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Validation of ICDPIC software injury severity scores using a large regional trauma registry.

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Date
2015-10
Authors
Greene, Nathaniel H
Kernic, Mary A
Vavilala, Monica S
Rivara, Frederick P
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Abstract
BACKGROUND: Administrative or quality improvement registries may or may not contain the elements needed for investigations by trauma researchers. International Classification of Diseases Program for Injury Categorisation (ICDPIC), a statistical program available through Stata, is a powerful tool that can extract injury severity scores from ICD-9-CM codes. We conducted a validation study for use of the ICDPIC in trauma research. METHODS: We conducted a retrospective cohort validation study of 40,418 patients with injury using a large regional trauma registry. ICDPIC-generated AIS scores for each body region were compared with trauma registry AIS scores (gold standard) in adult and paediatric populations. A separate analysis was conducted among patients with traumatic brain injury (TBI) comparing the ICDPIC tool with ICD-9-CM embedded severity codes. Performance in characterising overall injury severity, by the ISS, was also assessed. RESULTS: The ICDPIC tool generated substantial correlations in thoracic and abdominal trauma (weighted κ 0.87-0.92), and in head and neck trauma (weighted κ 0.76-0.83). The ICDPIC tool captured TBI severity better than ICD-9-CM code embedded severity and offered the advantage of generating a severity value for every patient (rather than having missing data). Its ability to produce an accurate severity score was consistent within each body region as well as overall. CONCLUSIONS: The ICDPIC tool performs well in classifying injury severity and is superior to ICD-9-CM embedded severity for TBI. Use of ICDPIC demonstrates substantial efficiency and may be a preferred tool in determining injury severity for large trauma datasets, provided researchers understand its limitations and take caution when examining smaller trauma datasets.
Type
Journal article
Subject
Injury Diagnosis
Abbreviated Injury Scale
Area Under Curve
Female
Forms and Records Control
Humans
Injury Severity Score
International Classification of Diseases
Male
Outcome Assessment (Health Care)
Quality Improvement
Registries
Retrospective Studies
Software
Wounds and Injuries
Permalink
https://hdl.handle.net/10161/10182
Published Version (Please cite this version)
10.1136/injuryprev-2014-041524
Publication Info
Greene, Nathaniel H; Kernic, Mary A; Vavilala, Monica S; & Rivara, Frederick P (2015). Validation of ICDPIC software injury severity scores using a large regional trauma registry. Inj Prev, 21(5). pp. 325-330. 10.1136/injuryprev-2014-041524. Retrieved from https://hdl.handle.net/10161/10182.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Greene

Nathaniel Howard Greene

Assistant Professor of Anesthesiology
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