national institute for public health and the environment cologne, 19/25-october 2003meeting of heads...

Cologne, 19/25-October 2003 Meeting of Heads of WHO FIC CC 1

National Institutefor Public Health andthe Environment

Applicability of Dutch ICD-10 Electronic tool for publication of ICD-10 updatesand control of derived classifications

Drs Huib Ten NapelWHO FIC CC & MI University Medical Centre Nijmegen

The Netherlands



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



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



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



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



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



What ClaM can do 1

• To explore the possiblities of the electronictool, 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



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



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



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



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)



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?



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



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?)



Discussion

• Questions?• Discussion points?



Thank you for your attention

national institute for public health and the environment cologne, 19/25-october 2003meeting of heads...

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