Abstract
This study evaluates the agreement of nosologic coding of cardiovascular causes of death between a Chilean coder and one in the United States, in a stratified random sample of death certificates of persons aged ≥ 60, issued in 2008 in the Valparaíso and Metropolitan regions, Chile. All causes of death were converted to ICD-10 codes in parallel by both coders. Concordance was analyzed with inter-coder agreement and Cohen's kappa coefficient by level of specification ICD-10 code for the underlying cause and the total causes of death coding. Inter-coder agreement was 76.4% for all causes of death and 80.6% for the underlying cause (agreement at the four-digit level), with differences by the level of specification of the ICD-10 code, by line of the death certificate, and by number of causes of death per certificate. Cohen's kappa coefficient was 0.76 (95%CI: 0.68-0.84) for the underlying cause and 0.75 (95%CI: 0.74-0.77) for the total causes of death. In conclusion, causes of death coding and inter-coder agreement for cardiovascular diseases in two regions of Chile are comparable to an external benchmark and with reports from other countries.
Highlights
Mortality statistics are a cornerstone of health planning and research [1,2,3]
This study evaluates the agreement of nosologic coding of cardiovascular causes of death between a Chilean coder and one in the United States, in a stratified random sample of death certificates of persons aged ≥ 60, issued in 2008 in the Valparaíso and Metropolitan regions, Chile
As part of a study on mortality due to heart failure, a stratified random sample was drawn from death certificates of people aged 60 years and over issued in the Valparaíso and Metropolitan regions in 2008 available in the Department of Health Statistics and Information (DEIS, acronym in Spanish) of the Chilean Ministry of Health (MINSAL, acronym in Spanish)
Summary
Mortality statistics are a cornerstone of health planning and research [1,2,3]. Their usefulness hinges on the quality of death certification and on the reliability of coding in line with the International Classification of Diseases – 10th revision (ICD-10) 4. Apart from possible errors associated with the medical certification of cause of death, a number of factors influence the quality of nosological coding of causes of death. Studies of intercoder agreement show varying levels of agreement in relation to code classification level, the number of causes of death recorded on the death certificate, and the age of the deceased [3, 7,10]
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