ICD-11 Content Model Reference Guide: version for December 2010

February 18, 2011 by

ICD-11 Content Model Reference Guide: version for December 2010

Post #62 Shortlink: http://wp.me/pKrrB-Xj

Update @ 1 March 2011

A more recent version of the Content Model document was uploaded to the ICD Revision site on 22 February.

It can be accessed here on the ICD Revision site:

View Word document

Download Word document

Or opened here on DSM-5 and ICD-11 Watch site: Content Model Reference Guide v January 2011

A revised version of the ICD-11 Content Model Reference Guide was uploaded to the WHO’s ICD Revision Google site in January.  This version of the document, dated 27 January 2011, replaces previous versions on DSM-5 and ICD-11 Watch site and on the ICD Revision Google site.

Content Model Reference Guide December 2010 v.1  27 Jan 2011

A copy of this 57 page document can be viewed on the ICD Revision Google site from this page:

http://sites.google.com/site/icd11revision/home/documents

View Word document

Download Word document

or open here on DSM-5 and ICD-11 Watch site: Content Model Reference Guide December 2010 [v.1]

 

Introductory pages

ICD-11 alpha

World Health Organization, Geneva

Content Model Reference Guide 11th Revision

December 2010

Table of Contents

Page 2

Introduction 3
What is the “Content Model”? 4
Explanations on the Content Model 5
Technical Specifications for the Content Model 7
ICD -11 Alpha Content Model 9

1. ICD Entity Title 9

2. Classification Properties 11

3. Textual Definition(s) 17

4. Terms 21

5. Body Structure Description 24

6. Temporal Properties 27

7. Severity Properties 31

8. Manifestation Properties 33

9. Causal Properties 35

10. Functioning Properties 38

11. Specific Condition Properties 42

12. Treatment Properties 44

13. Diagnostic Criteria 45

Section B 46

Appendices 48
Appendix 1: Body Systems Value Set 48
Appendix 2: Temporal Properties Value Set 49
Appendix 3: Temporal Properties Value Set and explanations 50
Appendix 4: Basic Aetiology Value Set 56
Appendix 5: Grammar Rules for Titles and Synonyms 57

Page 3

Reference Guide on the Content Model of the ICD 11α

Introduction

This Reference Guide is intended to define and explain the Content Model used in the ICD-11 alpha draft in practical terms. It aims to guide users to understand the purposes and parameters of the Content Model.

The Reference Guide also informs users about the technical specifications of each parameter which the designers of the iCAT (the computer platform that is used to fill in the content model: international Collaborative Authoring Tool) took into account in building the software.

Accordingly, information on each parameter is given in two sections:

(1) Explanations
(2) Technical specifications

The purpose of this Reference Guide is to ensure that the Content Model and its different parameters are properly understood.

This document will be periodically updated in response to user needs and evolution of the content model.

Brief introduction to the ICD – International Classification of Diseases

The International Classification of Diseases (ICD) is the global standard to report and categorize diseases in order to compile health information related to deaths, illness and injury. The ICD content includes diseases and a range of health problems including disorders, syndromes, signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury. The ICD is designed to promote international comparability in the collection, processing, classification, and presentation of these statistics.

In ICD there are multiple classification categories which are defined by explicit or implicit parameters such as: codes, titles, definitions and other characteristics. In ICD 11, we aim to formally represent all this classification knowledge in a systematic way. The Content Model serves this purpose.

Page 4

What is the “Content Model”?

The Content Model is a structured framework that defines “a classification unit” in ICD in a standard way in terms of its components that allows computerization.

A “model” is a technical term that refers to a systematic representation of knowledge that underpins any system or structure. Hence, the content model is an organized description of an ICD unit with its different parameters.

In the past, ICD did not explicitly define its “classification units” – in other words diseases were classified without defining “what is a disease?” (There have been efforts to provide some definitions, inclusions, exclusion information, and some coding rules in the instructions and in the index. Some chapters, such as mental health, oncology, or other groups of diseases have been elaborated with diagnostic criteria. All these efforts may be seen as implicit modelling.) In the ICD 11 revision process, deliberate action is being taken to define the ICD categories in a systematic way and represent the classification knowledge to allow processing within computer systems.

