ICD-10-CM/AIS Mapping Software, 49372-49374 [2014-19744]
Download as PDF
49372
Federal Register / Vol. 79, No. 161 / Wednesday, August 20, 2014 / Notices
granted, it would be limited to a single
procurement for the South Ferry Station
Project and conditioned upon NYCT
completing the safety testing for the
U.S.-made pad and rubber boot within
approximately three months of receipt
of CPT’s test results, which is expected
on or about September 15, 2014. In
addition, once all of the testing is
complete within the aforementioned
timeframe and if the testing confirms
that the U.S-made pad and rubber boot
meet NYCT’s safety specifications, FTA
expects NYCT to substitute the U.S.made pads and rubber boots for the
foreign-made items to the extent
possible. A full copy of the request has
been placed in docket number FTA–
2014–0019.
[FR Doc. 2014–19732 Filed 8–19–14; 8:45 am]
BILLING CODE 4910–57–P
DEPARTMENT OF TRANSPORTATION
Maritime Administration
[Docket No. MARAD–2014 0112]
Requested Administrative Waiver of
the Coastwise Trade Laws: Vessel
TUNATAILS.COM; Invitation for Public
Comments
Maritime Administration,
Department of Transportation.
ACTION: Notice.
AGENCY:
As authorized by 46 U.S.C.
12121, the Secretary of Transportation,
as represented by the Maritime
Administration (MARAD), is authorized
to grant waivers of the U.S.-build
requirement of the coastwise laws under
certain circumstances. A request for
such a waiver has been received by
MARAD. The vessel, and a brief
description of the proposed service, is
listed below.
DATES: Submit comments on or before
September 19, 2014.
ADDRESSES: Comments should refer to
docket number MARAD–2014–0112.
Written comments may be submitted by
hand or by mail to the Docket Clerk,
U.S. Department of Transportation,
Docket Operations, M–30, West
Building Ground Floor, Room W12–140,
1200 New Jersey Avenue SE.,
Washington, DC 20590. You may also
send comments electronically via the
Internet at https://www.regulations.gov.
All comments will become part of this
docket and will be available for
inspection and copying at the above
address between 10 a.m. and 5 p.m.,
E.T., Monday through Friday, except
emcdonald on DSK67QTVN1PROD with NOTICES
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Jkt 232001
DEPARTMENT OF TRANSPORTATION
FOR FURTHER INFORMATION CONTACT:
ICD–10–CM/AIS Mapping Software
Linda Williams, U.S. Department of
Transportation, Maritime
Administration, 1200 New Jersey
Avenue SE., Room W23–453,
Washington, DC 20590. Telephone 202–
366–0903, Email Linda.Williams@
dot.gov.
As
described by the applicant the intended
service of the vessel TUNATAILS.COM
is:
SUPPLEMENTARY INFORMATION:
Intended Commercial Use Of Vessel:
Charter 6 pack fishing, Gulf of Mexico
Geographic Region: Louisiana,
Mississippi, Alabama, Florida
Dana Nifosi,
Acting Chief Counsel.
SUMMARY:
federal holidays. An electronic version
of this document and all documents
entered into this docket is available on
the World Wide Web at https://
www.regulations.gov.
The complete application is given in
DOT docket MARAD–2014–0112 at
https://www.regulations.gov. Interested
parties may comment on the effect this
action may have on U.S. vessel builders
or businesses in the U.S. that use U.S.flag vessels. If MARAD determines, in
accordance with 46 U.S.C. 12121 and
MARAD’s regulations at 46 CFR Part
388, that the issuance of the waiver will
have an unduly adverse effect on a U.S.vessel builder or a business that uses
U.S.-flag vessels in that business, a
waiver will not be granted. Comments
should refer to the docket number of
this notice and the vessel name in order
for MARAD to properly consider the
comments. Comments should also state
the commenter’s interest in the waiver
application, and address the waiver
criteria given in § 388.4 of MARAD’s
regulations at 46 CFR Part 388.
Privacy Act
Anyone is able to search the
electronic form of all comments
received into any of our dockets by the
name of the individual submitting the
comment (or signing the comment, if
submitted on behalf of an association,
business, labor union, etc.). You may
review DOT’s complete Privacy Act
Statement in the Federal Register
published on April 11, 2000 (Volume
65, Number 70; Pages 19477–78).
