Accuracy of external cause of injury coding in hospital records : a systematic review

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 employed 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. Due to heterogeneity between studies meta-analysis was not performed. Results: There has been very limited research conducted examining the accuracy of external cause coding for injury-related hospitalization using medical record review and recoding methodologies, with only five studies matching the selection criteria. The accuracy of external cause coding using ICD-9-CM ranged from around 64% when examining exact code agreement, to around 85% when examining agreement for broader groups of codes. Conclusions: While researchers may be able to use broad external cause groupings coded in ICD-9-CM with some confidence, for very specific codes researchers should exercise caution 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.