To achieve this aim, different ICD categories have been defined by user groups as to what they are. For example, first a disease was defined as follows:

A disease is a set of dysfunction(s) in any of the body systems defined by:

1. Symptomatology: manifestations: known pattern of signs, symptoms and related findings
2. Aetiology: an underlying explanatory mechanism
3. Course and outcome: a distinct pattern of development over time
4. Treatment response: a known pattern of response to interventions
5. Linkage to genetic factors: e.g., genotypes, patterns of gene expression
6. Linkage to interacting environmental factors

Then the key components of this definition have been operationally defined as different parameters which, as a whole, formed the Content Model.

Page 5

Explanations on the Content Model:

A classification unit in ICD is called an “ICD entity”. In other words, any distinct classification rubric is called an Entity. (The term “Entity” is used interchangeably – in the same meaning — with the term “ICD Concept”.

An ICD entity may be:

– A category
– A block
– A chapter

A category (which is the most common reference to an ICD class) may be a disease, disorder or syndrome; sign, symptom or other health problem such as injuries, or a combination of the above. In addition, ICD has also been used to classify “external causes” or “other reasons for encounter” which are different kinds of entities than the diseases. In other words, “Category” refers to the individual classes represented in the ICD-10 printed version.

The Content Model, therefore, allows the various classification categories to be represented more clearly so that users can identify the classification units in a scientific fashion.

The purpose of the content model is to present the knowledge that lies under the definition of an ICD entity. Each ICD entity can be seen from different dimensions. The content model represents each one of these dimensions as a “parameter”. For example, there are currently 13 defined main parameters in the content model to describe a category in ICD.

TABLE 1: The Content Model main parameters

For each category, various parameters are given different values. For example:

Category: Myocardial Infarction

Parameters:                       Value:
Body system                         Cardiovascular system
Body part                              Heart
Signs/symptoms                   Crushing chest pain, etc.
Investigation Findings           ST elevation in ECG

It is not necessary to describe all categories with all parameters. Only parameters that are relevant to the description of the category should be used. In certain instances such as External Causes, only a number of the parameters are valid for the description of these entities.

The full range of different values for a given parameter is predefined using standard terminologies and ontologies. The predefined values constitute a “value set”.

Read full document here: Content Model Reference Guide December 2010 [v.1]

 

Related documents:

Paper:

http://bmir.stanford.edu/file_asset/index.php/1522/BMIR-2010-1405.pdf

A Content Model for the ICD-11 Revision

Samson W. Tu1, Olivier Bodenreider2, Can Çelik3, Christopher G. Chute4, Sam Heard5, Robert Jakob3, Guoquian Jiang4, Sukil Kim6, Eric Miller7, Mark M. Musen1, Jun Nakaya8, Jon Patrick9, Alan Rector10, Guillermo Reynoso11, Jean Marie Rodrigues12, Harold Solbrig4, Kent A Spackman13, Tania Tudorache1, Stefanie Weber14, Tevfik Bedirhan Üstün3

1Stanford Univ., Stanford, CA, USA; 2National Library of Medicine, Bethesda, MD, USA; 3World Health Organization, Geneva, Switzerland; 4Mayo Clinic College of Medicine, Rochester, MN, USA; 5Ocean Informatics, Chatswood, NSW, Australia; 6Catholic Univ. of Korea, Korea; 7Zepheira, Fredricksburg, VA, USA; 8Tokyo Medical and Dental Univ., Tokyo, Japan; 9Univ. of Sydney, Sydney, NSW, Australia; 10Univ. of Manchester, Manchester, UK; 11Buenos Aires, Argentina;12Université de Saint Etienne, Saint Priest en Jarez, France; 13IHTSDO, USA; 14DIMDI – German Institute of Medical Documentation and Information, Köln, Germany

Abstract

The 11th revision of the International Classification of Diseases and Related Health Problems (ICD) will be developed as a collaborative effort supported by Webbased software. A key to this effort is the content model designed to support detailed description of the clinical characteristics of each category, clear relationships to other terminologies and classifications, especially SNOMED-CT, multi-lingual development, and sufficient content so that the adaptations for alternative uses cases for the ICD – particularly the standard backwards compatible hierarchical form – can be generated automatically. The content model forms the basis of an information infrastructure and of a webbased authoring tool for clinical and classification experts to create and curate the content of the new revision.

