Updates on status of ICD-11 and changes to other classification and terminology systems

Dx Revision Watch said:
Modest or Moderate (single-organ type) bodily distress syndrome
Severe (multi-organ type) bodily distress syndrome
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Which organ(s) is/are meant? BDD is classified as Mental Disorder in SNOMED CT, and functional disorders (under which Fink's BDS might be classified) are psychological, too, so where's the organ? Or is meant the number of organs where symptoms are present?
 
Dx Revision Watch said:
Perhaps you would like to mention to those who have expressed an interest, that submitting these two queries (re the three severity options for CFS and the additional Medically unexplained symptoms Concept term, which are both exclusive to the SNOMED CT UK Edition) might be something they could consider taking over. This would be welcomed as I do need to focus on bringing my website up to date with recent developments before I step back in a couple of weeks' time.
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Could you please summarize the three queries you have in mind? (With some details if possible.) That would be helpful.
 
ME Association:

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

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

The change implemented in the July 31 release of the SNOMED CT International Edition will be incorporate into the

U.S. Edition September 01 release;
Belgium Edition September 15 release;
Danish Edition September 30 release;
Netherlands Edition September 30 release;
UK Edition October 01 release;
Canadian Edition October 30 release;
Swedish Edition November 31 release;
Uruguay Edition December 15 release;
Australian Edition December 30 release.
 
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Inara said:
Which organ(s) is/are meant? BDD is classified as Mental Disorder in SNOMED CT, and functional disorders (under which Fink's BDS might be classified) are psychological, too, so where's the organ? Or is meant the number of organs where symptoms are present?
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For the Fink et al (2010) Bodily distress syndrome, no psychological or behavioural responses are included in the criteria, which are based on physical symptom patterns or clusters from organ/body systems.

See criteria, below:

fink5.png




fink11.png


Source: "Syndromes of bodily distress or functional somatic syndromes - Where are we heading. Lecture on the occasion of receiving the Alison Creed award 2017", Per Fink, 2017

Slides: http://www.eapm2017.com/images/site/abstracts/PLENARY_Prof_FINK.pdf




Also see this document that Mary Dimmock and I published in July, which compares the conceptualization, characterization and criteria for

SSD, BDD, BDS and the proposed, BSS, with notes on all four constructs.


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

Comparison of SSD, BDD, BDS, BSS in classification systems Version 1 | July 2018
 
Inara said:
Could you please summarize the three queries you have in mind? (With some details if possible.) That would be helpful.
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If I am to spend time summarizing what questions are required to be asked, then I might just as well submit the queries, myself.

If a group on this forum is genuinely interested in monitoring and reporting on classification and terminology systems, then I think they should be prepared to consider and formulate what questions might usefully be submitted to the UK SNOMED CT National Release Center in relation to these Concept terms that are unique to the UK Edition, based on the discussions we have already had, in this thread:


SNOMED CT SCTID: 88776100000010 Medically unexplained symptoms (finding)

SNOMED CT ConceptID: 377181000000104 Mild chronic fatigue syndrome (disorder)

SNOMED CT ConceptID: 377171000000101 Moderate chronic fatigue syndrome (disorder)

SNOMED CT ConceptID: 377161000000108 Severe chronic fatigue syndrome (disorder)


If they would rather not take this on, please let me know and I will submit the queries, myself, if I have time before I step back.
 
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Esther12 said:
I suspect we'd benefit from having you take charge of these things for as long as possible. I struggle to just keep up with all the info you most, never mind really thinking critically about it myself.
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As I've said, I shall be retiring in a couple of weeks' time, as soon as I have brought my Dx Revision Watch site up to date.

My intention is to post a post in this thread that collates the links for key posts and documents already posted in this thread and on my site, and then I shall step back.

In the meantime, I am not taking on any new projects, as I really need to get my own site up to date. It is over 6 weeks since ICD-11 released the "advance preview" version and I still have a number of posts to prepare for my website.
 
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In Post #81 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:


snomed-ct-us-edition-2018-08-26-1.png




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

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


snomed-ct-us-edition-2018-09-01-2.png


*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
 
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In Post #81 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 #151 I confirmed that the latest release of the U.S. Edition was posted on September 01 and incorporated this change of parent.


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

SNOMED CT Belgium Edition 20180915

belgiumedition2.png



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, which will incorporate this change, 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
 
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As some of you are already aware, I shall be retiring shortly from advocacy work.

The plan had been to step back in September. But a hard drive failure, the purchase and setting up of a new laptop and some time consuming domestic stuff to deal with has delayed this. I now plan to step back around the end of the first week of October. There will be some "housekeeping" to carry out on my sites after I have stepped back but I won't be on forums or Twitter.

This delay will allow me to confirm the change of parent for CFS and terms under Synonyms for the next releases of the Danish and Netherlands SNOMED CT National Editions (both scheduled for release on September 30) and the UK National Edition (scheduled for release on October 01).

