ICD-10 Comparability Ratio

Office of Public Health Assessment

Utah Department of Health

Author: Tong Zheng

Jan-02

"ICD" stands for "International Classification of Diseases." It is a coding system maintained by the World Health Organization and the U.S. National Center for Health Statistics used to classify causes of death on death certificates and diagnoses, injury causes, and medical procedures for hospital and emergency department visits. They are also used in by public health assessment to track the number, incidence and prevalence rates of injury and disease in the community.

These codes are updated every decade or so to account for advances in medical technology. Currently, the U.S. is changing over from the 9th revision (ICD-9) to the 10th revision (ICD-10). The first public data set to change-over to the new ICD-10 codes was the 1999 death data from the National Center for Health Statistics.

ICD Revisions

Since the beginning of the century the ICD for mortality has been modified about once every ten years, except for the twenty year interval between the last two revisions, ICD-9 and ICD-10, as shown below:

 __________________________________________________________________

 

ICD IMPLEMENTATION DATES IN U.S.

__________________________________________________________________

Revision

Year in Effect

First (ICD-1)

1900 -- 1909

Second (ICD-2)

1910 -- 1920

Third (ICD-3)

1921 -- 1929

Fourth (ICD-4)

1930 --1938

Fifth (ICD-5)

1939 -- 1948

Sixth (ICD-6)

1949 -- 1957

Seventh (ICD-7)

1958 -- 1967

Eighth, Adapted (ICDA-8)

1968 -- 1978

Ninth (ICD-9)

1979 -- 1998

Tenth (ICD-10)

1999 --

_______________________________________________________________________

 

The rationale for the periodic revisions has been to reflect advances in medical science and changes in diagnostic terminology. Historically, the U.S. accepted theWHO versions of the ICD, except for the Eighth Revision, when the U.S. produced its own "adapted" version, which is symbolized by the "A" in ICDA-8. The U.S.ís rejection of the WHO version reflected principally disagreements on the content of the circulatory chapter. That changes in the ICD for mortality have been made only every ten to twenty years rather than annually promotes comparability over time in mortality trend data.

Differences between ICD-10 and ICD-9

ICD-10 differs from ICD-9 in a number of respects: 1) ICD-10 is far more detailed than ICD-9; about 8,000 categories compared with 4,000 categories. The expansion was mainly to provide more clinical detail for morbidity applications; 2) ICD-10 uses 4-digit alphanumeric codes compared with 4-digit numeric codes in ICD-9; 3) three additional chapters have been added and some chapters rearranged; 4) cause-of-death titles have been changed, and conditions have been regrouped; 5) some coding rules have been changed. 6) Finally, ICD-10 is published in three volumes compared with two volumes in ICD-9.

Statistical Impact and Comparability

The introduction of a new revision of the ICD can create major discontinuities in trend data, as shown in Figure 1. Figure 1 shows trends in leading causes of death in the United States from 1950 to 1997 in terms of age-adjusted death rates. The lines on the chart are not continuous, but rather are broken by vertical lines that represent the introduction of a new revision of the ICD. Thus, ICD-9 was introduced in 1979. Further, the level of the rates is sometimes discontinuous between revisions. For example, a large discontinuity occurred between 1978 and 1979 in mortality for the 11th leading cause of death, "Nephritis, nephrotic syndrome, and nephrosis." The rate for this cause in 1979 was over 70 percent higher than in the previous year, because of the introduction of ICD-9.

The extent of the discontinuity is measured using a "comparability ratio," which results from double-coding a large sample of the national mortality file, once by the old revision (ICDA-9), and again by the new revision (ICD-10), and expressing the results of the comparison as a ratio of deaths for a cause of death by the later revision divided by the number of that cause of death coded and classified by the earlier revision.

For ICD-10, two sets of comparability ratios are being prepared: a preliminary set scheduled for early release based on a very large sample of deaths (in excess of 1.8 million records) occurring in 1996 that will accompany the publication of preliminary national mortality data for 1999, and a final set of comparability ratios based on the entire national mortality file of 1996 (over 2.3 million records) that will be published one year later. The final comparability ratios are expected to differ little from the preliminary ratios, but will permit calculation of state-specific ratios, cross tabulation by age and sex, and the use of more detailed tabulation lists than the standard ICD-10 tabulation list of 113 Selected Causes of Death (see Appendix I). Preliminary comparability ratios for ICD-10 are shown in a companion document to this Guide.

