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Learn about the challenges and solutions in coding main injuries for mortality statistics, including the need for clearer rules, consistent training, and data quality. Explore international comparability and future developments with ICD versions.
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Selecting main Injury- Discussion Cleo Rooney Office of National Statistics England
Main injury coding /selection • For ROUTINE mortality statistics only • From vital registration • Death certificates – • Limited information and quality • All countries with VR systems • with /out multiple cause coding
Main injury in routine statistics • 70 countries published main injury as well as underlying cause in ICD-9 • None did when implemented ICD-10 • US does not • Data users demand main injury statistics
Main injury is not the limit- • Multiple cause of death codes where available • Special / research analyses • CF underlying cause of death tabulations • And multiple cause analyses
Issues • Data on death certificates limited • 2/3 only 1 injury mentioned • But, more detailed information can give less useful code eg stab wound to heart, open wound of anterior chest, heamhorrage, laceration of left ventricle > other specified chest injury
International comparability • Time trends • Consistency • ‘Public health’ • Prevention of deaths
Now and future • ICD-10 – • Mend problems • ‘quick and dirty’ • ICD-11 • Evidence based • Thought through • Piloted > feasible, relevant, useful data
Main injury coding for mortality • Automated or manual coding • Clear, unambiguous • Certifier training • Coder training • allocation of single codes, index entries • Selection rules • Modification rules – trivial conditions, linkage, specificity, Severity or precedence
Severity or precedence? • Use existing rules better • coder training & materials from WHO FIC • More comprehensive measure of severity? • Data on hospital admissions and deaths before reaching hospital? • Combination codes? • Define a FEW important, relevant combinations