Volume 54 | Number 3 | June 2019

Abstract List

John M. Austin PhD, Erin M. Kirley BS, Michael A. Rosen PhD, Bradford D. Winters PhD, MD, FCCM


To compare the Agency for Healthcare Research and Quality's Quality and Safety Review System () and the proposed triadic structure for the 11th version of the International Classification of Disease (‐11) in their ability to capture adverse events in U.S. hospitals.

Data Sources/Study Setting

One thousand patient admissions between 2014 and 2016 from three general, acute care hospitals located in Maryland and Washington D.C.

Study Design

The admissions chosen for the study were a random sample from all three hospitals.

Data Collection/Extraction Methods

All 1000 admissions were abstracted through by one set of Certified Coding Specialists and a different set of coders assigned the draft ‐11 codes. Previously assigned ‐10‐ codes for 230 of the admissions were also used.

Principal Findings

We found less than 20 percent agreement between and ‐11 in identifying the same adverse event. The likelihood of a mismatch between and ‐11 was almost twice that of a match. The findings were similar to the agreement found between and ‐10‐ in identifying the same adverse event. When coders were provided with a list of potential adverse events, the sensitivity and negative predictive value of ‐11 improved.


While ‐11 may offer an efficient way of identifying adverse events, our analysis found that in its draft form, it has a limited ability to capture the same types of events as . Coders may require additional training on identifying adverse events in the chart if ‐11 is going to prove its maximum benefit.