Mkb 11 when. WHO publishes new international classification of diseases

Frequently Asked Questions about the ICD-11

What is the International Classification of Diseases (ICD)?

The International Classification of Diseases (ICD) is the world standard methodology for collecting data on mortality and morbidity. It organizes and codes health information used for statistics and epidemiology, health management, resource allocation, monitoring and evaluation, research, primary health care, prevention and treatment. It helps to get an idea of ​​the overall health situation in countries and populations.

The 11th edition of the ICD is currently being developed as part of an innovative collaborative process. For the first time, WHO is calling on experts and users to participate in the review process on an online platform. This will allow the development of a classification based on user inputs and tailored to their needs.

Who uses the ICD?

Users include doctors, nurses, other health care providers, academic researchers, health information managers and coders, health information technology workers, policy makers, insurance companies, and patient organizations.

All Member States use the ICD, which has been translated into 43 languages. Most countries (117) use this system to report mortality, the main indicator of health status.

All Member States are expected to use the latest version of the ICD for reporting mortality and morbidity statistics (in accordance with the WHO Rules of Nomenclature adopted by the World Health Assembly in 1967).

Why is the ICD so important?

The ICD is of great importance because it provides mutual language for disease reporting and monitoring. It allows data to be collated and shared around the world in a consistent and standardized way – across hospitals, regions and countries, and over specific time periods. It simplifies the collection and storage of information for analysis and evidence-based decision making.

Why is the ICD under revision?

The ICD is being revised to better reflect scientific progress in health care and medical practice. In line with advances in the field information technology, ICD-11 will be usable in e-health devices and information systems.

What are the features of this revision process?

• The ICD-11 revision process allows web-based collaborative editing with the participation of all stakeholders. To ensure quality, incoming information will be reviewed for accuracy and relevance.
• The revision will be free to download online for personal use (and available for a fee in hard copy).
• Information on the revision process will be available in multiple languages.
• Definitions, signs and symptoms, and other content related to diseases will be defined in a structured way to record them more accurately.
• The revision is compatible with eHealth devices and information systems.

How can I participate in the ICD-11 revision?

Experts and stakeholders are invited to provide their comments and suggestions, and to participate in field testing of the revised classification. Participants will have the opportunity to make structured contributions, which will be peer-reviewed by experts in the field. WHO welcomes the active participation of scientific researchers, health information system managers, health care providers and others with an interest in the classification.

Guidance on how to participate in the review process is available on the online review platform.

Why is my contribution important?

Because different perspectives on health care and knowledge coming from every corner of the world will contribute to the creation of a better classification that takes into account the needs of users. Multiple inputs will improve the consistency, comparability and usefulness of the classification.

General Process lead to a global consensus on the definition and reporting of diseases and health-related problems. This is an opportunity to take part in international cooperation which will ensure more consistent and systematic collection of health information.

Where to begin?

To get started, register for member counting on the web portal. The web portal will be open for comments over the next three years and the adopted changes will be published immediately.

After registering, you will be able to do the following:

• comment on the structure and content of the classification and its implementation;
• make proposals for changing the ICD categories;
• offer definitions of diseases;
• participate in field testing;
• contribute to the translation into different languages.

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On Monday, the World Health Organization published the eleventh edition of the International Classification of Diseases (ICD-11). It included 55 thousand diseases, injuries and disorders, including gambling addiction. There was also a section of traditional medicine.

The International Classification of Diseases (ICD) is now used in more than 100 countries and has been translated into 43 languages. It allows data to be collated and shared around the world in a consistent and standardized way - across hospitals, regions and countries, and over specific time periods. This is convenient for collecting statistics on mortality and morbidity of the population, as well as for analyzing the prevalence of various diseases. latest version The ICD was adopted 27 years ago, in 1990. Now WHO has presented a new, eleventh edition, which has been in the works for more than a decade.

The new version of the ICD became fully electronic for the first time. More than one and a half thousand specialists were involved in its creation. Now the ICD-11 consists of 26 sections, which included a chapter on traditional medicine due to its wide distribution. In addition, there is a chapter on sexual health, which brings together illnesses and disorders that in the past belonged to other categories (for example, gender dysphoria was previously defined as a mental disorder) or described differently. The list of addiction-related disorders included gambling addiction - a pattern of persistent or repetitive behavior when playing online or offline games, which is accompanied by a violation of the control over the game (frequency, duration, and so on), the displacement of other hobbies and daily activities into the background , as well as the need to continue to play (including on the rise), despite the appearance of negative consequences. The disorder can be diagnosed if the individual's behavior entails disturbances in personal, family, social and other areas and has been observed for at least 12 months.

