Worldwide: WHO Releases New International Classification Of Diseases (ICD 11)

On June 18, 2018, 18 years after the launch of ICD-10, World Health Organization (WHO) released its new International Classification of Diseases (ICD-11)25. ICD-11 will be presented at the World Health Assembly in May 2019 for adoption by Member States and will come into effect on January 01, 2022. This release is an advance preview that will allow countries to plan how to use the new version, prepare translations, and train health professionals all over the country.

About ICD

The International Statistical Classification of Diseases and Related Health Problems (ICD) is the bedrock for health statistics. It maps human condition from birth to death - any injury or disease we encounter in life, and anything we might die of − is coded. Not only that, the ICD also captures factors influencing health, or external causes of mortality and morbidity, providing a holistic look at every aspect of life that can affect health.

Crucially, in a world of 7.4 billion people speaking nearly 7000 languages, the ICD provides a common vocabulary for recording, reporting and monitoring health problems. Fifty years ago, it would have been unlikely for a disease such as schizophrenia to be diagnosed similarly in Japan, Kenya and Brazil. Now, however, if a doctor in another country cannot read a person's medical records, they will still know the medical condition by virtue of knowing what the ICD code means. The ICD is also used by health insurers whose reimbursements depend on ICD coding; national health programme managers; data collection specialists; and others who track progress in global health and determine the allocation of health resources.

ICD 1126

Over a decade in the making, this version is a vast improvement on ICD-10; contains around 55 000 unique codes for injuries, diseases and causes of death.

  • First, it has been updated for the 21st century and reflects critical advances in science and medicine.
  • Second, it can now be well integrated with electronic health applications and information systems. This new version is fully electronic, significantly easier to implement which will lead to fewer mistakes, allows more details to be recorded, all of which will make the tool much more accessible, particularly for lowresource settings.
  • A third important feature is that ICD-11 has been produced through a transparent, collaborative manner, the scope of which is unprecedented in its revision history. An overriding motive in this revision was to make the ICD easier to use.

The new ICD also includes new chapters on:

  • Traditional medicine - although millions of people use traditional medicine worldwide, it has never been classified in this system. This will help in recording epidemiological data about disorders described in ancient Chinese medicine, commonly used in China, Japan, Korea, and other parts of the world.
  • New chapter on sexual health conditions that were previously categorized in other ways or described differently. For example, in the ICD 11 Gender incongruence has been moved out from mental disorders to be included in sexual health conditions. The rationale being that while evidence is now clear that it is not a mental disorder, and indeed classifying it as such causes enormous stigma to people who are transgenders, significant health care needs remain that can best be met if the condition is coded under the ICD.
  • Disorders - For the first time, WHO is classifying Gaming Disorder as an addictive behavior disorder, which evidence shows is enough of a health problem that it requires tracking through the ICD. Other addictive behaviors such as hoarding disorder are now included in ICD-11, and conditions such as 'excessive sexual drive' have been reclassified as 'compulsive sexual behaviour' disorder.

Disease trends and the biggest killers

The data captured through ICD codes is of huge importance for countries. It allows for the mapping of disease trends and causes of death around the world, which are key indicators for the health of a population and also the social determinants that link closely to health, such as education, nutrition, and public infrastructure - in short, a snapshot of where a country's vulnerabilities lie. For example, a country in which people live in crowded, inadequate housing with no clean water are inevitably likely to have a higher incidence of diarrheal disease.

Mortality data in the Global Health Observatory shows that while ischemic heart disease and stroke are the top two killers worldwide, together accounting for 15 million deaths in 2015, zooming into the statistics by continent can show radically different pictures. In Africa, lower respiratory infections and HIV/AIDS cause the most deaths, whereas violence is one of the top 10 causes of death in the region of the Americas and the Eastern Mediterranean region.

Note - ICD-11 is linked to the WHO non-proprietary names of pharmaceutical products, and it can be used for cancer registration. ICD-11 has been designed to be used in multiple languages, a central translation platform ensures that its features and outputs are available in all translated languages. Transition tables from and to ICD- 10 support migration to ICD-11. WHO will support countries as they move towards implementation of the new ICD-1127.

Footnotes

 25 http://www.who.int/health-topics/international-classification-of-diseases

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

 27 http://www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11)

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