By Order of the Maritime Administrator.
Dated: August 11, 2014.
Julie P. Agarwal,
Secretary, Maritime Administration.
[FR Doc. 2014–19644 Filed 8–19–14; 8:45 am]
BILLING CODE 4910–81–P
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National Highway Traffic Safety
Administration
[Docket No. NHTSA–2014–0062]
National Highway Traffic
Safety Administration (NHTSA),
Department of Transportation (DOT).
ACTION: Request for information;
reopening of comment period.
AGENCY:
This document announces the
reopening of the comment period on a
Request for Information (RFI) regarding
the potential development of a mapping
software to translate the International
Statistical Classification of Diseases and
Related Health Problems, 10th Revision,
Clinical Modification (ICD–10–CM)
discharge diagnoses into Abbreviated
Injury Scale (AIS) pre-dot codes, injury
descriptors, and severity scores. The
original RFI was issued on June 12,
2014, and had a 60-day comment period
ending on August 11, 2014. In response
to continued interest in this issue,
NHTSA is reopening the comment
period for this RFI until September 30,
2014.
DATES: The comment period for the RFI
published on June 12, 2014 (79 FR
33799) is extended. Comments must be
received no later than September 30,
2014.
SUMMARY:
ADDRESSES:
Comments: You may submit
comments [identified by Docket Number
NHTSA–2014–0062] by any of the
following methods:
• Internet: To submit comments
electronically, go to the U.S.
Government regulations Web site at
https://www.regulations.gov. Follow the
online instructions for submitting
comments.
• Fax: Written comments may be
faxed to 202–493–2251.
• Mail: Send comments to Docket
Management Facility, U.S. Department
of Transportation, 1200 New Jersey
Avenue SE., West Building Ground
Floor, Room W12–140, Washington, DC
20590.
• Hand Delivery: If you plan to
submit written comments by hand or
courier, please do so at 1200 New Jersey
Avenue SE., West Building Ground
Floor, Room W12–140, Washington, DC
between 9 a.m. and 5 p.m. Eastern Time,
Monday through Friday, except federal
holidays
• You may call Docket Management
at 1–800–647–5527.
Instructions: For detailed instructions
on submitting comments and additional
E:\FR\FM\20AUN1.SGM
20AUN1
emcdonald on DSK67QTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 161 / Wednesday, August 20, 2014 / Notices
information see the Comments heading
of the Supplementary Information
section of this document. Note that all
comments received will be posted
without change to https://
www.regulations.gov, including any
personal information provided. Please
see the Privacy Act heading in the
SUPPLEMENTARY INFORMATION.
FOR FURTHER INFORMATION CONTACT: For
questions about the program discussed
herein, contact John Kindelberger, Chief
of the Evaluation Division, Office of
Regulatory Analysis and Evaluation,
Room W53–312, 1200 New Jersey
Avenue SE., Washington, DC 20590.
Telephone: 202–366–4696. Email:
john.kindelberger@dot.gov.
SUPPLEMENTARY INFORMATION: On June
12, 2014, NHTSA published a notice (79
FR 33799) requesting comment and
information the potential development
of a mapping software to translate the
International Statistical Classification of
Diseases and Related Health Problems,
10th Revision, Clinical Modification
(ICD–10–CM) discharge diagnoses into
Abbreviated Injury Scale (AIS) pre-dot
codes, injury descriptors, and severity
scores.
On January 16, 2009, the U.S.
Department of Health and Human
Services (HHS) published a final rule
adopting ICD–10–CM to replace ICD–9–
CM in transactions covered by the
Health Insurance Portability
Accountability Act (HIPAA). The
deadline for adopting ICD–10–CM has
been postponed several times but is
currently scheduled to take place at
some point after October 1, 2015
(https://www.cms.gov/Medicare/Coding/
ICD10/?redirect=/icd10).
