Updates on ICD-11 and other classification and terminology systems

[Dx Revision Watch]

New document:

Comparison of SSD, BDD, BDS, BSS in classification systems
Version 1 | July 2018

https://dxrevisionwatch.files.wordp...-bdd-bds-bss-in-classification-systems-v1.pdf

or

http://bit.ly/2NmFZRa


Mary Dimmock and I have prepared a new Table and Notes comparing the key features of SSD, BDD, BSD and BSS.

At the top of the Table is a brief statement clarifying that ICD-11's BDD is differently conceptualized to Fink's BDS and captures different patient groups.

A copy of the PDF is also attached to this post.

We are still seeing a lot of confusion around ICD-11's BDD and Fink's BDS. Please share this document or the links on any platforms where members will find this comparison table helpful.

 

[Dx Revision Watch]

The document:

Comparison of Classification and Terminology Systems

has been updated with an amendment.

If you downloaded the document in Post #1 or Post# 39 please replace the PDF with


Comparison of Classification and Terminology Systems
Version 3 | July 2018

https://dxrevisionwatch.files.wordp...lassification-and-terminology-systems-v-3.pdf

or

http://bit.ly/2JGUQUi

A PDF of Version 3 is also attached to this post.

 

[Dx Revision Watch]

Audio file of WHO Press Conference

June 14, 2018 WHO Press Conference
14 June 2018 15:00 - 15:45

Release of ICD-11 – the 11th revision of the International Classification of Disease – Monday, 18 June 2018.

• Dr Shekhar Saxena, Director, Department for Mental Health and Substance Abuse, WHO

• Dr Robert Jakob, Team Lead, Classifications, Terminologies and Standards, WHO

Mp3 audio file [39:25 min] from WHO Press Conference - launch of ICD-11 "advance release":

http://terrance.who.int/mediacentre/presser/WHO-RUSH_ICD-11_Virtual_Press_Conference_18JUN2018.mp3

 

[Dx Revision Watch]

Dr First notes in this recent presentation that ICD-11 uses stab point "clinical descriptions" rather than more rigid criteria sets, as used in DSM-5; that as a result, the clinical descriptions in the ICD-11 specialty publication, ICD-11 Clinical Descriptions and Diagnostic Guideline for Mental and Behavioural Disorders (the equivalent to ICD-10's "Blue Book") are more flexible than the DSM-5 code sets; that on the whole, disorder durations are less specific for ICD-11 than for DSM-5, and that clinical judgment may be used in ICD-11 if symptom duration is longer or shorter than specified.


Presentation:

https://rop.no/roptv/hva-er-forskjellene-mellom-psykiske-lidelser-i-icd-11-og-dsm-5/

[32:38 mins]

Michael First: Differences Between ICD-11 Classification of Mental & Behavioural Disorders and DSM-5

Nasjonal kompetansetjeneste ROP
Published on 20 Jul 2018

First is a professor of clinical psychiatry, Columbia University, and research psychiatrist, New York State Psychiatric Institute. Dr. First is the Editorial and Coding Consultant for the DSM-5, the chief technical and editorial consultant on the World Health Organization's ICD-11, and is an external consultant to the NIMH Research Domain Criteria project. He was the Editor of the DSM-IV-TR, the Editor of Text and Criteria for DSM-IV and the APA's Handbook on Psychiatric Measures. In this lecture he gives an introduction to the differences between ICD-11 Classification of Mental and Behavioural Disorders and the DSM-5. The video was recorded in July 2018 for the Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders (norwegian: Nasjonal kompetansetjeneste ROP: rop.no).

 

[Dx Revision Watch]

https://hscic.kahootz.com/connect.t...RL=/connect.ti/t_c_home/viewblog?blogid=50136

NHS Digital

ICD-11 Launch

"...No decision has been made for the implementation of ICD-11 in England, however NHS Digital plan to undertake further testing of the latest release and supporting products that will inform a future decision."

 

[Dx Revision Watch]

According to this October 25-28, 2018 congress Abstract:

"As of the time of the Congress, the complete ICD-11 Clinical Descriptions and Diagnostic Guidelines (CDDG) will be available for public review and comment and a rigorous program of field testing will have been completed."

