{ "_id": "5a0358bf5cc97599cd0e5597", "bundle_id": "59e902355cc97506a2000001", "category": "Miscellaneous", "cms_id": "CMS13v2", "complexity": { "variables": [ { "name": "Patient", "complexity": 1 }, { "name": "SDE Ethnicity", "complexity": 1 }, { "name": "SDE Payer", "complexity": 1 }, { "name": "SDE Race", "complexity": 1 }, { "name": "SDE Sex", "complexity": 1 }, { "name": "Antithrombotic Not Given at Discharge", "complexity": 2 }, { "name": "Antithrombotic Therapy at Discharge", "complexity": 0 }, { "name": "Intervention Comfort Measures", "complexity": 1 }, { "name": "Comfort Measures during Hospitalization", "complexity": 1 }, { "name": "Denominator", "complexity": 1 }, { "name": "Denominator Exceptions", "complexity": 1 }, { "name": "Denominator Exclusions", "complexity": 1 }, { "name": "Initial Population", "complexity": 1 }, { "name": "Numerator", "complexity": 1 }, { "name": "Patient", "complexity": 1 }, { "name": "Non Elective Inpatient Encounter", "complexity": 2 }, { "name": "Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke", "complexity": 2 }, { "name": "Encounter with Principal Diagnosis and Age", "complexity": 1 }, { "name": "Encounter with Principal Diagnosis of Ischemic Stroke", "complexity": 1 }, { "name": "Inpatient Encounter", "complexity": 2 }, { "name": "Ischemic Stroke Encounters with Discharge Status and Comfort Measure Exclusions", "complexity": 1 }, { "name": "Patient", "complexity": 1 }, { "name": "ToDate", "complexity": 1 }, { "name": "CalendarAgeInYearsAt", "complexity": 1 }, { "name": "CalendarAgeInMonthsAt", "complexity": 1 }, { "name": "CalendarAgeInDaysAt", "complexity": 1 }, { "name": "CalendarAgeInYears", "complexity": 1 }, { "name": "CalendarAgeInMonths", "complexity": 1 }, { "name": "CalendarAgeInDays", "complexity": 1 }, { "name": "TotalLengthOfStay", "complexity": 1 }, { "name": "Hospitalization", "complexity": 0 }, { "name": "LengthInDays", "complexity": 1 } ] }, "continuous_variable": false, "cql": [ "library Test104 version '2.0.004'\r\n\r\nusing QDM version '5.3'\r\n\r\ninclude MATGlobalCommonFunctions version '2.0.000' called global\r\ninclude TJC_Overall version '7.0.000' called TJC\r\n\r\nvalueset \"ONC Administrative Sex\": 'urn:oid:2.16.840.1.113762.1.4.1'\r\nvalueset \"Race\": 'urn:oid:2.16.840.1.114222.4.11.836'\r\nvalueset \"Ethnicity\": 'urn:oid:2.16.840.1.114222.4.11.837'\r\nvalueset \"Payer\": 'urn:oid:2.16.840.1.114222.4.11.3591'\r\nvalueset \"Comfort Measures\": 'urn:oid:1.3.6.1.4.1.33895.1.3.0.45'\r\nvalueset \"Antithrombotic Therapy\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.201'\r\nvalueset \"Patient Expired\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.309'\r\nvalueset \"Left Against Medical Advice\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.308'\r\nvalueset \"Discharged to Health Care Facility for Hospice Care\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.207'\r\nvalueset \"Discharge To Acute Care Facility\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.87'\r\nvalueset \"Discharged to Home for Hospice Care\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.209'\r\nvalueset \"Medical Reason\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.473'\r\nvalueset \"Patient Refusal\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.93'\r\n\r\ncontext Patient\r\n\r\ndefine \"SDE Ethnicity\":\r\n\t[\"Patient Characteristic Ethnicity\": \"Ethnicity\"]\r\n\r\ndefine \"SDE Payer\":\r\n\t[\"Patient Characteristic Payer\": \"Payer\"]\r\n\r\ndefine \"SDE Race\":\r\n\t[\"Patient Characteristic Race\": \"Race\"]\r\n\r\ndefine \"SDE Sex\":\r\n\t[\"Patient Characteristic Sex\": \"ONC Administrative Sex\"]\r\n\r\ndefine \"Antithrombotic Not Given at Discharge\":\r\n\t[\"Medication, Not Discharged\": \"Antithrombotic Therapy\"] Antithrombotic\r\n\t\twhere Antithrombotic.negationRationale in \"Medical Reason\"\r\n\t\t\tor Antithrombotic.negationRationale in \"Patient Refusal\"\r\n\r\ndefine \"Antithrombotic Therapy at Discharge\":\r\n\t[\"Medication, Discharge\": \"Antithrombotic Therapy\"] Antithrombotic\n\n/*testing hospitalization function*/\r\n\r\ndefine \"Comfort Measures during Hospitalization\":\r\n\tTJC.\"Encounter with Principal Diagnosis of Ischemic Stroke\" NonElectiveEncounter\r\n\t\twith \"Intervention Comfort Measures\" ComfortMeasure\r\n\t\t\tsuch that Coalesce(start of ComfortMeasure.relevantPeriod, ComfortMeasure.authorDatetime)during global.\"Hospitalization\"(NonElectiveEncounter)\r\n\r\ndefine \"Denominator\":\r\n\tTJC.