The ‘‘Moving Ahead for Progress in
the 21st Century’’ Act (MAP–21), signed
into law on July 6, 2012, requires the
FHWA to establish measures for State
departments of transportation to assess
and report numbers and rates per
vehicle mile traveled of roadway
fatalities and serious injuries. [§ 1203;
23 USC 150(c).] In Notice of Proposed
Rulemaking 79 FR 13845 (Mar. 11,
2014), which can be found at https://
www.regulation.gov, the FHWA
recommends that States prepare
themselves so that no later than January
1, 2020, all States use a medical record
injury outcome reporting system that
links injury outcomes from medical
records to crash reports.
The DOT seeks comments and
information from the public sector,
private sector, and academic
communities concerning the potential
development of ICD–10–CM/AIS
mapping software that would address
the issues described in this RFI. While
VerDate Mar<15>2010
16:44 Aug 19, 2014
Jkt 232001
comments are welcome on any area of
the RFI, the DOT is particularly
interested in responses to the questions
listed below. Responders are reminded
that feedback or comments on any
aspect of this notice are welcome from
all interested public, private, and
academic entities. While all feedback is
welcome, the DOT is particularly
interested in feedback on the following
questions. Respondents may respond, to
some, all, or none of these specific
questions:
1. Is there a need for a mapping tool
that translates ICD–10–CM codes to the
AIS standard?
2. Is there a need for an updated
mapping tool that translates ICD–9–CM
codes to the AIS standard?
3. Are any steps currently being taken
to develop a mapping tool?
4. What capabilities should such a
mapping tool possess?
5. What platforms should the
mapping tool run on?
6. Should the mapping tool be nonproprietary?
Injury data enables epidemiologists,
researchers, and policymakers to better
identify the severity of injuries in
addition to where, when, and why they
occur. This data is, however, frequently
spread among discrete databases that are
difficult to link to each other or to injury
causation data. The ability to link these
datasets together is thus critical to
efforts to understand injury trends, set
injury prevention priorities, identify
high risk populations and geographic
areas, and develop targeted injury
prevention strategies. The DOT,
however, is particularly interested in
forging and maintaining links among
vehicle crash and injury datasets as
such links can provide more complete
information and better understanding of
crash outcomes.
State trauma registry and hospital
discharge databases are two of the more
significant sources of injury data.
Trauma registries are designed to collect
large amounts of information about the
most seriously injured patients and are
not typically used for injury
surveillance purposes on their own.
Hospital discharge datasets are designed
primarily to monitor hospital census,
utilization, and financial information
but record enough information—like
diagnosis codes and external cause/Ecodes—to make them useful injury
surveillance tools. In addition, the prehospital emergency medical services
(EMS) patient care reports, compliant
with the National EMS Information
System (NEMSIS) Standard, may be
helpful, as they can serve as good link
between the crash data and hospital
data. NEMSIS data is submitted to the
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Frm 00095
Fmt 4703
Sfmt 4703
49373
state level by local EMS agencies, and
the collective statewide data is
submitted to the National EMS
Database. The most effective linkage
point at this time is at the State level.
These datasets are generally coded
using different methodologies. Trauma
registries use the Abbreviated Injury
Scale while hospitals and emergency
departments use the International
Statistical Classification of Diseases and
Related Health Problems for diagnosis,
reporting, and billing.
The Abbreviated Injury Scale (AIS),
developed by the Association for the
Advancement of Automotive Medicine
(AAAM), is an anatomically based,
consensus derived, global severity
scoring system that classifies each
injury by body region according to its
relative importance on a 6-point ordinal
scale (1 = minor and 6 = maximal). The
AIS is the basis for the Injury Severity
Score (ISS) calculation of the multiply
injured patient. The AIS is protected by
copyright, and both individual use and
site licenses can be purchased from
AAAM (https://www.aaam.org/aboutais.html).
The maximum AIS (MAIS) severity
level is a recognized person-level injury
severity indicator. For example, the
Organization for Economic CoOperation and Development’s
International Traffic Safety Data and
Analysis Group (IRTAD) has
recommended that MAIS of level three
or higher be used as the standard for a
seriously injured person in a motor
vehicle crash (https://
www.internationaltransportforum.org/
irtadpublic/pdf/Road-CasualtiesWeb.pdf).
