Need for a standardised procedure classification system in global surgery

While the WHO’s International Classification of Diseases (ICD) has become the standard diagnostic tool for describing diseases and injuries, there is no equivalent classification system for surgical procedures and interventions that is universally accepted. Why is this important? Estimates reveal that roughly one-third of the global disease burden requires surgical and/or anaesthetic care, but these are only estimates. The main reason is the dearth of data regarding surgical conditions and interventions, especially in low income and middle income countries (LMICs). Currently, obtaining data on surgical interventions, including those performed by international organisations, often entails wading through years of aggregate hospital statistics, operating room logs or other paper records, which exist in a multitude of varying formats, classification schema and languages. Even when available, there is wide variability in the data being collected, as well as significant inconsistencies in the classification of procedures and pathologies requiring surgical intervention. Indeed, the lack of standardised data collection and processing at the local, national and global level impedes efforts to quantify the volume of surgical met need. More importantly, we are unable to determine what interventions are being performed to address this need.