\"Encounter with Principal Diagnosis of Ischemic Stroke\"\r\n\r\ndefine \"Denominator Exceptions\":\r\n\tTJC.\"Encounter with Principal Diagnosis of Ischemic Stroke\" Encounter\r\n\t\twith \"Antithrombotic Not Given at Discharge\" Antithrombotic\r\n\t\t\tsuch that Antithrombotic.authorDatetime during Encounter.relevantPeriod\r\n\r\ndefine \"Denominator Exclusions\":\r\n\tdistinct((TJC.\"Encounter with Principal Diagnosis of Ischemic Stroke\" Encounter\r\n\t\t\t\twhere Encounter.dischargeDisposition in \"Discharge To Acute Care Facility\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Left Against Medical Advice\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Patient Expired\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Discharged to Home for Hospice Care\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Discharged to Health Care Facility for Hospice Care\"\r\n\t\t)\r\n\t\t\tunion \"Comfort Measures during Hospitalization\"\r\n\t)\r\n\r\ndefine \"Initial Population\":\r\n\tTJC.\"Encounter with Principal Diagnosis and Age\"\r\n\r\ndefine \"Intervention Comfort Measures\":\r\n\t[\"Intervention, Performed\": \"Comfort Measures\"]\r\n\t\tunion [\"Intervention, Order\": \"Comfort Measures\"]\r\n\r\ndefine \"Numerator\":\r\n\tTJC.\"Encounter with Principal Diagnosis of Ischemic Stroke\" Encounter\r\n\t\twith \"Antithrombotic Therapy at Discharge\" Antithrombotic\r\n\t\t\tsuch that Antithrombotic.authorDatetime during Encounter.relevantPeriod\r\n", "library TJC_Overall version '7.0.000'\r\n\r\nusing QDM version '5.3'\r\n\r\ninclude MATGlobalCommonFunctions version '2.0.000' called global\r\n\r\ncodesystem \"LOINC:2.46\": 'urn:oid:2.16.840.1.113883.6.1' version 'urn:hl7:version:2.46'\r\ncodesystem \"SNOMEDCT:2016-03\": 'urn:oid:2.16.840.1.113883.6.96' version 'urn:hl7:version:2016-03'\r\n\r\nvalueset \"Encounter Inpatient\": 'urn:oid:2.16.840.1.113883.3.666.5.307'\r\nvalueset \"Non-Elective Inpatient Encounter\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.424'\r\nvalueset \"Ischemic Stroke\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.247'\r\nvalueset \"Hemorrhagic Stroke\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.212'\r\nvalueset \"Comfort Measures\": 'urn:oid:1.3.6.1.4.1.33895.1.3.0.45'\r\nvalueset \"Emergency Department Visit\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.292'\r\nvalueset \"Left Against Medical Advice\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.308'\r\nvalueset \"Discharged to Health Care Facility for Hospice Care\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.207'\r\nvalueset \"Patient Expired\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.309'\r\nvalueset \"Discharge To Acute Care Facility\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.87'\r\nvalueset \"Discharged to Home for Hospice Care\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.209'\r\n\r\ncode \"Birthdate\": '21112-8' from \"LOINC:2.46\" display 'Birth date'\r\ncode \"Dead\": '419099009' from \"SNOMEDCT:2016-03\" display 'Dead'\r\n\r\nparameter \"Measurement Period\" Interval\r\n\r\ncontext Patient\r\n\r\ndefine \"Encounter with Principal Diagnosis and Age\":\r\n\t\"Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke\" NonElectiveEncounter\r\n\t\twith [\"Patient Characteristic Birthdate\"] P\r\n\t\t\tsuch that global.\"CalendarAgeInYearsAt\"(P.birthDatetime, start of NonElectiveEncounter.relevantPeriod)>= 18\r\n\r\ndefine \"Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke\":\r\n\t\"Non Elective Inpatient Encounter\" NonElectiveEncounter\r\n\t\twhere NonElectiveEncounter.principalDiagnosis in \"Hemorrhagic Stroke\"\r\n\t\t\tor NonElectiveEncounter.principalDiagnosis in \"Ischemic Stroke\"\r\n\r\ndefine \"Encounter with Principal Diagnosis of Ischemic Stroke\":\r\n\t\"Encounter with Principal Diagnosis and Age\" NonElectiveEncounter\r\n\t\twhere NonElectiveEncounter.principalDiagnosis in \"Ischemic Stroke\"\r\n\r\ndefine \"Inpatient Encounter\":\r\n\t[\"Encounter, Performed\": \"Encounter Inpatient\"] Encounter\r\n\t\twhere Encounter.lengthOfStay <= 120 days\r\n\t\t\tand Encounter.relevantPeriod ends during \"Measurement Period\"\r\n\r\ndefine \"Ischemic Stroke Encounters with Discharge Status and Comfort Measure Exclusions\":\r\n\tdistinct((\"Encounter with Principal Diagnosis of Ischemic Stroke\" Encounter\r\n\t\t\t\twhere Encounter.dischargeDisposition in \"Discharge To Acute Care Facility\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Left Against Medical