The introduction of a new revision of ICD can create major discontinuities in trend data, for example discontinuities between 1998 death data and 1999 death data. The extent of the discontinuity is measured using a "comparability ratio."

Comparability Ratio

A comparability ratio measures the level of agreement between ICD-9 and ICD-10 classification systems. NCHS provides " comparability ratios" for 113 selected causes of death by a double-coding exercise using 1996 death data. NCHS coded 1.8 million death certifications from 1996 first using ICD-9 and then using ICD-10. Based on that double-coding, NCHS has produced the set of Comparability Ratios for 113 Selected Causes of Death. A list of comparability ratios for the National Center for Health Statistics (NCHS) 113 Causes of Death and 50 Leading Causes of Death may be found in Appendix 1. Each ratio is an expression of the results of the comparison as a ratio of death for a cause of death by the later revision divided by the number of cause of death coded and classified by the earlier revision:

Comparability ratio = ICD-10 deaths / ICD-9 deaths

To accurately portray trends that include both years 1980-1998 and 1999 on, the death counts or rates for the earlier years must be "comparability modified." This is accomplished by multiplying the earlier death count (or rate) by the comparability ratio for that cause of death.

Consider a cause of death in which there was no change in the true death rate, but for which the two coding systems produced incomparable rates. If you were to graph death rates across the two time periods for that cause of death, you would see a sharp increase or decrease in the trend line starting with 1999. This increase or decrease would be an artifact of the change in the coding system, and not an actual difference in the underlying risk of death from that cause.

 

Application of ICD-10 Comparability ratio to Utah Death Certificate Database in SAS

Comparability ratios are now available to 113 selected death causes provided by NCHS. For a statistical analysis of cause-specific mortality including 1999 death data or after, comparability ratios need to be applied to each death record in the earlier years data. Each count of death related to 113 selected death causes before 1999 data should multiply the comparability ratio. For example, If a record with the death cause "Salmonelia infections" (ICD-9 between "002" and "0039"), this record is counted as 0.81(=1*0.81) instead of 1. 0.81 is the comparability ratio for this specific cause. An example of applying comparability ratios using SAS may be found in Appendix 2.

Issues In Using Comparability Ratios

You should exercise caution and seek further information on the validity of using comparability ratios in the following circumstances:

  1. For analysis of geographic areas smaller than the U.S.
  2. The comparability ratios were computed empirically using a large national dataset. It is possible that the comparability ratio for one or more causes of death would be different for a population other than the entire U.S. When used with geographic areas that are smaller than the nation as a whole, there is a possibility that they will not be valid. By using them on the IBIS-Q query system website, the Utah Department of Health is offering defacto approval of their use in state level analyses. However, the smaller the geographic area, the less similar it is from the national death file, and the less certain you may be of the validity of the results of your comparability-modified results. If you are observing rates for a small geographic area, you may need to wait for two or more year's worth of data before evaluating the existence of a trend.

  3. For age-specific or directly age-adjusted rates.
  4. This issue is very similar to the one expressed immediately above in #1. The comparability ratios have been based on an analysis of the entire population. Applying these ratios to some smaller segment of the population may not be valid. Direct age-adjustment applies the same comparability ratio to each age group. Officials at NCHS have indicated that age-specific comparability ratios will eventually become available, and until then it is probably not misleading to use the current comparability ratios with age-adjusted data.

  5. To examine data prior to 1996.
  6. The comparability ratios are based on an empirical analysis of the death data that were double-coded in 1996. For years prior to 1996, and especially those in the 1980s, it is unknown whether the comparability ratios are valid.

  7. For statistical analysis of trends.

When performing statistical analyses on trend information using comparability-modified counts or rates, you will need to take the standard error of the comparability ratio into account. Please refer to the following publication: A Guide to State Implementation of ICD-10 for Mortality: Part II - Applying Comparability Ratios, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention, December 4, 2000.

Appendix 1. NCHS Comparability Ratios for 113 Causes of Death

and 50 Leading Causes of Death

Comparability ratios for NCHS 113 selected causes of death and UDOH Leading Causes of Death (LCD) for Reporting Purposes

NCHS Comparability Ratios for 113 Causes of Death

113#

LCD?

