ICD-11 Alpha Draft scheduled to launch in May

[Dx Revision Watch]

WHO announces revised ICD Revision Timelines (18 May 2011)

18 May 2011

[Note: This information does not apply to the forthcoming US specific Clinical Modification of ICD-10, called ICD-10-CM, which is scheduled for implementation in October 2013.]

The following has just been published on the WHO's website. Note that the original timeline had scheduled presentation to the World Health Assembly in May 2014 for pilot implementation in 2014. This most recent timeline for ICD-11 Revision suggests that implementation is being postponed until 2015.

I'll post further information on viewing the drafting platform as it becomes available. The last time the drafting platorm was in the public domain was November 2010.


http://www.who.int/classifications/icd/revision/timeline/en/

ICD Revision Timelines

May 2011

Open ICD-11 Alpha Browser to the public for viewing

July 2011

Open ICD-11 Alpha Browser to the public for commenting

May 2012

Open ICD-11 Beta to the public

ICD-11 Beta Information

WHO will engage with individuals from an outside community to participate in the ICD revision process.

Individuals will be allowed to:

• Make comments
• Make proposals to change ICD categories
• Participate in field trials
• Assist in translating
• May 2015
• Present the ICD-11 to the World Health Assembly

-------------------------------

Screenshots from the drafting platform, as it had stood between June and November, last year, can be seen in this post:

http://forums.phoenixrising.me/show...E.-Association&p=167301&viewfull=1#post167301

A brief summary of the proposals for the classification of PVFS, (B)ME and CFS as they stood in June-November, last year:

"Gj92* Chronic fatigue syndrome" is proposed as a Chapter 6 Diseases of the nervous system ICD Title term with a Definition and other "Content Model" parameters;

* "Gj92" is a "Sorting code" and not the ICD-11 code.


in the "Terms" Tab for Gj92 Chronic fatigue syndrome, "Benign myalgic encephalomyelitis" is listed as an Inclusion to "Gj92 Chronic fatigue syndrome".


in the Chapter 5 "Details" for F48.0 Neurasthenia

postviral fatigue syndrome is specified as an Exclusion to F48.0 Neurasthenia with the Reference

"G93.3 -> Gj92 Chronic fatigue syndrome"


in the Chapter 18 "Details" for R53 Malaise and Fatigue

fatigue syndrome postviral [sic] is specified as an Exclusion to R53 Malaise and Fatigue with the Reference

G93.3 -> Gj92 Chronic fatigue syndrome​

Suzy Chapman
_____________________

me.agenda@virgin.net
http://dxrevisionwatch.wordpress.com
http://meagenda.wordpress.com
http://www.facebook.com/MEagenda
http://twitter.com/MEagenda

 

[Enid]

Great work Suzy and all involved in the modifications for WHO. (the real thing now)

 

[Dx Revision Watch]

Great work Suzy and all involved in the modifications for WHO. (the real thing now)

Just to clarify, I have been closely monitoring the development of ICD-11 since early 2009, but I have had no involvement in any proposals for the drafting of ICD-11 nor have I had any discussions with WHO, ICD Revision Steering Group, Topic Advisory Group Managers, or external peer reviewers over specific content for ICD-11 or proposals for changes to ICD-10 categories.

The contact I have had with several ICD Revision and WHO personnel, since 2009, has been of a purely general nature around the overall development process or where specific clarifications have been requested in respect of draft proposals as they had stood, in the iCAT drafting platform, last June to November.

So when the latest release of the ICD-11 drafting platform is publicly available, later this month, however it now stands, I'd like to make it clear that I have had no input.

To date, there has been no process through which public input into the Alpha Draft might be made, other than via the "ICD Update and Revision Platform intranet" which has been open since 2007:

https://extranet.who.int/icdrevision/nr/login.aspx?ReturnUrl=/icdrevision/default.aspx


In September 2009, I raised several queries with the WHO's Dr Robert Jakob around the functioning of the iCAT drafting platform, which included whether the names and affiliations of those acting as independent peer reviewers to the various Topic Advisory Groups, and the external sources from whom input/opinion might otherwise be being sought, would be identified via the iCAT to viewers outside the ICD revision process.

I also asked whether COI disclosures would be required of external reviewers; whether the progress of proposals through the drafting Workflow would be transparent to viewers of the drafting platform beyond WHO, ICD Revision and IT personnel. These queries received no acknowledgement from Dr Jakob and a response has been left hanging.

It is understood that some professional bodies have been preparing submissions of proposals to various chapters of ICD but there is no information on any of the ICD Revision platforms about through what means professional bodies are invited to submit, which bodies/organizations/institutions may already have submitted, or whether their submissions are going to be collated and made publicly available by ICD Revision.

As soon as I have information about accessing the Alpha drafting platform (or in whatever form ICD Revision intends to present an Alpha draft) I'll update. At the moment, the drafting platform is sitting on a Stanford server, behind a password, since the earlier version was taken out of the public domain, last November.

If you are interested in the projected drafting process once the Alpha is released and through what means public interaction and input might be facilitated, see this post on my site, where I have slides from some recent PowerPoint presentations:

ICD Revision Process Alpha Evaluation Meeting documents and PowerPoint slide presentations, April 19, 2011:
http://wp.me/pKrrB-10i

Suzy

 

[Dx Revision Watch]

ICD-11 Alpha Drafting platform launched 17 May (public version) Part One

May be republished if source acknowledged

From Suzy Chapman for http://dxrevisionwatch.wordpress.com

18 May 2011

The information in this report relates only to ICD-11, the forthcoming revision of ICD-10 that is scheduled for completion and pilot implementation in 2015. It does not apply to the forthcoming US specific Clinical Modification of ICD-10, known as ICD-10-CM.


ICD-11 Alpha Drafting platform launched 17 May (public version)

A number of new pages were published on the WHO's main website, on 17 May. Yesterday, I posted the revised ICD-11 Revision Timeline. For completeness, I'm appended the Timeline to this report.


What can be seen for PVFS, (B)ME and CFS in the public Alpha Draft?

