Cause of death coding in asthma

Abstract Background While clinical coding is intended to be an objective and standardized practice, it is important to recognize that it is not entirely the case. The clinical and bureaucratic practices from event of death to a case being entered into a research dataset are important context for ana...

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Main Authors: Alexandria Chung, George Addo Opoku-Pare, Holly Tibble
Format: Article
Language:English
Published: BMC 2024-06-01
Series:BMC Medical Research Methodology
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Online Access:https://doi.org/10.1186/s12874-024-02238-x
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author Alexandria Chung
George Addo Opoku-Pare
Holly Tibble
author_facet Alexandria Chung
George Addo Opoku-Pare
Holly Tibble
author_sort Alexandria Chung
collection DOAJ
description Abstract Background While clinical coding is intended to be an objective and standardized practice, it is important to recognize that it is not entirely the case. The clinical and bureaucratic practices from event of death to a case being entered into a research dataset are important context for analysing and interpreting this data. Variation in practices can influence the accuracy of the final coded record in two different stages: the reporting of the death certificate, and the International Classification of Diseases (Version 10; ICD-10) coding of that certificate. Methods This study investigated 91,022 deaths recorded in the Scottish Asthma Learning Healthcare System dataset between 2000 and 2017. Asthma-related deaths were identified by the presence of any of ICD-10 codes J45 or J46, in any position. These codes were categorized either as relating to asthma attacks specifically (status asthmatic; J46) or generally to asthma diagnosis (J45). Results We found that one in every 200 deaths in this were coded as being asthma related. Less than 1% of asthma-related mortality records used both J45 and J46 ICD-10 codes as causes. Infection (predominantly pneumonia) was more commonly reported as a contributing cause of death when J45 was the primary coded cause, compared to J46, which specifically denotes asthma attacks. Conclusion Further inspection of patient history can be essential to validate deaths recorded as caused by asthma, and to identify potentially mis-recorded non-asthma deaths, particularly in those with complex comorbidities.
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spelling doaj-art-5169c7be3b714a4fa422c075989e473e2025-08-20T02:19:58ZengBMCBMC Medical Research Methodology1471-22882024-06-012411610.1186/s12874-024-02238-xCause of death coding in asthmaAlexandria Chung0George Addo Opoku-Pare1Holly Tibble2Usher Institute, University of EdinburghUsher Institute, University of EdinburghUsher Institute, University of EdinburghAbstract Background While clinical coding is intended to be an objective and standardized practice, it is important to recognize that it is not entirely the case. The clinical and bureaucratic practices from event of death to a case being entered into a research dataset are important context for analysing and interpreting this data. Variation in practices can influence the accuracy of the final coded record in two different stages: the reporting of the death certificate, and the International Classification of Diseases (Version 10; ICD-10) coding of that certificate. Methods This study investigated 91,022 deaths recorded in the Scottish Asthma Learning Healthcare System dataset between 2000 and 2017. Asthma-related deaths were identified by the presence of any of ICD-10 codes J45 or J46, in any position. These codes were categorized either as relating to asthma attacks specifically (status asthmatic; J46) or generally to asthma diagnosis (J45). Results We found that one in every 200 deaths in this were coded as being asthma related. Less than 1% of asthma-related mortality records used both J45 and J46 ICD-10 codes as causes. Infection (predominantly pneumonia) was more commonly reported as a contributing cause of death when J45 was the primary coded cause, compared to J46, which specifically denotes asthma attacks. Conclusion Further inspection of patient history can be essential to validate deaths recorded as caused by asthma, and to identify potentially mis-recorded non-asthma deaths, particularly in those with complex comorbidities.https://doi.org/10.1186/s12874-024-02238-xICD-10MortalityAsthma
spellingShingle Alexandria Chung
George Addo Opoku-Pare
Holly Tibble
Cause of death coding in asthma
BMC Medical Research Methodology
ICD-10
Mortality
Asthma
title Cause of death coding in asthma
title_full Cause of death coding in asthma
title_fullStr Cause of death coding in asthma
title_full_unstemmed Cause of death coding in asthma
title_short Cause of death coding in asthma
title_sort cause of death coding in asthma
topic ICD-10
Mortality
Asthma
url https://doi.org/10.1186/s12874-024-02238-x
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