International Classification and Information Management Office to the Director-General for Statistics, Information Policy and Policy Evaluation, Ministry of Health, Labour and Welfare
【Curriculum Vitae】
2004GraduatedfromKyushuUniversity,SchoolofMedicine 2004KyushuUniversityHospital
2006TuberculosisandInfectiousDiseasesControlDivision,
MinistryofHealth,LabourandWelfare
2010EnvironmentalRiskAssessmentOffice,Ministryofthe
Environment
2012HealthCareInsuranceDivision,MedicalProfessionsDivision,
MinistryofHealth,LabourandWelfare 2016present
The International Classification of Diseases and Related Health Problems （ICD） was originally adopted in 1900. It has been implemented in Japan since that time and applied to various statistical studies, including mortality statistics.
In Japan, the "Statistical classification of diseases, injuries and causes of death" is stipulated as a statistical standard under the Statistics Act and is applied to producing official statistics, including Vital Statistics and Patient Statistics, and is used in management of medical records in medical institutions.
With global aging, where Japan especially is entering a high-mortality society, it is important to prepare effectively by constructing a sustainable health and medical system.
A foundation of statistics and information constitutes the basis of this, and its maintenance and utilization will become even more required, while the newly ICD-11 and related international classifications are expected to fulfil its role to assist such a framework. From now on, we would like to verify the legal-system issues and the usage environment in cooperation with stakeholders and work toward smooth implementation in Japan.
25 シ ン ポ ジ ウ ム 日
5月25日（土）8：00 ～ 9：30 第7会場(大阪国際会議場10F 会議室1008)
公募 En
SS-06-2 Neurology and Neurosurgery in ICD11
○ RaadShakir
Imperial College London University, UK
【Curriculum Vitae】
Prof Raad Shakir FRCP. Division of Brain Sciences Imperial College London UK. Honorary consultant Neurologist Charing Cross Hospital London. President World Federation of Neurology 2014-18. Chair Neurology Topic Advisory Group WHO ICD11 2009-.
Secretary- Treasurer General World Federation of Neurology 2006-2014. President South of England Neurological Association, EAN representative WHO. Honorary member Japan Society of Neurology, European Academy of Neurology,American Academy of Neurology, Indian Academy of Neurology, Sri Lanka Academy of Neurology.
The International classifi cation of diseases is the backbone of recognition of various illnesses and disorders. The classification system in a primary function of the WHO, which started long before its establishment in 1948. The initial reporting was on causes of mortality, which evolved into mortality and morbidity. The aim of the revision was to produce a modern classifi cation to replace ICD10 that was established in the 1980s. Our knowledge in genetics, microbiology, immunology, imaging, therapeutics and management has made our current medical practice totally diff erent.
There are many highlights in ICD11, which makes it stand out, perhaps the most salient for Neurology is stroke. Since 1955 in ICD7, stroke was classified under the vascular system and hence in all the WHO statistics it was not counted as a brain disease. Stroke is the second cause of death and should be separated from cardiac disease. The neurology topic advisory group with the support of the World Stroke organization, worked for years to disentangle stroke and bring it to the neurology chapter. This was accomplished and in the future brain diseases will receive their rightful recognition as the second cause of death and the fi rst cause of disability.
Other conditions, which were not recognised accurately, are Prion disease, which were labeled as "slow virus"
infections in ICD1 0. We still have some unresolved issues such as placement of cognitive disorders between Neurology and Psychiatry, similarly functional/dissociative disorders and their accurate placement.
ICD11 is still being discussed at the WHO classification department and will hopefully be presented to the World Health Assembly for approval in May 2019. It is expected that implementation will start in January 2022.
SS-06-3 Reserach framework for Alzheimer's disease
○ PhilipScheltens
Amsterdam University Medical Centers, The Netherlands
【Curriculum Vitae】
Prof. dr. Philip Scheltens studied at the VU University Amsterdam, gaining his MD in 1984, and PhD （Magnetic Resonance Imaging in Alzheimer's disease） in 1993. Since 2000 he is Professor of Cognitive Neurology and Director of the Alzheimer Center Amsterdam. His main interests are AD, FTD, MRI, PET imaging and fluid biomarkers. He is active in the field of biomarkers and clinical trials and has been the national PI for many studies, including phase 1-3 multicenter clinical trials. He founded and directs the Alzheimer Center since 2000, from which over 65 PhD theses have appeared since then. In 2013, he co-founded the Dutch national plan against dementia and serves as vice-chair of the board since then. He has authored over 920 peer reviewed publications （H-factor is 103）.
