Author Description

"This report describes the historic development of the disease nomenclatures and classifications that ultimately became the major international standard known as the World Health Organization's (WHO) International Classification of Diseases (ICD). Written largely at the initiative of Dr. Iwao Moriyama, a participant in these developments for much of the 20th century, the report describes the historical, cultural, and scientific environment in which ICD evolved, expanded, and improved. Although the report focuses on the application of ICD to mortality, it also touches on nonmortality applications, particularly as these affected the classification for mortality. With respect to mortality, the report is broad in scope. It begins by briefly describing the registration system used to collect death data, including cause of death (Chapter 1), and notes periodic efforts to standardize language that might be used to convey information in the death registration system (Chapter 2), but focuses on the classification, how the language reported in the registration system is collapsed into this classification (Chapter 3), and other issues associated with the classification's development (Chapter 4). The report discusses issues, some singular and some recurrent, that needed to be addressed during the evolution of ICD (Chapters 4 and 8), and describes the expanding application of the classification from a narrow focus on causes of death to the broader scope of causes of illness, and from an emphasis on statistical presentation and analysis to administrative uses such as hospital records indexing and medical billing (Chapter 7). The report also discusses implications of ICD choices on quality and statistics (Chapters 5 and 6). The history of ICD is rich in international collaboration and cooperation. This, and the fact that it is a classification based on sound, time-tested principles, accounts for its long and continuous international acceptance. More use is now being made of ICD th