ICD-11

ICD-11 Revision Steering Group

An ICD-11 Revision Steering Group, which includes the chairs of the various Topic Advisory Groups (TAGs), serves as the planning and steering authority in the update and revision process. Dr Christopher Chute, MD, Mayo Clinic bioinformatics specialist, chairs the ICD-11 Revision Steering Group.

Revision Steering Group Terms of Reference

Revision Steering Group Member biographies

Topic Advisory Groups (TAGs)

A number of ICD-11 Topic Advisory Groups (TAGs) have been set up, under Managing Editors (TAGMEs), who report to the Revision Steering Group (RSG). It is understood that TAG Managing Editors will be expected to network to recruit reviewers with interest and professional expertise in the categories which Managing Editors have been allocated to work on, to act as external peer reviewers for the drafting of content and reviewing of proposals.

136 scientists from 36 countries and all WHO regions are contributing to the Topic Advisory Groups. See PDFs for TAG members:

Topic Advisory Groups

Topic Advisory Group for Internal Medicine    Last updated: 07.08.10
Topic Advisory Group for External Causes
Topic Advisory Group for Rare Diseases

Topic Advisory Group for Muskuloskeletal    Last updated: 20.01.10
Topic Advisory Group for Dermatology    Last updated: 02.02.10
Topic Advisory Group for Ophthalmology    Last updated: 20.01.10
Topic Advisory Group for Mental Health     Last updated: 03.02.10
Topic Advisory Group for Neurology     Last updated: 04.02.10

See ICD Revision Topic Advisory Groups page for

Working Groups for Internal Medicine
Terms of Reference for the Topic Advisory Groups

For the purpose of revising ICD-10 Mental and Behavioural disorders, the following groups were established:

International Advisory Group (AG) for the Revision of ICD-10 Mental and Behavioural Disorders
Global Scientific Partnership Coordination Group  Terms of Reference and members
GSPC Group Members’ Details
Stakeholder Input and Partnership Coordination Group
Global Health Practice Network (GHPN)
DSM-ICD Harmonization Coordination Group

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

The International Advisory Group (AG) for the Revision of ICD-10 Mental and Behavioural Disorders was constituted by the WHO with the primary task of advising WHO on all steps leading to the revision of the mental and behavioural disorders classification in ICD-10 in line with the overall revision process. A list of participants is provided in the Annexes to Advisory Group meeting Summary Reports.

A fifth meeting took place on December 1-3, 2009. A Summary Report for that meeting was anticipated in early 2010, but no report appears to have been published.

A request to the APA Board of Trustees that APA gives consideration to publishing copies of the summaries of the four International Advisory Group meetings that have already taken place (and for any subsequent meetings) on the DSM-5 Development website has produced no response.

(I took up the issue, inter alia, of the discontinuation of publication of AG meeting Summaries with WHO’s, Dr Bedirhan Üstün, in April 2011, but have received no response despite an earlier communication from Dr Üstün in which he had expressed a willingness to engage, in the spirit of transparency.) 

It has not been possible to establish whether any further meetings, either face-to-face or tele-conferencing, of the Advisory Group or the DSM-ICD Harmonization Coordination Group (or any group that might have replaced it) have taken place since December 2009.

International Advisory Group meetings 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. Dr Hyman refers to a “harmonization” meeting in this March 2011 journal response:

Journal of Child Psychology and Psychiatry 52:6 (2011), pp 661-662 doi:10.1111/j.1469-7610.2011.02386.x

by SE Hyman, March 24, 2011

http://onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.2011.02386.x/pdf  (free access to PDF)

Commentary: Repairing a plane while it is flying – reflections on Rutter (2011)

[Extract]

The revision processes

“One of the key points that Rutter makes is the need for harmonization between DSM-5 and ICD-11. It is hard to see the benefit of having two diagnostic manuals that result, at least to some degree, in different epidemiologies, different clinical trials inclusion criteria, and differences in the identification of patients in need of treatment.”

“Rutter is not quite right that there have been no meetings aimed at harmonization to date, but the meetings have not had a formal scientific status, and have generally focused on administrative and procedural matters. By the time this commentary appears, a scientific meeting focused on harmonization will have occurred.”

“The goals of a shared organization for the two classifications and of shared disorders and diagnostic criteria are important, but almost as important is Rutter’s additional advice. He would eschew abrupt, radical change that would be confusing to clinicians and highly disruptive for existing scientific data and prior regulatory decisions. As noted at the beginning of this commentary, however, he would also reject stasis as the appropriate fallback position: failures of the classification are serious and growing in number, most rapidly in genetics and brain imaging studies (Hyman, 2010). The harmony that may be most needed between the committees revising the DSM and ICD systems is a shared desire to move, responsibly, but with open minds toward classifications that invite scientific progress while achieving greater utility in the clinic.”

