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The World Health Organization (WHO) Classifications and Terminologies Unit announces the release of the DORIS tool version 1.1, an advanced digital tool designed to support countries in automatically selecting the underlying cause of death (UCOD).

DORIS is a multilingual software developed to facilitate the identification of the underlying cause of death. This tool examines the information provided on the medical certificate of cause of death (MCCD) and assists in automatically selecting the underlying cause of death using the fully digitalized mortality coding rules of the International Classification of Diseases, 11^th revision (ICD-11).

The DORIS tool (Digital Open Rule Integrated cause of death Selection) version 1.1 features significant improvements based on user feedback. 

The updated version integrates enhancements to its algorithm improving the accuracy and consistency of cause of death coding particularly:

• Refined specificity for infectious diseases, neoplasms, and injury-related conditions. 
• Improved logic for HIV, tuberculosis, and substance intoxications. 
• Better handling of external causes and injury-related deaths.

To improve transparency and user engagement, DORIS 1.1 now offers four complementary visualization modes to assist coders, reviewers, and trainers:

• Textual Report: Describes applied rules and warnings in a step-by-step summary and full textual report.
• Tabular Report: Provides an interactive view of each rule application aligned with the MCCD.
• Rule Flow Report: Illustrates the logical path that led to the final selection of the underlying cause of death.
• Rule Sequence Report: Displays a horizontal sequence of the rules applied during processing.

The new version runs on the latest release of ICD-11 and supports all the released languages. It is accessible via:

• Web-based interface
• Desktop application for Windows and macOS
• APIs for integration in other software

DORIS plays a vital role in improving the quality of mortality statistics and supports country efforts to implement ICD-11 in line with international standards. The release of version 1.1 underscores WHO’s commitment to leveraging digital innovation to strengthen health information systems worldwide.

For more information and access to the tool:

• Visit the DORIS homepage icd.who.int/doris or the DORIS user guide 
• Contact the WHO Classifications and Terminologies team  at icd@who.int or alsokhnc@who.int. 
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