The World Health Organization (WHO) is about to publish the 11th revision of the International Classification of Diseases and Related Disorders (ICD-11). A pre-final version has been disseminated in 2018, in order to allow the 194 member States to provide suggestions for amendments and to prepare shared strategies for the implementation of the diagnostic system. Furthermore, the Ecological Implementation Field Studies (EIFS) have been conducted in various countries, with the aim to assess the reliability and clinical utility of the ICD-11 diagnostic guidelines. In this paper we present the overall methodology of the EIFS and discuss the results of the Italian field trials concerning the reliability in the use of ICD-11 diagnostic guidelines concerning schizophrenia and related disorders. In Italy the field trials have been carried out at the Department of Psychiatry of the University of Campania “L. Vanvitelli”, WHO Collaborating Centre. The inter-rater reliability of the diagnostic guidelines for schizophrenia and related disorders has been assessed on the basis of clinical interviews with 100 patients conducted by 14 psychiatrists. The results show an almost perfect reliability for the diagnosis of schizophrenia (kappa=0.85) and a good reliability for the diagnosis of schizoaffective disorder (kappa=0.79). These Italian data are in line with those of the international sample, and the kappa values are higher than those previously reported in the ICD-10 field trials. They suggest the feasibility of the implementation of ICD-11 diagnostic guidelines in ordinary clinical practice in our country.
L’Organizzazione Mondiale della Sanità (OMS) è in procinto di pubblicare l’undicesima revisione dell’International Classification of Diseases and Related Disorders (ICD-11). Nel 2018 è stata resa pubblica una versione pre-finale della classificazione, al fine di consentire ai 194 Stati membri di fornire suggerimenti per eventuali modifiche e di mettere a punto strategie condivise per l’implementazione del sistema diagnostico. Inoltre, sono stati condotti in vari Paesi del mondo gli Ecological Implementation Field Studies (EIFS), con l’obiettivo di valutare la riproducibilità e l’utilità clinica delle direttive diagnostiche contenute nell’ICD-11. In questo lavoro presentiamo la metodologia generale degli EIFS e discutiamo i risultati dei field trial italiani relativi alla riproducibilità nell’uso delle direttive diagnostiche dell’ICD-11 per quanto riguarda la schizofrenia e i disturbi collegati. In Italia i field trial sono stati condotti presso il Dipartimento di Psichiatria dell’Università della Campania “L. Vanvitelli”, Centro Collaboratore dell’OMS. La riproducibilità tra valutatori nell’uso delle direttive diagnostiche per la schizofrenia e i disturbi collegati è stata valutata sulla base di interviste cliniche con 100 pazienti condotte da 14 psichiatri. I risultati mostrano una riproducibilità quasi perfetta per la diagnosi di schizofrenia (kappa=0,85) e buona per il disturbo schizoaffettivo (kappa=0,79). I dati italiani sono in linea con quelli del campione internazionale. I valori del kappa sono superiori a quelli precedentemente riportati nei field trial dell’ICD-10. Essi suggeriscono la fattibilità dell’implementazione delle direttive diagnostiche dell’ICD-11 nella pratica clinica ordinaria nel nostro Paese.
The Italian ICD-11 field trial: Inter-rater reliability in the use of diagnostic guidelines for schizophrenia and related disorders
Steardo L.;
2019-01-01
Abstract
The World Health Organization (WHO) is about to publish the 11th revision of the International Classification of Diseases and Related Disorders (ICD-11). A pre-final version has been disseminated in 2018, in order to allow the 194 member States to provide suggestions for amendments and to prepare shared strategies for the implementation of the diagnostic system. Furthermore, the Ecological Implementation Field Studies (EIFS) have been conducted in various countries, with the aim to assess the reliability and clinical utility of the ICD-11 diagnostic guidelines. In this paper we present the overall methodology of the EIFS and discuss the results of the Italian field trials concerning the reliability in the use of ICD-11 diagnostic guidelines concerning schizophrenia and related disorders. In Italy the field trials have been carried out at the Department of Psychiatry of the University of Campania “L. Vanvitelli”, WHO Collaborating Centre. The inter-rater reliability of the diagnostic guidelines for schizophrenia and related disorders has been assessed on the basis of clinical interviews with 100 patients conducted by 14 psychiatrists. The results show an almost perfect reliability for the diagnosis of schizophrenia (kappa=0.85) and a good reliability for the diagnosis of schizoaffective disorder (kappa=0.79). These Italian data are in line with those of the international sample, and the kappa values are higher than those previously reported in the ICD-10 field trials. They suggest the feasibility of the implementation of ICD-11 diagnostic guidelines in ordinary clinical practice in our country.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.