pecquet, for The Hill, February 14, 2012

“The acting head of the Medicare agency said Tuesday that she is considering giving the nation’s doctors more time to switch to a new insurance coding system that critics say would cost millions of dollars for little gain to patients.

“Marilyn Tavenner, the acting administrator of the Centers for Medicare and Medicaid Services, told a conference of the American Medical Association (AMA) that her agency could delay adoption of the so-called ICD-10 system. Current law calls for physicians to adopt the new codes next year…

“…Speaking to reporters after her prepared remarks, Tavenner said her office would formally announce its intention to craft new regulations “within the next few days.”

ICD-10 Deadline Review Update | Andrea Kraynak, for HealthLeaders Media, February 15, 2012

“Big news regarding the ICD-10-CM/PCS implementation timeline came Tuesday morning during the American Medical Association (AMA) National Advocacy Conference in Washington, DC.”

“Per CMS acting administrator Marilyn Tavenner, CMS plans to revisit the current implementation deadline of October 1, 2013. Tavenner said CMS wants to reexamine the pace of implementing ICD-10 and reduce physicians’ administrative burden, according to an AMA tweet…”

Practice Central: Resources for Practicing Psychologists

Practice Central, a service of the APA Practice Organization (APAPO), supports practicing psychologists in all settings and at all stages of their career. APAPO is a companion organization to the American Psychological Association. Our mission is to advance and protect your ability to practice psychology.

http://www.apapracticecentral.org/update/2012/02-09/transition.aspx

Practice Update | February 2012

Transition to the ICD-10-CM: What does it mean for psychologists?

Psychologists should be aware of and prepare for the mandatory shift to ICD-10-CM diagnosis codes in October 2013

By Practice Research and Policy staff

February 9, 2012—Beginning October 1, 2013 all entities, including health care providers, covered by the Health Insurance Portability and Accountability Act (HIPAA) must convert to using the ICD-10-CM diagnosis code sets. The mandate represents a fundamental shift for many psychologists and other mental health professionals who are far more attuned to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

Most psychologists were trained using some version of DSM. For other health care providers, the World Health Organization’s International Classification of Diseases and Related Health Problems (ICD) – which contains a chapter on mental disorders – is the classification standard.

Over the years, efforts to harmonize these two classifications have resulted in systems with similar (often identical) codes and diagnostic names. In fact, even if psychologists record DSM diagnostic codes for billing purposes, payers recognize the codes as ICD-9-CM – the official version of ICD currently used in the United States. Since 2003, the ICD-9-CM diagnostic codes have been mandated for third-party billing and reporting by HIPAA for all…

Read full article here

 

Dr Geoffrey M. Reed, PhD, Senior Project Officer, WHO Department of Mental Health and Substance Abuse, is seconded to WHO through IUPsyS (International Union for Psychological Science). Dr Reed co-ordinates the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders.

Meetings of the International Advisory Group are chaired by Steven Hyman, MD, Harvard University, Cambridge, MA, a former Director of the National Institute of Mental Health (NIMH) and DSM-5 Task Force Member.

The Department of Mental Health and Substance Abuse will also be managing the technical part of the revision of Diseases of the Nervous System (currently Chapter VI), as it is doing for Chapter V.

February 2012 edition of the American Psychological Association’s “Monitor on Psychology”:

http://www.apa.org/monitor/2012/02/disorder-classification.aspx

Feature

Improving disorder classification, worldwide

With the help of psychologists, the next version of the International Classification of Diseases will have a more behavioral perspective.

By Rebecca A. Clay

February 2012, Vol 43, No. 2

Print version: page 40

What’s the world’s most widely used classification system for mental disorders? If you guessed the Diagnostic and Statistical Manual of Mental Disorders (DSM), you would be wrong.

According to a study of nearly 5,000 psychiatrists in 44 countries sponsored by the World Health Organization (WHO) and the World Psychiatric Association, more than 70 percent of the world’s psychiatrists use WHO’s International Classification of Diseases (ICD) most in day-to-day practice while just 23 percent turn to the DSM. The same pattern is found among psychologists globally, according to preliminary results from a similar survey of international psychologists conducted by WHO and the International Union of Psychological Science.

“The ICD is the global standard for health information,” says psychologist Geoffrey M. Reed, PhD, senior project officer in WHO’s Department of Mental Health and Substance Abuse. “It’s developed as a tool for the public good; it’s not the property of a particular profession or particular professional organization.”

Now WHO is revising the ICD, with the ICD-11 due to be approved in 2015. With unprecedented input from psychologists, the revised version’s section on mental and behavioral disorders is expected to be more psychologist-friendly than ever—something that’s especially welcome given concerns being raised about the DSM’s own ongoing revision process. (See “Protesting proposed changes to the DSM” .) And coming changes in the United States will mean that psychologists will soon need to get as familiar with the ICD as their colleagues around the world…

Read full article here

For more information about the ICD revision, visit the World Health Organization.

Rebecca A. Clay is a writer in Washington, D.C

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