International Classification of External Causes of Injuries ICECI

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International Classification of External
Causes of InjuriesICECI
International Classification of External Causes
of Injuries
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Relevance of a standard injury classification
- International comparability - Not re-inventing
wheels - Centralised maintenance
International Classification of External a of
Injuries
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ICD-10 and injuries
- Conditions diagnoses, Chapter XIX - External
causes circumstances, Chapter XX
International Classification of External a of
Injuries
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Limitations of ICD
- Development for mortality statistics - Not
multi-dimensional - Not covering relevant areas
of interest - Inadequate basis injury research
International Classification of External a of
Injuries
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Design of ICECI

• - Multi-axial
• - Hierarchical
• - Modular
• - Pick and choose
• Reference classification
• All injury
• Based on existing classifications
• Not replace ICD external causes

International Classification of External Causes
of Injuries
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Developers

• Center for Disease Control (CDC, USA)
• Flinders University (Aust)
• Pan American Health Organisation (PAHO)
• World Health Organization (WHO)
• Health Canada
• Testers
• Consumer Safety Institute (Nl, secretariate)

International Classification of External Causes
of Injuries
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State of affairs

• Acknowledged by WHO as a related member of the
  Family of International Classifications (October
  2003
• Installation of Co-ordination and Maintenance
  Group (April 2003)
• Version 1.2 published (July 2004, including
  index)
• Translations (Spanish and French)

International Classification of External Causes
of Injuries
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Development of ICECI
- Testing (review, case scanarios,
field) - Taxonomic review - Index - Translations

International Classification of External Causes
of Injuries
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International Classification of External Causes
of Injuries
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Transport module
- Mode of transport - Role of the injured
person - Counterpart - Type of transport injury
event
International Classification of External Causes
of Injuries
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Violence module

• - Proximal risk factor for intentional self-harm
• Previous suicide attempt
• Perpetrator/victim relationship
• - Age and sex of perpetrator
• Context of assault
• Type of legal intervention
• Type of conflict

International Classification of External Causes
of Injuries
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Place module

• Indoor/outdoor
• Part of building or grounds
• Type of home
• Resident of home
• Type of medical service area
• Type of school
• Inside/outside city limits

International Classification of External Causes
of Injuries
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Sports module

• Type of sports
• Phase of activity
• Personal countermeasures
• Environmental countermeasures

International Classification of External Causes
of Injuries
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Occupational module

• Economic activity
• Occupation

International Classification of External Causes
of Injuries
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Hierarchy a selection from Place of occurrence
1 Home 2 Residential institution 2.1 Home for
the elderly 2.2 Nursing home 2.3 Prison 2.4 She
lter for battered women and their
children 2.5 Military institution 2.8 Other
specified residential institution
area 2.9 Unspecified residential institution
area 3 Medical service area 3.1 Hospital 3.2 Out
patient clinic, health centre 3.3 Health
professionals office 3.8 Other specified
medical service area 3.9 Unspecified medical
service area

International Classification of External Causes
of Injuries
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Derivatives of ICECI
- Less resourced countries - IDB Coding manual
in Europe (EU) (ED) - Burn injuries - Spinal cord
injuries - CDCs short version - Minimum Data
Sets in Europe (EU)
International Classification of External Causes
of Injuries
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Use of ICECI for surveillance
- Select data elements (incl. modules) - Select
level of detail per data element - Add data
elements not external cause related
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of Injuries
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ICECI and the IDB Coding Manual (1)

• Core data set ICECI
• - Intent (level 1)
• Place of occurrence
• Mechanism of injury (full)
• Activity when injured
• Object/substance producing injury
• Excluded
• - Alcohol drug use

International Classification of External Causes
of Injuries
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ICECI and the IDB Coding Manual (2)

• Violence module
• - Proximal risk factor (level 1)
• Previous intentional self harm
• Relation victim/perpetrator (level 1)
• - Sex and age of perpetrator
• - Context of assault (level 1)
• Excluded
• - Type of legal intervention
• - Type of conflict

International Classification of External Causes
of Injuries
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ICECI and the IDB Coding Manual (3)

• Transport module
• - Mode of transport
• - Role of injured person
• - Counterpart
• Excluded
• - Type of transport injury event

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ICECI and the IDB Coding Manual (4)

• Sports module
• - Type of sports
• Excluded
• Phase of activity
• Personal countermeasures
• Environmental countermeasures
• Excluded
• Place module
• Occupational module

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of Injuries
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Use of ICECI
- Emergency Department surveillance - Other
surveillance - Surveys - ...
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of Injuries
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Use of ICECI some examples
- Sport module NHIS data (USA) - Violence data
(3 EU-countries) - Electronic Medical Record
(Indonesia) - Research project Perth - Personal
accidents (Insurance company, It) - Internat.
course on surveillance (Sw) - EDs British
Columbia (Can)
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of Injuries
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Future activities
- Minor updates (per 1, 2 years) - Major updates
(per 5, 10 years) - Translations - Training
module - Additional data elements/modules - Techni
cal development
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of Injuries
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of Injuries
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Website
www.ICECI.org
International Classification of External Causes
of Injuries