Cause of death

ICD-9 Codes

ICD-10 codes

Comparability Ratio

Standard Error

Note

1

LCD

Salmonella infections

002-003

A01-A02

0.81

0.0644

2

LCD

Shigellosis and amebiasis

004,006

A03,A06

*

*

3

Certain other intestinal infections

007-009

A04,A07-A09

0.60

0.0248

LCD

Tuberculosis

010-018

A16-A19

0.85

0.0172

4

Respiratory tuberculosis

010-012

A16

0.91

0.0201

5

Other tuberculosis

013-018

A17-A19

0.70

0.0407

6

LCD

Whooping cough

033

A37

*

*

7

LCD

Scarlet fever and erysipelas

034.1 - 035

A38,A46

*

*

8

LCD

Meningococcal infection

036

A39

1.00

0.0149

9

LCD

Septicemia

038

A40-A41

1.19

0.0042

10

LCD

Syphilis

090-097

A50-A53

0.64

0.1184

11

LCD

Acute poliomyelitis

045

A80

*

*

12

LCD

Arthropod-borne viral encephalitis

062-064

A83-A84,A85.2

*

*

13

LCD

Measles

055

B05

*

*

14

LCD

Viral hepatitis

070

B15-B19

0.83

0.0120

15

LCD

Human immunodeficiency virus (HIV) disease

042-044

B20-B24

1.06

0.0018

16

LCD

Malaria

084

B50-B54

*

*

17

Other and unspecified infectious and parasitic diseases and their sequelae

001,005,020-032,037,039-041,046-054,056-061,065-066,071-083,085-088,098-134,136-139,771.3

A00,A05,A20-A36,A42-A44,A48-A49,A54-A79,A81-A82,A85.0-A85.1,A85.8,A86-B04,B06-B09,B25-B49,B55-B99

1.10

0.0154

LCD

Malignant neoplasms

140-208

C00-C97

1.01

0.0002

18

Malignant neoplasms of lip, oral cavity and pharynx

140-149

C00-C14

0.96

0.0040

19

Malignant neoplasm of esophagus

150

C15

1.00

0.0020

20

Malignant neoplasm of stomach

151

C16

1.01

0.0019

21

Malignant neoplasms of colon, rectum and anus

153-154

C18-C21

1999 --1.00

0.0009

22

Malignant neoplasms of liver and intrahepatic bile ducts

155

C22

0.96

0.0023

23

Malignant neoplasm of pancreas

157

C25

1.00

0.0009

24

Malignant neoplasm of larynx

161

C32

1.00

0.0053

25

Malignant neoplasms of trachea, bronchus and lung

162

C33-C34

0.98

0.0005

26

Malignant melanoma of skin

172

C43

0.97

0.0032

27

Malignant neoplasm of breast

174-175

C50

1.01

0.0010

28

Malignant neoplasm of cervix uteri

180

C53

0.99

0.0034

29

Malignant neoplasms of corpus uteri and uterus, part unspecified

179,182

C54-C55

1.03

0.0040

30

Malignant neoplasm of ovary

183.0

C56

1.00

0.0016

31

Malignant neoplasm of prostate

185

C61

1.01

0.0015

32

Malignant neoplasms of kidney and renal pelvis

189.0,189.1

C64-C65

1.00

0.0022

33

Malignant neoplasm of bladder

188

C67

1.00

0.0026

34

Malignant neoplasms of meninges, brain and other parts of central nervous system

191-192

C70-C72

0.97

0.0025

Malignant neoplasms of lymphoid, hematopoietic and related tissue

200-208

C81-C96

1.00

0.0012

35

Hodgkin's disease

201

C81

0.99

0.0089

36

Non-Hodgkin's lymphoma

200,202

C82-C85

0.98

0.0018

37

Leukemia

204-208

C91-C95

1.01

0.0019

38

Multiple myeloma and immunoproliferative neoplasms

203

C88,C90

1.04

0.0030

39

Other and unspecified malignant neoplasms of lymphoid, hematopoietic and related tissue

