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Enhancing Cause of Death Coding with a Language-Independent System

On June 5, key insights on developing a language-independent system for cause of death coding were presented. By leveraging the MICAR and ACME systems, the proposal suggests using ICD codes to streamline the coding function and minimize language dependency. Challenges in coding, influenced by different meanings across languages, were addressed, emphasizing the necessity for an international standard. The prototype, currently tested on over 17,000 records, shows substantial discrepancies with current coding methods, prompting the need for further error review and dictionary development.

karyn-everett
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Enhancing Cause of Death Coding with a Language-Independent System

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  1. Saturday, June 5 PLANS FOR A LANGUAGE-INDEPENDENT SYSTEM Lars Age Johansson Gérard Pavillon

  2. Coding function Selection function Causes of death coding Death certificate Super Micar Micar { Icd codes } ACME Underlying cause of death

  3. Death certificate language 1 Death certificate language 2 Coding function 1 Coding function 2 ACME Underlying cause Causes of death coding { ICD codes }

  4. Coding Vs selection Selectionlanguage independent (input = ICD codes) Codinglanguage dependent (input = text) Coding can greatly influence the underlying cause selection

  5. Effects of language on coding function Language differences Hjärtinfarkt Myocardial infarction Infarctus du myocarde

  6. Effects of language on coding function Different meanings for similar expressions English "Metastatic cancer of lung": primary? secondary? French "Cancer métastatique du poumon": secondary

  7. Coding difficulties One diagnosis - several codes Haemorrhage (R58? T14.5?) Metastatic cancer of lung (C34.9, C78.0?)

  8. Relations to other conditions must be expressed "haemorrhage" External cause? Yes No R58 T14.8 Coding difficulties Codes cannot always be directly assigned to each diagnosis expression

  9. Coding difficulties One code - several diagnosis Primary cancer, metastatic cancer (C80)

  10. The coding function is not just an index It must include: Dictionary (terms to codes) Indications for code relations

  11. Dictionary ERN? Tentative ICD ? { ICD codes } Coding function Death certificate language 1 Super Micar ”Relations table" Micar 200

  12. Conclusion ACME is now a standard for the selection function How to get an international standard for the coding function ?

  13. A LANGUAGE INDEPENDENT SYSTEM 3 main ideas • Use MICAR ACME system (code relations) • Use ICD codes instead of ERN to link dictionary to the coding function • The dictionary is the only language dependent part of the system

  14. Translation ICD-ERN MICAR ACME A LANGUAGE INDEPENDENT SYSTEM Causes of death text or ICD codes Dictionary (text - ICD) Underlying cause

  15. A LANGUAGE INDEPENDENT SYSTEM • Advantages • Use ICD codes or national dictionary • No translation of MICAR dictionary (160 000 items) • Micar formats the input records according to ACME specifications (international standard) • Interactive system for coding and UC selection • Considerations • Need to handle some records manually (External causes, procedures…) • Some coders have to know input coding

  16. A LANGUAGE INDEPENDENT SYSTEM • IRIS project Status • Prototype using codes • Test on 17,567 records already coded by Swedish Mikado system • 200 records to review manually • 2,744 records differ from Mikado coding (85%) • Next steps • Review differing records, correct errors • Develop dictionary functions • Develop international interface

  17. Saturday, June 5 PLANS FOR LANGUAGE-INDEPENDENT SYSTEM

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