Maintained by the World Health
Organization (WHO), the International
Statistical Classification of Diseases and
Related Health Problems (ICD) is the
international standard diagnostic tool
for epidemiology, health management,
and clinical purposes. While a version
of the ninth revision, ICD–9–CM, is
currently still widely used in the US, a
replacement based on the tenth revision,
ICD–10–CM, has been developed by a
National Center for Health Statistics
(NCHS) Technical Advisory Panel
following extensive consultation with
physician groups, clinical coders, and
others to assure clinical accuracy and
utility (https://www.cdc.gov/nchs/icd/
icd10cm.htm).
In the early 90’s researchers at Johns
Hopkins University developed a
software tool (ICDMAP) that allowed
analysts to generate a Maximum AIS
(MAIS) or an Injury Severity Score (ISS)
for each injured patient in the hospital
discharge database using the ICD–9–CM
diagnosis codes of each patient’s record.
E:\FR\FM\20AUN1.SGM
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49374
Federal Register / Vol. 79, No. 161 / Wednesday, August 20, 2014 / Notices
The ICDMAP enabled statewide
performance measurement by MAIS and
allowed analysts to associate the
severity outcomes to with crash,
vehicle, and roadway circumstances for
planning and/or evaluation of
countermeasures.
While the ICDMAP-generated results
are not as precise as those derived by
clinicians in trauma registries, this
approach has been validated and yields
good sensitivity in estimating severity
for studying the larger universe of injury
hospitalizations. Translating ICD codes
to AIS allows all crash-involved injuries
to be compiled and analyzed in terms of
AIS and MAIS severity. When linked to
causal information—State crash
databases, for example—ICD codes can
be used to improve measurement of
crash-related injury severity.
There is not, however, currently any
known software or service capable of
translating between ICD–10–CM and
AIS. Once hospitals transition to the
ICD–10–CM, combining these two sets
of injury data will no longer be possible,
and analyses will be less complete and
less useful. Significant effort is needed
to develop a mapping tool that will
enable mapping of ICD–10–CM
diagnosis codes with the corresponding
AIS severity codes.
RFI Guidelines
Responses to this notice are not offers
and cannot be accepted by the
Government to form a binding contract
or issue a grant. Information obtained as
a result of this RFI may be used by the
Government for program planning on a
non-attribution basis. This RFI notice is
NOT a solicitation for proposals,
applications, proposal abstracts, or
quotations. This RFI notice is not to be
construed as a commitment on the part
of the Government to award a contract
or grant, nor does the Government
intend to directly pay for any
information or responses submitted as a
result of this RFI notice.
emcdonald on DSK67QTVN1PROD with NOTICES
Comments
How do I prepare and submit
comments?
Your comments must be written and
in English. To ensure that your
comments are correctly filed in the
Docket, please include the Docket
number of this document (NHTSA–
2014–0062) in your comments.
Your primary comments must not be
more than 15 pages long (49 CFR
553.21). However, you may attach
additional documents to your primary
comments. There is no limit on the
length of the attachments.
Please submit one copy of your
comments, including the attachments,
VerDate Mar<15>2010
16:44 Aug 19, 2014
Jkt 232001
to Docket Management at the address
given above under ADDRESSES.
Please note that pursuant to the Data
Quality Act, in order for substantive
data to be relied upon and used by the
agency, it must meet the information
quality standards set forth in the OMB
and DOT Data Quality Act guidelines.
Accordingly, we encourage you to
consult the guidelines in preparing your
comments. OMB’s guidelines may be
accessed at https://www.whitehouse.gov/
omb/fedreg_reproducible. DOT’s
guidelines may be accessed at https://
www.rita.dot.gov/bts/sites/
rita.dot.gov.bts/files/subject_areas/
statistical_policy_and_research/data_
quality_guidelines/.
Privacy Act: Anyone is able to search
the electronic form of all comments
received into any of our dockets by the
name of the individual submitting the
comment (or signing the comment, if
submitted on behalf of an association,
business, labor union, etc.). You may
review DOT’s complete Privacy Act
Statement in the Federal Register
published on April 11, 2000 (65 FR
19477–78) or you may visit https://
www.regulations.gov.
How can I be sure that my comments
were received?
