Blog posting on ICD-10 and Diagnosis

Mark Graber mark.graber at IMPROVEDIAGNOSIS.ORG
Tue Nov 10 21:27:07 UTC 2015


Thanks Mark E. for forwarding these articles - they illustrate very nicely how much easier it is to study diagnosis when you start out capturing the chief complaint.  These articles have detailed compilations of the final diagnoses deriving from those complaints, one element of the pre-test probabilities that we need.  And research would hopefully follow to measure how long it took to make each of those diagnosis, which would open the next door to study why there was variability.  Try doing any of those starting with ICD-10 codes and you'll have an instant headache.  


Mark L Graber MD FACP
President, SIDM  www.improvediagnosis.org



On Nov 10, 2015, at 6:52 AM, Mark H Ebell <ebell at UGA.EDU> wrote:

The Europeans, and in particular the Dutch, used this system. I know the Lee Green (Alberta) and Don Nease (Colorado) were working with it and created software around it while at Michigan. And, Henk Lamberts published a series of great articles. I’ve attached a couple, I published the grainy one while I was editor of JFP because I thought it was so important. Unfortunately, Henk died a few years ago.

Best,

Mark

From: Mark Graber <mark.graber at improvediagnosis.org <mailto:mark.graber at improvediagnosis.org>>
Date: Tuesday, November 10, 2015 at 9:49 AM
To: Listserv ImproveDx <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, Mark Ebell <ebell at uga.edu <mailto:ebell at uga.edu>>
Subject: Re: [IMPROVEDX] Blog posting on ICD-10 and Diagnosis

Thanks to Mark Ebell for calling attention to the WHO's classification system, the International Classification for Primary Care (ICPC-2).  One NICE feature in ICPC-2 is that it captures the reason for the encounter, which would be a huge help to future research on diagnostic error.  We need that !

Our exclusive use of ICD-10 in the US is a complicating factor in regard to research, because so often a presumptive diagnosis is chosen instead of just the chief complaint.  


Mark L Graber MD FACP
President, SIDM  www.improvediagnosis.org <http://www.improvediagnosis.org/>


On Nov 9, 2015, at 8:47 PM, Mark H Ebell <ebell at UGA.EDU <mailto:ebell at uga.edu>> wrote:

How about:

http://www.who.int/classifications/icd/adaptations/icpc2/en/ <http://www.who.int/classifications/icd/adaptations/icpc2/en/>

Mark Ebell

From: "graber.mark at GMAIL.COM <mailto:graber.mark at GMAIL.COM>" <graber.mark at GMAIL.COM <mailto:graber.mark at GMAIL.COM>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, "graber.mark at GMAIL.COM <mailto:graber.mark at GMAIL.COM>" <graber.mark at GMAIL.COM <mailto:graber.mark at GMAIL.COM>>
Date: Monday, November 9, 2015 at 11:08 PM
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: [IMPROVEDX] Blog posting on ICD-10 and Diagnosis

Dr Yul Ejnes (an internist and  past chair of ACP's Board of Regents) has an interesting  blog post <http://www.kevinmd.com/blog/2015/10/icd-10-isnt-just-the-problem-its-also-the-symptom.html> on the new ICD-10 coding system.  Echoing the same point made in the IOM report Improving Diagnosis in Health Care, he labels ICD-10 an "absurdly complicated payment 'non-system'" and calls for "alternatives that make getting the diagnosis right more important than selecting the correct code."  

Mark L Graber MD FACP
President, Society to Improve Diagnosis in Medicine




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Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine

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<Fam Pract 2012 - Transitions Project.pdf><J Fam Pract 2002 - Dutch pretest probability database.pdf><Top10_Differential_Diagnosis_In_Primary_Care.pdf>







Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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