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guage game in which the classification is inserted. This indeed is the purpose of the rules contained in volume 2. This attention to both the base level and its metalevel is a bureaucratic necessity, which at the same time conjures the wild world of the patient's body into the ordered world of medical knowledge. Second, the rules themselves serve to systematically reduce ambiguity and uncertainty, even where these are integral to the attendant physician's depiction of the patient's situation. Those who see the patients are aware of this uncertainty; those who apply the rules also know of it; those who read the final statistics are shielded from it. The patients live it. |
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Finally, there is a potential infinite regress in the control of first the name of the disease then on rules for using these names and so forth. The final level at which regress occurs is in the presentation of results. The WHO recognizes that when dealing with small populations, one may get wild fluctuations of information on mortality or morbidity from year to year. To achieve stability and certainty at this level, one needs to sacrifice precision, to go up to broader ICD rubrics, aggregate data over a longer period, use the broadest of the recommended age groupings and aggregate areas (ICD-10, 2: 137). Recommended age groupings and regional groupings are: |
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< 1, 14, 5 year groups from 5 to 84, 85+
< 1, 14, 514, 1524, 2534, 3544, 4554, 5564, 6574, 75+
< 1, 114, 1544, 4564, 65+
(ICD-10, 3: 128) |
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Classification by area should, as appropriate, be in accordance with: |
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(i) each major civil division; |
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(ii) each town or conurbation of 1,000,000 population and over, otherwise the largest town with a population of at least 100,000; |
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(iii) a national aggregate of urban areas of 100,000 population and over; |
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(iv) a national aggregate of urban areas of less than 100,000 population; |
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(v) a national aggregate of rural areas.
(ICD-10, 3: 128) |
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The regress itself to ever higher levels of control marks the fact that the world is always slightly out of reach. It cannot be contained in the classification system, or the (system + set of rules), or the (system + |
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