Classification of diseases is a challenge, and will continue to be, as new complexities and developments arise in the classification.
Let’s have a look at the history of healthcare industry’s momentous push towards classification of diseases.
Early History: ICD’s history is old, very old. Sir George Knibbs, an Australian statistician credits François Bossier de Lacroix of first classifying diseases systemically. The classification of disease in most general use was introduced by William Cullen and was published in 1785 under the title Synopsis nosologiae methodicae. A statistical study began by John Graunt was revolutionary as he attempted to estimate the proportion of children who died before reaching the age of six years. Before him, no type of medical diseases classification record was available. He classified the deaths as thrush, convulsions, rickets, teeth and worms. In 1837, William Farr labored to solve the problem of imperfect classification and tried to introduce some sort of international uniformity. Farr kept on improving the system and along with Marc d’Espine, both presented their own classification methods. Farr classified diseases under five groups according to anatomical site while d’Espine divided the diseases by nature. Farr’s model was revised multiple times in 1874, 1880, and 1886. Farr’s principle of classifying diseases by anatomical site survived. It became the basis of the International List of Causes of Death.
Adoption of the International List of Causes of Death took considerable time. In 1891, preparation of a classification of causes of death was approved by the committee that the International Statistical Institute had organized. Three classifications were approved: the first, an abridged classification of 44 titles; the second, a classification of 99 titles; and the third, a classification of 161 titles. It was called The Bertillon Classification of Causes of Death and was adopted in several countries. It was further decided that revision will be made every ten years.
The French Government in August 1900 convened the first International Conference for the Revision of the Bertillon or International List of Causes of Death. On August 21, 1900, a classification of causes of death consisting of 179 groups; and an abridged classification of 35 groups were authorized and adopted by several countries. After further revisions in subsequent years: 1910, and 1920; and with The Health Organization of the League of Nations’ active interest, “Mixed Commission” was formed which helped approve a revision in 1938 of the International List of Causes of Death.
Countries participating in the classification of diseases, found that the list of causes of death does not take into account the morbidity data. As a result, a Standard Morbidity Code was prepared by the Dominion Council of Health of Canada and published in 1936. Subsequent improved followed in different countries.
Many technical innovations followed. An optional alternative method of classifying diagnostic statements called dagger and asterisk system was introduced, the idea was to include the general user in the development process of the classification. The World Health Organization Collaborating Centres for Classification of Diseases stepped in to prepare the new model of classification that includes ICD-9 and ICD-10. The classification system is complex enough to classify 14,000 and 68,000 codes respectively.
The historical development took its time. But the goal has allows been the same, to make complex process of classification simpler. The new coding system is another step in the writing the new history in a positive light.
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