Edited to add:

But they had also said this in November 2017 ( http://www.aepc.es/PsClinicaX/CV/CVC4.html )

so Dr Reed might be referring not to a forthcoming public stakeholder review of the CDDG draft but to the GCPNetwork for clinicians who have been able to register for access to review and comment on the draft for a number of years.


http://www.aepc.es/PsClinicaXI/CV/CV_3.html

11th International Congress And 16th National Of Clinical Psychology, 25-28 October 2018, Granada (Spain)

Clinical descriptions and diagnostic guidelines of the ICD-11

Geoffrey Reed
Senior Project Officer of ICD-11 Mental and Behavioural Disorders
World Health Organization (WHO)
SWITZERLAND
1 English

Senior Project Officer of ICD-11 Mental and Behavioural Disorders, Department of Mental Health and Substance Abuse, World Health Organization...

(...)

KEYNOTE ABSTRACT

Clinical descriptions and diagnostic guidelines of the ICD-11

A decade of work by the World Health Organization Department of Mental Health and Substance Abuse to develop the ICD-11 classification of Mental and Behavioural Disorders is nearing completion. As of the time of the Congress, the complete ICD-11 Clinical Descriptions and Diagnostic Guidelines (CDDG) will be available for public review and comment and a rigorous program of field testing will have been completed. This address will provide an overview of WHO's work in developing the CDDG and the major features of the new classification...

 

[Dx Revision Watch]

Some good news to share:

Important update on SNOMED CT terminology system and the classification of CFS and its Synonym terms

The July 2018 Release for the SNOMED CT International Edition was published on the SNOMED CT Browser earlier today.

I can now officially confirm the addition of the Supertype (Parent): Disorder of nervous system for Chronic fatigue syndrome and its Synonym terms.


Brief context:

For the January 2018 Release, CFS's parent concept: Multisystem disorder was retired.

There had been 90 Children disease and disorder terms under SCTID: 281867008 Multisystem disorder and the retirement of this parent concept had implications for all 90 terms — not just for CFS and its Synonym terms.

Many of these 90 disease and disorder terms were assigned a more specific parent but a few, including CFS, were not.

In February 2018, a request and rationale text for the addition of Supertype: Disorder of nervous system to CFS was drafted by Suzy Chapman and submitted by Sonya Chowdhury on behalf of Forward-ME.

Following a peer review process, the addition of the parent: Disorder of nervous system for CFS was approved for implementation for the next release.

I can now confirm that this change has been included in the July 2018 release (v20180731) of the SNOMED CT International Edition.

This change will subsequently be incorporated into the next releases of the U.S. Edition (in September 2018), the UK Edition (in October 2018) and all other National Editions, as they release their next updates.


Full report in this PDF (also in attachment):

https://dxrevisionwatch.files.wordp...snomed-ct-and-chronic-fatigue-syndrome-v1.pdf

Statement on SNOMED CT and Chronic fatigue syndrome August 2018


Text of Request and justification for modification of SNOMED CT content in this PDF (also in attachment)*:

*Justification includes link for document: Evidence Supporting a Classification of ME and CFS in the Neurological Chapter 2017, compiled by Mary Dimmock and texts extracted from Chapman and Dimmock joint proposal to ICD Revision, March 2017.

https://dxrevisionwatch.files.wordp...ntent-for-snomed-ct-international-edition.pdf


Screenshot from July 2018 Release (v20180731) accessed July 31, 2018:

http://browser.ihtsdotools.org/?per...g/api/v1/snomed&langRefset=900000000000509007

Chronic fatigue syndrome (disorder) SCTID: 52702003

 

[Dx Revision Watch]

Update on SNOMED CT terminology system and classification of Bodily distress disorder

This PDF document confirms the addition of the three severity specifiers under Children to Bodily distress disorder:

https://dxrevisionwatch.files.wordp...snomed-ct-and-bodily-distress-disorder-v2.pdf

Statement on SNOMED CT and Bodily distress disorder August 2018


Bodily distress disorder for the July 2018 release (v20180731) of the International Edition:

http://browser.ihtsdotools.org/?per...g/api/v1/snomed&langRefset=900000000000509007

 

[anni66]

Some good news to share:

Important update on SNOMED CT terminology system and the classification of CFS and its Synonym terms

The July 2018 Release for the SNOMED CT International Edition was published on the SNOMED CT Browser earlier today.

