Th. Lu et al., Accuracy of cause-of-death coding in Taiwan: types of miscoding and effects on mortality statistics, INT J EPID, 29(2), 2000, pp. 336-343
Citations number
38
Categorie Soggetti
Envirnomentale Medicine & Public Health","Medical Research General Topics
Background The objectives of this study were to assess the accuracy of caus
e-of-death coding, determine the extent to which coders follow the selectio
n rules of coding set out in the International Classification of Diseases,
9th Revision (ICD-9), and the effects of miscoding on mortality statistics
in Taiwan.
Method A systematic sample of 5621 death certificates was reviewed. The und
erlying cause of death (UCD) selected by the reviewer for each death certif
icate was compared with that selected by the original coder. The UCD was se
lected according to ACME (Automated Classification of Medical Entities) Dec
ision Tables.
Results The overall agreement rates between the reviewer and coders accordi
ng to the three-digit and two-digit categories of ICD-9 were 80.9% and 83.9
%, respectively. Good agreement was found for malignant neoplasms (kappa =
0.94) and injuries and poisoning (kappa = 0.97), but there was poor agreeme
nt for nephrotic dis eases (kappa = 0.74), hypertension-related diseases (k
appa = 0.74), and cerebral infarction (kappa = 0.77). Reasons for disagreem
ents included disagreement in nomenclature (42.8%), inappropriate judgement
of causal relationships (41.5%), and incorrect interpretation of Selection
Rule 3 and Modification Rules (15.7%).
Conclusion This study showed various levels of agreement for different dise
ases between the reviewer and the original coders in selection of the UCD.
Owing to the 'compensatory effect of errors', the national mortality statis
tics were not affected significantly. The national administration should un
dertake routine internal studies to control the quality of UCD coding pract
ices.