Accuracy of external cause-of-injury coding in hospital records

Abstract

Objective: To appraise the published evidence regarding the accuracy of external cause-of-injury codes in hospital records. Design: Systematic review. Data sources: Electronic databases searched included PubMed, PubMed Central, Medline, CINAHL, Academic Search Elite, Proquest Health and Medical Complete, and Google Scholar. Snowballing strategies were used by searching the bibliographies of retrieved references to identify relevant associated articles. Selection criteria: Studies were included in the review if they assessed the accuracy of external cause-of-injury coding in hospital records via a recoding methodology. Methods: The papers identified through the search were independently screened by two authors for inclusion. Because of heterogeneity between studies, meta-analysis was not performed. Results: Very limited research on the accuracy of external cause coding for injury-related hospitalisation using medical record review and recoding methodologies has been conducted, with only five studies matching the selection criteria. The accuracy of external cause coding using ICD-9-CM ranged from ~ 64% when exact code agreement was examined to ~85% when agreement for broader groups of codes was examined. Conclusions: Although broad external cause groupings coded in ICD-9-CM can be used with some confidence, researchers should exercise caution for very specific codes until further research is conducted to validate these data. As all previous studies have been conducted using ICD-9-CM, research is needed to quantify the accuracy of coding using ICD-10-AM, and validate the use of these data for injury surveillance purposes.