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Selecting main Injury- Discussion

This discussion explores the importance of accurate main injury coding for mortality statistics, highlighting the limitations of death certificates and the need for improved coding practices. It discusses international comparability, the current challenges, and potential solutions for better coding. The ultimate goal is to enhance public health and prevent deaths through evidence-based data.

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Selecting main Injury- Discussion

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  1. Selecting main Injury- Discussion Cleo Rooney Office of National Statistics England

  2. 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

  3. 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

  4. 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

  5. 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

  6. International comparability • Time trends • Consistency • ‘Public health’ • Prevention of deaths

  7. Now and future • ICD-10 – • Mend problems • ‘quick and dirty’ • ICD-11 • Evidence based • Thought through • Piloted > feasible, relevant, useful data

  8. 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

  9. 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

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