In addition, how the disease began to be defined and a dangerous passion for games (hazardous gaming). It is described as gambling, online or offline, that greatly increases the risk of harmful physical or mental consequences to the person or others. . It was included in the class of factors affecting the state of health of the population and appeals to health care institutions.

According to Vladimir Poznyak, member of the WHO department who proposed the new diagnosis, the organization is trying to follow the trends and innovations that occur both in society and in the professional environment. In his opinion, the inclusion of a gaming disorder in the list of diseases means that medical professionals and systems will be more “aware of the existence of this condition”, and at the same time increases the likelihood that “people who suffer from this disorder can receive appropriate help” .

The ICD-11 will be presented to the World Health Assembly in May 2019 for endorsement by WHO Member States. By virtue of new classification will come into effect on January 1, 2022.

What WHO intends to include gambling addiction to the list of disorders, back in December 2017. Then the initiative caused a double attitude on the part of experts. While some studies point to positive effects, such as cognitive ability in the elderly, others point to negative effects, such as college students' suicidal tendencies.

Kristina Ulasovich

“ICD is a product that WHO is rightly proud of,” said the WHO Director-General

Dr. Tedros Adhanom Ghebreyesus. “It enables us to understand the many reasons why people get sick and die, and to take action to prevent suffering and save lives.”

The ICD-11, which has been in preparation for over ten years, differs from previous versions in a number of important improvements. It is the first time it has been published in fully electronic form and has a much more reader-friendly format. In addition, an unprecedented number of health workers participated in the joint meetings and put forward their proposals as inputs. The ICD Group at WHO Headquarters has received over 10,000 proposals for changes to the Classification.

The ICD-11 will be submitted for adoption by Member States at the World Health Assembly in May 2019 and will enter into force on 1 January 2022. This release is preliminary and exploratory in nature and will allow countries to develop plans for the use new version, prepare its translations and conduct nationwide training for health professionals.

The ICD is also used by health insurance companies, which determine compensation payments based on the ICD codes; national health program managers; data collectors; and everyone who monitors trends in global health and makes decisions about the allocation of resources in this area.

The new ICD-11 reflects the progress in medicine and the achievements of scientific thought. For example, antimicrobial resistance codes are now more in line with the Global Antimicrobial Resistance Surveillance System (GLASS) criteria. ICD-11 also makes it possible to more effectively record health safety data and, accordingly, to identify and prevent undesirable events that may be harmful to health, such as unsafe practices in hospitals.

AT new ICD also included new chapters, in particular on folk (traditional) medicine: although the methods of traditional medicine are used by millions of people around the world, it has not yet been included in this classification system. Another one new chapter The sexual health section includes disorders that were previously categorized differently (e.g., gender incongruity was listed under the category of mental disorders) or described differently. Gaming disorder has been added to the Addictive Disorders section.

“A key principle of this revision was to simplify the structure of codes and electronic instruments so that health professionals can more easily and comprehensively record different diseases,” said Dr Robert Jakob, Team Leader, WHO Classifications, Terminology and Standards .

According to Dr. Lubna A. Al-Ansary, assistant Director General on metrics and statistical measurements, "The ICD is the cornerstone of health information, and ICD-11 will provide an updated look at the typology of diseases."

Center for Primary Immunodeficiencies in Adults

Primary immunodeficiencies (PID) are genetically determined diseases that lead to disruption of one or more parts of the immune system. Despite the fact that these diseases are associated with the "breakdown" of genes, not all of them manifest themselves from childhood. There are forms of primary immunodeficiency, the debut of which occurs at the age of over 18 years.

The immune system is involved in the implementation of the work of many organs and systems, so the symptoms of PID are diverse. For adults, the most common manifestations are recurrent severe infections of the upper and lower respiratory tract, abscesses of the skin and internal organs, persistent diarrhea, especially with weight loss, an increase in the size of lymphoid organs (lymph nodes and spleen), etc. Due to the low awareness of both patients and doctors about this pathology, the diagnosis is established with a great delay, when complications lead to irreversible changes in organs, reducing the quality and life expectancy of patients. While timely diagnosis and adequate therapy allows you to have a good quality of life, maintain working capacity and have healthy offspring.

PID is not AIDS, this disease is a birth defect and is not dangerous to others.

When should you consider having a PID? If you or your relative has 2 or more of the warning signs of PID, you should contact an immunologist to rule out this disease.