Filed under iCAT, ICD revision process, ICD-10, ICD-10-CM, ICD-11, ICD-11 Alpha Draft, ICD-11 Beta Draft, ICD-11 consultation, ICD-11 in the media, ICD-11 revision docs, WHO (World Health Organization)

CFS orphaned in the “R” codes in ICD-10-CM

February 13, 2011 by

CFS orphaned in the “R” codes in US specific ICD-10-CM

Post #60 Shortlink: http://wp.me/pKrrB-V4

Current proposals for ICD-10-CM place CFS in Chapter 18, under R53 Malaise and fatigue at R53.82 Chronic fatigue syndrome NOS (Not otherwise specified).

According to a Note to a Recommendation on the CSFSAC webpages:

*DFO Note: The ICD 10-CM is scheduled for implementation on October 1, 2013. In that classification, two mutually exclusive codes exist for chronic fatigue [sic]:

post-viral fatigue syndrome (in the nervous system chapter), and
chronic fatigue syndrome, unspecified (in the signs and symptoms chapter).

HHS has no plans at this time to change this classification in the ICD 10-CM.

Images Copyright 2011 ME agenda  No unauthorized reproduction

 

The revision of ICD-10, ICD-11, is scheduled for implementation in 2015.

Once ICD-10-CM has been adopted, the US does not envisage moving on to ICD-11 (or a “Clinical Modification” adaptation of ICD-11) for many years.

Partial Code Freeze

Although ICD-10-CM is not scheduled for implementation until October 2013, it had been proposed that at some point prior that date codes might be “frozen”.

At the ICD-9-CM Coordination & Maintenance Committee Meeting on Sept. 15, 2010, it was announced that the committee had finalized the decision to implement a partial freeze for both ICD-9-CM codes and ICD-10-CM and ICD-10-PCS codes prior to implementation of ICD-10 on Oct. 1, 2013.

       Partial Code Freeze Announcement

As of October 1, 2011, only limited updates will be instituted into the code sets so that providers, payers, clearinghouses, and health IT vendors will not have to simultaneously keep pace with code updates while also reconfiguring their existing systems for ICD-10-CM/PCS.

So the clock is ticking for CFS and US advocates and patients need to be aware of how little time may be left.

References:

[1] International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Note: The 2011 release of ICD-10-CM is now available. It replaces the December 2010 release:
http://www.cdc.gov/nchs/icd/icd10cm.htm

[2] US “Clinical Modification” ICD-10-CM
This article clarifies any confusion between ICD-10, ICD-11 and the forthcoming US Clinical Modification, ICD-10-CM: http://wp.me/pKrrB-Ka

[3] Chronic Fatigue Syndrome Advisory Committee (CFSAC). The Chronic Fatigue Syndrome Advisory Committee (CFSAC) provides advice and recommendations to the Secretary of Health and Human Services via the Assistant Secretary for Health of the U.S. Minutes of meetings, Recommendations and meeting videocasts:
http://www.hhs.gov/advcomcfs/meetings/index.html

Filed under ICD revision process, ICD-10, ICD-10-CM, ICD-11, ICD-11 Alpha Draft, ICD-11 Beta Draft, ICD-11 consultation, ICD-11 revision docs, WHO (World Health Organization), WHO Collaborating Centre

Allen Frances and Robert Spitzer on DSM-5 Scientific Review Work Group and DSM-5 Field Trials and deadlines

December 18, 2010 by

Allen Frances, MD and Robert Spitzer, MD write to the APA Board of Trustess re DSM-5 Scientific Review Work Group; Frances on DSM-5 Field Trials and deadlines

Post #54 Shortlink: http://wp.me/pKrrB-Ru

On 10 December 2009, the American Psychiatric Association (APA) issued a news release announcing a revised timeline for the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The anticipated release date for DSM-5 was being shifted from May 2012 to May 2013.

