Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) (NQF 0083)
-
Initial Patient Population =
- AND: "Patient Characteristic: birth date" >= 18 year(s) starts before start of "Measurement period"
- AND: "Diagnosis, Active: Heart Failure" starts before or during
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
- AND: Count >= 2 of:
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
-
Denominator =
- AND: "Initial Patient Population"
- AND:
- OR: "Diagnostic Study, Result: Ejection Fraction (result < 40 %)" starts before start of
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
- OR: "Diagnostic Study, Result: LVF ASSMT (result < 40 %)" starts before start of
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
- OR: "Diagnosis, Active: Moderate or Severe LVSD" starts before start of
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
- OR: "Diagnosis, Active: Left ventricular systolic dysfunction (severity: 'moderate or severe')" starts before start of
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
-
Denominator Exclusions =
-
Numerator =
- AND:
- OR: "Medication, Active: Beta Blocker Therapy"
- OR: "Medication, Order: Beta Blocker Therapy"
- during "Measurement period"
-
Denominator Exceptions =
- AND:
- OR:
- OR:
- OR: "Medication, Active not done: Medical reason" for "Beta Blocker Therapy RxNorm Value Set"
- OR: "Medication, Active not done: Patient reason" for "Beta Blocker Therapy RxNorm Value Set"
- OR: "Medication, Active not done: System reason" for "Beta Blocker Therapy RxNorm Value Set"
- during "Measurement period"
- OR:
- OR: "Medication, Order not done: Medical reason" for "Beta Blocker Therapy RxNorm Value Set"
- OR: "Medication, Order not done: Patient reason" for "Beta Blocker Therapy RxNorm Value Set"
- OR: "Medication, Order not done: System reason" for "Beta Blocker Therapy RxNorm Value Set"
- during "Measurement period"
- OR:
- OR:
- AND: "Diagnosis, Active: Atrioventricular Block"
- AND NOT: "Diagnosis, Active: Cardiac Pacer in Situ"
- AND NOT: "Device, Applied: Cardiac Pacer"
- OR: "Diagnosis, Active: Arrhythmia"
- OR: "Diagnosis, Active: Hypotension"
- OR: "Diagnosis, Active: Asthma"
- OR: "Medication, Adverse Effects: Beta Blocker Therapy"
- OR: "Medication, Allergy: Beta Blocker Therapy"
- OR: "Medication, Intolerance: Beta Blocker Therapy"
- OR: "Diagnosis, Active: Bradycardia"
- OR: "Procedure, Performed: Cardiac Monitoring"
- OR: "Diagnosis, Active: Atresia and stenosis of aorta"
- starts before or during
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
- OR: IMMEDIATE PRIOR "Physical Exam, Finding: Heart Rate (result < 50 bpm)" starts before start of (CURRENT "Physical Exam,
Finding: Heart Rate (result < 50 bpm)" starts before or during
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
)
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"Device, Applied: Cardiac Pacer" using "Cardiac Pacer SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.303)"
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"Diagnosis, Active: Arrhythmia" using "Arrhythmia Value Set GROUPING (2.16.840.1.113883.3.526.03.366)"
-
"Diagnosis, Active: Asthma" using "Asthma Value Set GROUPING (2.16.840.1.113883.3.526.03.362)"
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"Diagnosis, Active: Atresia and stenosis of aorta" using "Atresia and stenosis of aorta Value Set GROUPING (2.16.840.1.113883.3.526.03.414)"
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"Diagnosis, Active: Atrioventricular Block" using "Atrioventricular Block Value Set GROUPING (2.16.840.1.113883.3.526.03.367)"
-
"Diagnosis, Active: Bradycardia" using "Bradycardia Value Set GROUPING (2.16.840.1.113883.3.526.03.412)"
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"Diagnosis, Active: Cardiac Pacer in Situ" using "Cardiac Pacer in Situ Value Set GROUPING (2.16.840.1.113883.3.526.03.368)"
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"Diagnosis, Active: Heart Failure" using "Heart Failure Value Set GROUPING (2.16.840.1.113883.3.526.03.376)"
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"Diagnosis, Active: Hypotension" using "Hypotension Value Set GROUPING (2.16.840.1.113883.3.526.03.370)"
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"Diagnosis, Active: Left ventricular systolic dysfunction" using "Left ventricular systolic dysfunction SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.859)"
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"Diagnosis, Active: Moderate or Severe LVSD" using "Moderate or Severe LVSD SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.861)"
-
"Diagnostic Study, Result: Ejection Fraction" using "Ejection Fraction SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.29)"
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"Diagnostic Study, Result: LVF ASSMT" using "LVF ASSMT CPT Value Set (2.16.840.1.113883.3.526.02.31)"
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"Encounter: Encounter Nursing Facility" using "Encounter Nursing Facility CPT Value Set (2.16.840.1.113883.3.526.02.28)"
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"Encounter: Encounter Outpatient" using "Encounter Outpatient CPT Value Set (2.16.840.1.113883.3.526.02.26)"
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"Medication, Active: Beta Blocker Therapy" using "Beta Blocker Therapy RxNorm Value Set (2.16.840.1.113883.3.526.02.133)"
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"Medication, Active not done: Medical reason" using "Medical reason SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.313)"
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"Medication, Active not done: Patient reason" using "Patient reason SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.311)"
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"Medication, Active not done: System reason" using "System reason SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.310)"
-
"Medication, Adverse Effects: Beta Blocker Therapy" using "Beta Blocker Therapy RxNorm Value Set (2.16.840.1.113883.3.526.02.133)"
-
"Medication, Allergy: Beta Blocker Therapy" using "Beta Blocker Therapy RxNorm Value Set (2.16.840.1.113883.3.526.02.133)"
-
"Medication, Intolerance: Beta Blocker Therapy" using "Beta Blocker Therapy RxNorm Value Set (2.16.840.1.113883.3.526.02.133)"
-
"Medication, Order: Beta Blocker Therapy" using "Beta Blocker Therapy RxNorm Value Set (2.16.840.1.113883.3.526.02.133)"
-
"Medication, Order not done: Medical reason" using "Medical reason SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.313)"
-
"Medication, Order not done: Patient reason" using "Patient reason SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.311)"
-
"Medication, Order not done: System reason" using "System reason SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.310)"
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"Patient Characteristic: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"
-
"Physical Exam, Finding: Heart Rate" using "Heart Rate SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.409)"
-
"Procedure, Performed: Cardiac Monitoring" using "Cardiac Monitoring SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.267)"
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Attribute: "Severity: Moderate or severe" using "Moderate or severe SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.860)"
- "Patient Characteristic: Gender" using "Gender HL7 Value Set (2.16.840.1.113883.1.11.1)"
- "Patient Characteristic: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"
- "Patient Characteristic: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"
- "Patient Characteristic: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.113883.3.221.5)"