Report of the United States Delegation to the International Conference for the Eighth Revision of the International Classification of Diseases, Geneva, Switzerland, July 6-12, 1965 : discussion and recommendations at the Conference that was concerned primarily with Eighth Revision of the International Classification of Diseases and gave some consideration to multiple-cause tabulation and analysis and to hospital statistics.

  • United States. Public Health Service.
Date:
1966
Catalogue details

Licence: Public Domain Mark

Credit: Report of the United States Delegation to the International Conference for the Eighth Revision of the International Classification of Diseases, Geneva, Switzerland, July 6-12, 1965 : discussion and recommendations at the Conference that was concerned primarily with Eighth Revision of the International Classification of Diseases and gave some consideration to multiple-cause tabulation and analysis and to hospital statistics. Source: Wellcome Collection.

    17/84 (page 9)
    cation of Diseases and matters related to it, included other items reflecting national and international de- velopments in the field of health statistics. 1, ELGHTH REVISION OF THE INTERNATIONAL CLASSIFICATION OF DISEASES (ICD) 1.1 General structure of the Classification Before reviewing the revision proposals for the various sections of the Classification, the Conference considered some of its more general aspects. 1.1.1 Numbering system of the Classification The Conference recalled the comments of the Expert Committee on Health Statistics in its Ninth Report” on the numbering system of the Classification and endorsed the view that the three-digit categories should form the basic framework of the ICD in all its varied applications. In regard to the fourth digit, the Expert Committee had said: The role of the fourth digit was the identification of greater detail within the three-digit categories. The extent of the detail needed would vary for different applications of the ICD; greater, for example, in diagnostic indexing and special studies than in routine statistical use. Furthermore, the fourth-digit detail required in the various sections of the Classification would | differ in different countries or regions. The ICD, therefore, should include the essential and desirable fourth-digit sub-divisions but countries should be free to use them or not or even to prepare their own fourth- digit adaptations instead. The Committee con- sidered, however, that the internationally recom- mended four-digit structure would be suitable for most purposes and that countries would only rarely need to depart from it. Any departure from the fourth digits of the ICD must be clearly identified as such and must not affect the contents of the three-digit categories concerned, The Conference appreciated the need for flexibility at the level of the fourth digit, though it was clear that in some sections, e.g. the perinatal section, meaningful statistics would require four-digit coding, but was con- cerned that the option to vary the fourth-digit break- down should not be used more than is necessary. The Conference considered that this option need be exer- cised only in exceptional circumstances, when the internationally recommended fourth digits were in- appropriate for national purposes and could not be expanded with suitable additional fourth-digit cate- gories. Subject to this comment, the Conference en- 2WHO/HS/ICD/74.65 dorsed the views of the Expert Committee on this subject. It was also agreed that when it was appropriate and possible to include separate sub-categories for Other and ''Unspecified,' they should be numbered consistently .8 and .9. 1.1.2 Classification of symptoms The ‘Conference agreed on the continuing need for a special section of the ICD for the classification of symptoms which do not point definitely to a given diagnosis and cannot therefore be assigned to a cate- gory in the disease sections of the code. It was appreci- ated that a final revision of this section would require a systematic review of all terms in the present alpha- betical index in relation to this criterion. 1.1.3 Notes under ICD categories The Conference requested WHO to review the notes defining the content of categories with a viewto making them more immediately intelligible to coders and to persons using the Classification for the purpose of interpreting published statistics. 1.1.4 Supplementary classifications The Conference reviewed the functions of the supplementary (Y) classifications. That for causes of stillbirth would now disappear since it 'was integrated into Section XV, ''Certain causes of perinatal morbidity and mortality. The categories YOO-Y29 were regarded as essential to provide a full count of admissions to hospital, attendances at out-patient clinics, etc. »in respect of persons who were not sick and who could not, therefore, be classified to the main code. The Conference accordingly considered that this classifica- tion, suitably revised, should appear in the Manual of the ICD. The classification of impairments in categories Y40-Y88 was seen as a parallel code, collecting in one group a number of conditions scattered throughout the main code. It had been used by somecountries in health surveys and the Conference, appreciating that such surveys were likely to increase, considered that it would be useful if such a classification appeared in the Manual of the ICD for optional use. 162 Categories and sub-categories of the ICD The Conference considered the recommendations in the ninth report of the Expert Committee on Health Statistics (WHO/HS/ICD/74.65) and the revision pro- posals annexed to it (WHO/HS/ICD/74.65 Add.1-17), which were the outcome of two meetings of the Sub- Committee on Classification of Diseases and of com-