According to the DSM-5 Development Timeline:

[Timeline superceded by revised Timeline]

But field trials are barely underway.

Allen Frances, MD, currently professor emeritus at Duke, had chaired the DSM-IV Task Force. Frances maintains the blog DSM5 in Distress at Pyschology Today and also writes for Psychiatric Times where he’s been documenting and commenting on the development of DSM-5 since June 2009. Robert Spitzer had chaired the DSM-III Task Force.

Links to two recent commentaries by Allen Frances on DSM-5 deadlines and a joint letter by Frances and Spitzer to the APA Board of Trustees in response to the APA’s appointment of a DSM-5 Scientific Review Work Group, below:

DSM5 in Distress

The DSM’s impact on mental health practice and research.
by Allen Frances, M.D.

Letter To Board Of Trustees of the American Psychiatric Association sent December 6, 2010

Published on December 13, 2010

We are delighted that you have appointed a DSM-5 Scientific Review Work Group and charged it with assessing the quality of evidence supporting the DSM 5 proposals. This is great news, probably the last hope to weed out proposals that could do great harm to the Association, our field, and to our patients. Our relief and hope are tempered only by several problems with the process as you have established it:

CONTINUED SECRECY: Given all of the negative publicity surrounding the DSM-5 confidentiality agreements, we are amazed to see the following statement in the charge to the Scientific Review committee: “Deliberations and reports to the BOT will be confidential. The existence of the committee (work group) will be public.” Why on earth is this case? What is the possible harm of making this esteemed committee’s final report public? While we can appreciate the need for the committee to be able to deliberate candidly and not feel constrained by the possibility that every aspect of their deliberations will be made public, it is essential that the final report containing the committee’s assessment of the scientific merits of the proposals be made public.

COMPOSITION OF WORK GROUP: The announcement makes an ambitious claim, namely, that this review will be equivalent to an independent NIMH peer review. This desirable standard cannot possibly be met by the DSM-5 Scientific Review Work Group as you have constituted it. The people chosen are all well-respected, but all but two of the committee members have been involved with DSM 5 or its oversight. To have credibility, a review committee must be completely unattached to the work that has already been done on DSM 5. Preferably, APA should contract out the review process to experts in evidence based medicine who would be both fully independent and also able to apply the standards of scientific proof used across all medical specialties. At the very least, the membership of the committee needs to be broadened to guarantee both the reality and the appearance of a truly unbiased and independent review process.

CHARGE: Although labeled a “Scientific Review Work Group”, the charge needs to go beyond just being a scientific review and include a thorough risk/ benefit analysis of all suggestions. That such an analysis is planned in suggested by the statement in the charge that “issues of clinical utility, public health, and potential impact on patients should also be considered.” We applaud this plan to conduct a risk/benefit analysis but are concerned that such a review requires broader experience in primary care, public policy, health economics, and forensics that goes beyond the current composition of the Workgroup. At a minimum, close consultation with such experts should be part of the planned review process.

METHOD: It appears the assessments will be limited to evidence already generated by the work groups, with no check to determine if their reviews have been comprehensive and balanced. Since there was no standard operating procedure in the literature review process, the work group reviews are variable in quality and method. A recheck to ensure that all pertinent references have been included is necessary.

TIMING: This scientific review is occurring unbelievably late in the DSM 5 process- it should have been completed more than a year ago, not after the field trials have already begun. There is little purpose to be doing expensive field testing on proposal likely to be eliminated because of limited scientific support. Every step in the DSM 5 process has missed its deadline, sometimes by a year or more. We are concerned that the momentum of the DSM 5 process and limited time left for its review will result in the rushed inclusion of proposals that are both risky and unsupported by evidence.

All these serious concerns notwithstanding, The DSM 5 Scientific Review Work Group has our very best wishes. It is in a key position to do a great service for our field and for our patients and to save APA from further embarrassment.

Robert Spitzer and Allen Frances

DSM5 in Distress

The DSM’s impact on mental health practice and research.
by Allen Frances, M.D.

DSM 5 Field Trials-Part 1 Missed Deadlines Have Troubling Consequences
DSM 5 is falling far behind its schedule.

