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使慢性疼痛有数据可依:对 ICD-11 慢性疼痛分类的实证支持。

Making chronic pain count: empirical support for the ICD-11 classification of chronic pain.

机构信息

Division of Clinical Psychology and Psychological Intervention, Institute of Psychology, University of Duisburg-Essen, Essen, Germany.

出版信息

Curr Opin Anaesthesiol. 2023 Oct 1;36(5):589-594. doi: 10.1097/ACO.0000000000001297. Epub 2023 Jul 26.

Abstract

PURPOSE OF REVIEW

The purpose is to review the evidence that has been collected with regard to the new classification of chronic pain. In 2022, the World Health Assembly endorsed the 11 th revision of the International Classification of Diseases and Related Health Problems (ICD-11), and with it a new classification of chronic pain.

RECENT FINDINGS

The evidence from the formative field testing indicated that the categories were clearly delineated and the coverage of chronic pain excellent (<3% in remainder categories). Official WHO field tests showed that the classification works well within the technical parameters WHO classifications must conform to and outperformed the ICD-10 diagnoses in all respects. International field tests, in which clinicians diagnosed consecutive patients in settings of medium and high resources, showed substantial interrater reliability (κ = 0.596 to κ = 0.783) for the diagnoses and the clinicians rated their clinical utility as very high. Studies using complete hospital records demonstrated that with the information they contain, retrospective coding of the new diagnoses is possible and provides much more meaningful information than the ICD-10 diagnoses.

SUMMARY

The evidence supports the use of the new classification and highlights its informational gains - using it will contribute to making chronic pain count in many contexts.

摘要

目的综述

目的是回顾与慢性疼痛新分类相关的证据。2022 年,世界卫生大会批准了《国际疾病分类》第 11 次修订版(ICD-11),并采用了新的慢性疼痛分类。

最近的发现

形成性现场测试的证据表明,这些类别划分明确,慢性疼痛的涵盖范围很广(<3%归入其他类别)。世界卫生组织的官方现场测试表明,该分类在世界卫生组织分类必须符合的技术参数范围内运作良好,在所有方面均优于 ICD-10 诊断。在中高资源环境中对连续患者进行诊断的国际现场测试表明,诊断的观察者间可靠性很高(κ=0.596 至 κ=0.783),临床医生对其临床实用性的评价非常高。使用完整住院记录的研究表明,利用其中包含的信息,可以对新诊断进行回顾性编码,提供比 ICD-10 诊断更有意义的信息。

总结

证据支持使用新的分类,并强调了其信息增益——使用它将有助于在许多情况下对慢性疼痛进行统计。

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