ArticleInternational journal for quality in health care : journal of the International Society for Quality in Health Care2021
Accuracy and reliability of injury coding in the national Dutch Trauma Registry.
Article in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Evaluation of reporting quality of cohort studies using real-world data based on RECORD: systematic review.BMC medical research methodology · 2023Pooled it
- Timing of fracture fixation for femur and pelvis fractures in patients with severe traumatic brain injury - an analysis of the TraumaRegister DGUEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Early discharges in severely injured patients by ISS score: exploring injury patterns and coding practices.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Advancing trauma scoring through large language models: automated estimation of injury severity.BMC emergency medicine · 2026Article
- Comparison of the different versions of the abbreviated injury scale in the assessment of isolated head trauma severity.BMC public health · 2025Article
- Coding traumatic brain injury with the abbreviated injury scale following a standardised radiologic template will improve classification of trauma populations.European radiology · 2025Article
- Identification of major trauma using the simplified abbreviated injury scale to estimate the injury severity score: a diagnostic accuracy and validation study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- [Consistency of injury severity score in severe trauma patients].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2024Article
- Excellent agreement of Norwegian trauma registry data compared to corresponding data in electronic patient records.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
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Authors and funding
3 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveInjury coding is well known for lack of completeness and accuracy. The objective of this study was to perform a nationwide assessment of accuracy and reliability on Abbreviated Injury Scale (AIS) coding by Dutch Trauma Registry (DTR) coders and to determine the effect on Injury Severity Score (ISS). Additionally, the coders' characteristics were surveyed.
methodsThree fictional trauma cases were presented to all Dutch trauma coders in a nationwide survey (response rate 69%). The coders were asked to extract and code the cases' injuries according to the AIS manual (version 2005, update 2008). Reference standard was set by three highly experienced coders. Summary statistics were used to describe the registered AIS codes and ISS distribution. The primary outcome measures were accuracy of injury coding and inter-rater agreement on AIS codes. Secondary outcome measures were characteristics of coders: profession, work setting, experience in injury coding and training level in injury coding.
resultsThe total number of different AIS codes used to describe 14 separate injuries in the three cases was 89. Mean accuracy per AIS code was 42.2% (range 2.4-92.7%). Mean accuracy on number of AIS codes was 23%. Overall inter-rater agreement per AIS code was 49.1% (range 2.4-92.7%). The number of assigned AIS codes varied between 0 and 18 per injury. Twenty-seven percentage of injuries were overlooked. ISS was correctly scored in 42.4%. In 31.7%, the AIS coding of the two more complex cases led to incorrect classification of the patient as ISS < 16 or ISS ≥ 16. Half (47%) of the coders had no (para)medical degree, 26% were working in level I trauma centers, 37% had less than 2 years of experience and 40% had no training in AIS coding.
conclusionsAccuracy of and inter-rater agreement on AIS injury scoring by DTR coders is limited. This may in part be due to the heterogeneous backgrounds and training levels of the coders. As a result of the inconsistent coding, the number of major trauma patients in the DTR may be over- or underestimated. Conclusions based on DTR data should therefore be drawn with caution.
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