Published on November 15, 2010

This is a sad tale of completely unrealistic timetables, poorly executed work effort, consistently missed deadlines, and what will undoubtedly be a rushed and botched DSM 5. It all started at the annual meeting of the American Psychiatric Association in May 2009, when the DSM 5 leadership blithely announced it was ready to begin field testing in the early summer of 2009…

…It was patently obvious from the moment of its announcements that the new DSM 5 field test timetable was also a product of fantasy that would not be met in the real world. First off, it should have been clear that the field trials could not possibly start on time two months after their announcement. Recruiting the sites, training the personnel, gaining human rights approvals, and pilot testing always take at least six months. Predictably, we are already in mid Nov 2010 and it is still not at all clear when the DSM 5 field tests will actually begin to enroll patients at all its sites.

Read full commentary: DSM 5 Field Trials-Part 1 Missed Deadlines Have Troubling Consequences

DSM5 in Distress

The DSM’s impact on mental health practice and research.
by Allen Frances, M.D.

The DSM 5 Field Trials, Part 2: Asking The Wrong Question Will Lead To Irrelevant Answers
A waste of talent, time, and money.

Published on November 23, 2010

…Field tests also fail to account for the pressures that will lead to systematic, future misuse-especially the drug company marketing of mental disorders that leads to over-diagnosis.

…What do I mean? DSM 5 has made a number of radical suggestions for change, particularly the inclusion of many new diagnoses at the threshold of normality. These have the potential to reclassify as mentally disordered tens of millions of people currently considered normal. The only relevant questions are the overall rates of these disorders in the general population and the risks of false negative over-diagnosis.

…At the end of the DSM 5 field trials, we will have no idea whatever whether its suggestions will create false epidemics of misidentified pseudo-patients.

Read full commentary: Part 2: Asking The Wrong Question Will Lead To Irrelevant Answers

ICD-11

Implementation of the WHO’s ICD-11 is scheduled for 2014. Earlier this year, I asked ICD Revision to clarify for stakeholders whether any form of Alpha Draft for ICD-11 will be placed in the public domain, when this will be released and in what formats. 

In October, ICD Revision stated via its Facebook site, that there will be no publication of an ICD-11 Alpha Draft for public scrutiny and that a public Beta Draft is still targeted for May 2011.

ICD-11 targets also slipping 

According to the September iCamp2 meeting PowerPoint presentation, Frequent Criticisms and this iCamp2 YouTube, targets for the population of content for the ICD-11 Alpha Draft had not been reached.   

Less that 80% of 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 at that point. [The Content Model identifies the basic properties needed to define any ICD concept (unit, entity or category) through the use of multiple parameters.] Not all Topic Advisory Groups were at a similar developmental stage and ICD-11 Beta Plans were behind schedule.   (See Post #48)

International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders

The APA participates with the WHO in the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders and the DSM-ICD Harmonization Coordination Group.

The International Advisory Group for the Revision of the ICD-10 Chapter for Mental and Behavioural Disorders (currently ICD-10 Chapter V but will be Chapter 5 in ICD-11) was constituted by the WHO with the primary task of advising the WHO on all steps leading to the revision of the mental and behavioural disorders classification in ICD-10, in line with the overall ICD revision process.

The Group is chaired by Steven E Hyman, MD, Harvard University, Cambridge, Massachusetts. Steven E Hyman, MD is also a member of the APA’s DSM-5 Task Force.

There is already a degree of correspondence between DSM-IV and Chapter V of ICD-10. For the next editions, the APA and the WHO have committed as far as possible:

To facilitate the achievement of the highest possible extent of uniformity and harmonization between ICD-11 mental and behavioural disorders and DSM-V disorders and their diagnostic criteria.

with the objective that

The WHO and APA should make all attempts to ensure that in their core versions, the category names, glossary descriptions and criteria are identical for ICD and DSM.

The Advisory Group has published no Summary Reports of its meetings since its fourth meeting in December 2008. A fifth meeting of the group was held on 28 – 29 September 2009.  Over a year later, no Summary Report has been published for that meeting. It is uncomfirmed whether any meetings of the Advisory Group were held in 2010.