---

C96

1999 --1999 --1999 --1999 --1999 --1999 --*

*

40

All other and unspecified malignant neoplasms

152,156,158-160,163-171,173,181,183.2-184,186-187,189.2-190,193-199

C17,C23-C24,C26-C31,C37-C41,C44-C49,C51-C52,C57-C60,C62-C63,C66,C68-C69,C73-C80,C97

1.13

0.0021

41

LCD

In situ neoplasms, benign neoplasms and neoplasms of uncertain or unknown behavior

210-239

D00-D48

1.67

0.0164

42

LCD

Anemias

280-285

D50-D64

0.96

0.0077

43

LCD

Diabetes mellitus

250

E10-E14

1.01

0.0011

LCD

Nutritional deficiencies

260-269

E40-E64

1.16

0.0165

44

Malnutrition

260-263

E40-E46

0.98

0.0151

45

Other nutritional deficiencies

264-269

E50-E64

6.20

0.5961

46

LCD

Meningitis

320-322

G00,G03

1.01

0.0136

47

LCD

Parkinson's disease

332

G20-G21

1.00

0.0028

48

LCD

Alzheimer's disease

331.0

G30

1.55

0.0071

Major cardiovascular diseases

390-434,436-448

I00-I78

1.00

0.0002

LCD

Diseases of heart

390-398,402,404,410-429

I00-I09,I11,I13,I20-I51

0.99

0.0002

49

Acute rheumatic fever and chronic rheumatic heart diseases

390-398

I00-I09

0.82

0.0089

50

Hypertensive heart disease

402

I11

0.80

0.0028

51

Hypertensive heart and renal disease

404

I13

1.07

0.0160

Ischemic heart diseases

410-414,429.2

I20-I25

1.00

0.0002

52

Acute myocardial infarction

410

I21-I22

0.99

0.0003

53

Other acute ischemic heart diseases

411

I24

1.01

0.0117

Other forms of chronic ischemic heart disease

412-414,429.2

I20,I25

1.01

0.0004

54

Atherosclerotic cardiovascular disease, so described

429.2

I25.0

1.05

0.0016

55

All other forms of chronic ischemic heart disease

412-414

I20,I25.1-I25.9

0.99

0.0004

Other heart diseases

415-429.1,429.3-429.9

I26-I51

0.97

0.0010

56

Acute and subacute endocarditis

421

I33

1.00

0.0137

57

Diseases of pericardium and acute myocarditis

420,422-423

I30-I31,I40

1.03

0.0160

58

Heart failure

428

I50

1.04

0.0013

59

All other forms of heart disease

415-417,424-427,429.0-429.1,429.3-429.9

I26-I28,I34-I38,I42-I49,I51

0.94

0.0014

60

LCD

Essential (primary) hypertension and hypertensive renal disease

401,403

I10,I12

1.12

0.0050

61

LCD

Cerebrovascular diseases

430-434,436-438

I60-I69

1.06

0.0008

435:transient cerebral ischemia

62

LCD

Atherosclerosis

440

I70

0.96

0.0025

Other diseases of circulatory system

441-448

I71-I78

0.95

0.0021

63

LCD

Aortic aneurysm and dissection

441

I71

1.00

0.0010

64

Other diseases of arteries, arterioles and capillaries

442-448

I72-I78

0.85

0.0053

65

Other disorders of circulatory system

451-459

I80-I99

1.03

0.0172

LCD

Influenza and pneumonia

480-487

J10-J18

0.70

0.0018

66

Influenza

487

J10-J11

1.01

0.0073

67

Pneumonia

480-486

J12-J18

0.70

0.0018

Other acute lower respiratory infections

466

J20-J22

0.97

0.0392

68

LCD

Acute bronchitis and bronchiolitis

466

J20-J21

0.75

0.0264

69

Unspecified acute lower respiratory infection

---

J22

*

*

LCD

Chronic lower respiratory diseases

490-494,496

J40-J47

1.05

0.0009

495:extrinsic allergic alveolitis

70

Bronchitis, chronic and unspecified

490-491

J40-J42

0.39

0.0107

71

Emphysema

492

J43

0.97

0.0031

72

Asthma

493

J45-J46

0.89

0.0061

73

Other chronic lower respiratory diseases

494,496

J44,J47

1.10

0.0014

74

LCD

Pneumoconioses and chemical effects

500-506

J60-J66,J68

1.02

0.0099

75

LCD

Pneumonitis due to solids and liquids