I shall also be posting a list of recent key documents from my site as "legacy" documents.
 
A public meeting of the ICD-10-CM Coordination and Maintenance Committee took place on 11th and 12th September.

These twice yearly meetings are co-chaired by CDC and NCHS who are responsible for the development and maintenance of the U.S. specific, ICD-10-CM.

ICD-10-CM is a "clinical modification" of the WHO's ICD-10 and there are coding and chapter structure differences between the WHO's ICD-10 and the U.S. adaptation of ICD-10.


The C & M meetings page is here: https://www.cdc.gov/nchs/icd/icd10cm_maintenance.htm


The "Tentative Agenda" for the September 11th-12th meeting had been posted three or four weeks ahead of the meeting and had not included an item for discussion of CFS coding.

The full agenda is known as the meeting "Topic Packet" and Topic Packet Parts 1 and 2, as posted the day before the meeting, had also not included discussion of CFS coding.

On Day 2, Donna Pickett did present on CFS coding.

You can watch the videocast of this section of the meeting here:




In this presentation, two proposals are shown on the slides:

Option 1:

option-1.png



and an Option 2:

option-2.png



(Please refer to the videocast for the full content of the Option slides, which includes proposed modifications to the R53.82 codes and the exclusion terms which aren't captured in the screenshots.)


Revised PDFs for Topic Packets Parts 1 and 2 were subsequently posted which can be downloaded from the C & M Meetings page, here. I've also attached a copy of Part 2, for ease of access:

September 11-12, 2018
Note: These documents were re-posted, if you downloaded the previous documents you will need to download the updated documents.​


In the updated version of Topic Packet Part 2:

https://www.cdc.gov/nchs/data/icd/Topic_packet_Sept_2018_part2.pdf

the item on CFS is on Pages 11 and 12.

But only Option 2 has been included with the background text for the item on CFS - although two options had been displayed on the screen and two options had been referred to by Ms Pickett at the start of her presentation:

Extract (which does not include the background text) from Page 12: Revised Topic Packet Part 2:


topic-packet-2.png





Donna Pickett invites questions from the floor at this point and introduces Dr Lily Chu, who was participating via a phone link, on behalf of the IACFS/ME.

You can hear Dr Chu's contributions from this point:




Dr Chu states that the IACFS/ME supports the Option that proposes inclusion of SEID in ICD-10-CM.

(Please refer to the videocast for her full comments.)


Deadline for comments on proposals presented at the September 11th and 12th meeting:

"November 13, 2017 Deadline for receipt of public comments on proposed new codes and revisions discussed at the September 11-12, 2018 ICD-10 Coordination and Maintenance Committee meetings for implementation on October 1, 2019."

Comments should be emailed to: nchsicd10CM@cdc.gov

by November 13, 2018.


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

Sly Saint has started a dedicated thread for discussion of this development, here:

https://www.s4me.info/threads/usa-nchs-cdc-proposal-for-icd-10-cm-adding-seid.5929/


As I'm winding down to retirement and still have a backlog of stuff to clear, I won't be discussing this development. But my position is that I do not support the inclusion of SEID in ICD-10-CM and I would oppose any proposals for the potential inclusion of SEID in ICD-11.
 

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The International Classification of Primary Care, Second edition (ICPC-2) is managed by WONCA (World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians).

WHO has approved ICPC-2 within the WHO FIC mainly as a reason for encounter classification, and users may use it as a classification for primary care or general practice.


Development of ICPC-3:

IPCP-2 is under revision for ICPC-3.

ICPC-3 Consortium http://www.ph3c.org/4daction/w3_CatVisu/en/icpc-3-consortium-a-3-years-international-project.-.html?wDocID=493

Presentation, August 2018 http://www.ph3c.org/PH3C/docs/27/000493/0000912.pdf

ICPC-3 development milestones, August 2018 http://www.ph3c.org/PH3C/docs/62/000209/0000929.pdf

icpc-3-dev-milestones.png


Dr Marianne Rosendal of Aarhus University is a member of the revision committee for ICPC-2, as is the U.S.'s Dr Michael Klinkman.

Both are members of the WHO's Primary Care Consultation Group (PCCG) that has been making recommendations for the revision of the "Diagnostic and Management Guidelines for Mental Disorders in Primary Care: ICD-10 Chapter V Primary Care Version. 1996 (aka ICD-10-PHC)".

ICPC-2 documents dating from 2010/2011 indicate that Dr Rosendal has been pushing for a Bodily Distress Syndrome type construct for potential inclusion in ICPC-3.

The development of ICPC-3 will need monitoring.
 
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


snomed-ct-netherlands-edition-20180930.png



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
 
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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

danishedition20180930.png




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
 
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