title: New Methodology for an Expert-Designed Map From International Classification of Diseases (ICD) to Abbreviated Injury Scale (AIS) 3+ Severity Injury.
abstract: OBJECTIVE
  There has been a longstanding desire for a map to convert International Classification of Diseases (ICD) injury codes to Abbreviated Injury Scale (AIS) codes to reflect the severity of those diagnoses. The Association for the Advancement of Automotive Medicine (AAAM) was tasked by European Union representatives to create a categorical map classifying diagnoses codes as serious injury (Abbreviated Injury Scale [AIS] 3+), minor/moderate injury (AIS 1/2), or indeterminate. This study's objective was to map injury-related ICD-9-CM (clinical modification) and ICD-10-CM codes to these severity categories.
  
  
  METHODS
  Approximately 19,000 ICD codes were mapped, including injuries from the following categories: amputations, blood vessel injury, burns, crushing injury, dislocations/sprains/strains, foreign body, fractures, internal organ, nerve/spinal cord injury, intracranial, laceration, open wounds, and superficial injury/contusion. Two parallel activities were completed to create the maps: (1) An in-person expert panel and (2) an electronic survey. The panel consisted of expert users of AIS and ICD from North America, the United Kingdom, and Australia. The panel met in person for 5 days, with follow-up virtual meetings to create and revise the maps. Additional qualitative data were documented to resolve potential discrepancies in mapping. The electronic survey was completed by 95 injury coding professionals from North America, Spain, Australia, and New Zealand over 12 weeks. ICD-to-AIS maps were created for: ICD-9-CM and ICD-10-CM. Both maps indicated whether the corresponding AIS 2005/Update 2008 severity score for each ICD code was AIS 3+, 1/2, or indeterminable. Though some ICD codes could be mapped to multiple AIS codes, the maximum severity of all potentially mapped injuries determined the final severity categorization.
  
  
  RESULTS
  The in-person panel consisted of 13 experts, with 11 Certified AIS specialists (CAISS) with a median of 8 years and an average of 15 years of coding experience. Consensus was reached for AIS severity categorization for all injury-related ICD codes. There were 95 survey respondents, with a median of 8 years of injury coding experience. Approximately 15 survey responses were collected per ICD code. Results from the 2 activities were compared, and any discrepancies were resolved using additional qualitative and quantitative data from the in-person panel and survey results, respectively.
  
  
  CONCLUSIONS
  Robust maps of ICD-9-CM and ICD-10-CM injury codes to AIS severity categories (3+ versus <3) were successfully created from an in-person panel discussion and electronic survey. These maps provide a link between the common ICD diagnostic lexicons and the AIS severity coding system and are of value to injury researchers, public health scientists, and epidemiologists using large databases without available AIS coding.
authors.affiliation: a Center for Injury Research and Prevention and Division of Emergency Medicine , The Children's Hospital of Philadelphia , Philadelphia , Pennsylvania.|b Department of Pediatrics, Perelman School of Medicine , University of Pennsylvania , Philadelphia , Pennsylvania.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Zonfrillo
authors.affiliation: c Virginia Tech-Wake Forest University, Center for Injury Biomechanics , Medical Center Boulevard , Winston-Salem , North Carolina.|d Wake Forest University, School of Medicine , Medical Center Boulevard , Winston-Salem , North Carolina.
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Weaver
authors.affiliation: e Association for the Advancement of Automotive Medicine , Chicago , Illinois.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Gillich
authors.affiliation: e Association for the Advancement of Automotive Medicine , Chicago , Illinois.
authors.forename: Janet P
authors.initials: JP
authors.lastname: Price
authors.affiliation: c Virginia Tech-Wake Forest University, Center for Injury Biomechanics , Medical Center Boulevard , Winston-Salem , North Carolina.|d Wake Forest University, School of Medicine , Medical Center Boulevard , Winston-Salem , North Carolina.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Stitzel
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic; D032921:Consensus; D005062:European Union; D006801:Humans; D015601:Injury Severity Score; D038801:International Classification of Diseases; D014947:Wounds and Injuries / Q000145:classification
keywords: AIS; ICD; injury severity; mapping