title: Field-testing the new anaphylaxis' classification for the WHO International Classification of Diseases-11 revision.
abstract: BACKGROUND
  To consolidate the new classification model addressed to the allergic and hypersensitivity conditions according to the International Classification of Diseases (ICD)-11 revision timeline, we here propose real-life application of quality assurance methodology to evaluate sensitivity and accuracy of the 'Anaphylaxis' subsection.
  
  
  METHODS
  We applied field-testing methodology by analysing all the consecutive inpatients' files documented as allergies from the University Hospital of Montpellier electronic database for the period of 1 year. The files clinically validated as being anaphylaxis were manually blind-coded under ICD-10 and current ICD-11 beta draft. The correspondence of coding and the impressions regarding sensibility were evaluated.
  
  
  RESULTS
  From all 2318 files related to allergic or hypersensitivity conditions, 673 had some of the anaphylaxis ICD-10 codes; 309 files (46%) from 209 patients had anaphylaxis and allergic or hypersensitivity comorbidities description. The correspondence between the two coders was perfect for 162 codes from all 309 entities (52.4%) (Cohen-kappa value 0.63) with the ICD-10 and for 221 codes (71.5%) (Cohen-kappa value 0.77) with the ICD-11. There was a high agreement regarding sensibility of the ICD-11 usability (Cohen-kappa value 0.75).
  
  
  CONCLUSIONS
  We here propose the first attempt of real-life application to validate the new ICD-11 'Anaphylaxis' subsection. Clearer was the improvement in accuracy reaching 71.5% of agreement when ICD-11 was used. By allowing all the relevant diagnostic terms for anaphylaxis to be included into the ICD-11 framework, WHO has recognized their importance not only to clinicians but also to epidemiologists, statisticians, healthcare planners and other stakeholders.
authors.affiliation: Hospital Sírio Libanês, São Paulo, Brazil.|University Hospital of Montpellier, Montpellier, France.|UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Universités, Paris, France.
authors.forename: L K
authors.initials: LK
authors.lastname: Tanno
authors.affiliation: IMAG UMR 5149, DIM CHRU de Montpellier, Montpellier, France.
authors.forename: N
authors.initials: N
authors.lastname: Molinari
authors.affiliation: University Hospital of Montpellier, Montpellier, France.
authors.forename: S
authors.initials: S
authors.lastname: Bruel
authors.affiliation: University Hospital of Montpellier, Montpellier, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Bourrain
authors.affiliation: Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Calderon
authors.affiliation: University Hospital of Montpellier, Montpellier, France.
authors.forename: P
authors.initials: P
authors.lastname: Aubas
authors.affiliation: University Hospital of Montpellier, Montpellier, France.|UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Universités, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Demoly
mesh_terms: D000707:Anaphylaxis / Q000175:diagnosis*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014944:World Health Organization
keywords: International Classification of Diseases; World Health Organization; anaphylaxis; classification; validation