507

J69

1.12

0.0048

76

Other diseases of respiratory system

034.0,460-465,470-478,495,508-519

J00-J06,J30-J39,J67,J70-J98

1.17

0.0052

77

LCD

Peptic ulcer

531-534

K25-K28

0.97

0.0045

534:Gastrojejunal ulcer

78

LCD

Diseases of appendix

540-543

K35-K38

1.03

0.0242

79

LCD

Hernia

550-553

K40-K46

1.04

0.0154

560:intestinal obstruction without mention of hernia

LCD

Chronic liver disease and cirrhosis

571

K70,K73-K74

1.04

0.0027

80

Alcoholic liver disease

571.0-571.3

K70

1.02

0.0050

81

Other chronic liver disease and cirrhosis

571.4-571.9

K73-K74

1.05

0.0041

82

LCD

Cholelithiasis and other disorders of gallbladder

574-575

K80-K82

0.96

0.0060

LCD

Nephritis, nephrotic syndrome and nephrosis

580-589

N00-N07,N17-N19,N25-N27

1.23

0.0044

83

Acute and rapidly progressive nephritic and nephrotic syndrome

580-581

N00-N01,N04

0.65

0.0342

84

Chronic glomerulonephritis, nephritis and nephritis not specified as acute or chronic, and renal sclerosis unspecified

582-583,587

N02-N03,N05-N07,N26

0.39

0.0144

85

Renal failure

584-586

N17-N19

1.29

0.0050

86

Other disorders of kidney

588-589

N25,N27

0.91

0.0867

87

LCD

Infections of kidney

590

N10-N12,N13.6,N15.1

1.01

0.0144

88

LCD

Hyperplasia of prostate

600

N40

1.00

0.0159

89

LCD

Inflammatory diseases of female pelvic organs

614-616

N70-N76

0.98

0.0410

LCD

Pregnancy, childbirth and the puerperium

630-676

O00-099

*

*

90

Pregnancy with abortive outcome

630-639

O00-O07

*

*

91

Other complications of pregnancy, childbirth and the puerperium

640-676

O10-O99

*

*

92

LCD

Certain conditions originating in the perinatal period

760-771.2,771.4-779

P00-P96

1.07

0.0033

771.3:tetanus neonatorum

93

LCD

Congenital malformations, deformations and chromosomal abnormalities

740-759

Q00-Q99

0.85

0.0055

94

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified

780-799

R00-R99

0.96

0.0034

95

All other diseases (Residual)

Residual

Residual

0.90

0.0015

LCD

Unintentional injuries

E800-E869,E880-E929

V01-X59,Y85-Y86

1.03

0.0014

Unintentional injury: Transport

E800-E848,E929.0,E929.1

V01-V99,Y85

1.00

0.0006

96

Motor vehicle crash

E810-E825

V02-V04,V09.0,V09.2,V12-V14,V19.0-V19.2,V19.4-V19.6,V20-V79,V80.3-V80.5,V81.0-V81.1,V82.0-V82.1,V83-V86,V87.0-V87.8,V88.0-V88.8,V89.0,V89.2

0.85

0.0027

97

Unintentional injury: Other land transport

E800-E807,E826-E829

V01,V05-V06,V09.1,V09.3-V09.9,V10-V11,V15-V18,V19.3,V19.8-V19.9,V80.0-V80.2,V80.6-V80.9,V81.2-V81.9,V82.2-V82.9,V87.9,V88.9,V89.1,V89.3,V89.9

14.13

0.9952

98

Unintentional injury: Water, air and space, and other transport

E830-E848,E929.0,E929.1

V90-V99,Y85

1.01

0.0209

Unintentional injury: Nontransport

E850-E869,E880-E928,E929.2-E929.9

W00-X59,Y86

1.08

0.0035

99

Falls

E880-E888

W00-W19

0.84

0.0049

100

Accidental discharge of firearms

E922

W32-W34

1.06

0.0127

101

Accidental drowning and submersion

E910

W65-W74

1.00

0.0127

102

Accidental exposure to smoke, fire and flames

E890-E899

X00-X09

0.97

0.0089

103

Accidental poisoning and exposure to noxious substances

E850-E869,E924.1

X40-X49

0.89

0.0191

104

Other and unspecified nontransport accidents and their sequelae

E900-E909,E911-E921,E923-E924.0,E924.8-E928,E929.2-E929.9

W20-W31,W35-W64,W75-W99,X10-X39,X50-X59,Y86

1.42

0.0123

LCD

Intentional self-harm (suicide)

