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Use of automation in France for Medical Causes of Death Coding The coding system Styx

Use of automation in France for Medical Causes of Death Coding The coding system Styx. Epidemiology Centre on Medical Causes of Death CépiDc - IFR69 - Inserm. Gérard Pavillon pavillon@vesinet.inserm.fr. Inclusion in the electronic document management system. Index Explanation ability.

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Use of automation in France for Medical Causes of Death Coding The coding system Styx

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  1. Use of automation in France for Medical Causes of Death Coding The coding system Styx Epidemiology Centre on Medical Causes of Death CépiDc - IFR69 - Inserm Gérard Pavillon pavillon@vesinet.inserm.fr

  2. Inclusion in the electronic document management system Index Explanation ability Use of ACME decision tables Context and motivations for ACS use Context electronic document management  Implementation of ICD10 new codes rules complexity (linkage...) Data quality / International comparability

  3. Death certificates Pictures Scanner Individual data OCR STYX MC text and codes UC code System general architecture

  4. Individual data Index Pictures Acme decision tables Medical causes text and codes Underlying cause code Styx architecture Medical causes of death text STYX

  5. System description INDEX Text, code, author, date Same text, several codes Hemorragie R58 T14.5 T81.0 Minor standardisation, synonyms, abreviation Search tool online 70 000 lines 64 000 expressions 4 700 codes (including Z codes) Use of index is mandatory

  6. System description Underlying cause selection Specific algorithm of ICD rules (logic) Acme decision tables (knowledge) General principle If there is only one cause in the lowest used line of part I If thiscause can give rise to all other causesmentioned above General Principle applies end if End if

  7. System description Rejects Cause not in the index Inconsistency age/sex Several possible codes Code not to be used as underlying cause Perinatal period (< 28 days) Multiple site cancers Ill defined cause and age < 75 Ill defined external cause ….

  8. System description Styx output 540 000 death certificates a year 65 % of death certificates OK 26 % rejects 9 % cause text not in index places of adjective Technical features Programming language C++ Database Microsoft Access Interactive / Batch

  9. System description Other features Vocal capture of diagnoses Display of death certificate picture Search and update tools for index online Silent/talkative mode Explanation of rule application and sequence

  10. Conclusion  Styx is now better accepted by coders  Explanations capabilities are essential for nosologists  Coding performances should be improved - automated standardisation of expressions - multiple codes for one diagnosis ?

  11. Use of automation in France for Medical Causes of death The coding system Styx Epidemiology Centre on Medical Causes of Death CépiDc - IFR69 - Inserm Gérard Pavillon pavillon@vesinet.inserm.fr

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