Topic Advisory Group for Neurology

The lead WHO Secretariat for Topic Advisory Group (TAG) for Neurology is Dr Tarun Dua, Management of Mental and Brain Disorders, Department of Mental Health and Substance Abuse, WHO, Geneva.

The TAG for Neurology is chaired by Raad Shakir, MD, Imperial College London. For further information on TAG Neurology see this page.

Filed under American Psychiatric Association (APA), Clinical Modification, Criticism of DSM-V, DSM-5, DSM revision process, DSM-5, DSM-5 draft proposals, DSM-5 in the media, DSM-V, ICD-10-CM, ICD-11, ICD-11 Alpha Draft, Psychiatric Times, WHO (World Health Organization)

No publication of an ICD-11 Alpha Draft for public scrutiny

November 19, 2010 by

There will be no publication of an ICD-11 Alpha Draft for public scrutiny

Post #53 Shortlink: http://wp.me/pKrrB-QL

For some time now, I have been trying to establish whether ICD Revision intends to release any form of ICD-11 Alpha Draft for public scrutiny. An Alpha Draft had originally been scheduled for May 2010.

On 6 August, ICD Revision on Facebook had stated:

“The ICD-11 Alpha Drafting process has been ongoing since the first iCamp that was held in Geneva, Switzerland in September 2009. A draft print version will be available in September 2010.”

On 29 September, I asked:

“Clarification would be welcomed on whether an Alpha Draft will be available this month for internal use only or whether it is intended for public viewing, and if for public viewing, in what format(s)?”

which received no response.

On 6 October, I asked, again:

“On 6 August, ICD Revision on Facebook stated that “A draft print version will be available in September 2010”. Other than what can be seen on the iCAT collaborative authoring platform, will ICD Revision please clarify for stakeholders, whether any form of Alpha Draft for ICD-11 is going to be placed in the public domain, when this will now be released, and in what formats?”

On 15 October, ICD Revision on Facebook responded: 

“Indeed a print version is available but as an alpha draft it is not for public consumption. Public draft ( beta draft) was and (is still) targeted for MAY 2011. iCAT authoring platform is not open to public and should be only seen by designated authors. — This is not something opaque. any project of this size and complexity has to pass through stages. In May 2011 more user-friendly software and easy-to-view options will be available…”

At that point, it was in fact the case that both the iCAT authoring platform server and the iCAT demo and training platform had been viewable by the public, although only WHO, ICD Revision Steering Group, ICD Revision IT technicians and Topic Advisory Groups (TAGs) had editing access.

The iCAT production server is at: http://icat.stanford.edu/
The iCAT demo and training platform is at: http://icatdemo.stanford.edu/

In early November, access to viewing the iCAT and the iCAT demo platform was closed to the public. 

Topic Advisory Group (TAG) members now require a password login for both browsing and editing the iCAT or importing data and the public can no longer view the iCAT and the population of ICD Title Categories and Content, at all.

Filed under iCAT, ICD revision process, ICD-10, ICD-11, ICD-11 Alpha Draft, ICD-11 consultation, ICD-11 revision docs, Somatic Symptom Disorder, Somatoform Disorders, WHO (World Health Organization)

Web Protégé: Supporting the Creation of ICD-11 and iCAMP2 YouTubes

October 26, 2010 by

Web Protégé: Supporting the Creation of ICD-11 and iCAMP2 YouTubes

Post #51 Shortlink: http://wp.me/pKrrB-Qv

http://iswc2010.semanticweb.org/pdf/502.pdf

Web Protégé: Supporting the Creation of ICD-11

Sean M. Falconer, Tania Tudorache, Csongor Nyulas, Natalya F. Noy, Mark A. Musen

Stanford Center for Biomedical Informatics Research, Stanford University, US

1 Introduction

The International Classification of Diseases (ICD) is a public global standard that organizes and classifes information about diseases and related health problems [4]. Health offcials use ICD in all United Nations member countries to compile basic health statistics, to monitor health-related spending, and to inform policy makers. In the United States, use of the ICD is also a requirement for all medical billing. ICD has therefore a major impact on many aspects of health care all over the world.

