Validation of an in-house Dutch Forensic Death Coding system (FDC).

Area of Science:

• Forensic Pathology
• Medical Coding Systems
• Public Health Statistics

Background:

• The International Classification of Diseases (ICD-11) is standard for mortality coding but not optimized for forensic diagnoses.
• A specialized Forensic Death Classification (FDC) system was developed in the Netherlands for forensic settings.

Purpose of the Study:

• To evaluate the validity and applicability of the FDC system for classifying causes of death in forensic investigations.

Main Methods:

• The FDC system, with parameters including Main category, Subcategory, and Mode of death, was applied to 138 forensic autopsy reports.
• Inter-investigator and intra-investigator agreement were assessed using Krippendorff's alpha (kalpha) statistics among three forensic experts.

Main Results:

• High inter-investigator agreement was observed for the Main category (kalpha=0.91) and Subcategory (kalpha=0.74).
• Intra-investigator agreement also demonstrated good reliability across all FDC parameters, with Main category at 0.95 and Subcategory at 0.87.

Conclusions:

• The FDC system provides a valid and applicable method for coding forensic causes of death, reducing ambiguity.
• This system can improve case understanding for legal professionals and has potential for broader use in forensic medicine and public health mortality reporting.