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M LeMier

Publications and source records attributed to M LeMier.

4 recordsLinked to original sources
PubMed2001

Accuracy of external cause of injury codes reported in Washington State hospital discharge records.

OBJECTIVE: To evaluate the accuracy of external cause of injury codes (E codes) reported in computerized hospital discharge records. METHODS: All civilian hospitals in Washington State submit computerized data for each hospital discharge to a file maintained by the Department of Health. In 1996, 32 hospitals accounted for 80% of the injury related discharges in this file; from these hospitals, we sampled 1,260 computerized records for injured patients in a stratified, but random, manner. An expert coder then visited the 32 study hospitals, reviewed the medical records that corresponded to each computerized record, and assigned an E code for that hospitalization. The computerized E code information was compared with codes provided by the expert reviewer. RESULTS: The incidence of hospitalization for injury based upon computerized hospital discharge data was very similar to that based upon chart review: incidence rate ratio 1.0 (95% confidence interval 1.00 to 1.02). Computerized hospital discharge data correctly ranked injuries in regard to both mechanism and intent. Overall agreement on coding was 87% for mechanism of injury, 95% for intent of injury, and 66% for the complete E code. The sensitivity of computerized hospital discharge data for identification of falls, motor vehicle traffic injuries, poisonings, and firearm injuries was 91% or better. The predictive value positive of coding for these four categories of injury ranged from 88% for motor vehicle traffic injuries to 94% for poisonings. The amount of agreement for intent coding ranged from 84% for firearm injuries to 99% for falls. Agreement on coding of the complete E code ranged from 57% for firearm injuries to 72% for poisonings. CONCLUSIONS: Computerized hospital discharge data can be used with confidence to determine how many injuries are treated in a hospital setting and the relative magnitude of various categories of injury. E codes reported in hospital discharge data are a reliable source of information on the types of information most often used for injury related analyses and priority setting. The detail codes (complete E codes) reported in hospital discharge codes are less reliable and must be used with caution.

Forms and Records Control↗
PubMed1998

Trends in firearm-related injuries in Washington State, 1989-1995.

STUDY OBJECTIVES: To describe the incidence and outcome of firearm-related injuries and to describe trends over time. DESIGN: Information about firearm-related injuries in Washington state was extracted from computerized death certificate and hospital discharge files for the period 1989 through 1995. Cases seen only in emergency departments were estimated using initial results from a statewide firearm injury surveillance system. RESULTS: An estimated 9,995 persons were shot during the 7-year period (incidence 28.0/100,000 person-years); 2,944 persons (29%) required ED care only, 2,864 persons (29%) were hospitalized and survived, and 4,187 persons (42%) died. Survival was lowest for suicide attempts (11%), intermediate for assaults (68%), and greatest for unintentional shootings (96%). Most deaths (91%) occurred before hospital admission. From 1989 to 1995, the incidence of firearm-related injuries showed little change: an increase of 4.5%. However, suicidal shootings among persons younger than 35 years increased by 31.3%, and the incidence of firearm-related assaults rose by 53.7% among persons of all ages. Survival among all persons who were shot and among hospitalized shooting victims showed little change over time. CONCLUSION: Firearm-related suicides among the young and assault-related shootings among all persons increased. The estimated proportion of shooting victims who survived did not change over time.

Adolescent↗
PubMed1998

Washington State Gunshot-Wound Surveillance System.

CONTEXT: Gunshot is the second leading mechanism of injury death in Washington State, but data on nonfatal gun-related injuries are limited. OBJECTIVE: Develop and evaluate a system for surveillance of fatal and nonfatal gunshot injuries. DESIGN: A gunshot wound surveillance system was pilot-tested. Reports from emergency departments were compared with emergency department logs and reports from medical examiners and coroners were compared with death certificates. SETTING: Six Washington counties, with 57% of the state's population. PARTICIPANTS: Hospital emergency departments, coroners, medical examiners, and local law enforcement agencies. MAIN OUTCOME MEASURES: Surveillance system simplicity, acceptability, sensitivity, and predictive value positive. RESULTS: The pilot system was found to be simple and acceptable to data providers. The predictive value positive was 99% for reports from hospital emergency departments and 100% for reports from medical examiners and coroners. The sensitivity of hospital emergency department reporting was 76%; the sensitivity of reporting by medical examiners and coroners was 81%. CONCLUSIONS: States interested in developing gunshot-wound surveillance systems should: (1) verify the existence of a statewide gunshot-wound reporting requirement, (2) consider establishing such a requirement if one does not exist, (3) include hospital emergency departments as a data source, (4) establish the capacity to link records if multiple data sources are used, (5) limit the data reporting requirements to fit on a one-page form, preferably one-side only, (6) periodically review the data and the reporting practices of data providers, and be prepared to make changes if things are not working as planned, and (7) disseminate surveillance data and system evaluation findings on a regular basis.

Cause of Death↗