In 2007, the WHO initiated the 11th revision of ICD. Several ambitious goals were set for this version (details in [2]). One such goal is to allow the ICD to become a multi-purpose classification for a much larger number of usages. Previous versions of ICD were strictly classification hierarchies used for statistical purposes. To meet the new revision goals, ICD-11 will use OWL to create a rich formal representation. Another key diference between ICD-11 and previous versions is that the development process of ICD-11 will use a Web-based open process powered by collaboration and social features. That is, similar to Wikipedia, the WHO hopes that a large number of medical experts will contribute to the content of ICD-11.

Our group has been working closely with the WHO to provide the technical support for these ambitious goals. We have created a customized version of Protégé specifcally designed to support the ICD authoring process. In [2], we discuss in detail the use of Semantic Web technologies for the revision of ICD. Our demo will showcase features of the customized Protégé such as content creation and collaboration. For the remainder of this paper, we present the architecture and highlight features of the user interface…

Full document

————–

iCamp2: 27 September – 1 October 2010

http://sites.google.com/site/icd11revision/home/face-to-face-meetings/icamp2-2010   

The iCamp2 meeting, scheduled for April but postponed due to volcanic ash cloud disruption of air traffic, was held between 27 September – 1 October, in Geneva.   

iCamp2
27 September – 1 October 2010 Geneva, Switzerland WHO Headquarters   

RSG 2010 [Revision Steering Group]
30 September – 1 October 2010 Geneva, Switzerland WHO Headquarters   

The revised Agenda for the meeting can be read here in html on the ICD Revision site.   

Download here as a Word document from the ICD Revision site or open here iCamp2 Agenda September 2010 on DSM-5 and ICD-11 Watch site.   

I will post a link for the minutes, summary or note of this meeting when these are available on the ICD Revision site.

There are two ICD-11 iCamp2 on YouTube   

ICD-11 ICAMP2 Day 5 

WHOICD11’s Channel  | 21  October 2010  |  9.53 mins

iCAMP2 Day 2   

WHOICD11’s Channel  | 29 September 2010  |  7:32 mins    

 

Related information

ICD Revision iCamp2 meeting, new documents and status of the ICD-11 Alpha Draft

Filed under iCAT, ICD on YouTube, ICD revision process, ICD-10, ICD-11, ICD-11 Alpha Draft, ICD-11 revision docs, WHO (World Health Organization), Wikipedia

ICD-11 revision: where are we now? Ontology-driven tools and the web platform: Meeting abstract

October 7, 2010 by

ICD-11 revision: where are we now? Ontology-driven tools and the web platform: Meeting abstract

Post #49 Shortlink: http://wp.me/pKrrB-PW

A PDF of an associated slide presentation by JM Rodrigues et al can be downloaded here:

http://tinyurl.com/ICD-11revision-Rodrigues

 

This article is part of the supplement:

Patient Classification Systems International: 2010 Case Mix Conference, Munich, Germany. 15-18 September 2010.

http://www.biomedcentral.com/bmchealthservres/10?issue=S2

BMC Health Services Research

Volume 10
Suppl 2

http://www.biomedcentral.com/1472-6963/10/S2/A7

PDF: http://www.biomedcentral.com/content/pdf/1472-6963-10-S2-A7.pdf

Open access

Meeting abstract

ICD-11 revision: where are we now? Ontology-driven tools and the web  platform

J Rodrigues¹²
1 SSPIM, CHU Saint etienne, Saint Etienne, France
2 WHO FIC Collaborative Centre, WHO FIC Collaborative Centre, Paris, France

corresponding author email

from 26th Patient Classification Systems International (PCSI) Working Conference

Munich, Germany. 15-18 September 2010
BMC Health Services Research 2010, 10(Suppl2):
A7doi:10.1186/1472-6963-10-S2-A7

The electronic version of this abstract is the complete one and can be found online at: http://www.biomedcentral.com/1472-6963/10/S2/A7

Published: 6 October 2010

© 2010 Rodrigues; licensee BioMed Central Ltd.

