K. Dupriez et al., USE OF THE INTERNATIONAL CLASSIFICATION O F DISEASES FOR THE DISABILITY INSURANCE IN SWITZERLAND - A RELIABILITY STUDY, Sozial- und Praventivmedizin, 42(5), 1997, pp. 306-313
The International Classification of Diseases (ICD-10) was introduced i
n a pilot phase for coding of diagnoses in a sample of cases encounter
ed in the Swiss Disability Insurance (SDI), as a substitute for the SD
I codes, judged unsuitable for the description of disability. The goal
of this study is to evaluate the reliability of use of these codes, b
y studying the coding reproductibility between the Medical Observation
Centers (MOC) and the Evaluation and Coordination Center. A second go
al was to evaluate the feasibility of coding by non-physicians. Reliab
ility of diagnoses was examined by level of precision: chapters, group
s categories and sub-categories. The agreement between the two coding
Centers varies from 78%, at the chapter level, to 29% at the most deta
iled level. This agreement is improved if taking into account the thre
e main diagnoses for the comparison, reaching 91%. The results of the
physician coder, concerning the precision and reliability of coding, a
re significantly superior to those of an economist coder and a medical
secretary coder. To improve coding agreement, it is proposed to train
coding professionals, provide coding tools, clarify which diagnosis i
s the main one, and seek a consensus for cases of systematic disagreem
ent. The ideal level of precision should not be so high as to produce
diagnostic codes with low reliability. It should, however, be precise
enough to give a satisfactory description of the problems encountered.