Clin Exp Emerg Med.  2016 Dec;3(4):219-238. 10.15441/ceem.16.126.

International Classification of Diseases 10th edition-based disability adjusted life years for measuring of burden of specific injury

Affiliations
  • 1Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. sdshin@snu.ac.kr
  • 2Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
  • 3Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
  • 4Department of Emergency Medicine, Gachon University Gil Hospital, Incheon, Korea.
  • 5Department of Emergency Medicine, Dongkuk University Ilsan Hospital, Goyang, Korea.
  • 6Department of Emergency Medicine, Gyeongsang National University Hospital, Jinju, Korea.
  • 7Department of Emergency Medicine, Hallym University College of Medicine, Dongtan, Korea.
  • 8Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institue, Seoul, Korea.
  • 9Hallym University School of Public Health, Chuncheon, Korea.

Abstract


OBJECTIVE
We aimed to develop an International Classification of Diseases (ICD) 10th edition injury code-based disability-adjusted life year (DALY) to measure the burden of specific injuries.
METHODS
Three independent panels used novel methods to score disability weights (DWs) of 130 indicator codes sampled from 1,284 ICD injury codes. The DWs were interpolated into the remaining injury codes (n=1,154) to estimate DWs for all ICD injury codes. The reliability of the estimated DWs was evaluated using the test-retest method. We calculated ICD-DALYs for individual injury episodes using the DWs from the Korean National Hospital Discharge Injury Survey (HDIS, n=23,160 of 2004) database and compared them with DALY based on a global burden of disease study (GBD-DALY) regarding validation, correlation, and agreement for 32 injury categories.
RESULTS
Using 130 ICD 10th edition injury indicator codes, three panels determined the DWs using the highest reliability (person trade-off 1, Spearman r=0.724, 0.788, and 0.875 for the three panel groups). The test-retest results for the reliability were excellent (Spearman r=0.932) (P<0.001). The HDIS database revealed injury burden (years) as follows: GBD-DALY (138,548), GBD-years of life disabled (130,481), and GBD-years of life lost (8,117) versus ICD-DALY (262,246), ICD-years of life disabled (255,710), and ICD-years of life lost (6,537), respectively. Spearman's correlation coefficient of the DALYs between the two methods was 0.759 (P<0.001), and the Bland-Altman test displayed an acceptable agreement, with exception of two categories among 32 injury groups.
CONCLUSION
The ICD-DALY was developed to calculate the burden of injury for all injury codes and was validated with the GBD-DALY. The ICD-DALY was higher than the GBD-DALY but showed acceptable agreement.

Keyword

Disability adjusted life year; Wounds and injuries; International Classification of Diseases

MeSH Terms

International Classification of Diseases*
Methods
Quality-Adjusted Life Years*
Weights and Measures
Wounds and Injuries
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