INTOX tools for harmonized data collection
The collection of internationally harmonized data on poisoning cases provides a means to improve the knowledge-base on the toxic effects of chemicals through facilitating the comparison and pooling of case data collected by different centres.
IPCS has developed a number of multilingual tools to facilitate harmonized data collection. These are the INTOX Data Management System and a set of authority lists and classifications.
Authority lists provide a controlled, defined vocabulary for describing poisoning cases. This ensures that different poisons centres, and staff within the same poisons centre, use the same terms to describe the same concept. This facilitates the comparison of case data collected by different centres e.g. for multi-centre studies. It also makes it possible to pool data from different centres e.g. to compile national statistics.
The terms in the Authority Lists were drawn up and agreed at a series of international working group meetings organized by IPCS. The working group adapted a number of existing lists of terms used by different poisons centres in order to generate a comprehensive and internationally agreed, harmonized terminology. Definitions were also agreed for these terms.
In order to allow flexibility, while maintaining comparability, the authority lists have a hierarchical structure: the top levels are supplied with the system and are fixed, while the content of the lowest level is determined by the user.
The authority lists are included in the INTOX Data Management System but are available to be used separately, for example, they can be incorporated into other data collection systems.
Authority list definitions
IPCS has developed two classification schemes to facilitate the collection of harmonized data: a use-function classification for substances and products, and a scheme for classifying the severity of poisoning.
The Use-Function classification was developed for use within the INTOX Data Management System. It incorporates an adapted version of the Anatomical Therapeutic Chemical (ATC) classification for human and veterinary pharmaceuticals. The remainder of the classification was formulated at a series of international working group meetings organized by IPCS. This working group also agreed definitions for the classifications. The English version of the Use-Function classification was revised in 2007 by the INTOX Users Group.
This classification is available for use by others, in the interests of promoting the collection of comparable data on exposures to chemicals.
The Poisoning Severity Score classification was developed in a joint project by IPCS and the Swedish Poisons Information Service, with the support of the European Association of Poisons Centres and Clinical Toxicologists and the European Commission. It provides a standardized scale for grading the severity of acute poisoning based on observed signs and symptoms.
The scheme takes the form of a chart organized by body system and lists symptoms, signs and selected clinical chemistry results that indicate minor, moderate and severe toxicity for each system. The overall severity is determined by the most severe symptoms and signs.