Introduction

ICD is the international de facto standard classification for most epidemiological and many health-care and clinical uses. Originally designed to record causes of death, the usage of ICD has been extended to include morbidity classification, reimbursement, and several other specialty areas such as oncology and primary care. The current 10th edition of ICD was endorsed by the World Health Assembly in 1990 and has been periodically updated over the years. Recently, the World Health Assembly decided to develop a completely new version named the 11th revision.

Methods

In previous revisions of ICD, specialty experts and national representatives of WHO collaborative-classification centers proposed additions and changes to the codes (using lists of codes for creating new drafts). In contrast, the development of ICD-11 aims to create an information infrastructure and workflow processes that utilize knowledge engineering and management techniques that are supported by software.

Instead of just codes, titles, and associated rules and indices, the information infrastructure will enable a more detailed definition of disease and health conditions, as well as the use of reference terminologies and ontologies, review of best scientific evidence, and field trials of draft standards.

In terms of workflow, the information infrastructure should support the collaborative development of new content and proposed changes, rigorous review and approval processes, and the creation of draft classifications for field testing. The ICD revision process was initially the work of Topic Advisory Groups (TAG) that had been set up for various specialty areas. The ICD-11 revision process will eventually be opened up for comments and suggestions from interested parties on the Internet.

Lastly, the final output will be multiple for different use cases such as mortality, morbidity and primary care, which can be mapped with ontology-driven tools

Results

The content model is made up of three different parts:

A) Descriptive Characteristics
ICD Concept Title
Hierarchy, Type and Use
Textual Definition
Terms
Index Terms
Synonyms
Inclusion Terms
Exclusion Terms

B) Clinical Description
Manifestation Properties
Signs & Symptoms
Findings
Temporal Properties
Severity Properties
Functional Properties
Treatment Properties
Diagnostic Rules
Reason For Encounter

C) Formal Characteristics
Body Structure
Morphologic Abnormality
Causal Properties
Mechanisms/ Agents
Risk Factors
Genomic Characteristics
Dysfunction

The web platform named ICAT has been developed by a team of Stanford University to allow a collaborative population of the content model by their different tags.

The ICD-11 content model is still evolving, but the main components have been specified. A detailed guide describes the expected content and usage of each component. It is the document that records the shared understanding  of the content model.

The OWL content model realizes the informal description in the guide and formalizes the three-layer  conceptualization of the original UML model.

Conclusions

The ICD-11 content model is very much a work in progress. Consensus formulation of several components such as temporal properties, severity properties, and diagnostic criteria is not yet available. From the view point of case mix, the new tools will provide an ICD of better quality for morbidity, thus allowing better mapping between diagnosis systems and, as a result of this, better mapping across case-mix systems based on diagnosis coding.

[Abstract Ends]

Update on status of ICD-11 Alpha Draft in previous post on DSM-5 and ICD-11 site:

ICD Revision iCamp2 meeting, new documents and status of the ICD-11 Alpha Draft

2 October 2010

Shortlink Post #48: http://wp.me/pKrrB-O9

Reference material:

PVFS, ME, CFS: the ICD-11 Alpha Draft and iCAT Collaborative Authoring Platform, 7 June 2010, Post # 46: http://wp.me/pKrrB-KK

[1] ICD-11 Revision Project Plan – Draft 2.0 (v March 10):
Describes the ICD revision process as an overall project plan in terms of goals, key streams of work, activities, products, and key participants: ICD Revision Project Plan
http://www.who.int/classifications/icd/ICDRevisionProjectPlan_March2010.pdf

[2] User Manual [Content Model User Guide, 53 pp Word doc]  Key ICD-11 document
Identifies the basic properties needed to define any ICD concept (unit, entity or category) through the use of multiple parameters. Open here on DSM-5 and ICD-11 Watch: User Manual 20.09.10

[3] iCAT production server:
http://sites.google.com/site/icd11revision/home/icat
iCAT production server: http://icat.stanford.edu/

[4] iCAT Glossary
http://apps.who.int/classifications/apps/icd/icatfiles/iCAT_Glossary.html

Filed under iCAT, ICD revision process, ICD-10, ICD-11, ICD-11 Alpha Draft, ICD-11 consultation, ICD-11 revision docs, WHO (World Health Organization)

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