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Pilot field testing of the chronic pain classification for ICD-11: the results of ecological coding

A task force of the International Association for the Study of Pain (IASP) has developed a classification of chronic pain for the ICD-11 consisting of seven major categories. The objective was to test whether the proposed categories were exhaustive and mutually exclusive. In addition, the perceived...

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Published in:BMC public health 2018-11, Vol.18 (1), p.1239-1239, Article 1239
Main Authors: Barke, Antonia, Korwisi, Beatrice, Casser, Hans-Raimund, Fors, Egil A, Geber, Christian, Schug, Stephan A, Stubhaug, Audun, Ushida, Takahiro, Wetterling, Thomas, Rief, Winfried, Treede, Rolf-Detlef
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description A task force of the International Association for the Study of Pain (IASP) has developed a classification of chronic pain for the ICD-11 consisting of seven major categories. The objective was to test whether the proposed categories were exhaustive and mutually exclusive. In addition, the perceived utility of the diagnoses and the raters' subjective diagnostic certainty were to be assessed. Five independent pain centers in three continents coded 507 consecutive patients. The raters received the definitions for the main diagnostic categories of the proposed classification and were asked to allocate diagnostic categories to each patient. In addition, they were asked to indicate how useful they judged the diagnosis to be from 0 (not at all) to 3 (completely) and how confident they were in their category allocation. The two largest groups of patients were coded as either chronic primary pain or chronic secondary musculoskeletal pain. Of the 507 patients coded, 3.0% had chronic pain not fitting any of the proposed categories (97% exhaustiveness), 20.1% received more than one diagnosis. After adjusting for double coding due to technical reasons, 2.0% of cases remained (98% uniqueness). The mean perceived utility was 1.9 ± 1.0, the mean diagnostic confidence was 2.0 ± 1.0. The categories proved exhaustive with few cases being classified as unspecified chronic pain, and they showed themselves to be mutually exclusive. The categories were regarded as useful with particularly high ratings for the newly introduced categories (chronic cancer-related pain among others). The confidence in allocating the diagnoses was good although no training regarding the ICD-11 categories had been possible at this stage of the development.
doi_str_mv 10.1186/s12889-018-6135-9
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subjects Back pain
Cancer
Care and treatment
Categories
Chronic pain
Chronic Pain - classification
Chronic Pain - diagnosis
Classification
Clinical Coding
Clinical utility
Coding
Developmental stages
Diagnosis
Diagnostic categories
Diagnostic systems
Ecological coding
Ecological effects
Field study
Field testing
Humans
International Classification of Diseases
Medical diagnosis
Nosology
Pain
Patients
Pilot Projects
Primary care
Psychiatry
Public health
Task forces
title Pilot field testing of the chronic pain classification for ICD-11: the results of ecological coding
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