Warning signs of PID in adults:

• 1. Two or more otitis media per year
• 2. Two or more sinusitis per year
• 3. Two pneumonias in 1 year or 1 pneumonia for 2 or more consecutive years
• 4. Chronic diarrhea with weight loss
• 5. Recurrent viral infections(herpes, shingles, warts, warts)
• 6. The need for repeated courses of parenteral antibiotics to achieve infection control
• 7. Antibiotic therapy for 2 or more months with insufficient effect
• 8. Recurrent deep abscesses of the skin and internal organs
• 9. Persistent fungal infection of the skin and mucous membranes
• 10. Infection normally caused by non-pathogenic mycobacteria
• 11. Two or more episodes of severe generalized infection (meningitis, sepsis)
• 12. The presence of PID in relatives

For all general epidemiological purposes and many public health management purposes. They include an analysis of the general health situation of population groups, as well as a calculation of the frequency and prevalence of diseases and other health problems in their relationship with various factors.

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ICD revisions

Periodic revisions of the ICD, beginning with the Sixth Revision in 1948, have been coordinated by the World Health Organization. As the use of the classification expanded, there was a natural desire among its users to participate in the revision process. The tenth revision is the result of a huge international activities, cooperation and compromise.

The history of the creation and development of the ICD

Francois Bossier de Lacroix.

For the first time, Francois Bossier de Lacroix (1706-1767), better known as Sauvage (fr. Sauvages), made an attempt to arrange diseases systematically. Sauvage's work was published under the title "Methodology of Nosology" (Nosologia Methodica).

The first International Statistical Congress, held in Brussels in 1853, asked Dr. Farr and Dr. Marc d'Espine of Geneva to prepare a uniform classification of causes of death applicable internationally. At the Second Congress, held in Paris in 1855, Farr and d'Espin presented two separate lists based on very different principles. Farr's classification consisted of five groups: epidemic diseases, organic (systemic) diseases, diseases subdivided according to anatomical localization, developmental diseases, and diseases that are a direct consequence of violence. D'Espin grouped diseases according to the nature of their manifestation (gouty, herpetic, hematic, etc.). Congress adopted a compromise list of 139 headings. In 1864, this classification was revised in Paris on the basis of the model proposed by W. Farr. The next revisions took place in , and 1886.

The classification prepared by Bertillon was based on the classification of causes of death used in Paris, which, after its revision in 1885, was a synthesis of English, German and Swiss versions. This classification was based on the principle adopted by Farr, which consisted in the division of diseases into systemic and related to a specific organ or anatomical localization.

ICD-5

International Conference on the Fifth Revision international list causes of death, was convened by the French government and held in Paris in October 1938.

• a detailed list of 200 headings;
• a short list of 44 headings;
• an intermediate list of 87 headings.

ICD-6

The International Conference on the Sixth Revision of the International Lists of Diseases and Causes of Death was organized by the Government of France and held again in Paris from 26 to 30 April 1948.

• International classification with a full list of rubrics included;
• Classification rules;
• Form of medical certificate of cause of death;
• Special lists for statistical developments.

The "Guide to the International Statistical Classification of Diseases, Injuries and Causes of Death" was published. "Manual of the International Classification of Diseases, Injuries, and Causes of Death") in two volumes. The second volume contained alphabetical diagnostic terms coded under the appropriate headings.

ICD-7

The International Conference on the Seventh Revision of the International Classification of Diseases was held in February 1955. In this revision, the necessary changes were made, inconsistencies were eliminated and errors were corrected.

ICD-8

The International Conference on the Eighth Revision was held July 6-12, 1965. This revision was more radical than the seventh, but the basic structure of the classification remained intact.

ICD-9

International Conference on the Ninth Revision of the International Classification of Diseases, Injuries and Causes of Death was held World Organization Health in Geneva from 30 September to 6 October 1975. During the conference, it was decided to make the smallest changes, with the exception of those related to updating the classification, mainly due to the possible costs that would be required for adaptation automated systems data processing (ASOD) .

The Ninth Revision retained the basic structure of the International Classification of Diseases, and added many of the level details of the optional five-character subcategories and four-character subcategories. A system of "asterisks" (*) and "crosses" (†) has also been introduced, which is used as an optional alternative method for classifying diagnostic statements (to indicate information both about the underlying disease and its manifestations in areas of the body or specific organs) . This system is retained in the next, Tenth revision.

