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

Prof Jes OlesenAfter 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.

Jes Olesen
Headache Classification Committee
International Headache Society

Preface for ICHD-3 beta website

ICHD-3 beta, like ICHD-2, is now available in digital format. The ICHD-3 beta website makes it very easy to understand and follow the precise organisation and content of the current classification, making the practical application in the clinical field and in research simpler than ever before. The three main chapters and the appendix are listed in the main menu. The respective diagnoses can be viewed and selected in the text area after choosing a main heading. Using the text, the menu and the search function, answers to specific questions in clinical practice can be researched quickly. The ICHD-3 beta online service enables fast digital access to all information of the international headache classification.

Since ICHD-3 beta version is still in the test phase, the digital version initially will be only produced in English language. Currently available translations can be viewed in the downloads section. After finalisation of the classification, the different translations can be digitally integrated one by one. The information about classification and diagnosis of headaches is supplemented by original documents and accompanying materials including lecture presentations and media library. The digital media centre about classification and diagnosis of headaches will be continuously expanded.

The first edition of the International Headache Classification was published in 1988. The very first website that went online was published in 1990 almost at the same time. While ICHD-1 did not become available digitally, the website for ICHD-2 was launched for the first time in 2006. In recent years, there has been a tremendous advance of digital media in medicine. The use of mobile smartphones and tablets has become a standard in all areas of medicine. Many different operating systems and display formats are available. For ICHD-3 beta, we have chosen a platform that responsively adjusts to the different devices and display formats. The web address can be directly added to the home screen of the particular device and thereby opened and used just like a native app. The links demonstrate, how digital ICHD-3 beta can be added to iOS or Android home screen. The website also provides a reader mode, a one-tap solution for reading web pages formatted for easy reading. After loading the ICHD-3 beta website page in the Safari browser for example, click the Reader button at the left end of the address bar. Likewise, reader mode is also available in other up-to-date mobile browsers.

My sincere thanks go to Professor Jes Olesen, chairman of Headache Classification Committee of the International Headache Society and the members of the committee for delegating the task to develop this digital version. I would also like to thank the committee members who helped in creating this digital version.

Hartmut Göbel
Chairman ICHD-Website Committee