ArticleInjury epidemiology2022
Multi-site medical record review for validation of intentional self-harm coding in emergency departments.
Article in Injury epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Validity and reliability International Classification of Diseases-10 codes for all forms of injury: A systematic review.PloS one · 2024Pooled it
- Machine Learning Model for Predicting Suicide Risks Among Patients With Posttraumatic Stress Disorder Who Received Opioids.Depression and anxiety · 2026Article
- Article
- Self-harm surveillance: an analysis of ICD-10-CM code R45.88, non-suicidal self-harm, with no co-occurring injury code.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2025Article
- Article
- Suicide prevented or delayed? Suicide rates during North Carolina's stay-at-home order.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2025Article
- Suicide-Related Mortality Trends in Europe, 2012-2021.International journal of environmental research and public health · 2025Article
- Accuracy of ICD-10 Codes for Suicidal Ideation and Action in Pediatric Emergency Department Encounters.Pediatric emergency care · 2025Article
- Considerations and Challenges When Using Clinical and Vital Record Review for Suicide Research.Journal of patient safety · 2025Article
- Suicide-Related Emergency Department Visits Before and During the COVID-19 Pandemic in the United States.Cureus · 2024Article
- Self-harm among youth during the first 28 months of the COVID-19 pandemic in Ontario, Canada: a population-based study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundCodes in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), are used for injury surveillance, including surveillance of intentional self-harm, as they appear in administrative billing records. This study estimated the positive predictive value of ICD-10-CM codes for intentional self-harm in emergency department (ED) billing records for patients aged 10 years and older who did not die and were not admitted to an inpatient medical service.
methodsThe study team in Maryland, Colorado, and Massachusetts selected all or a random sample of ED billing records with an ICD-10-CM code for intentional self-harm (specific codes that began with X71-X83, T36-T65, T71, T14.91). Positive predictive value (PPV) was determined by the number and percentage of records with a physician diagnosis of intentional self-harm, based on a retrospective review of the original medical record.
resultsThe estimated PPV for the codes' capture of intentional self-harm based on physician diagnosis in the original medical record was 89.8% (95% CI 85.0-93.4) for Maryland records, 91.9% (95% CI 87.7-95.0) for Colorado records, and 97.3% (95% CI 95.1-98.7) for Massachusetts records.
conclusionGiven the high PPV of the codes, epidemiologists can use the codes for public health surveillance of intentional self-harm treated in the ED using ICD-10-CM coded administrative billing records. However, these codes and related variables in the billing database cannot definitively distinguish between suicidal and non-suicidal intentional self-harm.
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