Emergency department diagnostic codes: useful data?

NHS England have confirmed that the Emergency Care Data Set (ECDS) will be the new method of reporting ED activity levels within the Commissioning Data Set,1 which is used to generate the Secondary Uses Service (SUS) data and then the Hospital Episode Statistics (HES) from which the influential Dr Foster data are derived. The ECDS will use a truncated version of SNOMED for diagnostic coding rather than the current HES ED data dictionary, which has a limited number of codes with dubious clinical validity. This is an important methodological step forward, but will it be enough to improve the quality of the data?

In the EPIC1 study,2 63/178 of the cohort had suffered an epileptic seizure in the opinion of the ED doctor. Of these, only 30/63 (48%) were given the correct ED (A&E) Diagnosis Code for epilepsy (241 'CNS Conditions—Epilepsy'). The primary diagnosis in the majority...

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