For the Alpha browser, go to this page:

http://www.who.int/classifications/icd/revision/en/index.html

Here it states that:

"The International Classification of Diseases 11th Revision is due by 2015"

"ICD is the international standard to measure health & health services

Mortality statistics
Morbidity statistics
Health care costs
Progress towards the Millenium Development Goals
Research


Alpha draft is updated daily as the work progresses
It is intended to show the new features to stakeholders early
Commenting will be available in July 2011"


The link for the alpha browser is:

http://apps.who.int/classifications/icd11/browse/f/en


There is also a link to a page called "Caveats"

"Read more on what to expect in the ICD-11 Alpha Draft"

http://www.who.int/classifications/icd/revision/caveat/en/index.html


ICD-11 Alpha Draft Caveats

ICD-11 alpha draft is:

• Incomplete
• May contain errors, omissions or imperfections
• The work in different chapters are at different stages

• The alpha drafting work is going on by the WHO, Revision Steering Group and Topic Advisory Groups
• The alpha draft is going to be updated on a daily basis

• The alpha draft is NOT TO BE USED for CODING at this stage
• The alpha draft has not yet been approved by the Topic Advisory Groups, Revision Steering Group or WHO

------------------------

Click here to access the public Alpha Draft browser. Poke around and open the Parent and Child categories and Tabs - you can't break anything.

http://apps.who.int/classifications/icd11/browse/f/en


Note this new platform is not as detailed or as easy to navigate as the version of the iCAT drafting platform that was in the public domain until November, last year. No windows for category "Details" and other "Content Model" parameters like "Definitions" and "Terms" appear to be viewable (compare with what can be seen in this screenshot, from last June: http://dxrevisionwatch.files.wordpress.com/2010/05/2icatgj92cfsdef.png ).

Though viewable now, the Alpha drafting browser is not planned to be open for public comment until July, this year. It's not yet clear which classes of public stakeholder will be able to participate in the drafting process at this stage or the extent of participation. ICD Revision has not reached its targets for the generation of content and the population of "Content Model" fields across all chapters and this draft is not as far forward as they had planned. Also, this is a public draft. It's understood that a different platform is being used by ICD Revision for ongoing drafting and that the public draft will be updated as work progresses.

If you are interested in the proposed public comment and input processes for Alpha and Beta stages, see this post on Dx Revision Watch for meeting presentation slides: http://wp.me/pKrrB-10i


In Part Two, I will post what can be seen, today.

Summary:

Caveat: This public version of the Alpha drafting platform is a "work in progress" and not all categories may have been entered into the draft and content is incomplete.

From what can be seen, today, "06N00 Chronic fatigue syndrome" is proposed to be coded within Chapter 6 Diseases of the nervous system, as an ICD Title category, under the Parent, "06N Other disorders of the nervous system".

"Benign myalgic encephalomyelitis" is specified as an Inclusion to "06N00 Chronic fatigue syndrome".

"Causal mechanisms" for "06N00 Chronic fatigue syndrome" is cited as "Virus (organism)". The relationship between category Title "Chronic fatigue syndrome" and Inclusion term "Benign myalgic encephalomyelitis" is not yet specified, ie whether for ICD-11 "Benign myalgic encephalomyelitis" is proposed to be specified as a "Synonym", "Subclass" or other relationship to "Chronic fatigue syndrome".

Many categories within the draft are still waiting for their Inclusion terms to be specified, not just the three terms of interest to us.

See: iCAT Glossary: http://apps.who.int/classifications/apps/icd/icatfiles/iCAT_Glossary.html

6 Inclusions

Details: Inclusion terms appear in the tabular list of the traditional print version and show users that entities are included in the relevant concept. All of the ICD-10 inclusion terms have been imported and accessible in the iCat. These are either synonyms of the category titles or subclasses which are not represented in the classification hierarchy. Since we have synonyms as a separate entity in our ICD-11 content model, the new synonyms suggested by the users should go into the synonyms section. In the future, iCat will provide a mechanism to identify whether an inclusion is a synonym or a subclass.​

"Postviral fatigue syndrome" is not accounted for in the "Foundations" or "Linearizations > Morbidity" listings.

I cannot confirm, but it may be that "Postviral fatigue syndrome" is intended to be subsumed under "06N00 Chronic fatigue syndrome" with "06N00 Chronic fatigue syndrome" becoming the ICD Title category, since PVFS has lost its ICD-10 [G93] Parent category.

But there is not enough information to determine what the intention is at the moment. I requested clarification last June, from the Chair of Topic Advisory Group for Neurology but Dr Raad Shakir has not provided a clarification.

In the iCAT, last November, "Postviral fatigue syndrome" where refered to within "Category Notes" and Exclusions was referenced as "G93.3 Postviral fatigue syndrome -> Gj92 Chronic fatigue syndrome".

["Gj92" was a "Sorting label" not the eventual ICD-11 code.]


Exclusions

No Exclusions have been specified yet for "06N00 Chronic fatigue syndrome".

"Postviral fatigue syndrome" is specified as an Exclusion to the following ICD-11 chapters:

Chapter 5 "05E06 Other neurotic disorders > 05E06.00 Neurasthenia"
Chapter 18 "18GF General symptoms and signs > 18F03 Malaise and fatigue."

(Chapter 18 is the "R code" chapter where ICD-10-CM proposes to retain CFS as "Chronic fatigue syndrome NOS".)


Proposed congruency with DSM-5 proposals

There is no obvious mirroring of the radical proposals currently being put forward by the DSM-5 Somatic Symptom Disorders Work Group to rename "Somatoform Disorders" to "Somatic Symptom Disorders" and combine a number of existing somatoform categories under a new rubric, "Complex Somatic Symptom Disorder".

------------------------

I shall post the sources in Part Two, in the next post.

Suzy Chapman

 

[Dx Revision Watch]

ICD-11 Alpha Drafting platform launched 17 May Part Two

May be republished if source acknowledged

Sources: ICD-11 Alpha Draft at May 17 - 11:02 UTC:

ICD11 Alpha : Morbidity
May 17 - 11:02 UTC

Chapter 6

http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_VI


Linearizations:

06 Diseases of the nervous system

06N Other disorders of the nervous system

06N00 Chronic fatigue syndrome
06N01 Disorders of the spinal cord​

07 Diseases of the eye and adnexa


http://apps.who.int/classifications/icd11/browse/f/en#/@_@who_3_int_1_icd_2_G93_3_3


Highlight "Chronic fatigue syndrome"

Click on "Foundation" Tab:

Chronic fatigue syndrome

Parent(s)

Other disorders of the nervous system


Inclusions

• Benign myalgic encephalomyelitis

Body Site

• Entire brain (body structure)

• Brain structure (body structure)

Causal Mechanisms

• Virus (organism)

http://who.int/icd#G93.3 [Ed: this link to the ICD-10 legacy code reverts to the wrong page]


Ed: "Change history" note from May 2010:

In ICD-10, "Postviral fatigue syndrome" is a Title code at G93.3 under Parent "G93 Other disorders of brain". "Benign myalgic encephalomyelitis" sat under the "G93.3 Postviral fatigue syndrome" (relationship unspecified).

