ICD Revision Process: Moving Towards ICD-11 Donna L. Hoyert, Ph.D. Mortality Statistics Branch Division of Vital Statistics CDC/National Center for Health Statistics Hyattsville, Maryland

ICD Basics WHO: Constitutional mandate Member countries: Obligated to use ICD World Health Organization Family of International Classifications Network: Priorities include: Implementing ICD Maintaining ICD Updating ICD

ICD Timeline 1990- WHA resolution on ICD-10 1994- Final ICD-10 volume published 1994- First country implemented ICD-10

International Implementation of ICD-10

Changes in ICD Basics Maintaining larger family of classifications World Health Assembly resolution recommended establishment of updating process and continuing 10-year cycle

ICD Timeline (continued) 1990- WHA resolution on ICD-10 1994- Final ICD-10 volume published 1994- First country implemented ICD-10 1997- Updating processes established 1997- Mortality Reference Group formed 1999- Update and Revision Committee formed

Updating Process Types of updates: Updates to the classification Clarification of application and interpretation of the classification and its associated rules Participants: Mortality Reference Group Update and Revision Committee WHO

Competing Considerations 1990 WHA resolution mandated 10-year revision cycle 1997 Heads of Collaborating Centers agreed that need an evaluation of the updating mechanisms for ICD-10 before considering an ICD-11

Ongoing ICD Revision Efforts Evaluation of ICD-10 Implementation and Updating Process Meetings on selected ICD-10 problem issues Mental health Injury and external causes Diabetes mellitus Cystic fibrosis Lymphomas

Conclusion Consensus Initial steps ICD-10 evaluation Problem focused meetings