WHO Health Statistics: GHO Portal
Global Health Observatory
WHO's portal providing access to data and analyses
for monitoring the global health situation
• Data repository
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Mortality
Millennium Development Goals
Burden of disease
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World Health Statistics reports
Statistical reports
Country statistics
Map gallery
WHO Indicator Registry
NHO
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NHO
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GHO and other
observatories
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Information
Products
African
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Health
Profiles
Observatory
Data
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Other databases
NHO
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GHO Quality Improvement
• Improved data and metadata standards
– SDMX implementation - XMART
– Indicator Metadata Registry update  2.0  HISP
• Improved Visualization Tools
• Infrastructure renewal
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Regional Health Observatories
Country Health Observatories
Linked Data initiatives
WEB services
An Information Paradox:
Reporting of Mortality in the World
Information Paradox
Burden of Mortality
800000000
700000000
600000000
YLLs
500000000
400000000
300000000
200000000
100000000
0
1
VR countries
2
3
vs
4
No VR
CAUSES of DEATH ESTIMATES
UPDATE para 3
• WHO released regional-level estimates of mortality
in July 2013, by:
– cause, age and sex
– for years 2000 - 2011.
• country-level estimates for years 2000-2012 will be
released late 2013.
• UN Inter-agency Group for Child Mortality Estimation
will release Child Mortality estimates in September.
Consultation with Member States
• WHO reporting is regulated by its Governing
Bodies ( Executive Board Resolution EB107.R8 )
• WHO’s main interlocutor, by constitution, is
the Ministry of Health in a Member State
• WHO encourages the MoH to coordinate with
all relevant government agencies, including
the National Statistical Offices.
Criteria for
WHO Official Statistics
in line with the general principles of statistics:
(1) an accurate listing of data inputs used, with
relevant metadata
ideally, such data should be publicly accessible
(2) correction of known biases in the input data
(3) a clear explanation of the modeling approach
used, preferably in the peer-reviewed literature
(4) country consultation, (if country estimates are
to be released).
PART 2: ICD Revision
Genealogy of ICD  1664
450
years
14,473
100000
ICD-10-M
ICD 10
8,173
1,967
1,164
ICD 9
ICD-9-M
1,040
ICD 8
200
ICD 5
965
214
ICD 4
ICD 7
205
ICD 3
954
189
ICD 2
10000
ICD 6
179
ICD 1
1
161
10
Bertillon
100
139
1000
Farr/d'Espine
ICD Revisions
1853 1893 1900 1909 1920 1929 1938 1948 1955 1968 1975 1979 1993 1993
Placing WHO Classifications in HIS & IT
ICD
ICF
Linkages
KRs
e-Health Record
Systems
ICHI
Classifications
Terminologies
Population Health Clinical
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Births
Deaths
Diseases
Disability
Risk factors
Administration
• Decision Support • Scheduling
• Integration of care • Resources
• Outcome
• Billing
Reporting
• Cost
• Needs
• Outcome
ICD-11 Revision Goals
Evolve a multi-purpose and coherent classification
1.
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Mortality, morbidity, primary care, clinical care, research, public
health…
Consistency & interoperability across different uses
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2.
Serve as an international and multilingual reference standard
for scientific comparability and communication purposes
3.
Ensure that ICD-11 will function in an electronic
environment.
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ICD-11 will be a digital product
Support electronic health records and information systems
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Link ICD logically to underpinning terminologies and ontologies (e.g. SNOMED, GO, …)
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ICD Categories “defined” by "logical operational rules" on their associations and details
Construction of ICD-10:
Revision Process in 20th Century
• 8 Annual Revision Conferences
(1982 - 89)
• 17 – 58 Countries participated
– 1- 5 person delegation
• Manual curation
– List exchange
– Index was done later
• "Decibel" ? Method of discussion
• Output: Paper Copy
• Work in English only
• Limited testing in the field
Construction of ICD-11:
Revision Process in the 21st Century
• Internet-based permanent platform
– All year round
– Open to all people in a structured way
– Content experts focus
• Digital curation
– Wiki enabled collaboration
– Ontology based
• Enhanced discussion & peer review
– TAGs serve as the editorial group
• Electronic copy  print version
• Work in multiple languages
• Planned field tests
– Based on Use Cases
How do we go
from Here to
21st Century?
• Open and Collaborative Platform
– Web based
– Like WIKI
• But
– by the Content
Model
• with
– by the TAGs , and scientific peers
What is
Ontology?
Ontology (philosophy)
– the Organization of Reality
Ontology

(computer science)
– the explicit – operational
description of the
conceptualization of a domain:
An ontology defines:
– a common vocabulary  a
shared understanding/exchange:
among people
among software agents
between people and software
– to reuse data - information
– to introduce standards to allow
interoperability
ICD11 βeta
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http://www.who.int/classifications/icd/revision
• Beta – Browser & Print
10 look & feel + descriptions – code structure !
βeta
• ICD-11 Beta draft is NOT FINAL
• updated on a daily basis
•NOT TO BE USED for CODING
except for agreed FIELD TRIALS
ICD-11 Features
Internet Based
Platform
Input from
all Stakeholders
Content Model
Definitions
Field Trials for
Use Cases
Electronic Health Record
Ready
‫لعربية‬
官话
English
Français
Multi Lingual Representations
Arabic
Chinese
English
French
Русский язык Russian
Español
Spanish
Deutsch
Português
German
Portuguese
FIELD TESTS (1): Bridge-Coding
• The Case information
• live
• medical record
• Coded using
• ICD10
• ICD11
• Agreement rates
measured
FIELD TESTS (2): Reliability
• The Case information
• live
• medical record
• Coded using ICD11 by
at least two different
people
• Agreement rates
measured
ICD-11 Timeline
• 2011 : Alpha version ( ICD 11 alpha draft)
– +1 YR : Commentaries and consultations
• 2012 : Beta version & Field Trials Version
– +3 YR : Field trials
• 2015
: Final version for WHA Approval
– 2015+ implementation
ICD-10
ICD-11
• Annual Revision
Conferences
• Continuous web
platform + meetings
• Focus on mortality
statistics
• Focus on ALL
statistical use cases
• Produced manually
• Produced digitally
– w/ information model
• Produced in
English
• Multilingual
development
• NO field tests
• Field tests done before
• Update mechanism
built in later
• Continuous update –
revision mechanism
Questions & Answers
ustunb@who.int
@ustunb