Advice\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Patient Expired\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Discharged to Home for Hospice Care\"\r\n\t\t\t\t\tor Encounter.dischargeDisposition in \"Discharged to Health Care Facility for Hospice Care\"\r\n\t\t)\r\n\t)\r\n\r\ndefine \"Non Elective Inpatient Encounter\":\r\n\t[\"Encounter, Performed\": \"Non-Elective Inpatient Encounter\"] NonElectiveEncounter\r\n\t\twhere NonElectiveEncounter.lengthOfStay <= 120 days\r\n\t\t\tand NonElectiveEncounter.relevantPeriod ends during \"Measurement Period\"\r\n", "library MATGlobalCommonFunctions version '2.0.000'\r\n\r\nusing QDM version '5.3'\r\n\r\ncodesystem \"LOINC:2.46\": 'urn:oid:2.16.840.1.113883.6.1' version 'urn:hl7:version:2.46'\r\ncodesystem \"SNOMEDCT:2016-03\": 'urn:oid:2.16.840.1.113883.6.96' version 'urn:hl7:version:2016-03'\r\n\r\nvalueset \"Emergency Department Visit\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.292'\r\n\r\ncode \"Birthdate\": '21112-8' from \"LOINC:2.46\" display 'Birth date'\r\ncode \"Dead\": '419099009' from \"SNOMEDCT:2016-03\" display 'Dead'\r\n\r\nparameter \"Measurement Period\" Interval\r\n\r\ncontext Patient\n\n/*CalendarAgeInYearsAt calculates the calendar age (meaning the age without\nconsidering time components) in years.*/\r\n\r\ndefine function \"CalendarAgeInYearsAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tyears between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInMonthsAt calculates the calendar age (meaning the age without considering time components) in months.*/\r\n\r\ndefine function \"CalendarAgeInMonthsAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tmonths between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInDaysAt calculates the calendar age (meaning the age without\nconsidering time components) in days.*/\r\n\r\ndefine function \"CalendarAgeInDaysAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tdays between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInYears calculates the calendar age (meaning the age without\nconsidering time components) in years as of today.*/\r\n\r\ndefine function \"CalendarAgeInYears\"(BirthDateTime DateTime):\r\n\tCalendarAgeInYearsAt(BirthDateTime, Today())\n\n/*CalendarAgeInMonths calculates the calendar age (meaning the age without\nconsidering time components) in months as of today.*/\r\n\r\ndefine function \"CalendarAgeInMonths\"(BirthDateTime DateTime):\r\n\tCalendarAgeInMonthsAt(BirthDateTime, Today())\n\n/*CalendarAgeInDays calculates the calendar age (meaning the age without\nconsidering time components) in days as of today.*/\r\n\r\ndefine function \"CalendarAgeInDays\"(BirthDateTime DateTime):\r\n\tCalendarAgeInDaysAt(BirthDateTime, Today())\n\n/*TotalLengthOfStay calculates the difference in calendar days between the\nstart and end of the given stay interval.*/\r\n\r\ndefine function \"TotalLengthOfStay\"(Stay Interval):\r\n\tdifference in days between start of Stay and end of Stay\n\n/*Hospitalization returns the total interval for admission to discharge for\nthe given encounter, or for the admission of any immediately prior emergency \ndepartment visit to the discharge of the given encounter.*/\r\n\r\ndefine function \"Hospitalization\"(Encounter \"Encounter, Performed\"):\r\n\t( singleton from ( [\"Encounter, Performed\": \"Emergency Department Visit\"] EDVisit\r\n\t\t\twhere EDVisit.relevantPeriod ends 1 hour or less on or before start of Encounter.relevantPeriod\r\n\t) ) X\r\n\t\treturn if X is null then Encounter.relevantPeriod else Interval[start of X.relevantPeriod, end of Encounter.relevantPeriod]\n\n/*ToDate takes a given DateTime value and returns a DateTime with the time components \"zeroed\", and the timezone of the input value. For example,\ngiven the DateTime @2012-01-01T06:30:00.0Z, this function will return\n@2012-01-01T00:00:00.0Z.*/\r\n\r\ndefine function \"ToDate\"(Value DateTime):\r\n\tDateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)\n\n/*calculates the difference in calendar days between the start and end of the given interval.