The International Advisory Group is co-ordinated by Senior Project Officer, Dr Geoffrey Reed, Ph.D., seconded to the Department of Mental Health and Substance Abuse through IUPsyS (International Union for Psychological Science).

The WHO Department of Mental Health and Substance Abuse, which is overseeing the revision of Chapter V (Mental and Behavioural Disorders), is also managing the technical part of the revision of Chapter VI (Diseases of the Nervous System).

Topic Advisory Group for Neurology

The lead WHO Secretariat for the Topic Advisory Group (TAG) Neurology is Dr Tarun Dua, Management of Mental and Brain Disorders, Department of Mental Health and Substance Abuse, WHO, Geneva. TAG Neurology is chaired by Dr Raad Shakir, Imperial College London.

Advisory Group for Mental and Behavioural Disorders Terms of Reference and members

Members of the Topic Advisory Group for Neurology

iCAT collaborative authoring platform

WHO is promoting the development of ICD-11 as an open and transparent process with stakeholder participation in the Alpha and Beta stages.

As well as print versions, it is intended that all volumes of ICD-11, when published, will be available electronically, will integrate with each other, be capable of integration with some other electonic systems and will enable ongoing updating and revision in response to scientific research and medical developments.

The revision of ICD via a collaborative e-platform (the iCAT) is a very ambitious and technically complex project and WHO has struggled with resources and funding.

Many of those involved in Topic Advisory Group work will be undertaking their roles as Managing Editors and Advisory Group members in addition to professional commitments. Topic Advisory Groups members are drawn from diverse global locations and will be meeting for only occasional face to face meetings. From meeting materials and reports, it appears that WHO is short of funds for the hosting of face-to-face meetings.

In October 2009, I raised some general queries with WHO’s, Dr Robert Jakob, around the operation of the iCAT. You can read those queries on this page. I received no acknowledgement or response. I have also raised more recent queries with WHO’s, Ms Sarah Cottler and Dr Tarun Dua, WHO Secretariat for TAG Neurology, and with Dr Raad Shakir, the Chair of TAG Neurology, but have received no response to my requests for specific clarifications from any of these.

ICD-11 Alpha Browser platform

Drafting is being carried out via a collaborative authoring platform, the iCAT, a wiki-like authoring tool, designed for use by ICD-11 Topic Advisory Group members and Managing Editors for the specification of taxonomic rules, category definitions and diagnostic criteria, in accordance with ICD-11’s “Content Model.”

In November 2010, a non interactive version of the iCAT, which had been accessible by the public for several months, was taken out of the public domain. You can see what it looked like in this post: Post #46 and in the YouTube videos.

In May 2011, a publicly viewable ICD-11 Alpha Browser platform was launched.

In July 2011, this platform was opened up to professionals and other interested stakeholders who can register via the site for fuller access and for reading and submitting comments. See the ICD-11 Alpha Browser User Guide for information on how the Browser functions and for registering for increased access. (Presumably the Alpha/Beta “hybrid” referred to in the WHO-FIC Council report.)

ICD-11 Revision and Topic Advisory Groups are continuing to use a separate platform for drafting purposes.

Stakeholder participation at the Beta stage

In preparation for the Beta drafting stage, another publicly viewable platform is being developed. According to presentations, this platform will invite and support a higher level of professional and stakeholder interaction with the drafting process, with various levels of input and editing authority for interested stakeholders who register for participation. According to editing status, registered stakeholders would be permitted to:

Make comments
Make proposals to change ICD categories
Participate in field trials
Assist in translating

See presentation slides in Posts #70 and #71:

ICD Revision Process Alpha Evaluation Meeting 11 – 14 April 2011: The Way Forward?

ICD Revision Process Alpha Evaluation Meeting documents and PowerPoint slide presentations

The “Start-Up List”

The starting point for the Alpha Draft was the “Start-Up List” of categories drafted by WHO HQ to initiate the editing process. This list included current ICD-10 content, input from ICD national modifications, primary care versions and speciality adaptations, textual definitions imported from affiliate classification publications, proposals received to revise the existing ICD via the ICD Update and Revision platform and via other channels.

During Alpha drafting, detailed structured definitions are added to the “Start-Up” ICD categories, according to thirteen parameters as set out in the “Content Model.”

