為了反映醫學與公共衛生知識與觀念的更新，國際疾病分類（International Statistical Classification of Diseases and Health Related Problem, ICD）會定期改版。本文回顧第二次世界大戰以後世界衛生組織成立，開始強力要求會員國遵守ICD-6的選擇準則來選則原死因，所造成美國腎炎腎病與糖尿病死亡率影響。接著看到英國1980年代針對選擇準則的修改，造成對肺炎與一些神經退化性疾病死亡率的影響。到了2000年代許多先進國家開始採用自動化編碼系統的經驗，台灣也跟上這個進步潮流在 2008年開始採用。最後再以六個死因為例，說明如何使用可比較性比值進行調整，可以更清楚看到選擇準則變動的影響。本文對於死因統計產出過程的關鍵步驟進行相當詳細的介紹，相信會有助於對死因別死亡率趨勢做出更適當的解釋。

To reflect the updating of medical and public health knowledge and concepts, the International Statistical Classification of Diseases and Health Related Problem (ICD) will be revised regularly. This article reviews the establishment of the World Health Organization after World War II, and it began to force member states to abide by the ICD-6 selection criteria to select the original cause of death, which has caused the mortality of nephritis and diabetes in the United States. Then I saw the revision of the selection rules in the UK in the 1980s, which impacted the mortality of pneumonia and some neurodegenerative diseases. By the 2000s, many advanced countries began to adopt the experience of automated coding systems, and Taiwan also kept up with this trend of advancement and adopted it in 2008. At the Final of this article, six examples of death causes were used to illustrate how to use the comparability ratio to adjust selection rules. You can more clearly see the impact of changes in the selection criteria. This article gives a reasonably detailed introduction to the critical steps of the death cause statistical output process, which is believed to help make a more appropriate explanation of the trend of death rate by cause.

International Statistical Classification of Diseases and Health Related Problem (ICD), automated coding, selection rules, cause-specific mortality