E950-E959

X60-X84,Y87.0

1.00

0.0005

105

Intentional self-harm (suicide) by discharge of firearms

E955.0-E955.4

X72-X74

1.00

0.0007

106

Intentional self-harm (suicide) by other and unspecified means and their sequelae

E950-E954,E955.5-E959

X60-X71,X75-X84,Y87.0

1.00

0.0023

LCD

Assault (homicide)

E960-E969

X85-Y09,Y87.1

1.00

0.0006

107

Assault (homicide) by discharge of firearms

E965.0-E965.4

X93-X95

1.00

0.0008

108

Assault (homicide) by other and unspecified means and their sequelae

E960-E964,E965.5-E969

X85-X92,X96-Y09,Y87.1

1.00

0.0024

109

LCD

Legal intervention

E970-E978

Y35,Y89.0

*

*

Events of undetermined intent

E980-E989

Y10-Y34,Y87.2,Y89.9

*

*

110

Discharge of firearms, undetermined intent

E985.0-E985.4

Y22-Y24

*

*

111

Other and unspecified events of undetermined intent and their sequelae

E980-E984,E985.5-E989

Y10-Y21,Y25-Y34,Y87.2,Y89.9

*

*

112

LCD

Operations of war and their sequelae

E990-E999

Y36,Y89.1

*

*

113

LCD

Complications of medical and surgical care

E870-E879,E930-E949

Y40-Y84,Y88

*

*

--- Category not applicable.

* Figure does not meet standards of reliability or precision

 

 

Appendix 2. Applying Comparability Ratios Using SAS

The steps to get a trend count from Utah Death Certificate Database in SAS are:

(1) Create a count variable (trendcnt) for yearly data.

For 1999 death data or after, let the variable trendcnt equal 1 for each record, which means each record is counted as 1.

(2) For death data before 1999, trendcnt equals to comparability ratio based on 113 selected death causes for each record. The one record could be counted as less than 1 or greater than one.

(3) Group the death cause of each record into 113 selected death causes.

(4) Sum up trendcnt by year and specific cause of death among 113 selected causes. The trend counts for specific cause of death in certain year are generated.

Example: Death Trend Over Time Including 1999 on Certain Other Intestinal Infections, Respiratory Tuberculosis, and Other Tuberculosis.

If year>=1999 then do; (1)

trendcnt=1;

end;

If year<1999 then do; (2)

/*Only part of 113 selected death causes */

If ('007 ' <=: dthcause1 <=: '0099') then trendcnt =0.6;

if ('010 ' <=: dthcause1<=: '0129') then trendcnt =0.91;

if ('013 ' <=: dthcause1 <=: '0189') then trendcnt =0.70;

if dthcause1 =: '038' then trendcnt =1.19;

end;

/*113 Selected death causes */

if ('002 ' <=: dthcause1 <=: '0039') then cause = '1'; (3)

if dthcause1 =: '004' | dthcause1 =: '006' then cause = '2';

if ('007 ' <=: dthcause1 <=: '0099') then cause = '3';

if ('010 ' <=: dthcause1 <=: '0129') then cause = '4';

if ('013 ' <=: dthcause1 <=: '0189') then cause = '5';

if dthcause1 =: '033' then cause = '6';

if ('0341' <=: dthcause1 <=: '0359') then cause = '7';

if dthcause1 =: '036' then cause = '8';

if dthcause1 =: '038' then cause = '9';

if ('090 ' <=: dthcause1 <=: '0979') then cause = '10';

if dthcause1 =: '045' then cause = '11';

if ('062 ' <=: dthcause1 <=: '0649') then cause = '12';

if dthcause1 =: '055' then cause = '13';

if dthcause1 =: '070' then cause = '14';

if ('042 ' <=: dthcause1 <=: '0449') then cause = '15';

if dthcause1 =: '084' then cause = '16';

