ICD-11 in Canada: Leveraging crosswalks to evaluate adoption, impact and transition strategies
Bibliographic record
Abstract
BACKGROUND: (ICD-11) is a modern classification system that provides enhanced granularity and flexibility for capturing clinical and health system data. For Canada, transitioning from ICD-10-CA, the Canadian modification, to ICD-11 poses opportunities and challenges. To explore these opportunities and challenges more thoroughly, a backward crosswalk was developed to evaluate statistical continuity. This approach helped identify the benefits of ICD-11, while also highlighting potential implications for health systems, case mix, and national health indicator reporting. OBJECTIVE: To examine how bidirectional crosswalks between ICD-10-CA and ICD-11 can support Canada's transition to ICD-11; and demonstrate how these crosswalks can be utilised in a Canadian-specific use case. METHOD: 14,652 ICD-11 Mortality and Morbidity Statistics (2022 release) codes were mapped to version 2022 ICD-10-CA codes. Each mapping was reviewed to determine the relationship between the ICD-11 and ICD-10-CA codes, categorising them as equivalent to, broader than or narrower than the source ICD-11 codes. The bidirectional crosswalks were applied to a Canadian use case to demonstrate level of specificity between ICD-10-CA and ICD-11 codes. RESULTS: 26% of the ICD-10-CA target codes were equivalent to a single ICD-11 code, 65% were broader, 9% were narrower and 0.03% had no applicable ICD-11 map. Findings from the Canadian use case showed that 55% of the ICD-11 target codes were equivalent to or narrower than their ICD-10-CA source codes in the forward crosswalk, and 57% of ICD-11 congenital anomaly concepts had greater specificity in the backward crosswalk. CONCLUSION: The backward crosswalk assessment highlights the benefits of ICD-11's increased specificity, which has the potential to enhance healthcare data in Canada. However, these findings must be considered alongside the forward crosswalk analysis, which noted a loss in specificity.Implications for health information management practice:As demonstrated in a Canadian use case example, bidirectional crosswalks can be leveraged to better understand the impact of ICD-11 adoption.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.049 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.009 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".