As previously reported, an iCAT "Change history" note dated 1 May 2010 records a "Change in hierarchy for class: G93.3 Postviral fatigue syndrome because its parent category (G93 Other disorders of brain) is removed."

This would leaves the existing ICD-10 G93.3 Title category, "Postviral fatigue syndrome" and "Benign myalgic encephalomyelitis" that sits beneath, and also the G93.3 index entry for chronic fatigue syndrome with no Parent category.

Note that the removal of the parent "G93 Other disorders of brain" affects many other categories also classified under G93 in ICD-10, which have also been assigned new parents under the reorganization of Chapter 6 (VI).




Screenshot of "Change history" Note from May 2010

Ed: In the iCAT draft of November 2010 (in which CFS had been assigned the "Sorting label" "Gj92) and this current draft, "06N00 Chronic fatigue syndrome" has been assigned the Parent code "06N Other disorders of the nervous system", with "Benign myalgic encephalomyelitis" specified as an Inclusion to "06N00 Chronic fatigue syndrome" (relationship not yet specified).

------------------------

Turning to Chapter 5 (the Mental and behavioural disorders chapter) and the F codes:

http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_F99-F99

http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_F45

05E Neurotic, stress-related and somatoform disorders


Somatoform Disorders [Ed: All clickable links on the site, which open subpages for disorder descriptions]

05E05 Somatoform disorders

05E05.00 Somatization disorder
05E05.01 Undifferentiated somatoform disorder
05E05.02 Hypochondriacal disorder
05E05.03 Somatoform autonomic dysfunction
05E05.04 Persistent somatoform pain disorder
05E05.04.00 Persistent somatoform pain disorder
05E05.04.01 Chronic pain disorder with somatic and psycological factors​

05E05.05 Other somatoform disorders
05E05.06 Somatoform disorder, unspecified​

05E06 Other neurotic disorders

05E06.00 Neurasthenia
05E06.01 Depersonalization-derealization syndrome
05E06.02 Other specified neurotic disorders
05E06.03 Neurotic disorder, unspecified​

http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_F48_3_0

05E06 Other neurotic disorders

05E06.00 Neurasthenia


Click on "Foundation" Tab:

Neurasthenia

Parent(s)

Other neurotic disorders


Inclusions

• Fatigue syndrome

Exclusions

• psychasthenia

• postviral fatigue syndrome

• malaise and fatigue

• asthenia NOS

• burn-out

------------------------

Turning now to Chapter 18 "Symptoms, signs and ill-defined conditions":

http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_R53


18GF General symptoms and signs

18F03 Malaise and fatigue


Click on "Foundation" Tab:

Malaise and fatigue

Parent(s)

• General symptoms and signs

Definition
Malais [sic] is a loss of physical and mental stamina, rapid muscular and cognitive fatigability, post-exertional fatigue, malaise and/or pain, and a tendency for other symptoms to worsen. Fatigue is the state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli.

Inclusions

• Lethargy

• Tiredness

• General physical deterioration

• Debility: nervous

• Debility: chronic

• Debility: NOS

• Asthenia NOS

Exclusions

• debility: congenital

• exhaustion and fatigue (due to)(in): excessive exertion

• exhaustion and fatigue (due to)(in): combat

• debility: senile

• exhaustion and fatigue (due to)(in): exposure

• exhaustion and fatigue (due to)(in): heat

• exhaustion and fatigue (due to)(in): neurasthenia

• exhaustion and fatigue (due to)(in): pregnancy

• exhaustion and fatigue (due to)(in): senile asthenia

• fatigue syndrome postviral

Signs and Symptoms

• Fatigue (finding)

• Malaise (finding)

------------------------

Registering for involvement

There is a Registration form here:

https://spreadsheets.google.com/spreadsheet/viewform?formkey=dDVabnF1RFpTQkVnVEN2TXhVRm55MGc6MQ

This form appears to be aimed at recruiting health professionals for putting their names down to "Make comments; Make proposals to change ICD categories; Participate in field trials; Assist in translating". I would advise waiting until July when the Alpha is scheduled to be open for public comment to establish what class of public stakeholder is going to be permitted involvement in the drafting process at this Alpha drafting or Alpha drafting/Beta drafting transition stage - at the moment this is unclear.


Register to become involved

ICD-11 Registration

"WHO wants to know if you are interested in being involved in the ICD Revision. We will contact you as certain features are opened to the public."

Fields are: Family name*; First name*; Email address*; Organization or Company*; LinkedIn ID; Are you a health care professional?* Yes/No. Continue...

*Required fields

------------------------


http://www.who.int/classifications/icd/revision/timeline/en/index.html

ICD Revision Timelines

May 2011
Open ICD-11 Alpha Browser to the public for viewing

July 2011
Open ICD-11 Alpha Browser to the public for commenting

May 2012
Open ICD-11 Beta to the public

ICD-11 Beta Information
WHO will engage with individuals from an outside community to participate in the ICD revision process.

Individuals will be allowed to:

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

May 2015
Present the ICD-11 to the World Health Assembly





Suzy Chapman
_____________________

me.agenda@virgin.net
http://dxrevisionwatch.wordpress.com
http://meagenda.wordpress.com
http://www.facebook.com/MEagenda
http://twitter.com/MEagenda

 

[Enid]

Just glad you are monitering - I'd wouldn't have the concentration powers yet to do so.

 

[Dx Revision Watch]

The ICD-11 " Content Mode"l

For more in depth information on the "Content Model", the most recent version of the Content Model document was uploaded to the ICD Revision site on 22 February.