 

if dthcause1 =: '001' | dthcause1 =: '005' |

('020 ' <=: dthcause1 <=: '0329') |

dthcause1 =: '037' |

('039 ' <=: dthcause1 <=: '0419') |

('046 ' <=: dthcause1 <=: '0549') |

('056 ' <=: dthcause1 <=: '0619') |

('065 ' <=: dthcause1 <=: '0669') |

('071 ' <=: dthcause1 <=: '0839') |

('085 ' <=: dthcause1 <=: '0889') |

('098 ' <=: dthcause1 <=: '1349') |

('136 ' <=: dthcause1 <=: '1399') |

dthcause1 = '7713' then cause = '17'

;

if ('140 ' <=: dthcause1 <=: '1499') then cause = '18';

if dthcause1 =: '150' then cause = '19';

if dthcause1 =: '151' then cause = '20';

if ('153 ' <=: dthcause1 <=: '1549') then cause = '21';

if dthcause1 =: '155' then cause = '22';

if dthcause1 =: '157' then cause = '23';

if dthcause1 =: '161' then cause = '24';

if dthcause1 =: '162' then cause = '25';

if dthcause1 =: '172' then cause = '26';

if ('174 ' <=: dthcause1 <=: '1759') then cause = '27';

if dthcause1 =: '180' then cause = '28';

if dthcause1 =: '179' | dthcause1 =: '182' then cause = '29';

if dthcause1 = '1830' then cause = '30';

if dthcause1 =: '185' then cause = '31';

if dthcause1 = '1890' | dthcause1 =: '189.1' then cause = '32';

if dthcause1 =: '188' then cause = '33';

if ('191 ' <=: dthcause1 <=: '1929') then cause = '34';

if dthcause1 =: '201' then cause = '35';

if dthcause1 =: '200' | dthcause1 =: '202' then cause = '36';

if ('204 ' <=: dthcause1 <=: '2089') then cause = '37';

if dthcause1 =: '203' then cause = '38';

if dthcause1 =: '152' | dthcause1 =: '156'|

('158 ' <=: dthcause1 <=: '1609') |

('163 ' <=: dthcause1 <=: '1719') |

dthcause1 =: '173' | dthcause1 =: '181'|

('1832 ' <=: dthcause1 <=: '1849') |

('186 ' <=: dthcause1 <=: '1879') |

('1892' <=: dthcause1 <=: '1909') |

('193 ' <=: dthcause1 <=: '1999') then cause = '40';

if ('210 ' <=: dthcause1 <=: '2399') then cause = '41';

if ('280 ' <=: dthcause1 <=: '2859') then cause = '42';

if dthcause1 =: '250' then cause = '43';

if ('260 ' <=: dthcause1 <=: '2639') then cause = '44';

if ('264 ' <=: dthcause1 <=: '2699') then cause = '45';

if ('320 ' <=: dthcause1 <=: '3229') then cause = '46';

if dthcause1 =: '332' then cause = '47';

if dthcause1 = '3310' then cause = '48';

if ('390 ' <=: dthcause1 <=: '3989') then cause = '46';

if dthcause1 =: '402' then cause = '50';

if dthcause1 =: '404' then cause = '51';

if dthcause1 =: '410' then cause = '52';

if dthcause1 =: '411' then cause = '53';

if dthcause1 =: '4292' then cause = '54';

if ('412 ' <=: dthcause1 <=: '4149') then cause = '55';

if dthcause1 =: '421' then cause = '56';

if dthcause1 =: '420' | ('422 ' <=: dthcause1 <=:'4239') then cause = '57';

if dthcause1 =: '428' then cause = '58';

if ('415 ' <=: dthcause1 <=: '4179') |

('424 ' <=: dthcause1 <=: '4279') |

('4290' <=: dthcause1 <=: '4291') |

('4293' <=: dthcause1 <=: '4299') then cause = '59';

if dthcause1 =: '401' | dthcause1 =: '403' then cause = '60';

if ('430 ' <=: dthcause1 <=: '4349') |

('436 ' <=: dthcause1 <=: '4389') then cause = '61';

if dthcause1 =: '440' then cause = '62';

if dthcause1 =: '441' then cause = '63';

if ('442 ' <=: dthcause1 <=: '4489') then cause = '64';

if ('451 ' <=: dthcause1 <=: '4599') then cause = '65';

if dthcause1 =: '487' then cause = '66';

if ('480 ' <=: dthcause1 <=: '4869') then cause = '67';

if dthcause1 =: '466' then cause = '68';

