Traditionally trained acupuncturists’ views on the World Health Organization traditional medicine ICD-11 codes: A Europe wide mixed methods study

Hughes, John, Fisher, Peter, Espinosa, Stéphane, Brinkhaus, Benno, Fonnebo, Vinjar, Rossi, Elio and Lewith, George (2019) Traditionally trained acupuncturists’ views on the World Health Organization traditional medicine ICD-11 codes: A Europe wide mixed methods study. European Journal of Integrative Medicine, 25, 49-54. (doi:10.1016/j.eujim.2018.11.009).

Abstract

Introduction: The diagnostic categories used in Traditional Medicine (TM) that originated in China and are now used around the world have been classified for inclusion as a chapter within the World Health Organization's International Classification of Diseases (ICD). As a new chapter in ICD, the TM ICD codes were subject to international field testing. A pilot field test of the TM ICD codes was conducted to investigate their clinical utility in the European context. Design: A mixed methods approach, including a Europe wide survey of practitioner views on TM ICD codes; and investigating the coding process of case study vignettes to explore coders’ experiences of using TM ICD codes. Results: Survey: The majority of participants felt TM ICD codes provide a meaningful way to classify TM disorders and patterns; felt their patients’ diagnoses could be represented within the codes; and felt the codes would be important in their clinical practice. Coding of vignettes: In 60.7% of cases the specificity of the assigned code was perceived as ‘just right’. Participants experienced difficulties assigning a single TM ICD disorder and pattern code, due to multiple codes being viewed as appropriate for the case. Conclusions: The European TM practitioners who participated in this study largely perceive the TM ICD codes as valuable, conceptually accurate, and incorporating the range of TM diagnoses utilized within clinical practice. The TM ICD codes could be improved for European TM practitioners by expanding the scope of TM ICD codes, and adopting a multidimensional approach whereby more than one disorder and/or pattern code can be applied to single patients.

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