It can be opened here in Word .doc format on Dx Revision Watch site:

http://dxrevisionwatch.files.wordpr...20model20reference20guide20january2020111.doc


ICD -11 Alpha Content Model

[Extract]

What is the Content Model?

Introduction

[...]

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...

...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.

[...]

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

[Extract ends]


Descriptions of each of the 13 parameters of the "Content Model" are set out from Page 8 of this document.


It needs to be understood that in ICD-10 there has been no textual content defining the terms PVFS, (B)ME and Chronic fatigue syndrome in any volume. But for ICD-11, textual content will be populated according to a common "Content Model".

So we will need to monitor not only classifications (and bear in mind the eventual codes in ICD-11 chapters may no longer mirror those of ICD-10 because of extensive reorganization within chapters, or within certain sections of chapters) but also the population of definitions and disorder descriptions, the relationships specified between ICD Title terms and their Inclusion terms; and Exclusions.


If you read on a website or forum or in the comment sections of media aticles, references to the "official WHO definition of ME" - there is no definition in ICD-10 of either PVFS, (B)ME or Chronic fatigue syndrome and neither does ICD-10 specify the relationships between these three terms.

All that can be determined from the ICD-10 Tabular List, is that PVFS and (B)ME are classified in Chapter VI Diseases of the nervous system (the Neurology chapter), under "Other disorders of the nervous system (G90-99)" under the Parent "G93 Other disorders of brain", at G93.3; and in the case of Chronic fatigue syndrome, not included in Volume 1 but indexed to G93.3, in Volume 3 The Alphabetical Index.

For information on what the WHO, in general, and WHO classification experts, in particular, have to say around relationships between terms, see this page on my site, about a third of the way down on Page 1: http://dxrevisionwatch.wordpress.com/icd-11-me-cfs/


Suzy Chapman

 

[Dx Revision Watch]

Change to ICD-11 Alpha draft at: May 19 - 11:02 UTC

The code/Sorting label assigned to Parent class "Other disorders of the nervous system" has just been changed from 06N to 06L:

http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_G90-G99

06L Other disorders of the nervous system

06L00 Chronic fatigue syndrome ​

 

[justinreilly]

The working draft, which as you indicated, was available to the public until Nov. 2010 looks really good... except for Neurasthenia under neurosis, with no exclusion for ME/CFS. As I understand it this diagnosis is still used in Asian countries. The charlatans will continue to use this against us if it stays in. But, overall, as I said, it looks good.

 

[Dx Revision Watch]

The working draft, which as you indicated, was available to the public until Nov. 2010 looks really good... except for Neurasthenia under neurosis, with no exclusion for ME/CFS. As I understand it this diagnosis is still used in Asian countries. The charlatans will continue to use this against us if it stays in. But, overall, as I said, it looks good.

When refering to ICD for any version, ie ICD-10, ICD-11 or any of the "Clinical Modifications" it's potentially confusing to use the dual terms "ME/CFS" or "CFS/ME" because the WHO does not use these terms within ICD.

The only terms used within ICD-10 and ICD-11 are:

Fatigue syndrome (Chapter 5 F48.0)

Postviral fatigue syndrome
Benign myalgic encephalomyelitis
Chronic fatigue syndrome

(and for the forthcoming US specific ICD-10-CM, Chronic fatigue syndrome NOS).



In ICD-10, Neurasthenia and "Fatigue syndrome" are classified under F48.0

http://www.who.int/classifications/apps/icd/icd10online/?gf40.htm+f480

F48 Other neurotic disorders
F48.0 Neurasthenia
Fatigue syndrome


with the Exclusions

asthenia NOS ( R53 )
burn-out ( Z73.0 )
malaise and fatigue ( R53 )
postviral fatigue syndrome ( G93.3 )
psychasthenia ( F48.8 )


In ICD-10, Chronic fatigue syndrome is an Index only term, so one would not expect it to be specified as an Exclusion to a Tabular List chapter because the term is not classified within Volume 1 The Tabular List.

In ICD-10, "Benign myalgic encephalomyelitis" is not the Title category, Postviral fatigue syndrome is the Title category and it is Postviral fatigue syndrome that is specified as the G93.3 Exclusion to Neurasthenia (F48.0).

If you compare the way that Exclusions are dealt with within the forthcoming ICD-10-CM:

in Chapter 18 (the R codes), the Exclusion to R53.82 is given as "postviral fatigue syndrome (G93.3)" only. It is the case that "Benign myalgic encephalomyelitis" is also proposed to be coded to G93.3 under PVFS, but only the G93.3 Title category is specified as the Exclusion, thus:

R53.82 Chronic fatigue, unspecified

Chronic fatigue syndrome NOS
Excludes1: postviral fatigue syndrome (G93.3)




In the drafts for ICD-11

http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_F48_3_0

Neurasthenia continues to be classified under

05E06 Other neurotic disorders

05E06.00 Neurasthenia

with an Inclusion of "Fatigue syndrome"

and an Exclusion of

postviral fatigue syndrome


This is the screenshot from the more detailed iCAT drafting platform that was available until November 2010, showing the Exclusions to Neurasthenia; the codes/labels assigned to Chapter 5 categories have changed since then to:

05E06 Other neurotic disorders
> 05E06.00 Neurasthenia

As you can see, postviral fatigue syndrome is listed as an Exclusion to the F48.0 Neurasthenia code like this:


Label

postviral fatigue syndrome

References

G93.3 -> Gj92 Chronic fatigue syndrome


From what can be seen, it doesn't appear that ICD-11 intends to make (B)ME a Title category to replace PVFS as a Title category but it's not clear what they intend to do with Postviral fatigue syndrome.

For ICD-11, Gj92 Chronic fatigue syndrome (in the latest draft labelled "06L00 Chronic fatigue syndrome") is listed as the ICD-11 Title code and (B)ME is specified as an Inclusion term to 06L00 Chronic fatigue syndrome.

The Details for "Gj92 Chronic fatigue syndrome" don't yet account for the relationship between 06LOO CFS and (as the as yet uncoded/unlabelled) "Postviral fatigue syndrome". (But note that the ICD-10 legacy code "G93.3" is accounted for at the top left of the image below.) [It is grayed out so that it cannot be edited.]

