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从阿里阿德涅之线到迷宫本身——疾病分类学和现代医学的基础架构
From Ariadne’s Thread to the Labyrinth Itself — Nosology and the Infrastructure of Modern Medicine


Anne Kveim Lie ... 其他 • 2020.03.26

2019年5月,世界卫生大会悄悄通过了《国际疾病分类》第十一次修订本(ICD-11),这是第一次采用完全电子版。之所以需要纯数字格式,部分原因是纲要部分过长,难以印刷:ICD-11包含55,000个病理条目,与前一版ICD-10的大约14,400个代码相比增加了近3倍1ICD-11就像是21世纪的潘多拉魔盒,它向世界“释放”了40,000种新的疾病,这一举动将对医学知识的组织和医疗实践的安排产生重大影响。但日内瓦的工作相对而言并不引人注目,因为人们通常认为疾病分类是一项沉闷乏味的工作,与正在传播的大流行病或正在研发的新疗法相去甚远。

然而,尽管ICD代码的变化看起来平淡无奇,但我们用于分类疾病的系统却以强大且有力的方式塑造了医学和公共卫生的本质。如今世界上有70%的卫生资源是根据ICD编码的数据进行分配2。作为临床医师,我们根据包括各种疾病类别在内的鉴别诊断来解释患者的症状,然后根据ICD代码列出最终诊断,由保险公司报销费用。作为流行病学家,我们利用依据这些公认类别汇总的统计学数据,并将我们的发现发表在根据疾病对文章进行分类的期刊上。作为患者,我们也越来越多地根据与我们症状对应的疾病名称来了解自己的状况3,并且利用这些名称在搜索引擎和社交媒体上寻找更多信息。





作者信息

Anne Kveim Lie, M.D., Ph.D., and Jeremy A. Greene, M.D., Ph.D.
From the Department of Community Medicine and Global Health, University of Oslo, Oslo (A.K.L.); and the Department of History of Medicine and the Center for Medical Humanities and Social Medicine, Johns Hopkins University School of Medicine, Baltimore (J.A.G.).

 

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