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Many circumstances necessitate judgments regarding causation in health information systems, but these can be tricky in medicine and epidemiology. In this article, we reflect on what the ICD Reference Guide provides on coding for causation and judging when relationships between clinical concepts are causal.
Based on the use of different types of codes and the development of a new mechanism for coding potential causal relationships, the ICD provides an in-depth transformation of coding expectations as compared to ICD In addition, determining causation involves using documentation from healthcare providers, which is the foundation for coding health information. The coding guidelines and examples taken from the quality and patient safety domain presented in this article underline how new ICD features and coding rules will enhance future health information systems and healthcare.
Determining causation is tricky in medicine and epidemiology. However, it is fundamental in decision-making [ 1 β 3 ]. Real-world data are potential sources of evidence, but because of the complexity of health systems, their use in addressing causation is challenging [ 4 , 5 ]. In health information systems, many circumstances necessitate judgments regarding causation e. In particular, the establishment of causal relationships represents a triple conceptual and methodological challenge, including searching for evidence on the potential link between exposure and outcomes e.
Historically, the causal nature of observed associations has been analyzed using the Bradford Hill criteria i. In addition, causal relationships represent complex systems characterized by a number of potential interactions between multiple potential causes [ 10 β 12 ].
