A global survey on the use of the international classification of diseases codes for metabolic dysfunction-associated fatty liver disease

Zhang H 1 , Targher G 2 , Byrne CD 3 , Kim SU 4 , Wong VW 5 , Valenti L 6 Show all authors , Glickman M 7 , Ponce J 8 , Mantzoros CS 9 , Crespo J 10 , Gronbaek H 11 , Yang W 12 , Eslam M 13 , Wong RJ 14 , Machado MV 15 , Yu ML 16 , Ghanem OM 17 , Okanoue T 18 , Liu JF 19 , Lee YH 20 , Xu XY 21 , Pan Q 22 , Sui M 23 , Lonardo A 24 , Yilmaz Y 25 , Zhu LY 26 , Moreno C 27 , Miele L 28 , Lupsor-Platon M 29 , Zhao L 30 , LaMasters TL 31 , Gish RG 32 , Zhang H 33 , Nedelcu M 34 , Chan WK 35 , Xia MF 36 , Bril F 37 , Shi JP 38 , Datz C 39 , Romeo S 40 , Sun J 41 , Liu D 42 , Sookoian S 43 , Mao YM 44 , Méndez-Sánchez N 45 , Wang XY 46 , Pyrsopoulos NT 47 , Fan JG 48 , Fouad Y 49 , Sun DQ 50 , Giannini C 51 , Chai J 52 , Xia ZF 53 , Jun DW 54 , Li GJ 55 , Treeprasertsuk S 56 , Li YX 57 , Cheung TT 58 , Zhang F 59 , Goh GB 60 , Furuhashi M 61 , Seto WK 62 , Huang H 63 , Di Sessa A 64 , Li QH 65 , Cholongitas E 66 , Zhang L 67 , Silveira TR 68 , Sebastiani G 69 , Adams LA 70 , Chen W 71 , Qi X 72 , Rankovic I 73 , De Ledinghen V 74 , Lv WJ 75 , Hamaguchi M 76 , Kassir R 77 , Müller-Wieland D 78 , Romero-Gomez M 79 , Xu Y 80 , Xu YC 81 , Chen SY 82 , Kermansaravi M 83 , Kuchay MS 84 , Lefere S 85 , Parmar C 86 , Lip GYH 87 , Liu CJ 88 , Åberg F 89 , Lau G 90 , George J 13 , Sarin SK 91 , Zhou JY 92 , Zheng MH 93 , MAFLD ICD-11 coding collaborators

