Eisele A, Dereskewitz C, Oberhauser C, Kus S, Coenen M. Int. J. Qual. Health Care 2019; ePub(ePub): ePub.
Affiliation
ICF Research Branch-a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Munich, Germany.
OBJECTIVE: To test the interrater reliability when using the codes of the 11th revision of the International Classification of Diseases (ICD)-11 beta draft as well as ICD-10 and to explore the usability of the ICD-11 beta draft and the applicability of ICD-11's Supplementary section for functioning assessment in hand injuries and diseases.
DESIGN: We conducted a validation study of the ICD-11 beta draft complemented by a single-centre study to collect clinical routine data on functioning. SETTING: German hand surgery clinics. PARTICIPANTS: Twenty-three physicians coded real-life cases containing diagnostic information on hand injuries and diseases. Additionally, clinical information of 100 patients was coded by 6 physicians and a nurse using ICD-11's Supplementary section for functioning assessment. MAIN OUTCOME MEASURES: Physicians coded 210 cases using the ICD-11 beta draft and ICD-10. Krippendorff's alpha was calculated. Clinical routine data was coded using 38 functioning categories.
RESULTS: Interrater reliability (Krippendorff's alpha) of 0.67 for ICD-11 coding and 0.71 for ICD-10 coding was obtained, indicating substantial agreement. However, physicians reported a high proportion of problems with ICD-11 coding and slightly fewer problems with ICD-10 coding. The collected data on functioning could be mapped to ICD-11's Supplementary section for functioning assessment. For some data, however, only unspecific codes were available.
CONCLUSIONS: Interrater reliability of ICD-10 and ICD-11 was satisfactory. Training material for ICD-11 is needed to further improve reliability and usability. Future users of ICD-11 should be encouraged to use the Supplementary section for functioning assessment to shed light on the problems patients experience in everyday life.