Iris is an automatic system for coding multiple causes of death and for the selection of the underlying cause of death. It can be used in batch or interactively. The aim of Iris is twofold:

1. To provide a system in which the language-dependent aspects are separated from the software itself. Moreover, the language-dependent parts are stored in database tables and can easily be modified.
2. To improve international comparability. Iris is based on the international death certificate form provided by WHO and the causes of death are coded according to the ICD-10 and ICD-11 coding rules. Updates to ICD-10 and ICD-11 are included according to the WHO-timelines.

Through version 4 the Iris software uses components of the Mortality Medical Data System (MMDS) of the U.S. National Center for Health Statistics (NCHS).

Iris version 5 uses the Multicausal and Unicausal Selection Engine (MUSE). MUSE operates based on internationally agreed decision tables which are based on the most recent version of ICD-10.

Since version 6 MUSE uses decision tables which have been maintained by the Iris Institute according to the WHO official updates of the ICD-10 and are currently updated for ICD-11.

Iris can be used in different modes. The ‘Data entry, no coding’ mode is the most restricted mode and can be used for data capture by staffs that are not medical coders. For coding, several modes are available. In the 'Code only as default' mode, the user enters ICD-11 codes corresponding to the conditions reported on the death certificates. Iris then selects the underlying cause. In this mode Iris is ready for use as soon as it is installed. In the text 'Default coding' mode and 'Data entry interface' mode, the user enters the causes of death in free text (diagnosis text), as they are reported on the death certificate. You could use the WHO ICD-11 Coding Tool (via the integrated API), or you need a dictionary that translates text into ICD-11 codes. The advantage of including a dictionary is that once a decision has been made on which ICD-11 code to use for a specific diagnostic expression, the expression will be coded in the same way each time it occurs on a death certificate. Iris also provides means for language standardisation, which very much reduces the size of the dictionary.

Note that an example about the structure of the dictionary is provided, when you install Iris. You can create your own dictionary and standardisations in your language, or you ask other countries if there is a dictionary and standardisations available in your language. The ICD-API assist the user in coding and assessing the quality of the coding. Please check/verify each output from the WHO ICD-11 Coding tool.

Third-party rights

Iris version 4 and 5: The Iris software uses the ICD 10 codes and titles of World Health Organisation (WHO). It is not allowed to duplicate and distribute the ICD 10 WHO contents. All rights of the ICD 10 WHO are at the WHO. The use of ICD 10 WHO requires an agreement with the WHO. Please contact the WHO for the conclusion of a license agreement.

Iris version 6: The Iris software uses ICD-11 codes, code titles and ICD-API of World Health Organisation (WHO). All rights of the ICD-11 are copyright reserved by WHO. Please check the Terms of Use and License Agreement for ICD-11 of WHO at: https://icd.who.int/en

• The ICD-11 Reference Guide contains information about the copyrights (section 0.1 Copyright page). International Classification of Diseases Eleventh Revision (ICD-11). Geneva: World Health Organization; 2022. License: CC BY-ND 3.0 IGO.
• Copyright for the ICD-11 Software (ICD-API, locally deployable versions of the ICD-API, ICD-11 Embedded Coding Tool). WHO has developed and retains all rights in the ICD-11 Software. The Software is copyright (©) World Health Organization, 2020 and is distributed under the terms of this Agreement. All rights not granted herein are reserved by WHO.

You can access the software at the Downloads area. For more information about the Iris software, please contact the Iris Institute.

E-mail: Iris Institute