7.4.2.5 Referrals for Special Procedures/Consultations Team physicians should continue to be authorized to refer individuals for further evaluation and treatment as necessary. 7.4.3 Vital Records A history of mortality and morbidity in the population should be obtained by recording medical information about each examinee’s relatives and acquaintances. This information should include questions about causes of any deaths andillnesses occurring since the last examination to augment existing vital records systems. This is necessary because deaths may occur without medical attention and autopsies are rarely performed. This and other information obtained from examinees abouttheir relatives and acquaintances also can assist on tracking individuals for future follow-up. 7.4.4 Medical Records Medical record data should be recorded in a standardized format, and the records retained by the visiting team with copies made available to the medical department of the Republic of the Marshall Islands. The Department of Energy’s contractor responsible for the medical follow-up of the population should maintain these records. These should be treated as confidential. The records should be microfiimed or copied and a duplicate set kept separately from the original records and retained indefinitely. The records should include illness diagnoses, coded according to the International Classification of Disease, Clinical Medicine, Ninth Revision (ICD-CM-9). Causes of death should be coded according to the International Classification of Disease, Adapted ' for use in the U.S., Ninth Revision (ICDA-9). All information obtained from interviews, laboratory tests, other diagnostic procedures and examinations should be computerized either on-site or in the U.S., to facilitate subsequent summarization and description of the data. 7.4.5 Quality Assurance Data collection forms should be standardized and designed so that interviewers will require 46 yULZ033