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Conversion between 2 military combat-related injury coding systems.

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Mapping military medical coding systems, Deployable Medical Systems (DEPMEDS) patient conditions (PCs) and Military Combat Injury Scale (MCIS), is difficult due to low inter-coder reliability. Enhancements to both systems are needed for effective military medical planning and simulation.

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Area of Science:

  • Military Medicine
  • Medical Informatics
  • Health Systems Engineering

Background:

  • Deployable Medical Systems (DEPMEDS) patient conditions (PCs) and Military Combat Injury Scale (MCIS) are critical for military medical planning but have limitations.
  • PCs offer comprehensive simulation data but are ambiguous for historical records; MCIS excels with real data but lacks predictive detail.

Purpose of the Study:

  • To assess the feasibility of converting between DEPMEDS PCs and MCIS coding systems.
  • To evaluate the inter-coder reliability for mapping MCIS to PCs for improved medical logistic planning.

Main Methods:

  • Three senior coders mapped MCIS codes to 187 combat-related PC codes.
  • Inter-rater reliability was measured using Cohen's kappa statistic and percent agreement.

Main Results:

  • Low inter-rater reliability was observed, indicating significant challenges in converting between PC and MCIS codes.
  • The study highlights the inadequacy of current coding systems for robust military medical planning and simulation.

Conclusions:

  • Conversion between DEPMEDS PCs and MCIS is currently unreliable, necessitating system improvements.
  • PC injury descriptors require expansion with standard medical data, and MCIS needs modification to include treatment and disposition details for better simulation and planning.