*/\r\n\r\ndefine function \"LengthInDays\"(Value Interval):\r\n\tdifference in days between start of Value and end of Value\r\n" ], "cql_statement_dependencies": { "Test104": { "Patient": [ ], "SDE Ethnicity": [ ], "SDE Payer": [ ], "SDE Race": [ ], "SDE Sex": [ ], "Antithrombotic Not Given at Discharge": [ ], "Antithrombotic Therapy at Discharge": [ ], "Intervention Comfort Measures": [ ], "Comfort Measures during Hospitalization": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis of Ischemic Stroke" }, { "library_name": "Test104", "statement_name": "Intervention Comfort Measures" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "Hospitalization" } ], "Denominator": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis of Ischemic Stroke" } ], "Denominator Exceptions": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis of Ischemic Stroke" }, { "library_name": "Test104", "statement_name": "Antithrombotic Not Given at Discharge" } ], "Denominator Exclusions": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis of Ischemic Stroke" }, { "library_name": "Test104", "statement_name": "Comfort Measures during Hospitalization" } ], "Initial Population": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis and Age" } ], "Numerator": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis of Ischemic Stroke" }, { "library_name": "Test104", "statement_name": "Antithrombotic Therapy at Discharge" } ] }, "TJC_Overall": { "Encounter with Principal Diagnosis of Ischemic Stroke": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis and Age" } ], "Encounter with Principal Diagnosis and Age": [ { "library_name": "TJC_Overall", "statement_name": "Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke" }, { "library_name": "MATGlobalCommonFunctions", "statement_name": "CalendarAgeInYearsAt" } ], "Encounter with Principal Diagnosis of Hemorrhagic or Ischemic Stroke": [ { "library_name": "TJC_Overall", "statement_name": "Non Elective Inpatient Encounter" } ], "Non Elective Inpatient Encounter": [ ] }, "MATGlobalCommonFunctions": { "CalendarAgeInYearsAt": [ { "library_name": "MATGlobalCommonFunctions", "statement_name": "ToDate" } ], "ToDate": [ ], "Hospitalization": [ ] } }, "created_at": "2017-11-08T19:19:27.746Z", "data_criteria": { "Payer_PatientCharacteristicPayer_bef27782_815f_43a3_b97e_3ecdb7616d4f": { "title": "Payer", "description": "Patient Characteristic Payer: Payer", "code_list_id": "2.16.840.1.114222.4.11.3591", "property": "payer", "type": "characteristic", "definition": "patient_characteristic_payer", "hard_status": false, "negation": false, "source_data_criteria": "Payer_PatientCharacteristicPayer_bef27782_815f_43a3_b97e_3ecdb7616d4f_source", "variable": false, "inline_code_list": { "Source of Payment Typology": [ "1", "11", "111", "112", "113", "119", "12", "121", "122", "123", "129", "13", "14", "19", "191", "2", "21", "211", "212", "213", "219", "22", "23", "24", "25", "26", "29", "291", "3", "31", "311", "3111", "3112", "3113", "3114", "3115", "3116", "3119", "312", "3121", "3122", "3123", "313", "32", "321", "3211", "3212", "32121", "32122", "32123", "32124", "32125", "32126", "322", "3221", "3222", "3223", "3229", "33", "331", "332", "333", "334", "34", "341", "342", "343", "349", "35", "36", "361", "362", "369", "37", "371", "3711", "3712", "3713", "372", "379", "38", "381", "3811", "3812", "3813", "3819", "382", "389", "39", "4", "41", "42", "43", "44", "5", "51", "511", "512", "513", "514", "515", "516", "519", "52", "521", "522", "523", "529", "53", "54", "55", "56", "561", "562", "59", "6", "61", "611", "612", "613", "619", "62", "63", "64", "69", "7", "71", "72", "73", "79", "8", "81", "82", "821", "822", "823", "83", "84", "85", "89", "9", "91", "92", "93", "94", "95", "951", "953", "954", "959", "96", "97", "98", "99", "9999" ] } }, "ComfortMeasures_InterventionPerformed_e1e87ad5_fabe_4618_903e_ed0ff64fcac1": { "title": "ComfortMeasures", "description": "Intervention, Performed: ComfortMeasures", "code_list_id": "1.3.6.1.4.1.33895.1.3.0.45", "type": "interventions", "definition": "intervention", "status": "performed", "hard_status": false, "negation": false, "source_data_criteria": "ComfortMeasures_InterventionPerformed_e1e87ad5_fabe_4618_903e_ed0ff64fcac1_source", "variable": false }, "ComfortMeasures_InterventionOrder_e1e87ad5_fabe_4618_903e_ed0ff64fcac1": { "title": "ComfortMeasures", "description": "Intervention, Order: ComfortMeasures", "code_list_id": "1.3.6.1.4.1.33895.1.3.0.45", "type": "interventions", "definition": "intervention", "status": "ordered", "hard_status": true, "negation": false, "source_data_criteria": "ComfortMeasures_InterventionOrder_e1e87ad5_fabe_4618_903e_ed0ff64fcac1_source", "variable": false }, "Ethnicity_PatientCharacteristicEthnicity_7a73d38a_a9a6_44c4_8021_661e3a074892": { "title": "Ethnicity", "description": "Patient Characteristic Ethnicity: