AGTCM-Congress 2014, Rothenburg o.d.T.
Report by Nora Laubstein
International Classification of Diseases (ICD-11)-revision by WHO/ Enhanced recording of morbidity in TM terms
In connection with the ICD which classifies all relevant diseases on international level (in the beginning 1900, later in 1948 accepted worldwide) the European TCM-Association (ETCMA) and the German organization AGTCM presented Mister Nenad Kostanjsek, Technical Officer for statistics CTS of the WHO in Geneva and his team. He was invited to give a review in three parts about the last three years of working together for a TM-alignment included into the ICD-system.
Until now (ICD-10) all diseases are listed but without any concrete definition. This situation should be changed with the new version ICD-11 which should be finished in 2017: Additionally to this process the department of Mister Kostanjsek works together with the WHO-T&CM department of Dr. Zang Qi. They have founded an internal Working-Group (ICTM) to develop categories for the health workforce in the so called WHO-TM-Modul-1.
Currently only three countries were represented in this group and give financial support: China, Japan and Korea. In the past eight CAM-disciplines have been standardized (under all TCM, Homeopathy, Chiropractic and Osteopathy) and connected with the WHO-benchmark-directive for T&CM (former called TM/CAM).
Mister Kostanjsek contested: Yes, T&CM is part of the health section, BUT „TM does not count, until we do not count TM!” More and more demands for quality and safety are strengthening the pressure. Because of growing necessarily we have to find a high level categorization!
For the WHO this situation leads to the following perspectives:
- Development of a bigger International Classification with ICTM
- Development of a specific terminology
- Creation of more TM-Modules
- Development of a common terminology for diagnosis
- The integration of TM and western medicine (probably it is TCM + Mainstream Medicine)
The concrete work and input should be done with the browser www.who.int/classifications/icd11/browse/l-m/en or in a direct dialog.
The national implementation of WHO-directives and codifications hast o be done by the national authorities and would be supported by the WHO only on a technical way. Until now there exists only English publications but in the future they should be available in eight languages.
“Diagnosis” was in the center of the second part of his presentation. The practitioners should define the specific characteristics for themselves in form of so called “Field trials” (selected Field trial Units- FTUs). Current existing technical terms and literature should be overworked and presented in a statistic and scientific way. Very important:
- the Input of all stakeholders (specific doctors and CAM-organizations) and
- clinical practice of Field Tests (FT) by hospitals, universities or ambulant studies.
Mister Kostanjsek stated widely what a huge design for studies is nescessary to start the system of codification: Basic questions, Double Coding and Reliabillity. Additional: Evaluation, Core studies, different settings and additional studies. More than helpful would be additional studies about Primary Care and General Health Care. All this work hast o be done voluntary by the stakeholders because the WHO has no funding opportunity in this case. For money the national governments, university-projects or manufactures should be asked for…
In the third part of this presentation Mister Kostanjsek and his team presented a questionnaire. Three groups argued and filled in this questionnaire about basic questions like: Necessity, the use and the personal impression about this codification-system for TM – especially in this case for the Traditional Chinese Medicine.
A fruitful and inspiring meeting – it shows very clear which political players of today (national governments, EU, Council of Europe, etc.) move on the top: The WHO rules discrete but slowly worldwide and behind the curtain! The hand for collaboration with the WHO is open, but full of financial conditions. This means for all CAM-stakeholders to search for funding and do this voluntary work for ourselves – and this is not an easy job.
Do we really need the ICD for CAM? It is a question of strategy……until now only three countries are doing this, all the others sit and wait – and will complain