Novedades en la reciente Clasificación Internacional de las Cefaleas: ICHD-III beta

The International Classification of Headache Disorders 3rd edition (Beta version)

After two very successful editions of the International Classification of Headache Disorders (ICHD), a third is now close to being final. The members of the Classification Committee have all worked hard for three years in order to accomplish this beta version. Most members have chaired the work on a specific chapter of the classification, assisted by a number of other experts. For this edition, there has been a substantial body of evidence available for the classification work, in contrast to our previous editions, which were mostly based on the opinions of experts. We have tried to be conservative, making changes only where there was good published evidence to support change or where the need for change was intuitively obvious.

This is the first time that we have published a beta version ahead of the final version. The main reason is to synchronize ICHD-3 with the World Health Organization’s next revision (11th edition) of the International Classification of Diseases (ICD-11). This classification is already well advanced, and we have not only secured a very good representation of headache within ICD-11 but also ensured congruence between ICD-11 and ICHD-3 (beta). However, ICD-11 now enters a phase of field trials, and ICHD-3 should do the same. Such a test period will allow identification and correction of mistakes and enable a broad input from the members of the International Headache Society.

ICD-11 diagnostic codes will not be finalized until two or three years from now, but it would be a major advantage for ICHD-3 to be able to include these codes along with our own. WHO’s ICD-11 codes will be used by health authorities for official diagnostic coding, and in many cases they will be employed for reimbursement purposes; we must have them right.

We publish ICHD-3 (beta) immediately on the International Headache Society’s website, and shortly after as an issue of Cephalalgia. Field-testing will continue for two or maybe three years. Small amendments are likely both to ICHD-3 and to the diagnostic codes of ICD-11, and these will be incorporated. At that time, we shall publish ICHD-3 in final form in Cephalalgia.

ICHD-3 (beta) is published only in English, but those throughout the world who wish to make their own careful translations of parts or in toto are welcome to do so subject to the conditions stated above. The final version of ICHD-3 should be translated into as many languages as possible, and these translations published, as happened to the second and first editions. As we expect ICHD-3 (beta) to be very similar to the final version, translation work begun now is likely to remain useful. Any changes necessitated later by the outcomes of field-testing can easily be made.

Already now, clinicians and researchers should start using the criteria of ICHD-3 (beta). There are many improvements over ICHD-II, and it would be unhelpful to continue to use ICHD-II for scientific work. We encourage readers to study ICHD-3 (beta) very closely, and document and comment upon any inconsistencies they may find. Comments should be sent not to me but to the chairmen of the relevant working groups. Their names and email addresses are found in this publication and on the IHS website.