The “Content Model”

ICD Revision says that the most important difference between ICD-10 and ICD-11 will be the Content Model.

Content in ICD-11 will be populated in accordance with the Content Model Reference Guide. There is the potential for considerably more content to be included for diseases, disorders and syndromes in ICD-11 than appears in ICD-10, across all chapters:

“Population of the Content Model and the subsequent review process will serve as the foundation for the creation of the ICD-11. The Content Model identifies the basic characteristics needed to define any ICD category through use of multiple parameters (e.g. Body Systems, Body Parts, Signs and Symptoms, Diagnostic Findings, Causal Agents, Mechanisms, Temporal Patterns, Severity, Functional Impact, Treatment interventions, Diagnostic Rules).”

This is the most recent available version of the Content Model Reference Guide January 2011

This iCAT Glossary page gives an overview of Content Model parameters.

See also Post #62: ICD-11 Content Model Reference Guide: version for December 2010

iCAMP on YouTube

iCAMP video reports are being collated on this Dx Revision Watch page. The videos give an overview of how the drafting platforms are intended to function as a multi-user, web-based authoring and review tool through which alpha and beta drafts will be developed, and the potential extent of the Content Model. If you are unable to stream YouTube videos, transcripts of some of the narrations are posted on the ICD-11 Revision Blog.

ICD-11 YouTubes

iCAMP on ICD-11 Blog

The ICD-11 Revision site

ICD Revision is posting meeting agendas, some meeting summaries, key documentation, information on the structure of ICD-11, style guide manuals, models for the population of content, PowerPoint presentations and ancillary documentation on a dedicated, public domain website:

ICD-11 Revision site | Revision resources
ICD-11 Revision site Documents Page | Key revision documents

ICD Revision Project Plan March 2010  [PDF]

Content Model Reference Guide January 2011  [MS Word]

Frequent Criticisms  [MS PowerPoint version .ppt]

Signs and Symptoms Chapter Discussion document  [MS Word]

Multisystem Chapter Discussion document  [MS Word]

[Note that some ICD Revision documents are “works in progress” or discussion documents and subject to ongoing review and revision.]

ICD-11 development resources

WHO News Release WHO/13 16 April 2007

WHO ICD Revision | Information on ICD Revision

ICD-11 Alpha Browser | Launched May 2011, register on site for fuller access

ICD Revision Google site

ICD-11 Revision site | Revision resources

ICD-11 Revision site face-to-face meetings | iCAT, iCAMP and other meetings
ICD-11 Revision site documents Page  | Key revision documents

Meeting Agendas and Summaries

Minutes August 2009 iCAT Meeting | Word doc
Agenda September 2009 iCAMP Meeting | Word doc
Summary September 2009 iCAMP Meeting | Word doc
Agenda September 2010 iCamp2 Meeting | Word doc
Agenda February 2011 Ankara Paediatrics Meeting | Word doc
Agenda April 2011 Software Development Meeting | Word doc

Summary Reports of meetings held by the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders (currently ICD-10 Chapter V)  [All in PDF format]

1st Meeting: 11 – 12 January 2007, Geneva |
2nd Meeting: 24 – 25 September 2007, Geneva |
3rd Meeting: 11 – 12 March 2008, Geneva |
4th Meeting 1 – 2 December 2008, Geneva |

[A 5th meeting of the International Advisory Group was held December 1-3, 2010. A Summary Report was anticipated in early 2011 but no report has been published for that meeting.]

ICD-11 YouTube Channel | Video reports from iCAMP meetings and iCAT training videos
ICD-11 on Facebook |
ICD-11 on Twitter |
ICD-11 BlogNot been updated since October 2009

Key links for the current version of ICD, ICD-10 Version: 2010:

About the World Health Organization (WHO)

The WHO Family of International Classifications  

WHO International Statistical Classification of Diseases and Related Health Problems

10th Revision (ICD-10) Online Version: 2010

ICD-10 Online Version: 2010: Tabular List of inclusions and four-character subcategories

ICD-10 Volume 2: Instruction Manual [PDF]

ICD-10 Volume 3: The Alphabetical Index

WHO does not make ICD-10 Volume 3: The Alphabetical Index available online.

[In ICD-11, all volumes, including The Alphabetical Index, will be available in print editions but will also be available for free, online.]

ICD-10 Mental and Behavioural Disorders

ICD-10 for Mental and Behavioural Disorders Diagnostic Criteria for Research  [PDF]
ICD-10 for Mental and Behavioural Disorders Clinical Descriptions and Diagnostic Guidelines  [PDF]

Last updated: February 6, 2012

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