Ethnicity", "code_list_id": "2.16.840.1.114222.4.11.837", "property": "ethnicity", "type": "characteristic", "definition": "patient_characteristic_ethnicity", "hard_status": false, "negation": false, "source_data_criteria": "Ethnicity_PatientCharacteristicEthnicity_7a73d38a_a9a6_44c4_8021_661e3a074892_source", "variable": false, "inline_code_list": { "CDC Race": [ "2135-2", "2186-5" ] } }, "ONCAdministrativeSex_PatientCharacteristicSex_b22c441a_3195_49f8_9004_fd5c93125d50": { "title": "ONCAdministrativeSex", "description": "Patient Characteristic Sex: ONCAdministrativeSex", "code_list_id": "2.16.840.1.113762.1.4.1", "property": "gender", "type": "characteristic", "definition": "patient_characteristic_gender", "hard_status": false, "negation": false, "source_data_criteria": "ONCAdministrativeSex_PatientCharacteristicSex_b22c441a_3195_49f8_9004_fd5c93125d50_source", "variable": false, "value": { "type": "CD", "system": "Administrative Sex", "code": "F" } }, "Non_ElectiveInpatientEncounter_EncounterPerformed_61e3c371_09df_4283_9098_cd37f778bdbb": { "title": "Non-ElectiveInpatientEncounter", "description": "Encounter, Performed: Non-ElectiveInpatientEncounter", "code_list_id": "2.16.840.1.113883.3.117.1.7.1.424", "type": "encounters", "definition": "encounter", "status": "performed", "hard_status": false, "negation": false, "source_data_criteria": "Non_ElectiveInpatientEncounter_EncounterPerformed_61e3c371_09df_4283_9098_cd37f778bdbb_source", "variable": false }, "Race_PatientCharacteristicRace_eea84021_fbeb_454e_8ec3_27f0a7b22243": { "title": "Race", "description": "Patient Characteristic Race: Race", "code_list_id": "2.16.840.1.114222.4.11.836", "property": "race", "type": "characteristic", "definition": "patient_characteristic_race", "hard_status": false, "negation": false, "source_data_criteria": "Race_PatientCharacteristicRace_eea84021_fbeb_454e_8ec3_27f0a7b22243_source", "variable": false, "inline_code_list": { "CDC Race": [ "1002-5", "2028-9", "2054-5", "2076-8", "2106-3", "2131-1" ] } }, "EmergencyDepartmentVisit_EncounterPerformed_22570436_105f_4bb7_99e6_aeb7eae2c10d": { "title": "EmergencyDepartmentVisit", "description": "Encounter, Performed: EmergencyDepartmentVisit", "code_list_id": "2.16.840.1.113883.3.117.1.7.1.292", "type": "encounters", "definition": "encounter", "status": "performed", "hard_status": false, 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All rights reserved.", "name": "Copyright", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "COPY", "title": "Copyright" }, "value_obj": { "type": "ED", "value": "Measure specifications are in the Public Domain\n\nLOINC(R) is a registered trademark of the Regenstrief Institute.\n\nThis material contains SNOMED Clinical Terms (R) (SNOMED CT(C)) copyright 2004-2016 International Health Terminology Standards Development Organization. All rights reserved.", "media_type": "text/plain" } }, { "code": "DISC", "value": "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. 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Anticoagulation therapy is not generally recommended for secondary stroke prevention in patients presumed to have a non-cardioembolic stroke.\nAnticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.", "name": "Rationale", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "RAT", "title": "Rationale" }, "value_obj": { "type": "ED", "value": "The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist.\n\nFor patients with a stroke due to a cardioembolic source (eg atrial fibrillation, mechanical heart valve), warfarin is recommended unless contraindicated. In recent years, novel oral anticoagulant agents (NOACs) have been developed and approved by the U.S. Food and Drug Administration (FDA) for stroke prevention, and may be considered as an alternative to warfarin for select patients. Anticoagulation therapy is not generally recommended for secondary stroke prevention in patients presumed to have a non-cardioembolic stroke.\nAnticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.", "media_type": "text/plain" } }, { "code": "CRS", "value": "Clinical trial results suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist", "name": "Clinical Recommendation Statement", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "CRS", "title": "Clinical Recommendation Statement" }, "value_obj": { "type": "ED", "value": "Clinical trial results suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist", "media_type": "text/plain" } }, { "code": "IDUR", "value": "Improvement noted as an increase in rate", "name": "Improvement Notation", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "IDUR", "title": "Improvement Notation" }, "value_obj": { "type": "ED", "value": "Improvement noted as an increase in rate", "media_type": "text/plain" } }, { "code": "REF", "value": "Adams HP, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks E. Guidelines for the Early Management of Adults with Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical CardiologyCouncil, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke. 2007;38:1655-1711.