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Reliability of coding causes of death with ICD-10 in Germany
Volker Winkler1, Jördis J Ott, Heiko Becher
1Unit of Epidemiology and Biostatistics, Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
Objectives:
The international classification of diseases (ICD) is used to code death worldwide uniformly and comparably. This study investigates the reliability of national ICD-10 coding practice by assessing agreement of two official coding offices in Germany.
Methods:
Inter-observer agreement for coding of 372 quasi-randomly selected death certificates is measured by percentages of agreement and simple kappa coefficients.
Results:
Only 209 (56%) deaths were coded with the same 3-digit ICD-10 code. Agreement of the main chapters according to ICD-10 is higher with 78.2% and a kappa statistic of 0.69 (CI 95%, 0.63-0.75). Examples show that the coding rules correctly applied to the information given on the death certificates may lead to different conclusions.
Conclusions:
Data show good agreement in the marginal distribution, and thus population frequencies of causes of death may be more reliable despite limited agreement between the two coding offices.
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