In 2011, he was elected as member of the Royal Dutch Academy of Arts and Sciences （KNAW） and serves as Secretary General since 2015. In 2016 he was awarded the European Grand Prix for Alzheimer's Research
In more than 1 0 0 years after the first description of Alzheimer's disease （AD）, a lot has changed. The first case was not diagnosed clincally, only pathologically. Only after 1984 it was possible to diagnose AD clinically using criteria based on exclusion of other diseases. The first attempt to formulate inclusionary criteria came from the IWG in 2007, including biomarker information on top of the clinical assessment. After many years of finetuning and progress in biomarker research, in 2018 the NIA/AA work group published the research framework for AD, stating that a diagnosis is now made on a biological basis, not any more on clinical grounds. The conseqences and implications for research and ultimately clinical practive will be discussed.
25 日 シ ン ポ ジ ウ ム
5月25日（土）8：00 ～ 9：30 第7会場(大阪国際会議場10F 会議室1008)
公募 En
SS-06-4 Prion disease is moved from atypical infections of central nervous system to neurological disease
○ HidehiroMizusawa
1,21 National Center of Neurology and Psychiatry, Japan,
2 Tokyo Medical and Dental University, Japan
【Curriculum Vitae】
Dr. Hidehiro Mizusawa is President of National Center of Neurology and Psychiatry since 2016 after 2 years of Director General, Hospital of the Center. He graduated with MD in 1976 from Faculty of Medicine, Tokyo University, where he received PhD in 1983. After he has been in Tsukuba University（1984-1988）, he has been Professor and Chair of Department of Neurology, Graduate School, Tokyo Medical and Dental University
（1996-2014）, where he has been Directors of Center for Brain Integration Research, of School of Medicine and Vice Director of Medical Hospital.
He has contributed to researches on ALS, Pure Akinesia/PSP, SCA, mitochondrial neuropathy, distal myopathy and Prion disease. He has been Chairman of MHWL Research Committees on Prion disease
（2002-） and on Ataxic Disorders（2014-） and PI of Initiative on Rare and Undiagnosed Disease（2015-）. He served as President of Japanese Society of Neurology（2010-2014） and was President of Prion 2016, WCN 2017 and Vice President of ICN 2018.
In ICD-10, prion diseases are classified under A81 Atypical infections of central nervous system after the approval in October 1997 and the implementation in January 1999. A81.0 Creutzfeldt-Jakob disease is further classified into A81.00 Creutzfeldt-Jakob disease, A81.01 Variant CJD and A81.09 other CJD including Familial CJD, Iatrogenic CJD, Sporadic CJD and Subacute spongiform encephalopathy. Kuru, Gerstman-Straeussler-Scheinker syndrome（GSS） and Fatal familial insomnia（FFI） are under A81.8 Other atypical viral infection of central nervous system.
During these decades, a lot of investigations were done and the prion hypothesis has been widely accepted. That means prion disease is not a slow viral infection at all, which made Neurology TAG （Topic Advisory Group） consider prion disease should stand alone as a disease entity of the nervous system. After lots of discussions in the TAG and negotiation with WHO Statistics Department, a new section Human prion disease is allocated in 08 Diseases of the nervous system in ICD-11. Human prion disease is classified mainly into 3 categories 8E10 Sporadic CJD, 8E11 Acquired prion disease and 8E12 Genetic prion disease based on etiology.
In addition, there are also 8E13 Variably protease-sensitive prionopathy and 8E1Y Other specified human prion diseases.
We consider now prion disease has the right position.
Correct classification is crucial for not only neurologists but also general practitioner and various medical staffs to appropriately understand, treat and care their patients.
This is particularly important under the situation that pathomechanism of prion disease has not been elucidated yet. Moreover, many proteins related to other neurodegenerative diseases such as Alzheimer disease, Parkinson disease and so on have been proved to behave as prion. We believe the new classification would contribute to patients care with reduced discrimination and to researches to elucidate mechanism and develop treatments of prion disease.