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Adams HP, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks E. Guidelines for the Early Management of Adults with Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical CardiologyCouncil, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke. 2007;38:1655-1711.", "media_type": "text/plain" } }, { "code": "REF", "value": "Adams H, Adams R, Del Zoppo G, Goldstein LB. Guidelines for the Early Management of Patients With Ischemic Stroke: Guidelines Update A Scientific Statement From the Stroke Council of the American Heart Association/American Stroke Association. Stroke Vol. 36, 2005: 916:923.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Adams H, Adams R, Del Zoppo G, Goldstein LB. Guidelines for the Early Management of Patients With Ischemic Stroke: Guidelines Update A Scientific Statement From the Stroke Council of the American Heart Association/American Stroke Association. Stroke Vol. 36, 2005: 916:923.", "media_type": "text/plain" } }, { "code": "REF", "value": "Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and Thrombolytic Therapy for Ischemic Stroke. Chest Vol. 119, 2001: 300-320.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and Thrombolytic Therapy for Ischemic Stroke. Chest Vol. 119, 2001: 300-320.", "media_type": "text/plain" } }, { "code": "REF", "value": "Brott TG, Clark WM, Grotta JC, et al. Stroke the first hours. Guidelines for acute treatment. Consensus Statement. National Stroke Association. 2000.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Brott TG, Clark WM, Grotta JC, et al. Stroke the first hours. Guidelines for acute treatment. Consensus Statement. National Stroke Association. 2000.", "media_type": "text/plain" } }, { "code": "REF", "value": "Chen ZM, Sandercock P, Pan HC, et al. Indications for early aspirin use in acute ischemic stroke: a combined analysis of 40,000 randomized patients from the Chinese acute stroke trial and the international stroke trial. On behalf of the CAST and IST collaborative groups, Stroke 2000;31:1240-1249.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Chen ZM, Sandercock P, Pan HC, et al. Indications for early aspirin use in acute ischemic stroke: a combined analysis of 40,000 randomized patients from the Chinese acute stroke trial and the international stroke trial. On behalf of the CAST and IST collaborative groups, Stroke 2000;31:1240-1249.", "media_type": "text/plain" } }, { "code": "REF", "value": "Coull BM, Williams LS, Goldstein LB, et al. Anticoagulants and Antiplatelet Agents in Acute Ischemic Stroke. Report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a Division of the American Heart Association) Stroke. 2002;33:1934 - 1942.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Coull BM, Williams LS, Goldstein LB, et al. Anticoagulants and Antiplatelet Agents in Acute Ischemic Stroke. Report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a Division of the American Heart Association) Stroke. 2002;33:1934 - 1942.", "media_type": "text/plain" } }, { "code": "REF", "value": "Guideline on the Use of Aspirin as Secondary Prophylaxis for Vascular Disease in Primary Care, Centre for Health Services Research University of Newcastle upon Tyne, & Centre for Health Economics of York, 1998.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Guideline on the Use of Aspirin as Secondary Prophylaxis for Vascular Disease in Primary Care, Centre for Health Services Research University of Newcastle upon Tyne, & Centre for Health Economics of York, 1998.", "media_type": "text/plain" } }, { "code": "REF", "value": "Kernan, W.N., B. Ovbiagele, H. R. Black, D. M. Bravata, M. I. Chimowitz, M. D. Ezekowitz, M. C. Fang, M. Fisher, K. L. Furie, D. V. Heck, S. C. Johnston, S. E. Kasner, S. J. Kittner, P. H. Mitchell, M. W. Rich, D. Richardson, L. H. Schwamm, J. A. Wilson. \"Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [in eng.] Stroke 45, no. 7 (May 2014): 