Firearm-Related Injuries at a Level-1 Trauma Center in Oregon: A Validity Study of Firearm Injury Intent Coding
Presenter Biography
Gina Stahla is an MPH student in Epidemiology at the OHSU School of Public Health.
Institution
OHSU
Program/Major
Epidemiology
Degree
MPH
Presentation Type
Presentation
Start Date
4-4-2023 12:30 PM
End Date
4-4-2023 12:45 PM
Rights
© Copyright the author(s)
IN COPYRIGHT:
http://rightsstatements.org/vocab/InC/1.0/
This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).
DISCLAIMER:
The purpose of this statement is to help the public understand how this Item may be used. When there is a (non-standard) License or contract that governs re-use of the associated Item, this statement only summarizes the effects of some of its terms. It is not a License, and should not be used to license your Work. To license your own Work, use a License offered at https://creativecommons.org/
Creative Commons License or Rights Statement
IN COPYRIGHT:
© Copyright the author(s)
https://rightsstatements.org/vocab/InC/1.0/
This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).
Persistent Identifier
https://archives.pdx.edu/ds/psu/40229
Subjects
injury, firearm-related injury, gun-related injury, injury epidemiology, ICD codes, intent coding
Abstract
Firearm-related injuries are a persistent and substantial public health problem in the US. More than 45,000 people died due to firearm injuries in 20201, and estimates suggest that for every death, two others suffer nonfatal injuries2 - meaning that more than 135,000 people suffer fatal or nonfatal firearm-related injuries every year in the US3. In order to inform prevention efforts, it is vital to understand the mechanisms and intent of these injuries. While we have a good sense of circumstances surrounding fatal firearm injuries, sources of data for nonfatal injuries are lacking. The purpose of this study is to describe firearm-related injuries managed in the OHSU ED from 2009-2022. Data were identified by ICD-9 and ICD-10 codes, and pertinent information was extracted from the electronic health record. Results indicated that of 1,887 participants, more than 90% had ICD codes pertaining to unintentional injury. After manual chart review of 222 charts from patients managed in the ED from 2018-2019, it was determined that 25% suffered unintentional injuries. A validity study was completed to examine concordance of intent assigned from ICD codes and chart reviews. The level of discordance indicates that ICD codes have low validity when used to determine intent of injury, indicating that they may be an unreliable source for this information. The extent to which systematic misclassification of intent has clouded our understanding of nonfatal firearm injury warrants further review.
1) Centers for Disease Control and Prevention. WISQARS, Fatal Injury Reports, National, Regional and State, 1981-2020. Accessed March 10, 2023 at https://www.cdc.gov/injury/wisqars/fatal.html.
2) Kaufman EJ, Wiebe DJ, Xiong RA, Morrison CN, Seamon MJ, Delgado MK. Epidemiologic Trends in Fatal and Nonfatal Firearm Injuries in the US, 2009-2017. JAMA Internal Medicine. 2021;181(2):237-244.
3) DeFrancesco S, Bhakta Y, Baker-Robinson W, Krushnic D, Chisholm L, Wright D, Coleman J, Tanaka Y, Couch A, Carlson K. Firearm injury emergency department visits in Oregon, 2018-2021. Accessed October 22, 2022. Available at: https://www.ohsu.edu/about/gun-violence-public-health-issue.
Firearm-Related Injuries at a Level-1 Trauma Center in Oregon: A Validity Study of Firearm Injury Intent Coding
Firearm-related injuries are a persistent and substantial public health problem in the US. More than 45,000 people died due to firearm injuries in 20201, and estimates suggest that for every death, two others suffer nonfatal injuries2 - meaning that more than 135,000 people suffer fatal or nonfatal firearm-related injuries every year in the US3. In order to inform prevention efforts, it is vital to understand the mechanisms and intent of these injuries. While we have a good sense of circumstances surrounding fatal firearm injuries, sources of data for nonfatal injuries are lacking. The purpose of this study is to describe firearm-related injuries managed in the OHSU ED from 2009-2022. Data were identified by ICD-9 and ICD-10 codes, and pertinent information was extracted from the electronic health record. Results indicated that of 1,887 participants, more than 90% had ICD codes pertaining to unintentional injury. After manual chart review of 222 charts from patients managed in the ED from 2018-2019, it was determined that 25% suffered unintentional injuries. A validity study was completed to examine concordance of intent assigned from ICD codes and chart reviews. The level of discordance indicates that ICD codes have low validity when used to determine intent of injury, indicating that they may be an unreliable source for this information. The extent to which systematic misclassification of intent has clouded our understanding of nonfatal firearm injury warrants further review.
1) Centers for Disease Control and Prevention. WISQARS, Fatal Injury Reports, National, Regional and State, 1981-2020. Accessed March 10, 2023 at https://www.cdc.gov/injury/wisqars/fatal.html.
2) Kaufman EJ, Wiebe DJ, Xiong RA, Morrison CN, Seamon MJ, Delgado MK. Epidemiologic Trends in Fatal and Nonfatal Firearm Injuries in the US, 2009-2017. JAMA Internal Medicine. 2021;181(2):237-244.
3) DeFrancesco S, Bhakta Y, Baker-Robinson W, Krushnic D, Chisholm L, Wright D, Coleman J, Tanaka Y, Couch A, Carlson K. Firearm injury emergency department visits in Oregon, 2018-2021. Accessed October 22, 2022. Available at: https://www.ohsu.edu/about/gun-violence-public-health-issue.