Developing an International Standard for the Classification of Surface Anatomic Location for Use in Clinical Practice and Epidemiologic Research

Background: There is currently no universally adopted terminology for defining human surface anatomic location. The lack of precision, accuracy, and reliability of terms used by health care providers, in particular dermatologic surgeons, is unsatisfactory both for epidemiologic research and for high-quality patient care.

Objective: We sought to create a clinically relevant yet concise surface anatomy terminology for international use including the International Classification of Diseases and to map it to existing disparate terminologies.

Methods: Widely used surface anatomy terminology data sets and diagrams were reviewed. A Delphi consensus convened to create a novel surface anatomy terminology. The new terminology was hierarchically mapped to Systematized Nomenclature of Medicine terms and New York University numbers and physically mapped to 2-dimensional anatomic diagrams for clarity and reproducibility.

Results: The final terminology data set contains 519 discrete terms arranged in a 9-level hierarchy and has been adopted by the World Health Organization for the International Classification of Diseases, 11th revision.

Limitations: Specification of most locations requires linking to laterality qualifiers. Fine granularity for larger sites may require the use of additional qualifiers.

Conclusion: Consistent use of precise and accurate surface anatomy terms is crucial to the practice of dermatology, particularly procedural dermatology. The proposed terminology is designed to form the basis for evolution of a universally adoptable terminology set to improve patient care, interprovider communication, and epidemiologic tracking.