2160-223.", "name": "Reference", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "REF", "title": "Reference" }, "value_obj": { "type": "ED", "value": "Kernan, W.N., B. Ovbiagele, H. R. Black, D. M. Bravata, M. I. Chimowitz, M. D. Ezekowitz, M. C. Fang, M. Fisher, K. L. Furie, D. V. Heck, S. C. Johnston, S. E. Kasner, S. J. Kittner, P. H. Mitchell, M. W. Rich, D. Richardson, L. H. Schwamm, J. A. Wilson. \"Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [in eng.] Stroke 45, no. 7 (May 2014): 2160-223.", "media_type": "text/plain" } }, { "code": "DEF", "value": "None", "name": "Definition", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DEF", "title": "Definition" }, "value_obj": { "type": "ED", "value": "None", "media_type": "text/plain" } }, { "code": "GUIDE", "value": "The \"Non-elective Inpatient Encounter\" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the \"Inpatient encounter\" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.\n\nThe \"Medication, Discharge\" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.", "name": "Guidance", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "GUIDE", "title": "Guidance" }, "value_obj": { "type": "ED", "value": "The \"Non-elective Inpatient Encounter\" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the \"Inpatient encounter\" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.\n\nThe \"Medication, Discharge\" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.", "media_type": "text/plain" } }, { "code": "TRANF", "value": "TBD", "name": "Transmission Format", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "TRANF", "title": "Transmission Format" }, "value_obj": { "type": "ED", "value": "TBD", "media_type": "text/plain" } }, { "code": "IPOP", "value": "Patients age 18 and older discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends during the measurement period", "name": "Initial Population", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "IPOP", "title": "Initial Population" }, "value_obj": { "type": "ED", "value": "Patients age 18 and older discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends during the measurement period", "media_type": "text/plain" } }, { "code": "DENOM", "value": "Patients with a principal diagnosis of Ischemic stroke", "name": "Denominator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENOM", "title": "Denominator" }, "value_obj": { "type": "ED", "value": "Patients with a principal diagnosis of Ischemic stroke", "media_type": "text/plain" } }, { "code": "DENEX", "value": "*Patients with comfort measures documented\n*Patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations.\n*Patients discharged to another hospital\n*Patients who left against medical advice\n*Patients who expired\n*Patients discharged to home for hospice care\n*Patients discharged to a health care facility for hospice care", "name": "Denominator Exclusions", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENEX", "title": "Denominator Exclusions" }, "value_obj": { "type": "ED", "value": "*Patients with comfort measures documented\n*Patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations.\n*Patients discharged to another hospital\n*Patients who left against medical advice\n*Patients who expired\n*Patients discharged to home for hospice care\n*Patients discharged to a health care facility for hospice care", "media_type": "text/plain" } }, { "code": "NUMER", "value": "Patients prescribed or continuing to take antithrombotic therapy at hospital discharge", "name": "Numerator", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "NUMER", "title": "Numerator" }, "value_obj": { "type": "ED", "value": "Patients prescribed or continuing to take antithrombotic therapy at hospital discharge", "media_type": "text/plain" } }, { "code": "NUMEX", "value": "Not Applicable", "name": "Numerator Exclusions", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "NUMEX", "title": "Numerator Exclusions" }, "value_obj": { "type": "ED", "value": "Not Applicable", "media_type": "text/plain" } }, { "code": "DENEXCEP", "value": "Patients with a documented reason for not prescribing antithrombotic therapy at discharge", "name": "Denominator Exceptions", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "DENEXCEP", "title": "Denominator Exceptions" }, "value_obj": { "type": "ED", "value": "Patients with a documented reason for not prescribing antithrombotic therapy at discharge", "media_type": "text/plain" } }, { "code": "SDE", "value": "For every patient evaluated by this measure