If you wish Docket Management to
notify you upon its receipt of your
comments, enclose a self-addressed,
stamped postcard in the envelope
containing your comments. Upon
receiving your comments, Docket
Management will return the postcard by
mail. You may also periodically access
https://www.regulations.gov and enter
the number for this docket (NHTSA–
2014–0062) to see if your comments are
on line.
How do I submit confidential business
information?
If you wish to submit any information
under a claim of confidentiality, you
should submit three copies of your
complete submission, including the
information you claim to be confidential
business information, to the Chief
Counsel, NHTSA, U.S. Department of
Transportation, 1200 New Jersey
Avenue SE., Washington, DC, 20590. In
addition, you should submit a copy,
from which you have deleted the
claimed confidential business
information, to Docket Management at
the address given above under
ADDRESSES. When you send a comment
containing information claimed to be
confidential business information, you
should include a cover letter setting
forth the information specified in our
confidential business information
regulation (49 CFR Part 512).
PO 00000
Frm 00096
Fmt 4703
Sfmt 9990
Will the agency consider late
comments?
In our response, we will consider all
comments that Docket Management
receives before the close of business on
the comment closing date indicated
above under DATES. To the extent
possible, we will also consider
comments that Docket Management
receives after that date.
How can I read the comments submitted
by other people?
You may read the comments received
by Docket Management at the address
given above under ADDRESSES. The
hours of the Docket are indicated above
in the same location.
You may also see the comments on
the Internet. To read the comments on
the Internet, take the following steps:
(1) Go to the Federal Docket
Management System (FDMS) at https://
www.regulations.gov.
(2) FDMS provides two basic methods
of searching to retrieve dockets and
docket materials that are available in the
system: (a) ‘‘Quick Search’’ to search
using a full-text search engine, or (b)
‘‘Advanced Search,’’ which displays
various indexed fields such as the
docket name, docket identification
number, phase of the action, initiating
office, date of issuance, document title,
document identification number, type of
document, Federal Register reference,
CFR citation, etc. Each data field in the
advanced search may be searched
independently or in combination with
other fields, as desired. Each search
yields a simultaneous display of all
available information found in FDMS
that is relevant to the requested subject
or topic.
(3) You may download the comments.
However, since the comments are
imaged documents, instead of word
processing documents, the ‘‘pdf’’
versions of the documents are word
searchable.
Please note that even after the
comment closing date, we will continue
to file relevant information in the
Docket as it becomes available. Further,
some people may submit late comments.
Accordingly, we recommend that you
periodically check the Docket for new
material.
Authority: 49 U.S.C. 30111, 30181–83
delegation of authority at 49 CFR 1.95 and
501.8.
Issued in Washington, DC.
Terry Shelton,
Associate Administrator for the National
Center for Statistics and Analysis.
[FR Doc. 2014–19744 Filed 8–19–14; 8:45 am]
BILLING CODE 4910–59–P
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Agencies
[Federal Register Volume 79, Number 161 (Wednesday, August 20, 2014)]
[Notices]
[Pages 49372-49374]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-19744]
-----------------------------------------------------------------------
DEPARTMENT OF TRANSPORTATION
National Highway Traffic Safety Administration
[Docket No. NHTSA-2014-0062]
ICD-10-CM/AIS Mapping Software
AGENCY: National Highway Traffic Safety Administration (NHTSA),
Department of Transportation (DOT).
ACTION: Request for information; reopening of comment period.
-----------------------------------------------------------------------
SUMMARY: This document announces the reopening of the comment period on
a Request for Information (RFI) regarding the potential development of
a mapping software to translate the International Statistical
Classification of Diseases and Related Health Problems, 10th Revision,
Clinical Modification (ICD-10-CM) discharge diagnoses into Abbreviated
Injury Scale (AIS) pre-dot codes, injury descriptors, and severity
scores. The original RFI was issued on June 12, 2014, and had a 60-day
comment period ending on August 11, 2014. In response to continued
interest in this issue, NHTSA is reopening the comment period for this
RFI until September 30, 2014.
DATES: The comment period for the RFI published on June 12, 2014 (79 FR
33799) is extended. Comments must be received no later than September
30, 2014.
ADDRESSES:
Comments: You may submit comments [identified by Docket Number
NHTSA-2014-0062] by any of the following methods:
Internet: To submit comments electronically, go to the
U.S. Government regulations Web site at https://www.regulations.gov.
