Julie Rust Managing Editor

Internal Medicine TAG Chair: Prof. Kentaro Sugano (JP) Co-chair: Dr. Rodney Franklin (UK) CardiovascularHepatologyEndocrinologyNephrologyGastroenterologyRespiratoryHaematologyRheumatology

Working GroupChairsManaging editor Nephrology Y Iino (JP) Lesley Stevens (USA) - RheumatologyJonathan Kay (USA) Masayoshi Harigai (JP) AW-Dahl (Musculoskeletal TAG) GastroenterologyP Malfertheiner (FRG) S. Miura (JP) J Akiyama HepatologyEB Keefe (USA)T Tomiya RespiratoryDH Ingbar (USA) S. Hashimoto (JP) - HematologyW Fibbe (Netherland)- Endocrinology & Metabolism A Shimatsu (JP) N Tajima (JP) - CardiovascularBJ Gersh (USA)T Kohro Structure of Working Groups

 Review of code hierarchy and content model in start up list of iCAT: ◦ Clinical currency ◦ New diseases/disorders and location ◦ Outdated terminology ◦ Need for further or less granularity  Managing editor guidance on: ◦ Conventions of a statistical classification ◦ Evidence based and transparent process

 Different approaches in groups: ◦ Proposal drafted with support of professional specialist society ◦ Sub-specialties within each group work on specific topic areas, with in-group peer review ◦ Combination of above  Communication via meetings, teleconferences and .  Draft proposal submitted to IM TAG managing editors for editing/commenting – iterative process (internal and external)  Finalised proposal entered into collaborative authoring tool (iCAT)

◦ Rare Diseases TAG  Congenital anomalies of digestive system  Metabolic diseases (liver and endocrine)  Congenital and paediatric cardiology ◦ Dermatology TAG  Inflammatory arthritis – psoriatic arthritis  Myositis ◦ Musculoskeletal TAG  Osteoarthritis  Inflammatory spondyloarthritis

◦ Separation of previously combined sites in first anatomical axis, eg oesophagus, stomach and duodenum ◦ Standardisation of second axis within each anatomical site ◦ Inclusion of functional gastrointestinal disorders ◦ Liver diseases – expanded with inclusion of new categories for NAFLD, metabolic and transporter liver diseases, infectious liver diseases ◦ ‘Claim’ for haemorrhoids, gastrointestinal varices, hepatitis

 Inclusion of acute kidney disease/acute kidney injury  Update of ‘renal osteodystrophy’ to ‘mineral and bone disease’  Addition of genetic linkages, via the content model, for cystic kidney disease  Expansion of renal dialysis status codes, to include details on modality and access  Expansion of codes for glomerular diseases, to add specificity on pathology findings

 Update of the classification of inflammatory arthropathies  Reference to the Chapel Hill International Consensus Conference classification of systemic vasculitis.  Change name of “Dermatopolymyositis” to “Idiopathic inflammatory myopathies’, change of axes and introduction of further granularity.  New category for autoinflammatory syndromes  Reduction in eponyms for code titles

 Examples of proposals for update to ICD-10: ◦ Removal of the term, code and dagger/asterisk link for ‘arthropathic psoriasis’ from the Dermatology chapter, and expand the codes for psoriatic arthritis in the Musculoskeletal chapter. ◦ Revisions to the classification of spondyloarthritis, with a separation of axial and peripheral spondyloarthritis.

 Global project – international representation and balance in TAGs/WGs, limited Australian input  Opportunity for classification experts to work with ‘horizontal’ TAGs of mortality, morbidity, functioning and safety/quality (for linearisations)  Planning for beta phase – education of key Australian clinical groups and stakeholders on how they can contribute and comment