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Recent advances in the field of Family Medicine classifications ICPC into WHO-FIC

Recent advances in the field of Family Medicine classifications ICPC into WHO-FIC. J K Soler Wonca International Classification Committee. International Classification of Primary Care. Why do we need ICPC?. A classification is the ordering principle of a defined domain.

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Recent advances in the field of Family Medicine classifications ICPC into WHO-FIC

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  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

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

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

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

  9. 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

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

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

  12. .... 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

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

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

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

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

  17. ..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’…

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

  19. Relationships to other classifications

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

  21. UMLS browser examples

  22. Recent advances • Entry into WHO-FIC • Research into diagnostics • ICPC-3

  23. Recent advances • Entry into WHO-FIC • Research into diagnostics • ICPC-3

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

  25. 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

  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. 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

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

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

  31. SOB as a predictor of diagnosis of asthma

  32. Recent advances • Entry into WHO-FIC • Research into diagnostics • ICPC-3

  33. Recent advances • Entry into WHO-FIC • Research into diagnostics • ICPC-3

  34. 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 • Data elements for classification and for EPR • Linkages to other classifications yet to come

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