I can now officially confirm the addition of the Supertype (Parent): Disorder of nervous system for Chronic fatigue syndrome and its Synonym terms.


Brief context:

For the January 2018 Release, CFS's parent concept: Multisystem disorder was retired.

There had been 90 Children disease and disorder terms under SCTID: 281867008 Multisystem disorder and the retirement of this parent concept had implications for all 90 terms — not just for CFS and its Synonym terms.

Many of these 90 disease and disorder terms were assigned a more specific parent but a few, including CFS, were not.

In February 2018, a request and rationale text for the addition of Supertype: Disorder of nervous system to CFS was drafted by Suzy Chapman and submitted by Sonya Chowdhury on behalf of Forward-ME.

Following a peer review process, the addition of the parent: Disorder of nervous system for CFS was approved for implementation for the next release.

I can now confirm that this change has been included in the July 2018 release (v20180731) of the SNOMED CT International Edition.

This change will subsequently be incorporated into the next releases of the U.S. Edition (in September 2018), the UK Edition (in October 2018) and all other National Editions, as they release their next updates.


Full report in this PDF (also in attachment):

https://dxrevisionwatch.files.wordp...snomed-ct-and-chronic-fatigue-syndrome-v1.pdf

Statement on SNOMED CT and Chronic fatigue syndrome August 2018


Text of Request and justification for modification of SNOMED CT content in this PDF (also in attachment)*:

*Justification includes link for document: Evidence Supporting a Classification of ME and CFS in the Neurological Chapter 2017, compiled by Mary Dimmock and texts extracted from Chapman and Dimmock joint proposal to ICD Revision, March 2017.

https://dxrevisionwatch.files.wordp...ntent-for-snomed-ct-international-edition.pdf


Screenshot from July 2018 Release (v20180731) accessed July 31, 2018:

http://browser.ihtsdotools.org/?per...g/api/v1/snomed&langRefset=900000000000509007

Chronic fatigue syndrome (disorder) SCTID: 52702003

Brilliant news - thank you for hard work

 

[Dx Revision Watch]

I have received a query about the use of "(disorder)" in SNOMED CT.

The number of unique concepts included in the SNOMED CT terminology system is huge (over 300,000 Concepts). The content includes not just unique concept terms and codes for diseases and disorders but also codes for findings, body structures, events, procedures, substances, social concepts etc.

The term in brackets after a SCTID Concept identifies the type of concept.

All diseases, disorders and syndromes are identified by "(disorder)" after their Concept name - also known as their "Fully specified name" (FSN).

The convention for SNOMED CT is that Concept terms are listed at the top of the blue panel in the SNOMED CT browser in this format:

22298006 | Myocardial infarction (disorder)
56265001 | Heart disease (disorder)
24700007 | Multiple sclerosis (disorder)
310701003 | Behcet's syndrome (disorder)
23502006 | Lyme disease (disorder)
2702003 | Chronic fatigue syndrome (disorder)

to distinguish the type of unique Concept from, for example, Concepts for

xxxxxxx xxxxx (finding)

xxxxxxxxx (procedure)

xxxxxxxxx (substance)

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


The Supertype Concept:

http://browser.ihtsdotools.org/?per...g/api/v1/snomed&langRefset=900000000000509007

118940003 | Disorder of nervous system (disorder) |

has the following Parent Concepts:

Parents

Disease (disorder)
>Finding by site (finding)
>>Disorder by body site (disorder)
>>>Disorder of body system (disorder)


and under Synonyms:

en Neurological disorder
en Nervous system disease
en Disorder of nervous system (disorder)
en Disorder of nervous system


It has 57 Children, arranged alphabetically, some of which also have Children terms under them (those marked with a blue arrow open up dropdowns for Children terms, some of which will also have Children terms under them):

 

[Dx Revision Watch]

Action for M.E.

https://www.actionforme.org.uk/news/gp-system-updated-to-reflect-m.e.-as-neurological/

GP system updated to reflect M.E. as neurological

-----------

NB: Just to clarify my position: I did not consider the Multisystem disorder parent Concept (which was retired from all 90 Children in January 2018) to be particularly unhelpful, per se.

