1. Recent advances in the field of Family Medicine classifications ICPC into WHO-FIC J K Soler Wonca International Classification Committee

2. International Classification of Primary Care

3. Why do we need ICPC?

4. A classification is the ordering principle of a defined domain

5. The International Classification of Primary Care is the ordering principle of the domain of primary care and family medicine  Rubrics code mutually exclusive concepts  Inclusion and exclusion criteria: definitions  Covers the breadth of the domain  “Granularity” appropriate for the domain  Classification based on empirical data

7. 200 600 400 10.000 SYMPTOMS DIAGNOSES ICPC: > 1 PER 1000 PPY ICD: <1 PER 1000 PPY

8. ICPC and ICD structure  ICPC (WONCA)  Conceptual construct  Localisation  About health problems and patient complaints  Patient centred  ICD (WHO)  Historical construct  Etiologic  About diseases  Provider centred

9. All included in UMLS All linked to Snomed-Ct ICD9 ICD10 ICPC and ICD relationships ICPC

10. UMLS  National Library of Medicine - Unified Medical Language System  Develops and distributes electronic knowledge sources and lexical programs  Facilitate development of software that understands medical terminology  Metathesaurus, SPECIALIST lexicon and Semantic Network

13. WHY DO WE NEED AN ICPC2-ICD10 THESAURUS?

14. Because Because ICPC does order the domain of family medicine.. family medicine.... but has insufficient granularity to document all individual patients’ diagnoses

15. .... thus a thesaurus would allow easy, semi-automatic double coding, using:  ICPC-2 as an ordering principle based on the high prevalence of common diagnoses in family practice  and ICD-10 as a nomenclature based on the wide range of known diagnoses

17. Example: In the Search text box, you type ‘pneumonia’,

18. there are many types of pneumonia in ICD-10,

19. ..and the various types by aetiology show. (Note: the cursor jumps to J18.9; the list starts with J12.0)

20. Say we want to select ‘pneumonia; Haemophilus influenzae’ (typing ‘pneum;h’ will do)..

21. ..double click, and the export box shows. Suppose you want to add a new type (e.g., ‘Amsterdam’). You can add that term, and also you may add this new type to your Thesaurus.. just click ‘Export and add’…

22. ..and now the label is added to your personal Thesaurus.

23. Relationships to other classifications

24. CONVERSIONS WITH ICPC-2 CONVERSIONS WITH ICPC-2 ICD-10 ICD-9-CM ICIDH-2/ICF Snomed-CT Read MESH ICPC-2

25. UMLS browser examples

26. Recent advances  Entry into WHO-FIC  Research into diagnostics  ICPC-3

27. Recent advances  Entry into WHO-FIC  Research into diagnostics  ICPC-3

28. WHO FIC  Reference classifications International Classification of Diseases (ICD) International Classification of Diseases (ICD) International Classification of Health Interventions (ICHI) International Classification of Health Interventions (ICHI) International Classification of Function, Disability and Health (ICF) International Classification of Function, Disability and Health (ICF) Anatomical Therapeutic Chemical (ATC) Anatomical Therapeutic Chemical (ATC)  Related classifications ICPC, ICD-O-3, ICECI ICPC, ICD-O-3, ICECI

29. ICPC Thesaurus UMLS ATC DDD ICDICFICHI ICPC within WHO-FIC ICPC is the ordering principle of the domain of primary care and acts as the link between other classifications in the FIC WHO-FIC

30. Recent advances  Entry into WHO-FIC  Research into diagnostics  ICPC-3

31. Recent advances  Entry into WHO-FIC  Research into diagnostics  ICPC-3

32. Research into diagnostics  Collecting data on all elements of the encounter  Structuring data within episodes of care  Using a classification with the correct granularity  Using Bayesian statistical methods to study non-linear relationships  The Transition Project

33. REASONS FOR ENCOUNTER AT START OF EPISODE BY ICPC-CHAPTER (%)

34. NEW EPISODES OF CARE BY ICPC-CHAPTER (%)

35. SOB as a predictor of diagnosis of asthma

36. Recent advances  Entry into WHO-FIC  Research into diagnostics  ICPC-3

37. Recent advances  Entry into WHO-FIC  Research into diagnostics  ICPC-3

38. ICPC-3  Work has started recently  ICPC structure will probably be maintained due to relationships with ICD within WHO-FIC  New types of data one can record? Classification of objective findings and investigations Classification of objective findings and investigations  Data elements for classification and for EPR  Linkages to other classifications yet to come