WHO Health Statistics: GHO Portal

Global Health ObservatoryWHO's portal providing access to data and analyses for monitoring the global health situation• Data repository

– Mortality – Millennium Development Goals– Burden of disease – ….

• World Health Statistics reports• Statistical reports• Country statistics• Map gallery• WHO Indicator Registry

Information ProductsProfiles

Data

African Health

Observatory

NHO

NHO

NHO

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GHO and other observatories

Other databases

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GHO Quality Improvement • Improved data and metadata standards

– SDMX implementation - XMART– Indicator Metadata Registry update 2.0 HISP

• Improved Visualization Tools

• Infrastructure renewal– Regional Health Observatories– Country Health Observatories– Linked Data initiatives– WEB services

An Information Paradox: Reporting of Mortality in the World

Information Paradox

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YLLs

VR countries vs No VR

Burden of Mortality

CAUSES of DEATH ESTIMATESUPDATE para 3

• WHO released regional-level estimates of mortality in July 2013, by:– cause, age and sex – for years 2000 - 2011.

• country-level estimates for years 2000-2012 will be released late 2013.

• UN Inter-agency Group for Child Mortality Estimation

will release Child Mortality estimates in September.

Consultation with Member States

• WHO reporting is regulated by its Governing Bodies ( Executive Board Resolution EB107.R8 )

• WHO’s main interlocutor, by constitution, is the Ministry of Health in a Member State

• WHO encourages the MoH to coordinate with all relevant government agencies, including the National Statistical Offices.

Criteria for WHO Official Statistics

in line with the general principles of statistics:

(1) an accurate listing of data inputs used, with relevant metadata

ideally, such data should be publicly accessible

(2) correction of known biases in the input data

(3) a clear explanation of the modeling approach used, preferably in the peer-reviewed literature

(4) country consultation, (if country estimates are to be released).

PART 2: ICD Revision

Genealogy of ICD 1664

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ICD Revisions13

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1853 1893 1900 1909 1920 1929 1938 1948 1955 1968 1975 1979 1993 1993

Placing WHO Classifications in HIS & IT

Population Health• Births • Deaths • Diseases• Disability • Risk factors

e-Health RecordSystems

ICD ICF

ICHI

Classifications

LinkagesKRs

Terminologies

Clinical• Decision Support• Integration of care• Outcome

Administration• Scheduling• Resources • Billing

Reporting• Cost• Needs• Outcome

ICD-11 Revision Goals1. Evolve a multi-purpose and coherent classification

– Mortality, morbidity, primary care, clinical care, research, public health…

– Consistency & interoperability across different uses

2. Serve as an international and multilingual reference standard for scientific comparability and communication purposes

3. Ensure that ICD-11 will function in an electronic environment.

• ICD-11 will be a digital product• Support electronic health records and information systems

• Link ICD logically to underpinning terminologies and ontologies (e.g. SNOMED, GO, …)• ICD Categories “defined” by "logical operational rules" on their associations and details

Construction of ICD-10: Revision Process in 20th Century

• 8 Annual Revision Conferences (1982 - 89)

• 17 – 58 Countries participated– 1- 5 person delegation

• Manual curation– List exchange– Index was done later

• "Decibel" ? Method of discussion• Output: Paper Copy• Work in English only• Limited testing in the field

Construction of ICD-11: Revision Process in the 21st Century

• Internet-based permanent platform – All year round – Open to all people in a structured way– Content experts focus

• Digital curation– Wiki enabled collaboration– Ontology based

• Enhanced discussion & peer review – TAGs serve as the editorial group

• Electronic copy print version

• Work in multiple languages

• Planned field tests – Based on Use Cases

How do we go from Here to 21st Century?

iCAT• Open and Collaborative Platform

– Web based

– Like WIKI • But

– by the Content Model • with

– by the TAGs , and scientific peers

iCATCollaborative Authoring Tool

for ICD Revision

structured

Editorial Oversight

Ontology (philosophy)– the Organization of Reality

Ontology (computer science) – the explicit – operational

description of the conceptualization of a domain:

An ontology defines:– a common vocabulary a

shared understanding/exchange:among peopleamong software agentsbetween people and software

– to reuse data - information– to introduce standards to allow

interoperability

What is Ontology?

ICD11 βetahttp://www.who.int/classifications/icd/revision

• Beta – Browser & Print 10 look & feel + descriptions – code structure !

• ICD-11 Beta draft is NOT FINAL

• updated on a daily basis• NOT TO BE USED for CODING

except for agreed FIELD TRIALS

βeta

ICD-11 FeaturesInternet Based Platform

Content Model

Multi Lingual Representations

Definitions

Input from all Stakeholders

Arabic 官话 Chinese لعربية English EnglishFrançais FrenchРусский язык Russian Español Spanish Deutsch German Português Portuguese

Field Trials for Use Cases

Electronic Health Record Ready

FIELD TESTS (1): Bridge-Coding• The Case information

• live • medical record

• Coded using • ICD10• ICD11

• Agreement rates measured

• The Case information• live • medical record

• Coded using ICD11 by at least two different people

• Agreement rates measured

FIELD TESTS (2): Reliability

ICD-11 Timeline

• 2011 : Alpha version ( ICD 11 alpha draft) – +1 YR : Commentaries and consultations

• 2012 : Beta version & Field Trials Version – +3 YR : Field trials

• 2015 : Final version for WHA Approval– 2015+ implementation

ICD-10 • Annual Revision

Conferences• Focus on mortality

statistics• Produced manually

• Produced in English• NO field tests• Update mechanism

built in later

ICD-11• Continuous web

platform + meetings• Focus on ALL

statistical use cases• Produced digitally

– w/ information model

• Multilingual development

• Field tests done before• Continuous update –

revision mechanism

Questions & Answers

ustunb@who.int

@ustunb