The ICD-11 Field Trial: Creating a Large Dually Coded Database

Abstract ObjectiveNew codes developed in the International Classification of Diseases, 11th Revision for Mortality and Morbidity Statistics (ICD-11) needed testing. Field-testing involves real-world application of the new codes to examine data quality. This paper describes the field trial methods to create a dually coded database to field test ICD-11 against ICD-10-CA (a Canadian modification of the International Classification of Diseases, Tenth Revision), and a reference standard data set of diagnoses. ResultsA random sample of discharge records previously coded using ICD-10-CA was selected. Nurses re-examined these entire charts for specific conditions and patient safety events. Clinical coders re-coded the same charts using ICD-11 codes. Inpatients discharged from hospitals in Calgary, Alberta, were identified and a dually coded database was created (n=2897). Inter-rater reliability and coding time improved with ICD-11 coding experience. Clinical coder comments enabled content to be improved in the ICD-11 browser, Coding Tool, and ICD-11 Reference Guide. This paper describes the field trial, database creation methods, and contributions for ICD-11 improvement. Crucial future research will use this database to test ICD-11 before implementation in Canada.