2023-09-25 Sequence, ICD-11, DORIS - Response 2

[mortality-forum]

Hello everyone, I hope you're well.

 

Has anyone used or tested the DORIS tool?

 

In the following sequence:

a) parkinson's disease

b) gastric ulcer

 

The underlying cause of death given by the tool is gastric ulcer.

 

Do you accept this sequence?

 

Thank you

 

Liliana Bernardo

Portugal

 

Response from Kathy O’Brien, Canada

 

I agree with Dr. Torres, that for meaningful statistics, Parkinson’s disease should be selected as underlying cause of death, even though there is some research that ulcers and Parkinson’s Disease could be linked, and it was certified as such.  As Dr. Torres pointed out, currently there is no instruction in the Reference Guide to stop the sequence at Parkinson’s, and DORIS is only programed to follow the instructions in the Reference Guide. 

 

This will be a challenge for the mortality community as we implement ICD-11, as the instructions in ICD-10 Volume 2 (which is what the Reference Guide is based on) contained only a portion of the rules that made up the decision tables that were used for ICD-10 underlying cause tabulation.   Therefore, we need to find a way in ensuring that we can continue to produce meaningful statistics in a transparent way as we transition to ICD-11.

 

 

Response from Dr. Torres, Mexico

 

DORIS should have applied SP5 and selected Parkinson's Disease, because this disease is not due to gastric ulcer. Its etiology is unknown, but it is associated with several factors that do not include gastric ulcer. However, this rejected sequence is not found in the ICD-11 Reference Guide and was therefore not applied. This must be included.​

Dr. Luis Manuel Torres Palacios

Centro Colaborador para la Familia de Clasificaciones Internacionales 

de la OMS en México (CEMECE)