Optimization of the allergen classification of the International Classification Of Diseases, 11th Revision (ICD-11).

Allergy International Classification of Diseases World Health Organization allergens classification coding epidemiology hypersensitivity

Journal

The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002

Informations de publication

Date de publication:
06 2023
Historique:
received: 15 01 2023
revised: 23 02 2023
accepted: 06 03 2023
medline: 9 6 2023
pubmed: 6 4 2023
entrez: 5 4 2023
Statut: ppublish

Résumé

Accurate diagnosis of triggers or causative allergens is essential for appropriate risk assessment, providing correct advice to patients with allergy and their caregivers and personalized treatment. However, allergens have never been represented in the World Health Organization International Classification of Diseases (ICD). In this article, we present the process of selection of allergens to better fit the ICD, 11th Revision (ICD-11) structure and the outcomes of this process. The Logical Observation Identifiers Names and Codes database, containing 1444 allergens, was used as the basis for the selection process. Two independent experts were responsible for the first selection of the allergens according to specific technical criteria. The second step of the selection process was based on real-life relevance of the allergens according to the frequency of requests regarding each of them. We selected 1109 allergens (76.8%) from all 1444 present in the Logical Observation Identifiers Names and Codes database, with considerable agreement between experts (Cohen κ = 8.6). After assessment of real-life data, 297 additional relevant allergens worldwide were selected and grouped as plants (36.4%), drugs (32.6%), animal proteins (21%), mold and other microorganisms (1.5%), occupational allergens (0.4%), and miscellaneous allergens (0.5%). The stepwise approach allowed us to select the most relevant allergens in practice, which is the first step to building a classification of allergens for the WHO ICD-11. Aligned with the achievement in the construction of the pioneer section addressed to the allergic and hypersensitivity conditions in the ICD-11, the introduction of a classification for allergens can be considered timely and much needed in clinical practice.

Sections du résumé

BACKGROUND
Accurate diagnosis of triggers or causative allergens is essential for appropriate risk assessment, providing correct advice to patients with allergy and their caregivers and personalized treatment. However, allergens have never been represented in the World Health Organization International Classification of Diseases (ICD).
OBJECTIVE
In this article, we present the process of selection of allergens to better fit the ICD, 11th Revision (ICD-11) structure and the outcomes of this process.
METHODS
The Logical Observation Identifiers Names and Codes database, containing 1444 allergens, was used as the basis for the selection process. Two independent experts were responsible for the first selection of the allergens according to specific technical criteria. The second step of the selection process was based on real-life relevance of the allergens according to the frequency of requests regarding each of them.
RESULTS
We selected 1109 allergens (76.8%) from all 1444 present in the Logical Observation Identifiers Names and Codes database, with considerable agreement between experts (Cohen κ = 8.6). After assessment of real-life data, 297 additional relevant allergens worldwide were selected and grouped as plants (36.4%), drugs (32.6%), animal proteins (21%), mold and other microorganisms (1.5%), occupational allergens (0.4%), and miscellaneous allergens (0.5%).
CONCLUSION
The stepwise approach allowed us to select the most relevant allergens in practice, which is the first step to building a classification of allergens for the WHO ICD-11. Aligned with the achievement in the construction of the pioneer section addressed to the allergic and hypersensitivity conditions in the ICD-11, the introduction of a classification for allergens can be considered timely and much needed in clinical practice.

Identifiants

pubmed: 37019392
pii: S0091-6749(23)00371-8
doi: 10.1016/j.jaci.2023.03.019
pii:
doi:

Substances chimiques

Allergens 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1655-1659.e3

Informations de copyright

Copyright © 2023. Published by Elsevier Inc.

Auteurs

Luciana Kase Tanno (LK)

Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier, France; Desbrest Institute of Epidemiology and Public Health, University of Montpellier-INSERM, Montpellier, France; World Health Organization (WHO) Collaborating Centre on Scientific Classification Support, Montpellier, France. Electronic address: luciana.tanno@gmail.com.

Yann Briand (Y)

Agence Numerique de Santé, Paris, France; French WHO Collaborating Centre, Paris, France.

Mélissa Mary (M)

Agence Numerique de Santé, Paris, France.

David A Khan (DA)

Division of Allergy and Immunology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Tex.

James L Sublett (JL)

Family Allergy and Asthma, Louisville, Ky; Section of Allergy and Immunology, Department of Pediatrics, University of Louisville School of Medicine, Louisville, Ky; University of Louisville School of Medicine, Louisville, Ky.

Mark L Corbett (ML)

University of Louisville School of Medicine, Louisville, Ky.

Ruby Pawankar (R)

Department of Pediatrics, Nippon Medical School, Tokyo, Japan.

Stefano Del Giacco (S)

Department of Medical Sciences and Public Health, University of Cagliari, Monserrato-Cagliari, Italy.

Maria Jose Torres (MJ)

Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain; Allergy Unit, Hospital Regional Universitario de Málaga, Málaga, Spain; Departamento de Medicina, Universidad de Málaga, Málaga, Spain.

Ignacio J Ansontegui (IJ)

Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia Erandio, Bilbao, Spain.

Motohiro Ebisawa (M)

Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Japan.

Bryan Martin (B)

Medicine and Pediatrics, The Ohio State University, Columbus, Ohio.

Pascal Demoly (P)

Division of Allergy, Department of Pulmonology, Allergy and Thoracic Oncology, University Hospital of Montpellier, Montpellier, France; Desbrest Institute of Epidemiology and Public Health, University of Montpellier-INSERM, Montpellier, France; World Health Organization (WHO) Collaborating Centre on Scientific Classification Support, Montpellier, France.

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