But that being left with

Clinical finding (finding)
> Disease (disorder)

and no body system/aetiology parent was undesirable.

If ICD-11 had progressed with its early discussions for a potential new chapter for Multisystem diseases, or for a Multisystem disorders linearization, it is possible that ME, CFS would have been a candidate for inclusion within that chapter or linearization [1][2].

1 Aymé, Chalmers, Chute, Jakob (2010). ICD Revision: Discussion paper: Multisystem Disorders. http://bit.ly/2nnilKW
PDF: https://dxrevisionwatch.files.wordp...-multisystem-diseases-discussion-document.pdf

2 WHO ICD Revision Information Note 19: Multisystem Diseases Chapter in ICD, January 29, 2013

Edited to add: Action for M.E. has amended its report.

 

[Dx Revision Watch]

NHS Digital

SNOMED CT Fact Sheet June 2018

Dual Coding and the GP Subsets

https://hscic.kahootz.com/gf2.ti/f/762498/28807269/PDF/-/Dual_Coding_FACT_Sheet.pdf

and attached

 

[Dx Revision Watch]

Please use Timeline image plus link on any platforms where it might be helpful:

Image URL: https://dxrevisionwatch.files.wordpress.com/2018/08/timelinesno1.png

Full report in PDF: Statement on SNOMED CT and Chronic fatigue syndrome

https://dxrevisionwatch.files.wordp...snomed-ct-and-chronic-fatigue-syndrome-v1.pdf

 

[Dx Revision Watch]

https://www.meassociation.org.uk/20...t-m-e-is-neurological-disease-06-august-2018/

NHS to update classification system to reflect that M.E. is neurological disease | 06 August 2018


Edited to add: I have asked the MEA if they will amend several errors and misconceptions in this write up. I have also asked WAMES if they can correct several errors, too.

 

[Dx Revision Watch]

https://dxrevisionwatch.files.wordpress.com/2018/09/grey61amended.png

 

[Dx Revision Watch]

Two new posts on https://dxrevisionwatch.com

Update on the status of the classification of PVFS, ME and CFS for ICD-11: Part One

https://dxrevisionwatch.com/2018/08...ation-of-pvfs-me-and-cfs-for-icd-11-part-one/


Update on the status of the classification of PVFS, ME and CFS for ICD-11: Part Two https://dxrevisionwatch.com/2018/08...ation-of-pvfs-me-and-cfs-for-icd-11-part-two/

 

[Dx Revision Watch]

In Post #47 I confirmed that a change of parent for CFS and its Synonyms terms was approved and implemented for the July 2018 release of the SNOMED CT International terminology system.

For SNOMED CT International Edition, CFS and its Synonyms terms now sits under parent Concept: Disorder of nervous system.


The September 01 release of the U.S. National Edition has now been posted and incorporates the change effected in the July International Edition.

Here is a screenshot from the March 01 release for the U.S. National Edition, followed by a screenshot of the September 01 release which was published, today:

March 01 release of SNOMED CT U.S. Edition:

September 01 release of SNOMED CT U.S. Edition:

http://browser.ihtsdotools.org/?per....org/api/snomed&langRefset=900000000000509007

*NB: The term in brackets after a SCTID Concept identifies the type of concept. All diseases, disorders and syndromes are identified by "(disorder)" after their Concept name to distinguish the Concept from a (finding), (body structure), (event), (procedure), (substance), (social concept) etc. Concept term.


A number of countries maintain National Editions which automatically incorporate the updated content from the core SNOMED CT International Edition releases. But they may also include country specific diagnostic terms, additional terms under Synonyms or additional terms under Children.

The International Edition releases updates twice yearly.

Note that the National Editions are also updated twice yearly but are released on a staggered schedule so their current content will not reflect the changes and additions to the most recent release of the International Edition until their next release is issued.

The SNOMED International SNOMED CT Browser and browsers for some of the National Editions can be accessed here: http://browser.ihtsdotools.org/


UK National Edition

Since April 2018, SNOMED CT UK Edition has been the mandatory terminology system for use in NHS primary care, replacing the Read Code (CTV3) terminology which is now retired. SNOMED CT UK Edition is scheduled for adoption across all NHS clinical settings by 2020.

The SNOMED CT UK Edition is managed by NHS Digital, as the designated UK National Release Centre.