Affiliations 

  • 1 Department of Medical Record, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 2 Metabolic Diseases Research Unit, IRCCS Sacro Cuore - Don Calabria Hospital, Negrar di Valpolicella, Italy
  • 3 Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton and University of Southampton, Southampton General Hospital, Southampton, UK
  • 4 Department of Internal Medicine, Yonsei University, Seoul, Korea
  • 5 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
  • 6 Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
  • 7 Health Analysis and Pandemic Insight Division, Office for National Statistics, London, UK
  • 8 Department Bariatric Surgery, CHI Memorial Hospital, Chattanooga, TN, USA
  • 9 Beth Israel Deaconess Medical Center and Boston VA Healthcare System, Harvard Medical School, Boston, MA, USA
  • 10 Gastroenterology and Hepatology Department, Clinical and Traslational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
  • 11 Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8200, Aarhus N, Denmark
  • 12 Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
  • 13 Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
  • 14 Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Veterans Affairs Palo Alto Healthcare System, Palo Alto, USA
  • 15 Department of Gastroenterology, Hospital de Vila Franca de Xira, Vila Franca de Xira, Portugal
  • 16 School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung, Taiwan
  • 17 Department of Surgery, Mayo Clinic, Rochester, MN, USA
  • 18 Department of Gastroenterology, Saiseikai Suita Hospital, Suita, Japan
  • 19 Department of Medical Records, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
  • 20 Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 21 Department of Infectious Diseases, Peking University First Hospital, Beijing, China
  • 22 Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
  • 23 Department of Medical Records Management, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
  • 24 Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Modena (-2023), Modena, Italy
  • 25 Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
  • 26 Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital, Central South University, Changsha, China
  • 27 Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, C.U.B. Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
  • 28 Department of Medicina e Chirurgia Traslazionale, Università Cattolica Del Sacro Cuore, Rome, Italy
  • 29 Medical Imaging Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", Cluj-Napoca, Romania
  • 30 Department of General Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin, China
  • 31 Department of Bariatric Surgery, UnityPoint Clinic Weight Loss, West Des Moines, USA
  • 32 Medical Director, Hepatitis B Foundation, Doylestown, PA, USA
  • 33 Department of Endocrinology and Metabolism, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou, China
  • 34 Department of Bariatric Surgery, ELSAN, Clinique Bouchard, Marseille, France
  • 35 Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 36 Department of Endocrinology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
  • 37 Division of Endocrinology, Diabetes and Metabolism, University of Alabama at Birmingham, Birmingham, AL, USA
  • 38 Department of Hepatology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
  • 39 Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
  • 40 Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
  • 41 Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 42 Department of Medical Record Statistics, Guizhou Provincial People's Hospital, Guiyang, China
  • 43 Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
  • 44 Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NHC Key Laboratory of Digestive Diseases, Shanghai Research Center of Fatty Liver Disease, Shanghai, China
  • 45 Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
  • 46 Child Healthcare Center and Child Nutrition Center, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China
  • 47 Department of Medicine, Rutgers New Jersey Medical School, Newark, USA
  • 48 Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • 49 Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University Hospitals, Minya, Egypt
  • 50 Department of Nephrology, Jiangnan University Medical Center, Wuxi, China
  • 51 Department of Pediatrics, University of Chieti, Chieti, Italy
  • 52 Department of Gastroenterology, Institute of Digestive Diseases of PLA, Cholestatic Liver Diseases Center and Center for Metabolic Dysfunction-Associated Fatty Liver Disease, the First Affiliated Hospital (Southwest Hospital), Third Military Medical University (Army Medical University), Chongqing, China
  • 53 Department of Gastrointestinal Surgery, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
  • 54 Department of Internal Medicine, Hanyang University, College of Medicine, Seoul, Korea
  • 55 Department of Medical Record, West China Hospital Affiliated to Sichuan University, Chengdu, China
  • 56 Department of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 57 Department of Bariatric Metabolic Surgery, The Second People's Hospital of Qujing, Qujing, China
  • 58 Department of Surgery, Queen Mary Hospital and the University of Hong Kong Shenzhen Hospital, Li Ka Shing Faculty of Medicine, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
  • 59 Department of Microbiota Medicine and Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
  • 60 Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore
  • 61 Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
  • 62 Department of Medicine and State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, China
  • 63 Department of Cardiology, the Eighth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
  • 64 Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Caserta, Italy
  • 65 Department of Medical Record, China-Japan Friendship Hospital, Beijing, China
  • 66 First Department of Internal Medicine, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece
  • 67 Department of Paediatrics, the Affiliated Children's Hospital of Jiangnan University, Wuxi, China
  • 68 Programa de Pós-Graduação em Pediatria, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
  • 69 Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Center, Montreal, QC, Canada
  • 70 Medical School, University of Western Australia, Perth, Australia
  • 71 Department of Clinical Nutrition, Department of Health Medicine, Peking Union Medical College Hospital, Beijing, China
  • 72 Center of Portal Hypertension, Department of Radiology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
  • 73 Department of Gastroenterology and Liver Unit, Royal Cornwall Hospitals NHS Trust, University of Exeter, Exeter, England, UK
  • 74 Hepatology Unit, University Hospital, CHU Bordeaux, Pessac, and INSERM 1312, Bordeaux University, Bordeaux, France
  • 75 Department of Medical Record, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
  • 76 Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • 77 Department of Bariatric Surgery, The View Hospital, Doha, Qatar
  • 78 Department of Medicine I, University Hospital Aachen, Aachen, Germany
  • 79 UCM Digestive Diseases, Virgen del Rocío University Hospital, Institute of Biomedicine of Seville (HUVR/CSIC/US), University of Seville, Seville, Spain
  • 80 Department of Medical Record, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
  • 81 Department of Medical Record, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
  • 82 Department of Gastroenterology, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
  • 83 Department of Surgery, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  • 84 Division of Endocrinology and Diabetes, Medanta the Medicity Hospital, Gurugram, Haryana, India
  • 85 Hepatology Research Unit, Department Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
  • 86 Department of General Surgery, Whittington Hospital, London, UK
  • 87 Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
  • 88 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, China
  • 89 Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
  • 90 Humanity and Health Clinical Trial Center, Hong Kong, China
  • 91 Department of Hepatology and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi, India
  • 92 Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. [email protected]
  • 93 MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. [email protected]
Hepatol Int, 2024 Aug;18(4):1178-1201.
PMID: 38878111 DOI: 10.1007/s12072-024-10702-5

Abstract

BACKGROUND: With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) and the publication of the metabolic dysfunction-associated fatty liver disease (MAFLD) nomenclature in 2020, it is important to establish consensus for the coding of MAFLD in ICD-11. This will inform subsequent revisions of ICD-11.

METHODS: Using the Qualtrics XM and WJX platforms, questionnaires were sent online to MAFLD-ICD-11 coding collaborators, authors of papers, and relevant association members.

RESULTS: A total of 890 international experts in various fields from 61 countries responded to the survey. We also achieved full coverage of provincial-level administrative regions in China. 77.1% of respondents agreed that MAFLD should be represented in ICD-11 by updating NAFLD, with no significant regional differences (77.3% in Asia and 76.6% in non-Asia, p = 0.819). Over 80% of respondents agreed or somewhat agreed with the need to assign specific codes for progressive stages of MAFLD (i.e. steatohepatitis) (92.2%), MAFLD combined with comorbidities (84.1%), or MAFLD subtypes (i.e., lean, overweight/obese, and diabetic) (86.1%).

CONCLUSIONS: This global survey by a collaborative panel of clinical, coding, health management and policy experts, indicates agreement that MAFLD should be coded in ICD-11. The data serves as a foundation for corresponding adjustments in the ICD-11 revision.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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