This paper compares five severity systems and two impairment systems in terms of purpose, code structure and use and discusses the reasons for the user modifications to these systems. With global "harmonization" encouraging greater sharing of international data, the paper also presents the relationship of the AIS worldwide to the larger scope of worldwide mortality (ICD-9/10) and US reimbursement (ICD-9-CM/10-CM) classification systems. To resolve compatibility issues resulting from multiple injury systems, the authors propose a "unified" system for global use, configured by inputs from major AIS "data owners", users and analysts. Six key attributes of the unified system are: (1) backward compatibility with historical data through "maps" so no data is lost; (2) "scalable" to allow a simple level of use for developing countries, a more complex level for crash research and a detailed level for clinical hospital use, all with data compatibility; (3) satisfy the needs of the engineering community for injury location information and aspect, and also the clinical requirement for precise injury description; (4) integrated interface for overall severity scores, such as MAIS, ISS and NISS; (5) coordination with other injury data systems such as the ICD-9/10 mortality systems and ICD-9/10-CM reimbursement systems; (6) establish a structured process to maintain and upgrade the system, on a data compatible basis for the 21st century. (A)
Abstract