Completeness and accuracy of International Classification of Disease (ICD) external cause of injury codes in emergency department electronic data.
Hunt-PR; Hackman-H; Berenholz-G; McKeown-L; Davis-L; Ozonoff-V
Inj Prev 2007 Dec; 13(6):422-425
The accuracy of external cause of injury codes (E codes) for work-related and non-work-related injuries in Massachusetts emergency department data were evaluated. Medical records were reviewed and coded by a nosologist with expertise in E coding for a stratified random sample of 1000 probable work-related (PWR) and 250 probable non-work-related (PNWR) cases. Cause of injury E codes were present for 98% of reviewed cases and accurate for 65% of PWR cases and 57% of PNWR cases. Place of occurrence E codes were present in less than 30% of cases. Broad cause of injury categories were accurate for about 85% of cases. Non-specific categories (not elsewhere classified, not specified) accounted for 34% of broad category misclassifications. Among specified causes, machinery injuries were misclassified most often (39/60, 65%), predominantly as cut/pierce or struck by/against. E codes reliably identify the broad mechanism of injury, but inaccuracies and incompleteness suggest areas for training of hospital admissions staff, providers, and coders.
Injuries; Surveillance-programs; Information-processing; Information-retrieval-systems; Information-systems; Statistical-analysis; Medical-monitoring; Medical-surveys
Dr P R Hunt, Occupational Health Surveillance Program, Massachusetts Department of Public Health, 250 Washington St, Sixth Floor, Boston, MA 02108
Research Tools and Approaches: Surveillance Research Methods
Massachusetts State Department of Public Health