ࡱ> GIH5"( / 0DArialNew Romanll T0DTimes New Romanll T0 D[SOes New Romanll T0 a9.Z  @n?" dd@  @@`` vnAC  +789:;<=>?@A 6AAԔ@"J ʚ;*e8ʚ;g4GdGdH T0ppp@ <4dddd8!0l <4!d!d8!0l  <4BdBd8O$0l80___PPT10 pp?  %<Revision trial of ICD-10 Ch XX on external causes of injury $=<b((< Martti Virtanen, Kristina Brnd Persson WHO Collaborating Centre for the Family of International Classifications in the Nordic Countries, Uppsala, SwedenZ' t_ICD revision process and relation of ICD to other classifications in health information systems&`_b __ 2The external causes classification constitutes a part of ICD but should also work quite independently How to collect detailed information with ability to aggregate to ICD-level Need for double coding must be avoided Terminology for ICD is included in ICECI and NCECI and the area is not covered by SNOMEDdgsYgbsbCbb2 'External causes in mortality statistics&('b$$ '' WHO database on mortality about 1/3 of all deaths are reported to WHO Approx. 7% of deaths are coded by Chapter XX Within transport accidents 45% of codes are "unspecified" 13 out of 70 countries do not use the 4th character of ICD-10 Approx. 400 ICD-10 codes are never used.8`` KMultiaxial system may cause problems for mortality statistics in continuity$LKb  "  A uICD-10 For Mechanism and Intent a partial multiaxiality exists in ICD-10 Several axes are implicit in Ch. XX, which allows for recoding of data ICD-11 A practical solution is needed; a multiaxial classification can be used to create a flat list/compination of flat lists for mortality. The needs and corresponding structure should be made clear before codes are consideredPPPPWPbbbbVb $   Y  #   2   u  ICECI relation to ICD-10`  Documentation for v1.2 includes overview of ICECI in relation to ICD Mapping of modules for Mechanism and Intent according to ICECI is also shown In Ch. XIX the classes/terms is a mix of injuries and external causes In analysis of ICECI vs. ICD one should use the matrix and analyse the terms/concepts. Some ICECI terms differ and some are the same as in ICD but they should all be compatible with ICD (Chapter XIX, XX and V (drugs)). 60PP0bb  ICECI relation to ICD-10 ` *Ch. XX is a separate axis of ICD Problem in differentiation of Ch. V and intoxications - intoxication can be caused by psychiatric illness The design of core modules in ICECI was based on existing structure of Ch XX a separation of mechanism and intent link to the mortality matrix was made in cooperation with ICE a minimal coding bridge to ICD-9/10 from ICECI exists but a more robust bridge is needed The problem in making a flat projection is that the structure in ICD-10 is not logical logical structure can be created from the multiaxial approach!ZjZNZZWZ>Z bbjbNbbWb> b &      Problems of ICD-10"   Instructions on Ch. XX use must be improved (inclusions, exclusions, coding instructions). Distinction between "undetermined intent" and "intent unspecified" Some intermediate level information should be permitted An algorithm for the selection of underlying cause code is neededT\C{\bCbzb !Necessary modifications in ICD-11""(<       nTrue axis/axes need to be developed Model 1  ICD-10 model The code structure will include an axiality All valid codes are listed External cause information is compressed to one code Number of codes is high Restgroups with complex definitions need to cover all possibilities Model 2  ICECI/NCECI modified Each axis of ICECI/NCECI is assigned own area of ICD-codes Complete description demands several external cause codes Restgroups are needed for each axis Number of combinations is almost unlimited Model 3 - Combined model Place, activity, intent as separate axis/axes i.e. own area(s) of ICD-codes Other axis combined to one list Number of coded need for external cause case limited to 1-3 $PPPPPPP$   PQ                 QlLoppu / !"#$%&'(!  0` ̙33` ` ff3333f` 333MMM` f` f` 3>?" dd@,|?" dd@   " @ ` n?" dd@   @@``PR    @ ` ` p>> )!@(    6\3 "P  PMuokkaa perustyyl. napsautt. -  0s "  [Muokkaa tekstin perustyylej napsauttamalla toinen taso kolmas taso neljs taso viides taso,     \  0| "``  ^* #  0\ "`   `* #  0 "`   `* #  pECW@WG "g Ԕ?Nordic CentreArial Black" PB  s *޽h ? ̙3380___PPT10.