if ('490 ' <=: dthcause1 <=: '4919') then cause = '70';

if dthcause1 =: '492' then cause = '71';

if dthcause1 =: '493' then cause = '72';

if dthcause1 =: '494' | dthcause1 =: '496' then cause = '73';

if ('500 ' <=: dthcause1 <=: '5069') then cause = '74';

if dthcause1 =: '507' then cause = '75';

if dthcause1 = '340' | dthcause1 =: '495' |

('460 ' <=: dthcause1 <=: '4659') |

('470 ' <=: dthcause1 <=: '4789') |

('508 ' <=: dthcause1 <=: '5199') then cause = '76';

if ('531 ' <=: dthcause1 <=: '5349') then cause = '77';

if ('540 ' <=: dthcause1 <=: '5439') then cause = '78';

if ('550 ' <=: dthcause1 <=: '5539') then cause = '79';

if ('5710' <=: dthcause1 <=: '5713') then cause = '80';

if ('5714' <=: dthcause1 <=: '5719') then cause = '81';

if ('574 ' <=: dthcause1 <=: '5759') then cause = '82';

if ('580 ' <=: dthcause1 <=: '5819') then cause = '83';

if ('582 ' <=: dthcause1 <=: '5839') | dthcause1 =: '587' then cause = '84';

if ('584 ' <=: dthcause1 <=: '5869') then cause = '85';

if ('588 ' <=: dthcause1 <=: '5899') then cause = '86';

if dthcause1 =: '590' then cause = '87';

if dthcause1 =: '600' then cause = '88';

if ('614 ' <=: dthcause1 <=: '6169') then cause = '89';

if ('630 ' <=: dthcause1 <=: '6399') then cause = '90';

if ('640 ' <=: dthcause1 <=: '6769') then cause = '91';

if ('760 ' <=: dthcause1 <=: '7712') |

('7714' <=: dthcause1 <=: '7799') then cause = '92';

if ('740 ' <=: dthcause1 <=: '7599') then cause = '93';

if ('780 ' <=: dthcause1 <=: '7999') then cause = '94';

if ('810 ' <=: dthcause1 <=: '8259') then cause = '96';

if ('800 ' <=: dthcause1 <=: '8079') |

('826 ' <=: dthcause1 <=: '8299') then cause = '97';

if ('830 ' <=: dthcause1 <=: '8489') |

dthcause1 = '9290' | dthcause1 = '9291' then cause = '98';

if ('880 ' <=: dthcause1 <=: '8889') then cause = '99';

if dthcause1 =: '922' then cause = '100';

if dthcause1 =: '910' then cause = '101';

if ('890 ' <=: dthcause1 <=: '8999') then cause = '102';

if ('850 ' <=: dthcause1 <=: '8699') |

dthcause1 = '9241' then cause = '103';

if ('900 ' <=: dthcause1 <=: '9099') |

('911 ' <=: dthcause1 <=: '9219') |

('923 ' <=: dthcause1 <=: '9240') |

('9248' <=: dthcause1 <=: '9289') |

('9292' <=: dthcause1 <=: '9299') then cause = '104';

if ('9550' <=: dthcause1 <=: '9554') then cause = '105';

if ('950 ' <=: dthcause1 <=: '9549') |

('9555' <=: dthcause1 <=: '9599') then cause = '106';

if ('9650' <=: dthcause1 <=: '9654') then cause = '107';

if ('960 ' <=: dthcause1 <=: '9649') |

('9655' <=: dthcause1 <=: '9699') then cause = '108';

if ('970 ' <=: dthcause1 <=: '9789') then cause = '109';

if ('9850' <=: dthcause1 <=: '9854') then cause = '110';

if ('980 ' <=: dthcause1 <=: '9849') |

('9855' <=: dthcause1 <=: '9899') then cause = '111';

if ('990 ' <=: dthcause1 <=: '9999') then cause = '112';

if ('870 ' <=: dthcause1 <=: '8799') |

('930 ' <=: dthcause1 <=: '9499') then cause = '113';

 

proc summary; (4)

where cause in (3,4,5); /*Certain Other Intestinal Infections, Respiratory

Tuberculosis, and Other Tuberculosis*/

var year cause trendcnt;

class year cause;

output out=temp sum(trendcnt)=;

run;