The utility and challenges of using ICD codes in child maltreatment research: A review of existing literature

Abstract

The importance of improved child maltreatment identification will assist in identifying risk factors and creating programs that can prevent and treat child maltreatment and assist in meeting reporting obligations under the CRC.

Variation in recording of child maltreatment in administrative records of hospital admissions for injury in England, 1997-2009

“…The evidence of under-recording of maltreatment syndrome in HES is consistent with previous findings that clinicians record or report only a minority of the child maltreatment cases that they recognise 4 23–25. Reasons include uncertainty about the diagnosis, inadequate clinical knowledge or inexperience, clinician–family interactions, concerns about the capacity of services to respond and fears that recording maltreatment will do more harm than good 24–28.…”

“…In combination, these codes could be used to monitor the impact of policy initiatives such as the NICE guidance. However, for international comparisons of the burden and trends in maltreatment, new ICD codes need to be devised as recommended by Scott et al 4. These need to reflect the uncertainty and protracted deliberations inherent in investigating possible maltreatment, and take into account the overwhelming evidence that clinicians are reluctant to specify maltreatment, which education alone will not change 40.…”

“…Healthcare administrative data offer a readily available system that could be used to monitor management of maltreatment, but a recent systematic review of 38 studies using International Classifications of Diseases (ICD) concluded that child maltreatment was under-reported in healthcare databases and death registrations 4. These findings are likely to apply to the UK, although only two of the 38 studies in the review were carried out in the UK and both were small studies done in the 1990s 5 6.…”

Assessing the accuracy of the International Classification of Diseases codes to identify abusive head trauma: a feasibility study

“…These data sources can be divided into two main categories-direct case ascertainment 2-6 and large-scale data sets, most of which use International Classification of Diseases (ICD) codes. [7][8][9][10][11][12] Direct case ascertainment is the gold standard for case identification, 13 14 but is time intensive and unlikely to be feasible or costeffective on a large scale. In contrast, ICD codes are collected as part of standard medical care and are available without charge as part of several large-scale data sets, such as the Kids' Inpatient Database (KID).…”

A simple approach to improve recording of concerns about childmaltreatment in primary care records: developing a quality improvement intervention

“…Concerns about maltreatment are recorded in routine health records using a wide variety of codes, including those that are indirect or euphemistic. 19,20 To reflect this, a list of Read Codes were developed that were maltreatment-related, ranging from codes likely to be specific (for example, child protection plan or physical abuse of child), to codes anticipated to be more sensitive, indicating high child welfare need or concerns about parenting (Box 2). For analysis, codes were grouped into four categories.…”