A public browser for the UK Edition is hosted by NHS Digital and can be accessed here: https://termbrowser.nhs.uk/ or from the landing page for the International Edition, which is here: http://browser.ihtsdotools.org/

This addition of the Disorder of nervous system parent for CFS and its Synonyms terms will be incorporated into the UK Edition on October 01 and the following national editions:

Belgium Edition on September 15;
Danish and Netherlands Edition on September 30;
UK Edition on October 01;
Canadian Edition on October 30;
Swedish Edition on November 31;
Uruguay Edition on December 15;
Australian Edition on December 30.​

If your country is a member of SNOMED International but does not have a browser hosted on the International Edition platform please refer to your country's SNOMED CT National Release Centre website for the release schedule.

A copy of my full statement on the addition of the Disorder of nervous system parent for CFS and its Synonyms terms can be downloaded here:

PDF: Statement on SNOMED CT and Chronic fatigue syndrome August 2018:

https://dxrevisionwatch.files.wordp...snomed-ct-and-chronic-fatigue-syndrome-v1.pdf

 

[Dx Revision Watch]

In Post #47 I confirmed that a change of parent for CFS and its Synonyms terms was approved and implemented for the July 2018 release of the SNOMED CT International terminology system. For SNOMED CT International Edition, CFS and its Synonyms terms now sits under parent Concept: Disorder of nervous system.

In Post #57 I confirmed that the latest release of the U.S. Edition was posted on September 01 and incorporated the change of parent.

The September 15 release of the Belgium Edition is now available:

SNOMED CT Belgium Edition 20180915

NB: The term in brackets after a SCTID Concept identifies the type of concept. All diseases, disorders and syndromes are identified by "(disorder)" after their Concept name to distinguish the Concept from a (finding), (body structure), (event), (procedure), (substance), (social concept) etc. Concept term.


The next releases of the Netherlands and Danish Editions are due at the end of September. The next release of the UK Edition is due October 01.

I will update when these releases are available.

A copy of my full statement on the addition of the Disorder of nervous system parent for CFS and its Synonyms terms can be downloaded here:

PDF: Statement on SNOMED CT and Chronic fatigue syndrome August 2018:

https://dxrevisionwatch.files.wordp...snomed-ct-and-chronic-fatigue-syndrome-v1.pdf

 

[Dx Revision Watch]

The SNOMED CT Netherlands Edition release for September 30, 2018 has been posted, today.

This release of the Netherlands Edition incorporates the July 2018 International Edition change of parent for CFS and the terms under Synonyms:

aandoening van zenuwstelsel = disorder of nervous system

Note: SNOMED CT International Edition and national editions used to include an SCTID Concept term: Neurasthenia. This Concept term was retired (Inactivated) some years ago. However, the Netherlands Edition retains the term "neurasthenie" under Synonym terms.

Netherlands Edition Release 20180930

http://browser.ihtsdotools.org/?per.../snomed&langRefset=31000146106,15551000146102

The Danish Edition release for September 31, 2018 will be available in the next few days.

The next release of the UK Edition is scheduled for October 01. I will post screenshots for both of these releases when they become available.


A copy of my full statement on the addition of the Disorder of nervous system parent for CFS and its Synonyms terms can be downloaded here:

PDF: Statement on SNOMED CT and Chronic fatigue syndrome August 2018:

https://dxrevisionwatch.files.wordp...snomed-ct-and-chronic-fatigue-syndrome-v1.pdf

 

[Dx Revision Watch]

The SNOMED CT Danish Edition release for September 30, 2018 is now available on the public browser.

This release of the Danish Edition incorporates the July 2018 International Edition change of parent for CFS and the terms under Synonyms.

UK Edition release for October 01 not available, yet, on the public NHS Digital browser.


Danish Edition Release 20180930

http://browser.ihtsdotools.org/?per...ols.org/api/snomed&langRefset=554461000005103

A copy of my full statement on the addition of the Disorder of nervous system parent for CFS and its Synonyms terms can be downloaded here:

PDF: Statement on SNOMED CT and Chronic fatigue syndrome August 2018:

https://dxrevisionwatch.files.wordp...snomed-ct-and-chronic-fatigue-syndrome-v1.pdf