ICD 11 – history of the development of the ICD from 1853 to 2015

The classification of disease began as a statistical study of disease.

This post looks back to the past from 1853 when William Farr (1807–1883) who was a medical statistician of the the General Register Office of England and Wales, laboured to use this imperfect classifications of disease available at the time. With the progress of preventive medicine and to embody the advances of medical science, Farr worked to secure better classifications and international uniformity in their use. Farr’s model survived as the basis of the International List of Causes of Death.

In 1983, The Bertillon Classification of Causes of Death by Jacques Bertillon (1851–1922), Chief of Statistical Services of the City of Paris was adopted as the revision to the International List of Causes of Death.

Revisions to The Bertillon or International List of Causes of Death were carried out in 1900 (ICD 1), 1910 (ICD 2) and 1920 (ICD 3).

With the lack of leadership after Bertillon’s death in 1922 and in preparation for subsequent revisions, the International Statistical Institute and the Health Organization of the League of Nations – which had taken an active interest in vital statistics, cooperated and prepared the expansion in the rubrics of the 1920 International List of Causes of Death into the Fourth (1929) and the Fifth (1938) revisions of the International List of Causes of Death.

The classification of disease remained almost wholly in relation to cause-of-death statistics.

But there was a growing need for a corresponding list of diseases, a classification of diseases for morbidity statistics.

Farr had actually recognised back in 1855 that it was also desirable to extend the cause-of-death statistics system for morbidity. It is interesting to note that 5 years later in 1860, Florence Nightingale urged the adoption of Farr’s classification of diseases for the tabulation of hospital morbidity in the paper, “Proposals for a uniform plan of hospital statistics”. Subsequently, all three revisions of ICD 1, ICD 2 and ICD 3 had adopted a parallel classification of diseases for use in statistics of sickness, however this parallel classification failed to receive general acceptance.

The International Classification of Diseases, Injuries, and Causes of Death as a single list was endorsed by the First World Health Assembly in 1948 as ICD 6. This list provided for the first time a common base for comparison of morbidity and mortality statistics that greatly facilitates coding operations.

The Seventh Revision (ICD 7) and The Eighth Revision (ICD 8) of the International Classification of Diseases were revised under the auspices of WHO in 1955 and 1965 respectively.

The Ninth Revision (ICD 9) was accepted in 1975 and included the dagger and asterisk system as an optional alternative method of classifying diagnostic statements, including information about both an underlying general disease and a manifestation in a particular organ or site.

The Tenth Revision (ICD 10) was originally scheduled for 1985, following the established 10 year interval between revisions

The WHO decided to delay ICD 10 until 1993 as it then realised the great expansion in the use of the ICD which necessitated a thorough rethinking of its structure. The WHO needed to devise a stable and flexible classification, which should not require fundamental revision for many years to come.

ICD 11 is not due until May 2015 when it is due to be presented to the World Health Assembly. As of May 2011. the Open ICD-11 Alpha Browser was open to the public for viewing and for commenting in July 2011. The ICD-11 Beta version was open to the public in the ICD revision process to make comments, make proposals, to change ICD categories, participate in field trials and assist in translating.

Below is an infographic (you can view a larger image by first clicking on the image below which will open in a new tab of your current window and then clicking again on the image in the new tab) I have designed as a display in a showcase way of all the past revisions of ICD leading to ICD 11 expected in 2015.


With the historical background of ICD and the run-up to ICD 11, I present this post as a pre-cursor to the previous post ICD 10 & ICD 11 Development – How, What, Why & When (this link will open in a new tab of your current window) and for my coming posts on ICD 11.

International Statistical Classification of Diseases and Related Health Problems, Volume 2 Instruction manual 2011, 2010 edn, World Health Organization, Geneva, Switzerland

World Health Organization, 2012, Classifications, viewed 18 December 2012, < http://www.who.int/classifications/icd/revision/timeline/en/index.html >

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