># NordDRG0 zr (    0tH P    P*    0a     R*  d  c $ ?    0\E  0  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S  6& _P   P*    6- _   R*  H  0޽h ? 3380___PPT10.wh$0  $(  r  S   r  S  `    H  0޽h ? 3380___PPT10.g0?$ 0 p$(  r  S PP   r  S d  H  0޽h ? ̙3380___PPT10.h$ 0  $(   r  S @P   r  S   H  0޽h ? ̙3380___PPT10.i*$ 0 $$(  $r $ S 8P   r $ S P  H $ 0޽h ? ̙3380___PPT10.i\} 0 D$(  Dr D S ,ؕP   r D S ؕ  H D 0޽h ? ̙33___PPT10i.m+D=' = @B +$ 0 `X$(  Xr X S GP   r X S (  H X 0޽h ? ̙3380___PPT10.mp|$ 0 ($(  (r ( S  1P   r ( S \   H ( 0޽h ? ̙3380___PPT10.jT} 0 p$(  r  S P1W   r  S   H  0޽h ? ̙33___PPT10i.8 q+D=' = @B + 0 (  r  S `P   H  0޽h ? ̙33___PPT10i.vp"+D=' = @B + 0 (  X  C      S  0    H  0޽h ? 3380___PPT10.wh 0 (  X  C      S  0    H  0޽h ? 3380___PPT10.wqh 0 (  X  C      S ߕ 0    H  0޽h ? 3380___PPT10.wqh 0 (  X  C      S ֕ 0    H  0޽h ? 3380___PPT10.wqh  0 (  X  C      S 0 0    H  0޽h ? 3380___PPT10.wqh 0 (  X  C      S  0    H  0޽h ? 3380___PPT10.wqh 0 (  X  C      S h 0    H  0޽h ? 3380___PPT10.wqh 0 (  X  C      S n 0    H  0޽h ? 3380___PPT10.wh 0 (  X  C      S x 0    H  0޽h ? 3380___PPT10.whrl ="h2@468? ;=zDAf,FHJLNPRU%WX9Y(1Oh+'0" hp   D P \hp\Progress report on pilot for revision trial of ICD-10 Ch XX on external causes of injury Martti VirtanenNordic centrelaf45Microsoft Office PowerPoint@RN@Fg@Q1ow+GP!g  \  y--$xx--'--$ STWUVZY VXWS----L8Y X X X Y Y Z [[\\\\[[ZYYZZ[[[[[[[ Z Z Z Y Y YZZ----&$ Z [ [ [ [ [ \ \ ] \ \ \\]^] Z----T8]aa``````_^^ ] ] \]] ^\]] _ _ ^ ^ ^ ^ ^ ^ ^____`__ _ _----8]^_^]]^_cb^^----L$$ c ddeeeddcbb a a a```aab c b b b a a a b b ccccdd c----P$&f g h hiihhhg f edcbbbccdeeedddddde f f g g g g gf----\8 j i i i j j j j j j k kkkkj j i hggffffgghijjjhhgggggghhh----4$ghhhhhhhiij n mjjjiiijj m lg----:$gijkkmmmnnnn o o o o n n nmljjiihg----,$jjkkkjjkkllllmmnn p pj----\8 pooppppppqqrrrqqpponmlkkllmnnpppnnmmmmmmnnn----$ RSWTUZY UXW R----L8Y X X X X Y Z[\\\[[ZYYYYZZZ[[[ZZZ Y Y Y Y YYYY----$$ Z Z [ [ [ [ [ \ \ \ \\]^] Z----R8\a`````__^] \ \ \ \ ] ]\\\_ ^ ^ ^ ] ] ] ^^^________----8]]^^]]^_bb^^----L$$ c dddddccba a ` ` ````aab b b a a a a a a bbbcccc c----R$' f g h hhhhhhgf f e dbbbabbcdeddccccdd e f f g g g f f----X8 i h i i i i i i j jkkjjji h h gfeeeffgghi i ihggggfgghh----4$gghhgghhij m mjiiiiiiij llg----4$giikjlmmmm o o n n n m mljjhhgg----,$ijkjjjjjklllllmmn p oi----Z8 onoopppppqqq q q pponmlkkkkllmnooonmmlllmmmnn----% RSWTUZY UXW R----&%Y X X X X Y Z[\\\[[ZYYY(%YZZZ[[[ZZZ Y Y Y Y YYYY----$% Z Z [ [ [ [ [ \ \ \ \\]^] Z----,%\a`````__^] \ \ \ \ ] ]\\\(%_ ^ ^ ^ ] ] ] ^^^________----%]]^^]]%^_bb^^----L%$ c dddddccba a ` ` ````aab b b a a a a a a bbbcccc c----R%' f g h hhhhhhgf f e dbbbabbcdeddccccdd e f f g g g f f----B% i h i i i i i i j jkkjjji h h gfeeeffgghi i i% hggggfgghh----4%gghhgghhij m mjiiiiiiij llg----4%giikjlmmmm o o n n n m mljjhhgg----,%ijkjjjjjklllllmmn p oi----B%onoopppppqqq q q pponmlkkkkllmnooo% nmmlllmmmnn--'@Times New Roman-. '2 !Revision trial of ICD."Systemp9-@Times New Roman-.  2 !]-n.-@Times New Roman-. 2 !` 10 Ch XX on .-@Times New Roman-. .2 ,$external causes of injury .-@Times New Roman-. 12 KMartti Virtanen, Kristina Br.-@Times New Roman-.  2 Ken.-@Times New Roman-. 2 Kh nd Persson.-@Times New Roman-. C2 S(WHO Collaborating Centre for the Family .-@Times New Roman-. 92 Y*!of International Classifications F.-@Times New Roman-. C2 `(in the Nordic Countries, Uppsala, Sweden.-՜.+,0h    ( On-screen Show HVT Healthcare Consulting OyY;  d  ArialTimes New Roman宋体NordDRG=Revision trial of ICD-10 Ch XX on external causes of injury `ICD revision process and relation of ICD to other classifications in health information systems(External causes in mortality statisticsLMultiaxial system may cause problems for mortality statistics in continuityICECI relation to ICD-10ICECI relation to ICD-10Problems of ICD-10"Necessary modifications in ICD-11Loppu  Fonts UsedDesign Template Slide Titles Root EntrydO)^;J@Current User,SummaryInformation(-"PowerPoint Document(Y  !"#$%&'()*+,./0123456789:;<=>@ABCDEFQ_Ylaf4laf4  !"#$%&'()*+,./0123456789:;<=>@ABCDEFHIJKLMNQRoot EntrydO)Current UserGSummaryInformation(-"PowerPoint Document(YDocumentSummaryInformation8?