Field-testing the new anaphylaxis’ classification for the who International Classification of Diseases ICD-11 revisionReport as inadecuate

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* Corresponding author 1 CHU de Montpellier 2 iPLESP - Institut Pierre Louis d-Epidémiologie et de Santé Publique 3 Hospital Sirio Libanes 4 IMAG - Institut Montpelliérain Alexander Grothendieck 5 Royal Brompton Hospital

Abstract : BackgroundIn order to consolidate the new classification model addressed to the allergic and hypersensitivity conditions according to the International Classification of Diseases ICD-11 revision timeline, we here propose real-life application of quality assurance methodology to evaluate sensitivity and accuracy of the -Anaphylaxis- subsection.MethodsWe applied field-testing methodology by analyzing all the consecutive inpatients’ files documented as allergies from the University Hospital of Montpellier electronic database for the period of one year. The files clinically validated as being anaphylaxis were manually blind-coded under ICD-10 and current ICD-11 beta draft. The correspondence of coding and the impressions regarding sensibility were evaluated.ResultsFrom all 2,318 files related to allergic or hypersensitivity conditions, 673 had some of the anaphylaxis ICD-10 codes; 309 files 46% from 209 patients had anaphylaxis and allergic or hypersensitivity comorbidities description. The correspondence between the two coders was perfect for 162 codes from all 309 entities 52.4% Cohen-kappa value 0.63 with the ICD-10 and for 221 codes 71.5% Cohen-kappa value 0.77 with the ICD-11. There was a high agreement regarding sensibility of the ICD-11 usability Cohen-kappa value 0.75.ConclusionWe here propose the first attempt of real-life application to validate the new ICD-11 -Anaphylaxis- subsection. Clearer was the improvement of accuracy reaching 71.5% of agreement when ICD-11 was used. By allowing all the relevant diagnostic terms for anaphylaxis to be included into the ICD-11 framework, WHO has recognized their importance not only to clinicians but also to epidemiologists, statisticians, health care planners and other stakeholders.

Author: Luciana Kase Tanno - Nicolas Molinari - Sophie Bruel - Jean-Luc Bourrain - Moises A. Calderon - Pierre Aubas - Pascal Demoly -



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