We know that a hierarchy change has been recorded for PVFS and CFS (because the Parent "Other disorders of brain" is being removed from Chapter 6) and that its removal affects many other categories. But it's still not clear in this latest draft what they now intend to do with Postviral fatigue syndrome.

And until the new hierarchical status of Postviral fatigue syndrome becomes explicit within the draft, it is too early, I think, to draw conclusions about which of the three ICD-11 terms would be expected, under ICD classification rules, to be specified as Exclusions to Chapter 5 or Chapter 18 (the R codes chapter).


This is why I wrote to Dr Raad Shakir, last June, for a clarification of the proposed hierarchy between "Postviral fatigue syndrome" and the other two terms.

If CFS is to become the ICD Title code, with (B)ME as an Inclusion term (and eventually specified as a "Synonym" or a "Subclass" or other relationship to CFS) and if PVFS were destined to be subsumed under CFS and is no longer a Title category, per se, then I agree that the Exclusions for Neurasthenia would need to be:

Chronic fatigue syndrome (06L00)

or whatever code is eventually assigned to CFS within the context of the reorganization of Chapter 6. Given the reorganisation that is being proposed within that section of the G codes, and given the removal of Parent category G93 Other disorders of brain, I think it unlikely that the familiar "G90-99" coding structure would be reassigned at the end of the drafting process.

At the moment, the draft shows Postviral fatigue syndrome as the sole Exclusion to Chapter 5 05E06.00Neurasthenia.

But remember - the draft is behind schedule, there are many gaps and thousands of categories to author content for and not all categories may be listed in the "Foundation" and "Linearized > Morbidity" lists. TAG Neurology or TAG Mental Health may not have got round yet to adjusting the Exclusions for Chapter 5 and Chapter 18, to reflect a change of hierarchy for PVFS and CFS. These are just three ICD categories amongst many, many thousands and the various ICD Revision Topic Advisory Groups are working on the revision of 20 odd chapters in addition to their "day jobs".

I would want to see (B)ME specified as an Exclusion, too, to 05E06.00 Neurasthenia and to

Chapter 18 18GF General symptoms and signs > 18F03 Malaise and fatigue.


But if (B)ME (which has also lost its Parent) is an Inclusion term (a Synonym, Subclass or whatever) to CFS, and is not destined to become a Title category in its own right, then one might not anticipate, under ICD taxonomy rules, that (B)ME would be listed as an Exclusion to Chapter 5 and Chapter 18, as it may not be a requirement within ICD taxonomy rules. Given the shenanigans in the UK with the WHO Collaborating Centre et al, there would be a basis for arguing that whatever terms are specified as Inclusions to CFS they should all be listed as Exclusions, in the applicable chapters, but it may not be in accordance with WHO classificatory rules to do so.


I have had some recent contact with the WHO's Dr B stn who is aware that I have been waiting over 9 months for a clarification from Dr Shakir for the proposed hierarchy within ICD-11 between these three terms and I am hoping I can make some headway with this.

It's disappointing that this public platform displays less information than the software being used for the iCAT platform, last year. This might possibly be in order to obscure the fact that this Alpha draft or Alpha/Beta transition draft (and they were supposed to be launching the Beta drafting platform, this May) is behind targets for the population of content and software development, so that it isn't evident, for example, what percentage of categories still lack draft Definitions and some other Content Model parameters because these fields are no longer visible.

The draft is being updated, daily, and I will be checking it every few days for new content/changes. Unhelpfully, there does not appear to be a log of daily edits.


One point I would like to make is that this International version of ICD-11, which will eventually replace ICD-10 in over 100 countries, looks as though it may be proposing to elevate the status of CFS to an ICD-11 Title category within Chapter 6, the Neurological chapter, with currently a question mark over the future status of PVFS within the hierarchy of PVFS, (B)ME and CFS, whereas the US specific ICD-10-CM proposes to retain CFS in the Symptoms, signs and ill-defined dustbin category of the R codes - so the US would be significantly at odds with the rest of the world, as well as Canada, as was discussed on Day One of the recent CFSAC meeting.

A final point: would all readers bear in mind the ICD Revision caveats.

Suzy

 

[insearchof]

Hi Suzy

Thank you for the update.

 

[Dx Revision Watch]

Hi Suzy

Thank you for the update.

You're welcome.

It's disappointing that there is less information displayed (for example, many of the parameter tabs, including Definitions) than was viewable in the platform used for the iCAT initial Alpha drafting platform that was in the public domain between May and November, last year, and from which my earlier screenshots were taken (the blue ones).

ICD Revision hasn't issued a news release launching this draft, either.

Suzy

 

[Dx Revision Watch]

Update on ICD-11 development: July 3, 2011

Update on ICD-11 development: July 3, 2011

Shortlink to Dx Revision Watch site Post #86: http://wp.me/pKrrB-1eb

The information in this mailing relates only to ICD-11, the forthcoming revision of ICD-10 that is scheduled for pilot implementation in 2015. It does not apply to the forthcoming US specific Clinical Modification of ICD-10, known as ICD-10-CM, scheduled for implementation in October 2013, or to Clinical Modifications of ICD-10 already in use.

Screenshot from ICD11 Alpha May 17 11.02 UTC Chapter 6 Diseases of the nervous system: Foundation Tab selected

ICD11 Alpha Chapter 6

http://apps.who.int/classifications/icd11/browse/f/en#/@_@who_3_int_1_icd_2_G93_3_3

Screenshot from ICD11 Alpha May 19 11.02 UTC Chapter 6: Linearizations Tab > Morbidity selected

http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_G93_3_3

Slipping Timeline

In May, I reported that the revision of ICD-10 and development of ICD-11 is running about a year behind targets for the population of content and software development and that the ICD-11 Timeline for Alpha and Beta drafting has been adjusted [1]. In order to meet its revised schedule, the technical work on ICD-11 will need to be completed by 2013, the year the APAs DSM-5 is slated for publication.

Drafting platforms

In November 2010, the iCAT platform through which ICD-11 was being drafted was taken out of the public domain. In May, this year, an ICD-11 Alpha browser was released for public viewing [2], with a number of caveats [3].

This most recently published Alpha platform does not include many of the Content Model parameters, for example, no draft Definitions are included and neither are the Discussion Notes and Change Histories that had been viewable in the iCAT, as it stood last June to November. You can see screenshots of the June to November 2010 version of the iCAT in this post [4].