also identify payer, race, ethnicity, and sex", "name": "Supplemental Data Elements", "code_obj": { "type": "CD", "system": "2.16.840.1.113883.5.4", "code": "SDE", "title": "Supplemental Data Elements" }, "value_obj": { "type": "ED", "value": "For every patient evaluated by this measure also identify payer, race, ethnicity, and sex", "media_type": "text/plain" } } ], "measure_id": "40280582-5DD7-3595-015E-29268F9D0B02", "measure_period": { "type": "IVL_TS", "low": { "type": "TS", "value": "201201010000", "inclusive?": true, "derived?": false }, "high": { "type": "TS", "value": "201212312359", "inclusive?": true, "derived?": false }, "width": { "type": "PQ", "unit": "a", "value": "1", "inclusive?": true, "derived?": false } }, "needs_finalize": false, "observations": [ ], "population_criteria": { "IPP": { "conjunction?": true, "type": "IPP", "hqmf_id": "37E39C61-6AA1-43EB-B6C7-CAB240B113A6", "preconditions": [ { "id": 2, "preconditions": [ { "id": 1, "reference": "Test104__Initial_Population__CEA13D81_C3AB_4B19_8B93_137EBDB9DDA7" } ], "conjunction_code": "allTrue" } ] }, "DENOM": { "conjunction?": true, "type": "DENOM", "hqmf_id": "53675D1E-CEA8-49EE-A5BC-98BA1FA2EBDB", "preconditions": [ { "id": 4, "preconditions": [ { "id": 3, "reference": "Test104__Denominator__CEA13D81_C3AB_4B19_8B93_137EBDB9DDA7" } ], "conjunction_code": "allTrue" } ] }, "NUMER": { "conjunction?": true, "type": "NUMER", "hqmf_id": "6B816917-46C3-4439-A762-5539ADC1921D", "preconditions": [ { "id": 6, "preconditions": [ { "id": 5, "reference": "Test104__Numerator__CEA13D81_C3AB_4B19_8B93_137EBDB9DDA7" } ], "conjunction_code": "allTrue" } ] }, "DENEXCEP": { "conjunction?": true, "type": "DENEXCEP", "hqmf_id": "83F6613E-3B28-4ED2-8261-FCA17A6FE055", "preconditions": [ { "id": 8, "preconditions": [ { "id": 7, "reference": "Test104__Denominator_Exceptions__CEA13D81_C3AB_4B19_8B93_137EBDB9DDA7" } ], "conjunction_code": "atLeastOneTrue" } ] }, "DENEX": { "conjunction?": true, "type": "DENEX", "hqmf_id": "F422F037-B79B-4BAE-A81E-D2398DFEE479", "preconditions": [ { "id": 10, "preconditions": [ { "id": 9, "reference": "Test104__Denominator_Exclusions__CEA13D81_C3AB_4B19_8B93_137EBDB9DDA7" } ], "conjunction_code": "atLeastOneTrue" } ] } }, "populations": [ { "IPP": "IPP", "DENOM": "DENOM", "NUMER": "NUMER", "DENEXCEP": "DENEXCEP", "DENEX": "DENEX", "id": "PopulationCriteria1", "title": "Population Criteria Section" } ], "populations_cql_map": { "IPP": [ "Initial Population" ], "DENOM": [ "Denominator" ], "DENEX": [ "Denominator Exclusions" ], "DENEXCEP": [ "Denominator Exceptions" ], "NUMER": [ "Numerator" ] }, "publish_date": null, "published": null, "record_ids": [ ], "source_data_criteria": { "Payer_PatientCharacteristicPayer_bef27782_815f_43a3_b97e_3ecdb7616d4f_source": { "title": "Payer", "description": "Patient Characteristic Payer: Payer", "code_list_id": "2.16.840.1.114222.4.11.3591", "property": "payer", "type": "characteristic", "definition": "patient_characteristic_payer", "hard_status": false, "negation": false, "source_data_criteria": "Payer_PatientCharacteristicPayer_bef27782_815f_43a3_b97e_3ecdb7616d4f_source", "variable": false, "inline_code_list": { "Source of Payment Typology": [ "1", "11", "111", "112", "113", "119", "12", "121", "122", "123", "129", "13", "14", "19", "191", "2", "21", "211", "212", "213", "219", "22", "23", "24", "25", "26", "29", "291", "3", "31", "311", "3111", 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"Non_ElectiveInpatientEncounter_EncounterPerformed_61e3c371_09df_4283_9098_cd37f778bdbb_source": { "title": "Non-ElectiveInpatientEncounter", "description": "Encounter, Performed: Non-ElectiveInpatientEncounter", "code_list_id": "2.16.840.1.113883.3.117.1.7.1.424", "type": "encounters", "definition": "encounter", "status": "performed", "hard_status": false, "negation": false, "source_data_criteria": "Non_ElectiveInpatientEncounter_EncounterPerformed_61e3c371_09df_4283_9098_cd37f778bdbb_source", "variable": false }, "Race_PatientCharacteristicRace_eea84021_fbeb_454e_8ec3_27f0a7b22243_source": { "title": "Race", "description": "Patient Characteristic Race: Race", "code_list_id": "2.16.840.1.114222.4.11.836", "property": "race", "type": "characteristic", "definition": "patient_characteristic_race", "hard_status": false, "negation": false, "source_data_criteria": "Race_PatientCharacteristicRace_eea84021_fbeb_454e_8ec3_27f0a7b22243_source", "variable": false, "inline_code_list": { "CDC 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