This retrospective study examined the accuracy of the International Classification of Diseases, Clinical Modification (ICD-10-CM) coding for physical child abuse among patients less than 18 years of age who were evaluated due to concern for physical abuse by a multidisciplinary child protection team (MCPT) during 2016–2017 (N=312) in a paediatric level I trauma centre. Sensitivity, specificity, predictive values and diagnostic OR for ICD-10-CM coding were calculated and stratified by admission status, using as a reference standard the abuse determination of the MCPT recorded in a hospital registry. Among inpatients, child physical abuse coding sensitivity was 55.6% (95% CI 41.4% to 69.1%) and specificity was 78.6% (95% CI 59.0% to 91.7%), with diagnostic OR of 4.58 (95% CI 1.64 to 12.70). Among outpatients, sensitivity was 22.2% (95% CI 15.5% to 30.2%) and specificity was 86.3% (95% CI 77.7% to 92.5%), with diagnostic OR of 1.80 (95% CI 0.89 to 3.64). Use of ICD-10-CM coded data sets alone for surveillance may significantly underestimate the occurrence of physical child abuse.

中文翻译：

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ICD-10-CM 编码在儿科 I 级创伤中心身体虐待儿童的准确性

这项回顾性研究检查了国际疾病分类临床修改 (ICD-10-CM) 对 18 岁以下患者的身体虐待进行编码的准确性，这些患者因担心身体虐待而受到多学科儿童保护团队的评估(MCPT) 2016-2017 年 (N=312) 在儿科 I 级创伤中心。ICD-10-CM 编码的敏感性、特异性、预测值和诊断 OR 通过入院状态计算和分层，使用医院登记处记录的 MCPT 滥用确定作为参考标准。在住院患者中，儿童身体虐待编码敏感性为 55.6%（95% CI 41.4% 至 69.1%），特异性为 78.6%（95% CI 59.0% 至 91.7%），诊断 OR 为 4.58（95% CI 1.64 至 12.70） . 在门诊患者中，敏感性为 22.2% (95% CI 15. 5% 至 30.2%），特异性为 86.3%（95% CI 77.7% 至 92.5%），诊断 OR 为 1.80（95% CI 0.89 至 3.64）。仅使用 ICD-10-CM 编码数据集进行监测可能会大大低估身体虐待儿童的发生率。