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Exploring uncertainty of the change from ICD-9 to ICD-10 on acute mortality effects of air pollution
Authors:Qian Zhengmin  He Qingci  Lin Hung-Mo  Kong Lingli  Liao Duanping  Gong Jie  Bentley Christy M  Wei Hongming
Affiliation:Penn State College of Medicine, USA. zqian@psu.edu
Abstract:The change in ICD coding from ICD-9 to ICD-10 may produce inconsistencies and discontinuities in cause-specific mortality, thus impacting on effects estimates of air pollution on mortality. The current study was conducted in Wuhan, China. We examined the concordant rates and Kappa statistics using the mortality data from the year 2002 coded with both ICD-9 and ICD-10 codes and compared the estimated effects of air pollution using the Generalized Additive Model in R. We found high concordant rates (>99.3%) and Kappa statistics close to 1.0 (>0.98). Little difference was identified in the estimated effects of air pollution on daily cardiovascular, stroke, cardiac, cardiopulmonary, and respiratory mortality. This study provides evidence that, based on the wide definitions of cause-specific morality typically used in the studies of time-series air pollution mortality, the change in the ICD coding does not significantly affect the estimated effects of air pollution.
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