|CDC's Short Version of the ICECI - International Classification of External Causes of Injury - A Pilot Test (Centers for Disease Control and Prevention, 2000, 30 p.)|
Background on ICECI and Short Versions of the ICECI
An international effort is underway to develop a new multi-axial classification system for external causes of injury designed for use in mortality and morbidity data systems. This system will provide a standard for coding more detailed information about injury circumstances than is possible using the current ICD-10 external-cause-of-injury coding system. This new system, called the International Classification of External Causes of Injury (ICECI),1 is designed to capture details about the place of occurrence, activity at the time of injury, alcohol and drug involvement, objects or substances involved, intent of injury, and mechanism of injury. Specific modules are being developed to capture more detailed information about injuries related to violence, transportation, sports, and work (occupational). Several short versions of the ICECI (subsequently referred to as short ICECIs) are being developed for use as injury surveillance tools in different settings. For example, a set of short ICECIs has been proposed by Dr. Yvette Holder, Dr. Etienne Krug, and colleagues for use in countries or societies with limited resources for injury surveillance.2 Also, CDC has developed a short ICECI for use in capturing external-cause-of-injury data from hospital emergency department (ED) records in the United States.3 This report will focus on a pilot study that was conducted in the United States to test the feasibility of CDCs short ICECI for abstracting data on external causes of injury using hospital ED records. The remainder of this report will provide a description of CDCs short ICECI as well as the methods, results, discussion, and recommendations stemming from the pilot study.
Purpose of the Pilot Test of CDCs Short ICECI
The purpose of the short ICECI pilot study was to test the reliability of capturing external-cause-of-injury data using the short ICECI data elements and code sets. The pilot study had two parts: (1) a case scenario test to measure validity, timeliness, and inter-coder and intra-coder reliability; and (2) a field test to measure inter-coder reliability and completeness of external-cause-of-injury data obtained from hospital ED records.
CDCs Short ICECI and Its Components
CDCs short ICECI has five major components: (1) type of incident (work-related or not), (2) locale of injury incident, (3) type of activity when the injury occurred, (4) intent of injury, and (5) mechanism of injury.3 Each of the major components or data elements consists of a code set with specified categories pertinent to the injury incident. For intent of injury and mechanism of injury, there are also subdata elements with code sets designed to capture more information about specific types of injury-related incidents. For instance, if a patient was treated for an injury resulting from a motor vehicle crash, the short ICECI captures information on traffic-relatedness, type of motor vehicle involved, occupant status (e.g., driver or passenger, boarding or alighting), and counterpart to the crash (e.g., another vehicle, pedestrian, or fixed object). In addition, the short ICECI data collection form provides space for recording safety equipment use, consumer products involved, and a narrative description of the injury incident.
The short ICECI data elements and code sets were derived from the full ICECI data elements and codes sets and the ICD-10 external-cause-of-injury code set. The short ICECI code sets have been cross-walked to code sets for both of these classification systems. The short ICECI consists of a hard copy check-box type data collection form, a manual with coding definitions and rules, and a training module. The current or modified versions of CDCs short ICECI are under consideration or are being used for other injury surveillance activities in the United States (e.g., voluntary reporting from hospital EDs in Michigan; data linkage study at the Grady Hospital ED in Atlanta). The short ICECI data elements and code sets for intent of injury and mechanism of injury components also have been modified to capture external-cause-of-injury data in the National Electronic Injury Surveillance System (NEISS), operated by the U.S. Consumer Product Safety Commission (CPSC). CPSC, in collaboration with CDC is expanding NEISS to capture nationally-representative data on all types and causes of injuries treated in U.S. hospital EDs.