As youll see, ICD-10 Chapter VI (6) is undergoing reorganization and the parent class G93 Other disorders of brain under which Postviral fatigue syndrome, Benign myalgic encephalomyelitis and many other ICD-10 categories had sat is proposed to be removed. A change of hierarchy between Postviral fatigue syndrome and Chronic fatigue sydrome is recorded in a Change History note, here: http://dxrevisionwatch.files.wordpress.com/2010/06/change-history-gj92-cfs.png and below:

Reorganization of Chapter 6 Diseases of the nervous system

Chapter 6 categories for ICD-11 are currently assigned the codes 06A thru 06L02. It is not known what codes will eventually be assigned to the categories within ICD-11 Chapter 6. As youll see from the screenshots, 06L00 Chronic fatigue syndrome is proposed to be classified under 06L Other disorders of the nervous system, with Benign myalgic encephalomyelitis specified as an Inclusion term to 06L00 Chronic fatigue syndrome.

Relationships between Inclusion terms are not specified within ICD-10, but they will be specified within ICD-11.

Go here for ICD-11 Chapter 5 Neurotic, stress-related and somatoform disorders > Somatoform Disorders and Neurasthenia:

http://apps.who.int/classifications/icd11/browse/f/en#/@_@who_3_int_1_icd_2_F45

http://apps.who.int/classifications/icd11/browse/f/en#/@_@who_3_int_1_icd_2_F48_3_0

Go here for ICD-11 Chapter 18 Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified > Malaise and fatigue:

http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_R53



The Revision Steering Group (RSG) and the various ICD Revision Topic Advisory Groups (TAGs) and their external reviewers for content and proposals are using a more layered version of the platform on which they are undertaking the ongoing drafting process; their platform is currently accessible only to WHO, ICD Revision and IT technicians.

The public version of the ICD-11 Alpha Browser, which is being updated daily, is currently open for public viewing only not for commenting on. But in July, ICD Revision is planning to open up the Alpha Browser for one year for public commenting and consultations.


Extracts from: http://www.who.int/classifications/icd/revision/en/index.html

ICD-11 Timeline

Compiled from the most recent Timelines [1] [7]:

May 2011: Alpha Browser opened up for public viewing [Reached]

July 2011: Alpha Browser opened up for public commenting
+1 year for Commentaries and consultations

May 2012: Beta version opened up to public and Field Trials Version
+2 years for Field trials

2014: Final version for public viewing

May 2015: Presentation of the final version for World Health Assembly (WHA) Approval​

Stakeholder participation

The WHO will be engaging with stakeholders who express an interest in participating in the ICD revision process.

Individuals may register to:

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

The drafting browsers will be open all year round, subject to continuous daily updates and open to all interested stakeholders Health Care Providers, Information Managers etc. Proposals and feedback will be subject to structured peer review by the Topic Advisory Groups.

For more information on how stakeholder participation is being projected see presentation slides in these reports on my site [8] [9].


Registering for participation

Its currently unclear which classes of stakeholder might be called upon to participate, and to what extent, during the Alpha drafting stage.

The Stakeholder Registration Form [10] currently appears geared for participation by medical and allied health professionals and administrators. Irrespective of whether the Yes or No field for the question Are you a health care professional? is selected, one is presented with the same options:

Register to become involved

http://www.who.int/classifications/icd/revision/en/index.html

WHO wants to know if you are interested in being involved in the ICD Revision. We will contact you as certain features are opened to the public.

What is your clinical profession?

Medicine
Psychology
Nursing
Counselling
Social Work
Health Information Manager
Coder

Which of the following describes your highest educational attainment? Pre-University; University Degree; Non-doctoral post graduate degree (e.g. Masters Doctoral degree (PhD, post bachelors MD, or similar)

Are you interested in participating in:

Making proposals
Peer-reviewing
Field trials​

I will check the form again, once the Alpha draft has been opened up for public comment, currently scheduled for July. It is anticipated that an Alpha browser using different software from that currently in use may be released in July. I will update when the browser is opened up for public comment.



The ICD-11 Content Model

The WHOs, Dr Bedhiran stn, describes ICD-10 as a laundry list. One of the most significant differences between ICD-10 and the forthcoming ICD-11 will be the Content Model.

Content Model

http://www.who.int/classifications/icd/revision/contentmodel/en/index.html

The content model is a structured framework that captures the knowledge that underpins the definition of an ICD entity.

Represents ICD entities in a standard way
Allows computerization
Each ICD entity can be seen from different dimensions or parameters. E.g. there are currently 13 defined main parameters in the content model to describe a category in ICD (see below).
A parameter is expressed using standard terminologies known as value sets

Content Model Parameters

ICD Entity Title
Classification Properties
Textual Definitions
Terms
Body System/Structure Description
Temporal Properties
Severity of Subtypes Properties
Manifestation Properties
Causal Properties
Functioning Properties
Specific Condition Properties
Treatment Properties
Diagnostic Criteria​

For more information on the application of the Content Model see document [11].


Definitions

There are no definitions inlcuded in any volume of ICD-10 for Postviral fatigue syndrome, Benign myalgic encephalomyelitis or Chronic fatigue syndrome. WHO has never set out what it understands by these terms nor has it specified what ICD-10 understands the relationships between these three terms to be (see page: http://dxrevisionwatch.wordpress.com/icd-11-me-cfs/) but there will be definitions in ICD-11 and the relationships between Inclusion terms will be specified.

