1. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC1 Applicability of Dutch ICD-10 Electronic tool for publication of ICD-10 updates and control of derived classifications Drs Huib Ten Napel WHO FIC CC & MI University Medical Centre Nijmegen The Netherlands

2. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC2 Presentation overview Purpose of presentation Ist & Soll situation What ClaM can do What we wish ClaM to do –Update massages –Derived classification schemes –Mapping Discussion

3. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC3 Purpose Presuppostion that electronic versions of classification schemes will prevail Main purpose of presentation –exploration of the possibilities of Dutch Centres electronic tool for: Update messages in ClaML Deriving Classification schemes from source files Mapping related Classifications schemes From a National point of view

4. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC4 Ist & Soll Ist Primarily focus on Presentation = production of book: –Text editing and lay-out –Alphabetical indexing Secondary –Updates –´Electronic versions´(hyperlinks in textfiles) Involving –Decentralised working: A high number of persons working separate & independent Various text processing tools Various versions of these tools Laborious and time consuming No standard for structure elements of classification

5. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC5 Ist & Soll External quest for: –Classifications in database format –Guidance in classifications to be derived –How ICD-9 CM maps to ICD-10 (crosswalks) –How ICD maps to ICF (and ICF to former ICIDH) –How ICD maps to DBC´s

6. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC6 Ist & Soll Soll Primarily focus on Representation = production of a central source file: –Using a standard, CEN/TS 14463 (ClaML) –Using a software tool for support of requirements, the Classification Manager (ClaM) Involving –Centralised working: A number of persons working separate but dependent One standard editing tool One version of the tool Less laborious and time consuming A standard for the structure elements of classifications

7. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC7 What ClaM can do 1 To explore the possiblities of the electronic tool, first to explain what it can do: Store classification schemes in electronic form –Preserving the internal structure –Explicitly representing rubrics, codes and the hierarchy that makes up the structure Offers several classification manipulation functions: –Edit functions such as: replace, move up move down, etc. –Standard operations that allow to add, edit, find, delete or move a class –More complex operations to collect, sort or shift children classes –Add modifiers and assign these modifiers to classes –Summarize existing classes under a new parent class

8. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC8 What ClaM can do 2 Offers several views: –Centre, expand, collaps, show from top, show class in structure and spawn the classification scheme Index the classification scheme as disered: –Class and rubric structure allows in- or exclusion of terms on every level –Import function of other indexes and theasauri Referencing: –Referral tool checks the text for references and places tags –Reference tags are shown as hyperlinks

9. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC9 What ClaM can do 3 Comparator tool: –Checks classification schemes –Reports absence, reports differences –Summary report Accountability: –Keeps complete history of changes made Export function: –Exports in several formats, such as old ClaM, ClaML, comma & tab separated, RTF –rtf already has a classification type style –Exports in selected levels

10. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC10 What we wish ClaM to do Presupposition repeated: electronic versions will prevail We want ClaM to support our work on: –Update messages –Derived classification schemes –Mapping between classification schemes

11. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC11 Update messages After translation of list of changes, Classification schemes are easily adjusted in ClaM: –New version of the Classification scheme –Based on the former version –Complete history of changes is in archive The Comparator tool: –Check´s the two versions and makes a summary of the differences –This summary could be used as an update Required: –Import and update mechanisme –A standard for the update message (CEN ´prEN 13609-1, Updating of coding schemes´, is a candidate)

12. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC12 Derived classification schemes Present situation is –Derived classification schemes are: Developed in unstructured environment Paper based Commited, but compatible? Univocal? With ClaM –Working directly in the source file: Extension within branches (most cases) Structured and controlled working History makes changes traceable and controllable Comparator makes additions visible for comment Required: Structuring of editorial process Central editing or is parallel editing possible?

13. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC13 Mapping classification schemes 1 This is a very complicated item Questions to be put here are: –Are crosswalks sensible? –What do these crosswalks formally represent? Same term or nearly same term? Same meaning, but referring to what? –What does a map mean in this context? With ClaM: –Classification schemes can be compared Only on the level of codes and text strings Not on semantics, referential meaning

14. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC14 Mapping classification schemes 2 ClaM does not support this function, the Classification Workbench (ClaW) does! –It offers the possibility to explore formal relations between (categories of) terms –To map classes to a reference model (RM) and –To expand similar classes to the RM (which is a kind of mapping) First we have to make explicit: –what is meant by mapping (or crosswalking) and –why it is needed (eg continuity of information?)

15. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC15 Discussion Questions? Discussion points?

16. National Institute for Public Health and the Environment Cologne, 19/25-October 2003Meeting of Heads of WHO FIC CC16 Thank you for your attention