ICD-11 struggling to meet targets for release of Beta Draft in May

ICD-11 Revision Steering Group struggling to meet targets for release of Beta Draft platform in May

Post #69 Shortlink: http://wp.me/pKrrB-ZB

The information in this mailing relates only to ICD-11, the forthcoming revision of ICD-10 that is scheduled for completion and pilot implementation in 2014/15. It does not apply to the forthcoming US specific Clinical Modification of ICD-10, known as ICD-10-CM, or to other Clinical Modifications of ICD-10, already in use.

Revision of the WHO’s ICD-10, the version of ICD in current use in the UK and over 110 countries worldwide, has been underway since 2007. The implementation date has already been shifted from 2012 to 2014/15.

A Beta Draft platform for ICD-11 had been scheduled for readiness by April, this year, for public release in May.

An ICD Revision Beta Requirements document states, “The Beta Phase will be open to [the] general public in May 2011 to enable structured input by interested parties subject to peer-review by relevant Technical Advisory Groups.”

But ICD Revision is evidently struggling to keep this project on track.

In October, last year, the Revision Steering Group’s “iCamp2” meeting acknowledged that a considerable amount of work needed to be done if ICD Revision if targets for a May 2011 release of a Beta Draft platform were going to be met.

According to an October iCamp2 PowerPoint presentation, Frequent Criticisms, and iCamp2 meeting videos, targets for the population of content for the Alpha Draft had not been reached: less than 80% of the Terminology Definitions had been uploaded to the iCAT and less than the 20% target for full Content Model completion for the thousands of diseases and disorders classified within ICD had been met.

The Revision Steering Group (RSG) identified a number of barriers to keeping this very technically ambitious project on track: lack of funding; the amount of time required for drafting definitions and population of textual content according to the complex ICD-11 “Content Model”; recruitment of external experts for reviewing proposals and generating content; familiarising the various Topic Advisory Group (TAG) members with informatics and the functionality of the iCAT (the collaborative authoring platform through which ICD-11 is being drafted); the paucity of face-to-face meetings for TAG managing editors and workgroup members, (scattered across the globe and undertaking these roles, by electronic means, in addition to their professional commitments), and difficulties facilitating interaction between the various Topic Advisory Groups where diseases overlap with other chapters.

If ICD Revision is already struggling to maintain targets, motivation and interaction between its various Topic Advisory Groups, then management of the project once the Beta drafting phase is reached and the process opened up to [the projected] thousands of stakeholders is going to present ICD-11 RSG and TAG managing editors with considerable challenges. The ICD-11 iCamp YouTube commentaries have an air of brittle optimism about them.

I have already predicted that come May 2011, we might anticipate some scaling back of plans and/or a possible shift in the release date for the Beta drafting platform (and potentially a further shift in the final ICD-11 implementation date) in response to recognition that the WHO may have significantly overestimated its capacity for obtaining funding and resources to fulfil this most ambitious vision by 2014.


Report of a WHO-FIC (WHO Family of International Classifications) Council conference call


or open  here on Dx Revision Watch site.

This document is the Report of a WHO-FIC Council conference call which took place between 14:00-15:30 Geneva Time, on Wednesday, February 16, 2011. It confirms that ICD Revision is debating whether to go public in May with a Beta drafting platform that falls short of targets for completion or whether to revise its schedule.

From Page 6

ICD-11 Beta Draft and Timeline

“In the context of the review of preparations for the ICD-11 Beta release, there was a set of arguments for and against a postponement of the beta release.

“The status was summarized as in the slide below.

“In discussion the WHO FIC Council Members commented:

• It is essential to have a good product that goes out to the general public.
• Extra time is needed for the cross-cutting TAGs as most substantive review is starting lately.
• On the other hand, having no public input into the process is of concern.

“Wider input is necessary; and public and transparency input was a goal of the revision process. A hybrid model of opening the revision process to public comment and suggestions at the same time not a full scale beta phase with field trials may be a better solution.

“WHO thanked the Council for their valuable input and contribution to the decision-making process. The TAG input is going on and the RSG has to review the topic as well. Given the current stage and pace of work, however, it is unlikely that the ICD-11 will be fulfilling the criteria for a beta version in April – either in terms of content or the software preparations. The financial situation of WHO requires more austere measures rather than a full-scale RSG meeting as planned in 11-15 April. Accordingly a decision will be made and conveyed to all stakeholders.”


I will update if and when ICD Revision issues an information release on its decision about the Beta Drafting platform and clarifies its intentions for the extent of public participation, or when more information becomes available.

In November, the iCAT electronic authoring platform through which the Alpha Draft was being developed was taken out of the public domain. The server for the improved version of the iCAT, which provides the platform for drafting the Beta is sitting behind a password, here: http://icat.stanford.edu/.

Access and editing rights are currently restricted to WHO, Revision Steering Group, the various ICD-11 Topic Advisory Group managing editors and members, reviewers of content and proposals and IT technicians. But it was envisaged that at the Beta stage, the drafting platform would be opened up for public access and to interested stakeholders who register for limited imput.

The Alpha and Beta drafts are “works in progress”. Proposals as they stood in the iCAT collaborative drafting platform in November, last year, are that all three terms, PVFS, (B)ME and Chronic fatigue syndrome should be classified within ICD-11 Chapter 6: Diseases of the nervous system [1].

A meeting was expected to be held in Geneva, this week, and I will post further information as it becomes available on the ICD Revision Google site.



1] PVFS, ME, CFS: the ICD-11 Alpha Draft and iCAT Collaborative Authoring Platform (Report with screenshots from the Alpha drafting stage iCAT)

2] Key document: ICD Revision Project Plan version 2.1 9 July 2010

3] Key document: Content Model Reference Guide version January 2011


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