Follow the online instructions for submitting comments.
Fax: Written comments may be faxed to 202-493-2251.
Mail: Send comments to Docket Management Facility, U.S.
Department of Transportation, 1200 New Jersey Avenue SE., West Building
Ground Floor, Room W12-140, Washington, DC 20590.
Hand Delivery: If you plan to submit written comments by
hand or courier, please do so at 1200 New Jersey Avenue SE., West
Building Ground Floor, Room W12-140, Washington, DC between 9 a.m. and
5 p.m. Eastern Time, Monday through Friday, except federal holidays
You may call Docket Management at 1-800-647-5527.
Instructions: For detailed instructions on submitting comments and
additional
[[Page 49373]]
information see the Comments heading of the Supplementary Information
section of this document. Note that all comments received will be
posted without change to https://www.regulations.gov, including any
personal information provided. Please see the Privacy Act heading in
the SUPPLEMENTARY INFORMATION.
FOR FURTHER INFORMATION CONTACT: For questions about the program
discussed herein, contact John Kindelberger, Chief of the Evaluation
Division, Office of Regulatory Analysis and Evaluation, Room W53-312,
1200 New Jersey Avenue SE., Washington, DC 20590. Telephone: 202-366-
4696. Email: john.kindelberger@dot.gov.
SUPPLEMENTARY INFORMATION: On June 12, 2014, NHTSA published a notice
(79 FR 33799) requesting comment and information the potential
development of a mapping software to translate the International
Statistical Classification of Diseases and Related Health Problems,
10th Revision, Clinical Modification (ICD-10-CM) discharge diagnoses
into Abbreviated Injury Scale (AIS) pre-dot codes, injury descriptors,
and severity scores.
On January 16, 2009, the U.S. Department of Health and Human
Services (HHS) published a final rule adopting ICD-10-CM to replace
ICD-9-CM in transactions covered by the Health Insurance Portability
Accountability Act (HIPAA). The deadline for adopting ICD-10-CM has
been postponed several times but is currently scheduled to take place
at some point after October 1, 2015 (https://www.cms.gov/Medicare/Coding/ICD10/?redirect=/icd10).
The ``Moving Ahead for Progress in the 21st Century'' Act (MAP-21),
signed into law on July 6, 2012, requires the FHWA to establish
measures for State departments of transportation to assess and report
numbers and rates per vehicle mile traveled of roadway fatalities and
serious injuries. [Sec. 1203; 23 USC 150(c).] In Notice of Proposed
Rulemaking 79 FR 13845 (Mar. 11, 2014), which can be found at https://www.regulation.gov, the FHWA recommends that States prepare themselves
so that no later than January 1, 2020, all States use a medical record
injury outcome reporting system that links injury outcomes from medical
records to crash reports.
The DOT seeks comments and information from the public sector,
private sector, and academic communities concerning the potential
development of ICD-10-CM/AIS mapping software that would address the
issues described in this RFI. While comments are welcome on any area of
the RFI, the DOT is particularly interested in responses to the
questions listed below. Responders are reminded that feedback or
comments on any aspect of this notice are welcome from all interested
public, private, and academic entities. While all feedback is welcome,
the DOT is particularly interested in feedback on the following
questions. Respondents may respond, to some, all, or none of these
specific questions:
1. Is there a need for a mapping tool that translates ICD-10-CM
codes to the AIS standard?
2. Is there a need for an updated mapping tool that translates ICD-
9-CM codes to the AIS standard?
3. Are any steps currently being taken to develop a mapping tool?
4. What capabilities should such a mapping tool possess?
5. What platforms should the mapping tool run on?
6. Should the mapping tool be non-proprietary?
Injury data enables epidemiologists, researchers, and policymakers
to better identify the severity of injuries in addition to where, when,
and why they occur. This data is, however, frequently spread among
discrete databases that are difficult to link to each other or to
injury causation data. The ability to link these datasets together is
thus critical to efforts to understand injury trends, set injury
prevention priorities, identify high risk populations and geographic
areas, and develop targeted injury prevention strategies. The DOT,
however, is particularly interested in forging and maintaining links
among vehicle crash and injury datasets as such links can provide more
complete information and better understanding of crash outcomes.
