ICD-11

ICD-11
Name	International Classification of Diseases, 11th Revision
Publisher	World Health Organization
Released	2018 (approved), 2019 (effective 2022)
Languages	Multilingual
Subject	Medical classification

ICD-11 is the eleventh revision of the International Classification of Diseases family produced by the World Health Organization. It serves as a global diagnostic tool for morbidity and mortality reporting used by member states including United States, United Kingdom, China, India, Brazil, South Africa, Germany, France, Japan, Canada, and Australia. The revision process involved collaborations with institutions such as Centers for Disease Control and Prevention, National Institutes of Health, European Commission, Gavi, the Vaccine Alliance, Médecins Sans Frontières, and academic partners like Harvard University, University of Oxford, University of Cambridge, and Johns Hopkins University.

History and development

The development originated after the approval by the World Health Assembly following precedents set by earlier editions used during eras marked by events like the Spanish flu and the aftermath of World War II. Working groups included experts from Pan American Health Organization, European Centre for Disease Prevention and Control, African Union, Bill & Melinda Gates Foundation, Wellcome Trust, United Nations Children's Fund, World Bank, and national agencies such as Public Health England and the Chinese Center for Disease Control and Prevention. Technical contributors came from medical schools including Mayo Clinic, Cleveland Clinic, Karolinska Institutet, University of Toronto, University of Melbourne, and research consortia linked to projects like the Human Genome Project and initiatives influenced by reports from the Institute of Medicine. Public consultations paralleled processes used in Paris Climate Agreement negotiations and treaty drafting such as the Geneva Conventions.

Structure and content

ICD-11 presents a hierarchical taxonomy with chapters analogous to classification schemes used by institutions like Library of Congress and taxonomies referenced in projects from European Space Agency and National Aeronautics and Space Administration. Its electronic architecture employs ontologies and standards from organizations such as International Organization for Standardization, Health Level Seven International, and data models familiar to users of Google, Microsoft, Amazon Web Services, and IBM. Chapters cover domains comparable to systems studied at Massachusetts Institute of Technology, Stanford University, Imperial College London, and clinical divisions at Mount Sinai Health System, UCLA Health, Karolinska University Hospital. The layerable content includes definitions, diagnostic criteria, clinical descriptions, and code sets used by agencies like Eurostat and surveillance programs run by World Meteorological Organization for environmental health intersections.

Implementation and adoption

Member states coordinated rollouts through ministries associated with national registries in Italy, Spain, Netherlands, Sweden, Norway, Denmark, Finland, and federated systems in Russia and Brazil. Training efforts drew on curricula from World Bank health systems strengthening projects and capacity building similar to programs by United Nations Development Programme and Asian Development Bank. Health information systems integrated ICD-11 via vendors including Cerner Corporation, Epic Systems Corporation, Siemens Healthineers, and regional e-health platforms in New Zealand and Singapore. Adoption timelines mirrored policy cycles seen in legislation such as the Affordable Care Act implementation phases and harmonization efforts like the General Data Protection Regulation.

Key changes from ICD-10

Major revisions echo methodological shifts seen in reports from Royal Society and commissions like the Lancet Commission on global health. Changes include new chapters and regroupings informed by research from World Psychiatric Association, International Association for the Study of Pain, American Psychiatric Association, European Respiratory Society, and disease definitions refined through consortia such as Global Burden of Disease and studies at Fred Hutchinson Cancer Research Center. The digital-ready format and code expansion provided compatibility with nomenclatures like SNOMED CT used by International Health Terminology Standards Development Organisation. Revisions reflect surveillance priorities comparable to those in responses to Ebola virus epidemic, Zika virus outbreak, and the COVID-19 pandemic.

Criticisms and controversies

Debates around content and governance involved stakeholders comparable to disputes in organizations like Human Rights Watch and Amnesty International and provoked commentary in outlets referencing cases from European Court of Human Rights and policy forums such as World Economic Forum. Critics invoked concerns similar to those raised about pharmaceutical influence in settings involving companies like Pfizer, GlaxoSmithKline, Roche, Novartis, and transparency issues analogous to controversies at International Agency for Research on Cancer. Disputes also mirrored past debates over classification seen in legal contexts like Brown v. Board of Education-era policy changes and standards-setting controversies such as those around FIFA governance.

Use in research, clinical practice, and health policy

Researchers at institutions including National Cancer Institute, Centers for Medicare & Medicaid Services, European Medicines Agency, and studies funded by National Science Foundation use the classification for epidemiology, clinical trials, and health economics. Clinical implementation guides were developed with professional societies like American Medical Association, Royal College of Physicians, American College of Cardiology, American Psychiatric Association, International Council of Nurses, and specialist organizations such as American Academy of Pediatrics. Health policy analysis employing ICD-11 supports ministries referenced in bilateral collaborations with USAID, multilateral programs of UNESCO, and monitoring by Organisation for Economic Co-operation and Development. The system underpins reporting used in global initiatives including Sustainable Development Goals and resource allocation influenced by financiers like International Monetary Fund and Global Fund to Fight AIDS, Tuberculosis and Malaria.

Category:Medical classification systems