Definitions

http://www.who.int/classifications/icd/revision/def/en/index.html

All ICD entities will have definitions: key descriptions of the meaning of the category in human readable terms to guide users

Limited definition in Print Version 100 words

Detailed definitions ONLINE

Definitions will be compatible with:

- the Content Model

- Diagnostic Criteria

- across the whole classification and the versions​

Versions of ICD-11 are planned for multiple settings:

Primary Care
Clinical Services
Research​

Specialty Adaptations of ICD-11 are being planned for:

Children and Youth
Oncology
Mental Health
Neurology
Musculoskeletal
Dermatology
Dentistry​

Sources, references and further reading:

ICD-11 Revision on main WHO website
http://www.who.int/classifications/icd/revision/en/

1] ICD-11 Revised Timeline
http://www.who.int/classifications/icd/revision/timeline/en/index.html

2] ICD-11 Alpha Browser Platform
http://apps.who.int/classifications/icd11/browse/f/en

3] ICD-11 Alpha Browser Caveats
http://www.who.int/classifications/icd/revision/caveat/en/index.html

4] Article: iCAT collaborative authoring platform, June to November 2010, screenshots and notes
http://dxrevisionwatch.wordpress.co...ft-and-icat-collaborative-authoring-platform/

5] Article: ICD-11 Alpha Browser Platform, screenshots and notes for Chapter 6: Diseases of the nervous system > 06L Other disorders of the nervous system > 06L00 Chronic fatigue syndrome
http://dxrevisionwatch.wordpress.co...ting-platform-launched-17-may-public-version/

6] ICD-11 Alpha Browser Platform: ICD-11 entity 06L00 Chronic fatigue syndrome

Foundation:
http://apps.who.int/classifications/icd11/browse/f/en#/@_@who_3_int_1_icd_2_G93_3_3

Linearizations Morbidity:
http://apps.who.int/classifications/icd11/browse/l-m/en#/@_@who_3_int_1_icd_2_G93_3_3

7] ICD-11 Timeline: PowerPoint presentation (in PDF format)
http://unstats.un.org/unsd/class/intercop/expertgroup/2011/AC234-P32.PDF

8] Article: ICD Revision Process Alpha Evaluation Meeting documents and PowerPoint slide presentations
http://dxrevisionwatch.wordpress.co...ocess-alpha-evaluation-meeting-presentations/

9] Article: ICD-11 Revision Steering Group struggling to meet targets for release of Beta Draft platform in May
http://dxrevisionwatch.wordpress.co...eet-targets-for-release-of-beta-draft-in-may/

10] Register for participation in ICD-11 Alpha drafting process
http://www.who.int/classifications/icd/revision/en/

Stakeholder Registration form
https://spreadsheets.google.com/spreadsheet/viewform?formkey=dDVabnF1RFpTQkVnVEN2TXhVRm55MGc6MQ

[11] ICD-11 Content Model Reference Guide version January 2011
http://sites.google.com/site/icd11revision/home/documents
http://dxrevisionwatch.files.wordpr...20model20reference20guide20january2020111.doc

 

[Dx Revision Watch]

Whats new in the ICD-11 Alpha drafting platform? (CFS)

Whats new in the ICD-11 Alpha drafting platform? (CFS)

April 10, 2012

Dx Revision Watch Post #157 Shortlink: http://wp.me/pKrrB-22h

Screenshot: ICD-11 Alpha Browser Foundation view selected, logged in at April 10, 2012:

Chapter 6: Diseases of the nervous system

http://apps.who.int/classifications/icd11/browse/f/en#/http://who.int/icd#G93.3

Apr 09 11:02 UTC

ICD-11 Beta drafting platform in May?

As reported in previous posts, the ICD-11 Beta drafting platform is supposed to be launching this May.

ICD-11 Revision Steering Group has yet to announce whether the Beta platform remains on target for a May release and if so, on what date it will be launched so I cannot give you a date yet.

Like the Alpha drafting Browser, the Beta drafting platform will be a work in progress not a final Beta draft. The final Beta isnt scheduled until 2014, after the ICD-11 field trials have been undertaken.

When it does launch, the Beta platform is intended to be accessible to professionals and the public for viewing, and for ongoing comment on proposals and interaction for registered users only.

In the meantime, the publicly viewable version of the Alpha drafting platform (known as the ICD-11 Alpha Browser) can still be accessed here:

http://apps.who.int/classifications/icd11/browse/f/en

The various ICD-11 Revision Topic Advisory Groups are carrying out their draft preparation work on a separate, more complex multi-author drafting platform that is accessible only to ICD Revision personnel.


Alpha drafting platform

As before, the publicly viewable version of the Alpha Browser should be viewed with the following caveats in mind:

the Alpha draft is a work in progress; it is incomplete; it may contain errors and omissions; it is in a state of flux and updated daily; textual content, codes and Sorting labels are subject to change as chapters are reorganized; the content has not been approved by Topic Advisory Groups, Revision Steering Group or WHO.

It is possible to register, or sign into the platform using existing accounts with several third party account providers such as Google, Yahoo and myOpenID, for increased access and functionality. Once signed in, PDFs of the drafts of the top level linearizations can be downloaded from the Linearization tab and Comments and Questions can be read.

See the Alpha Browser User Guide for information on how the Alpha Browser functions:

http://apps.who.int/classifications/icd11/browse/Help/en



ICD-11 will be available in both print and online versions and unlike most chapters of ICD-10, will include descriptive content for ICD terms.

For the online version of ICD-11, all ICD entities will include a definition and a number of additional key descriptive fields between 7 and 13 pre-defined parameters, populated according to a common Content Model (Word doc: Content Model Reference Guide January 2011).

For example, entity Title, Definition, Synonyms, Narrower Terms, Exclusions, Body Site, Body System, Signs and Symptoms, Causal Mechanisms, and possibly Diagnostic Criteria for some entities.

The print version will use a concise version of Definition due to space constraints.

In the Alpha Browser, not all these Content Model parameters display in the Foundation and Linearization views and not all of the parameters that have been listed for individual entities have had their draft text added yet, as some chapters are more advanced for the population of proposed content than others.

So the Alpha draft is still very patchy and many entities have no Definition and little or no other proposed content filled in.

With no Category Discussion Notes or Change histories pop-up windows visible in the public version of the Alpha, the viewer cannot determine the rationales behind the reorganization of terms and hierarchies within the various chapters.


Chapter location and hierarchy for CFS, PVFS and (Benign) ME in ICD-11

I have been reporting since June 2010 (with caveats) that the proposals for ICD-11 Alpha Draft appeared to be:

1] That a change of hierarchy had been recorded in a Category Discussion Note, dated May 1, 2010, which did display in the earlier iCAT version of the drafting platform, between ICD-10 Title term Postviral fatigue syndrome and Chronic fatigue syndrome. You can view a screenshot from June 2010 of that Change history record here:

http://dxrevisionwatch.files.wordpress.com/2010/06/change-history-gj92-cfs.png

Note that the Definition associated with the Chronic fatigue syndrome description panel is currently blank. But in June 2010, the Definition had stood as in this contemporaneous screenshot below:

http://dxrevisionwatch.files.wordpress.com/2010/05/2icatgj92cfsdef.png

2] That Chronic fatigue syndrome has been designated as an ICD-11 Title term within ICD-11 Chapter 6: Diseases of the nervous system, with the capacity for a Definition and up to 10 additional descriptive parameters.