State trauma registry and hospital discharge databases are two of
the more significant sources of injury data. Trauma registries are
designed to collect large amounts of information about the most
seriously injured patients and are not typically used for injury
surveillance purposes on their own. Hospital discharge datasets are
designed primarily to monitor hospital census, utilization, and
financial information but record enough information--like diagnosis
codes and external cause/E-codes--to make them useful injury
surveillance tools. In addition, the pre-hospital emergency medical
services (EMS) patient care reports, compliant with the National EMS
Information System (NEMSIS) Standard, may be helpful, as they can serve
as good link between the crash data and hospital data. NEMSIS data is
submitted to the state level by local EMS agencies, and the collective
statewide data is submitted to the National EMS Database. The most
effective linkage point at this time is at the State level.
These datasets are generally coded using different methodologies.
Trauma registries use the Abbreviated Injury Scale while hospitals and
emergency departments use the International Statistical Classification
of Diseases and Related Health Problems for diagnosis, reporting, and
billing.
The Abbreviated Injury Scale (AIS), developed by the Association
for the Advancement of Automotive Medicine (AAAM), is an anatomically
based, consensus derived, global severity scoring system that
classifies each injury by body region according to its relative
importance on a 6-point ordinal scale (1 = minor and 6 = maximal). The
AIS is the basis for the Injury Severity Score (ISS) calculation of the
multiply injured patient. The AIS is protected by copyright, and both
individual use and site licenses can be purchased from AAAM (https://www.aaam.org/about-ais.html).
The maximum AIS (MAIS) severity level is a recognized person-level
injury severity indicator. For example, the Organization for Economic
Co-Operation and Development's International Traffic Safety Data and
Analysis Group (IRTAD) has recommended that MAIS of level three or
higher be used as the standard for a seriously injured person in a
motor vehicle crash (https://www.internationaltransportforum.org/irtadpublic/pdf/Road-Casualties-Web.pdf).
Maintained by the World Health Organization (WHO), the
International Statistical Classification of Diseases and Related Health
Problems (ICD) is the international standard diagnostic tool for
epidemiology, health management, and clinical purposes. While a version
of the ninth revision, ICD-9-CM, is currently still widely used in the
US, a replacement based on the tenth revision, ICD-10-CM, has been
developed by a National Center for Health Statistics (NCHS) Technical
Advisory Panel following extensive consultation with physician groups,
clinical coders, and others to assure clinical accuracy and utility
(https://www.cdc.gov/nchs/icd/icd10cm.htm).
In the early 90's researchers at Johns Hopkins University developed
a software tool (ICDMAP) that allowed analysts to generate a Maximum
AIS (MAIS) or an Injury Severity Score (ISS) for each injured patient
in the hospital discharge database using the ICD-9-CM diagnosis codes
of each patient's record.
[[Page 49374]]
The ICDMAP enabled statewide performance measurement by MAIS and
allowed analysts to associate the severity outcomes to with crash,
vehicle, and roadway circumstances for planning and/or evaluation of
countermeasures.
While the ICDMAP-generated results are not as precise as those
derived by clinicians in trauma registries, this approach has been
validated and yields good sensitivity in estimating severity for
studying the larger universe of injury hospitalizations. Translating
ICD codes to AIS allows all crash-involved injuries to be compiled and
analyzed in terms of AIS and MAIS severity. When linked to causal
information--State crash databases, for example--ICD codes can be used
to improve measurement of crash-related injury severity.
There is not, however, currently any known software or service
capable of translating between ICD-10-CM and AIS. Once hospitals
transition to the ICD-10-CM, combining these two sets of injury data
will no longer be possible, and analyses will be less complete and less
useful. Significant effort is needed to develop a mapping tool that
will enable mapping of ICD-10-CM diagnosis codes with the corresponding
AIS severity codes.
RFI Guidelines
Responses to this notice are not offers and cannot be accepted by
the Government to form a binding contract or issue a grant. Information
obtained as a result of this RFI may be used by the Government for
program planning on a non-attribution basis. This RFI notice is NOT a
solicitation for proposals, applications, proposal abstracts, or
quotations. This RFI notice is not to be construed as a commitment on
the part of the Government to award a contract or grant, nor does the
Government intend to directly pay for any information or responses
submitted as a result of this RFI notice.
