探讨从国际疾病分类第九版（ICD - 9）转换至国际疾病分类第十版（ICD - 10）对空气污染急性致死效应的不确定性。

Exploring uncertainty of the change from ICD-9 to ICD-10 on acute mortality effects of air pollution.

作者信息

Qian Zhengmin, He Qingci, Lin Hung-Mo, Kong Lingli, Liao Duanping, Gong Jie, Bentley Christy M, Wei Hongming

机构信息

Penn State College of Medicine, USA.

出版信息

Environ Int. 2008 Feb;34(2):248-53. doi: 10.1016/j.envint.2007.08.006. Epub 2007 Sep 12.

DOI:10.1016/j.envint.2007.08.006

PMID:17854896

Abstract

The change in ICD coding from ICD-9 to ICD-10 may produce inconsistencies and discontinuities in cause-specific mortality, thus impacting on effects estimates of air pollution on mortality. The current study was conducted in Wuhan, China. We examined the concordant rates and Kappa statistics using the mortality data from the year 2002 coded with both ICD-9 and ICD-10 codes and compared the estimated effects of air pollution using the Generalized Additive Model in R. We found high concordant rates (>99.3%) and Kappa statistics close to 1.0 (>0.98). Little difference was identified in the estimated effects of air pollution on daily cardiovascular, stroke, cardiac, cardiopulmonary, and respiratory mortality. This study provides evidence that, based on the wide definitions of cause-specific morality typically used in the studies of time-series air pollution mortality, the change in the ICD coding does not significantly affect the estimated effects of air pollution.

摘要

国际疾病分类（ICD）编码从ICD - 9转换为ICD - 10可能会导致特定病因死亡率出现不一致和不连续的情况，从而影响空气污染对死亡率影响的估计。本研究在中国武汉开展。我们使用2002年同时采用ICD - 9和ICD - 10编码的死亡率数据，检查了一致性率和kappa统计量，并使用R语言中的广义相加模型比较了空气污染的估计影响。我们发现一致性率很高（>99.3%），kappa统计量接近1.0（>0.98）。在空气污染对每日心血管、中风、心脏、心肺和呼吸系统死亡率的估计影响方面，未发现明显差异。这项研究提供了证据，表明基于时间序列空气污染死亡率研究中通常使用的特定病因死亡率的宽泛定义，ICD编码的变化不会显著影响空气污染的估计影响。