World Federation of Neurology: “Important step further for the future of neurology”

London, 19 June 2018 – After 11 years of intensive work, the World Health Organisation (WHO) in Geneva released the new ICD-11 (International Statistical Classification of Diseases and Related Health Problems). With the involvement of 270 institutions in 99 countries, all of them directly engaged, this effort was one of the most consultative processes in WHO history, as experts underlined. The ICD-11 which is available in electronic format replaces the ICD-10, published in 1991. The Joint Taskforce and Review Group for the ICD-11 included hundreds of experts in various fields.

“From a neurology perspective, this major undertaking is a very positive step forward for the future of neurology practice and funding, although there are still some issues that need to be discussed further”, Prof Raad Shakir, Chair of the Neuroscience Topic Advisory Group (TAG) and Past President of the World Federation of Neurology (WFN) said in commenting on the neurology chapter of the new ICD-11. The TAG had seven core members and 42 other experts, with all subspecialty organisations involved.

In the view of neuroscience and neurology experts, one of the most important news is that stroke is now classified as a neurological disease. This has important implications for the funding of neurological services, according to Prof Shakir: “In the past, stroke was part of the cardiovascular diseases, together with cardiac conditions. With the recognition of stroke being a neurological disease we see an important clarification that a sufficient number of neurologists will be needed to apply all those lifesaving modern treatments in stroke which were not available 25 years ago.”

Another new aspect in ICD-11: “The field of genetics as a cause of neurodegenerative diseases is now opened by this classification,” Prof Shakir said. There are other important disorders reflected in ICD-11 which were not recognized more than 25 years ago when ICD-10 was published: This holds true for conditions in the field of neuroimmunology, especially cancer-related ones (paraneoplastic syndromes), and for Prion diseases, a group of serious, progressive fatal disorders caused by abnormally shaped infectious proteins and for which specialized care is needed.

“It is the aim of the neurology chapter of the ICD-11 to make it easy to apply for those working in the less developed parts of the world and at the same time sophisticated enough for those working in highly specialized institutions,” Prof Shakir said. “By and large we have achieved this purpose. I am most grateful to those specialists all over the world who helped and advised in the course of this process.”

“The World Federation of Neurology welcomes the commencement of this new era in disease classification”, said WFN President Prof William Carroll. “We recognize the difficulties that had to be overcome in the course of this complex process and appreciate all the efforts undertaken to make the ICD more workable and appropriate. The ICD-11 well reflects important advances in medicine, in particular in neurology.” According to Prof Carroll, “the WFN appreciates very much having been part in this important process and is looking forward to further collaborating with the WHO to discuss future developments.”

Prof Wolfgang Grisold, Secretary General of the WFN, said the new ICD-11 is “in the best interest of patients because it mirrors the reality of neurological practice. The example of stroke shows that this classification is paramount for healthcare policy because it will help shift resources and funding to where they are needed for the best care. For the first time, the newly emerging spectrum of autoimmune encephalopathies is mentioned in detail which will help to increase awareness for these diseases.”

The ICD-11 is now open for “trial implementation” and comments and is expected to be approved by the World Health Assembly in 2019.

 

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Prof. Tissa Wijeratne catches up with Prof. Raad Shakir, immediate past president of the WFN and Chair of the WHO ICD-11 Neurosciences Topic Advisory Group, and talks about the WHO release of the new International Classification of Diseases (ICD 11)