Comments
How do I prepare and submit comments?
Your comments must be written and in English. To ensure that your
comments are correctly filed in the Docket, please include the Docket
number of this document (NHTSA-2014-0062) in your comments.
Your primary comments must not be more than 15 pages long (49 CFR
553.21). However, you may attach additional documents to your primary
comments. There is no limit on the length of the attachments.
Please submit one copy of your comments, including the attachments,
to Docket Management at the address given above under ADDRESSES.
Please note that pursuant to the Data Quality Act, in order for
substantive data to be relied upon and used by the agency, it must meet
the information quality standards set forth in the OMB and DOT Data
Quality Act guidelines. Accordingly, we encourage you to consult the
guidelines in preparing your comments. OMB's guidelines may be accessed
at https://www.whitehouse.gov/omb/fedreg_reproducible. DOT's guidelines
may be accessed at https://www.rita.dot.gov/bts/sites/rita.dot.gov.bts/files/subject_areas/statistical_policy_and_research/data_quality_guidelines/.
Privacy Act: Anyone is able to search the electronic form of all
comments received into any of our dockets by the name of the individual
submitting the comment (or signing the comment, if submitted on behalf
of an association, business, labor union, etc.). You may review DOT's
complete Privacy Act Statement in the Federal Register published on
April 11, 2000 (65 FR 19477-78) or you may visit https://www.regulations.gov.
How can I be sure that my comments were received?
If you wish Docket Management to notify you upon its receipt of
your comments, enclose a self-addressed, stamped postcard in the
envelope containing your comments. Upon receiving your comments, Docket
Management will return the postcard by mail. You may also periodically
access https://www.regulations.gov and enter the number for this docket
(NHTSA-2014-0062) to see if your comments are on line.
How do I submit confidential business information?
If you wish to submit any information under a claim of
confidentiality, you should submit three copies of your complete
submission, including the information you claim to be confidential
business information, to the Chief Counsel, NHTSA, U.S. Department of
Transportation, 1200 New Jersey Avenue SE., Washington, DC, 20590. In
addition, you should submit a copy, from which you have deleted the
claimed confidential business information, to Docket Management at the
address given above under ADDRESSES. When you send a comment containing
information claimed to be confidential business information, you should
include a cover letter setting forth the information specified in our
confidential business information regulation (49 CFR Part 512).
Will the agency consider late comments?
In our response, we will consider all comments that Docket
Management receives before the close of business on the comment closing
date indicated above under DATES. To the extent possible, we will also
consider comments that Docket Management receives after that date.
How can I read the comments submitted by other people?
You may read the comments received by Docket Management at the
address given above under ADDRESSES. The hours of the Docket are
indicated above in the same location.
You may also see the comments on the Internet. To read the comments
on the Internet, take the following steps:
(1) Go to the Federal Docket Management System (FDMS) at https://www.regulations.gov.
(2) FDMS provides two basic methods of searching to retrieve
dockets and docket materials that are available in the system: (a)
``Quick Search'' to search using a full-text search engine, or (b)
``Advanced Search,'' which displays various indexed fields such as the
docket name, docket identification number, phase of the action,
initiating office, date of issuance, document title, document
identification number, type of document, Federal Register reference,
CFR citation, etc. Each data field in the advanced search may be
searched independently or in combination with other fields, as desired.
Each search yields a simultaneous display of all available information
found in FDMS that is relevant to the requested subject or topic.
(3) You may download the comments. However, since the comments are
imaged documents, instead of word processing documents, the ``pdf''
versions of the documents are word searchable.
Please note that even after the comment closing date, we will
continue to file relevant information in the Docket as it becomes
available. Further, some people may submit late comments. Accordingly,
we recommend that you periodically check the Docket for new material.
Authority: 49 U.S.C. 30111, 30181-83 delegation of authority at
49 CFR 1.95 and 501.8.
Issued in Washington, DC.
Terry Shelton,
Associate Administrator for the National Center for Statistics and
Analysis.
[FR Doc. 2014-19744 Filed 8-19-14; 8:45 am]
BILLING CODE 4910-59-P