ICD-11

Since 2012, WHO experts have been working to revise the classifier so that it better reflects progress in the field of medical sciences and medical practice. Experts and interested parties are invited to participate in the preparation of the ICD by making comments or suggestions on the classifier through the online platform, and later by participating in the translation into national languages. For each nosological form, the etiology, symptoms, diagnostic criteria, impact on everyday life and pregnancy, as well as principles of treatment. The preparatory version (version for submission to the assembly and translation into national languages) was officially released on June 18, 2018. The ICD-11 was presented at the 144th Executive Council meeting in January 2019 and will be submitted for approval by the World Health Assembly (WHA) in May 2019. The classification will come into force on January 1, 2022 in the participating countries.

The ICD-11 includes new chapters, in particular on traditional medicine, and the chapter on sexual health combines disorders that were previously classified in other classes (for example, transsexualism was included in the category of mental disorders, and now under the name "gender mismatch" is included into a separate category of "conditions related to sexual health"). In addition to gender inconsistency, this category includes sexual dysfunctions, sexual pain disorders, and “etiological explanations” (to indicate the cause of a sexual disorder, such as surgery or radiotherapy ( HA40.0 HA40.0), psychoactive substance or drug ( HA40.2 HA40.2), lack of knowledge or experience ( HA40.3 HA40.3) etc.). Paraphilias do not belong to this category and are still coded in the group of mental disorders ( 6D30 6D30- 6D3Z 6D3Z ). A new addictive disorder has emerged - gaming disorder ( 6C51 6C51) describing a pathological addiction to computer games.

In the eleventh revision, the coding system was also changed, its structure was simplified along with electronic tools.

Basic structure and principles of the ICD-10 classification

The basis of the ICD-10 classification is a three-digit code that serves as a mandatory level of coding for mortality data that individual countries provide to WHO, as well as for major international comparisons. AT Russian Federation The ICD has another specific purpose. The legislation of the Russian Federation (namely, the Law of the Russian Federation on Psychiatric Care, the Law of the Russian Federation on Expert Activities) establishes the mandatory use of the current version of the ICD in clinical psychiatry and during forensic psychiatric examinations.

The structure of the ICD-10 is based on the classification proposed by William Farr. His scheme was that, for all practical and epidemiological purposes, disease statistics should be grouped as follows:

• epidemic diseases;
• constitutional or general diseases;
• local diseases grouped by anatomical localization;
• developmental diseases;

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ICD-10 consists of three volumes:

• volume 1 contains the main classification;
• volume 2 contains instructions for use for users of the ICD;
• Volume 3 is an Alphabetical Index to the Classification.

Volume 1 also contains the section "Morphology of neoplasms", special lists for summary statistical developments, definitions, nomenclature rules.

Classes

The classification is divided into 22 classes. The first character of a code in the ICD is a letter, and each letter corresponds to a particular class, with the exception of the letter D, which is used in class II "Neoplasms" and in class III "Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism", and the letter H , which is used in class VII "Diseases of the eye and adnexa" and in class VIII "Diseases of the ear and mastoid". Four classes (I, II, XIX and XX) use more than one letter in the first character of their codes.

In Class II, the first axis is the nature of the neoplasms by site, although several three-character rubrics are for important morphological types of neoplasms (eg, leukemias, lymphomas, melanomas, mesotheliomas, Kaposi's sarcoma). The rubric range is given in brackets after each block title.

Three-character rubrics

Within each block, some of the three-character rubrics are for only one disease selected because of its frequency, severity, susceptibility to health services, while other three-character rubrics are for groups of diseases with some general characteristics. The block usually has rubrics for "other" conditions, making it possible to classify big number various but rare conditions, as well as "unspecified" conditions.

Four-character subcategories

Most three-digit rubrics are subdivided with a fourth digit after the decimal point, so that up to 10 more subcategories can be used. If a three-character rubric is not subdivided, it is recommended to use the letter “ ” to fill in the space for the fourth character so that the codes have a standard size for statistical processing.

Responsible for compiling and editing: Corresponding Member of the Russian Academy of Medical Sciences Professor V. K. Ovcharov, Ph.D. honey. Sciences M. V. Maksimova.

Clinical modification

Clinical modification of ICD-10 (ICD-10-KM)(English) ICD-10-CM - Clinical Modification) is the version of ICD-10 used for statistical purposes in the United States of America. Provided by the Center for Medicare and Medicaid Services (English)Russian(CMS; part of the U.S. Department of Health and Human Services responsible for the implementation of programs for the provision of preferential and free medical services to citizens) and the National Center for Health Statistics (NCHS) (English)