3] That Benign myalgic encephalomyelitis had been specified as an Inclusion term to ICD-11 Title term Chronic fatigue syndrome but that the relationships between the three terms, PVFS, (B) ME and CFS had yet to be specified, as in this screenshot from June 2010:

http://dxrevisionwatch.files.wordpress.com/2010/05/2icatgj92cfsterms.png

Continued in next post

 

[Dx Revision Watch]

Continued from previous post:


What is currently showing in the Chapter 6 Foundation Component?

It isnt possible to bring up a discrete ICD Title listing for either Benign myalgic encephalomyelitis or Postviral fatigue syndrome in either the Foundation Component or the Linearization.

In the Foundation view only, for Chapter 6: Diseases of the nervous system, Chronic fatigue syndrome is listed as a Title term with the ICD-10 legacy ID ID:http://who.int/icd#G93.3?;

the Definition field is currently blank;

a list of terms has now been added under Synonyms;

one term has been added under Narrower Terms.

(Note: there is a small asterisk at the end of term Benign myalgic encephalomyelitis, which is listed at the top of the Synonyms list. The asterisk Hover text reads This term is an inclusion term in the linearizations.)

If you want to view directly on the Browser site (which wont display the Comment and Questions icons which can be opened up next to the terms unless you have already registered and logged in) go here:

ICD-11 Alpha Browser Foundation view:

http://apps.who.int/classifications/icd11/browse/f/en#/http://who.int/icd#G93.3

ID:http://who.int/icd#G93.3

Chronic fatigue syndrome

Parent(s)

Selected cause is Remainder of diseases of the nervous system in Condensed and selected Infant and child mortality lists
Selected Cause is All other diseases in the Selected General mortality list
Selected cause is Diseases of the nervous system

Definition

This entity does not have a definition at the moment.

Synonyms

Benign myalgic encephalomyelitis * [Ed: Hover text "This term is an inclusion term in the linearizations."]
akureyri
akureyri disease
cfs chronic fatigue syndrome
chronic fatigue syndrome nos [Ed: from current proposals for ICD-10-CM, Chapter 18, R53.82]
chronic fatigue, unspecified [Ed: from current proposals for ICD-10-CM, Chapter 18, R53.82]
epidemic neuromyasthenia
iceland disease
icelandic disease
me myalgic encephalomyelitis
myalgic encephalomyelitis
myalgic encephalomyelitis syndrome
postviral fatigue syndrome
pvfs postviral fatigue syndrome

Narrower Terms

neuromyasthenia

Body Site

Entire brain (body structure)
Brain structure (body structure)

Causal Mechanisms

Virus (organism)​

Whats new in Chapter 5: Mental and behavioural disorders?

As reported in a Co-Cure mailing dated February 18, 2012, and in Post: http://wp.me/pKrrB-1Vx, the category Somatoform Disorders in Chapter 5, Mental and behavioural disorders is currently renamed to BODILY DISTRESS DISORDERS, under which currently sit three new child categories:

5M0 Mild bodily distress disorder
5M1 Moderate bodily distress disorder
5M2 Severe bodily distress disorder

(Click on the little grey arrows to display the child categories):

Chapter 5 Linearization view:

http://apps.who.int/classifications/icd11/browse/l-m/en#/http://who.int/icd#F45

Chapter 5 Foundation view:

http://apps.who.int/classifications/icd11/browse/f/en#/http://who.int/icd#F45


Child categories to BODILY DISTRESS DISORDERS:

http://apps.who.int/classifications...icd#1905_dd0250d2_e8cd_4c48_a93f_7997cc1c8b07

BODILY DISTRESS DISORDERS

5M0 Mild bodily distress disorder
5M1 Moderate bodily distress disorder
5M2 Severe bodily distress disorder
5M3 Somatization disorder
5M4 Undifferentiated somatoform disorder
5M5 Somatoform autonomic dysfunction
5M6 Persistent somatoform pain disorder
> 5M6.0 Persistent somatoform pain disorder
> 5M6.1 Chronic pain disorder with somatic and psycological [sic] factors
5M7 Other somatoform disorders
5M8 Somatoform disorder, unspecified​

None of these three new (proposed) categories have had any Definitions or other textual content added to the description panels on the right hand side of the Alpha Browser page since I first reported this change in February.

So one still cannot determine what disorders ICD-11 intends might be captured by these three new (proposed) terms, should ICD-11 Revision Steering Group and classification experts consider these terms to be valid constructs and approve their progression through to the Beta draft.

Because no Change Notes or Change history pop-up windows display in this version of the Alpha Drafting browser, it still isnt possible to determine:

whether ICD-11 is proposing to introduce three new terms 5M0 Mild bodily distress disorder; 5M1 Moderate bodily distress disorder; 5M2 Severe bodily distress disorder, in addition to retaining the existing terms 5M3 thru 5M8;

how ICD Revision intends to define these (proposed) new terms;

how these terms would relate to the existing ICD-10 Somatoform Disorders categories which remain listed as child categories to BODILY DISTRESS DISORDERS.

(See Parts 1 and 2 of my report: Bodily Distress Disorders to replace Somatoform Disorders for ICD-11?: http://wp.me/pKrrB-1Vx )



References:

ICD-11 Revision: http://www.who.int/classifications/icd/revision/en/

ICD-11 Alpha Browser User Guide: http://www.who.int/classifications/icd/revision/caveat/en/index.html
Alpha Browser Foundation view: http://apps.who.int/classifications/icd11/browse/f/en#
Alpha Browser Linearization view: http://apps.who.int/classifications/icd11/browse/l-m/en#
Bodily Distress Disorders to replace Somatoform Disorders for ICD-11?: http://wp.me/pKrrB-1Vx

 

[Kanae]

I got lost in amongst there. What's the connection with SNOMED? as SNOMED has ME as depricated and CFS as mental or...