Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy
for Patients with CAD and Diabetes and/or Left Ventricular Systolic Dysfunction (LVSD) (NQF 0066)
-
Initial Patient Population =
- AND: "Patient Characteristic: birth date" >= 18 year(s) starts before start of "Measurement period"
- AND:
- OR: "Diagnosis, Active: Coronary Artery Disease includes MI"
- OR: "Procedure, Performed: Cardiac Surgery"
- 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"
- OR: "Diagnosis, Active: Diabetes Mellitus and Diabetic Complications" starts before or during
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
-
Denominator Exclusions =
-
Numerator =
- AND:
- OR: "Medication, Order: ACE inhibitor or ARB"
- OR: "Medication, Active: ACE inhibitor or ARB"
- during "Measurement period"
-
Denominator Exceptions =
- AND:
- OR:
- OR:
- OR: "Medication, Order not done: Patient reason for ACE inhibitor or ARB decline" for "ACE inhibitor or ARB RxNorm Value Set"
- OR: "Medication, Order not done: Patient reason" for "ACE inhibitor or ARB RxNorm Value Set"
- OR: "Medication, Order not done: Medical reason" for "ACE inhibitor or ARB RxNorm Value Set"
- OR: "Medication, Order not done: System reason" for "ACE inhibitor or ARB RxNorm Value Set"
- OR:
- OR: "Medication, Active not done: Patient reason for ACE inhibitor or ARB decline" for "ACE inhibitor or ARB RxNorm Value
Set"
- OR: "Medication, Active not done: Patient reason" for "ACE inhibitor or ARB RxNorm Value Set"
- OR: "Medication, Active not done: Medical reason" for "ACE inhibitor or ARB RxNorm Value Set"
- OR: "Medication, Active not done: System reason" for "ACE inhibitor or ARB RxNorm Value Set"
- during "Measurement period"
- OR:
- OR: "Medication, Allergy: ACE inhibitor or ARB"
- OR: "Medication, Adverse Effects: ACE inhibitor or ARB"
- OR: "Medication, Intolerance: ACE inhibitor or ARB"
- OR: "Diagnosis, Active: Pregnancy"
- OR: "Diagnosis, Active: Deficiencies of circulating enzymes"
- OR: "Diagnosis, Active: Disease of aortic and mitral valves"
- OR: "Diagnosis, Active: Nonrheumatic mitral (valve) disease"
- OR: "Diagnosis, Active: Chronic Kidney Disease with and without Hypertension"
- OR: "Diagnosis, Active: Hypertensive renal disease with renal failure"
- OR: "Diagnosis, Active: Atherosclerosis of Renal Artery"
- OR: "Diagnosis, Active: Renal failure and ESRD"
- OR: "Diagnosis, Active: Acute renal failure"
- OR: "Diagnosis, Active: Atresia and stenosis of aorta"
- starts before or during
- OR: "Encounter: Encounter Nursing Facility"
- OR: "Encounter: Encounter Outpatient"
- during "Measurement period"
-
"Diagnosis, Active: Acute renal failure" using "Acute renal failure Value Set GROUPING (2.16.840.1.113883.3.526.03.239)"
-
"Diagnosis, Active: Atherosclerosis of Renal Artery" using "Atherosclerosis of Renal Artery Value Set GROUPING (2.16.840.1.113883.3.526.03.374)"
-
"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)"
-
"Diagnosis, Active: Chronic Kidney Disease with and without Hypertension" using "Chronic Kidney Disease with and without Hypertension Value Set GROUPING (2.16.840.1.113883.3.526.03.42)"
-
"Diagnosis, Active: Coronary Artery Disease includes MI" using "Coronary Artery Disease includes MI Value Set GROUPING (2.16.840.1.113883.3.526.03.365)"
-
"Diagnosis, Active: Deficiencies of circulating enzymes" using "Deficiencies of circulating enzymes Value Set GROUPING (2.16.840.1.113883.3.526.03.375)"
-
"Diagnosis, Active: Diabetes Mellitus and Diabetic Complications" using "Diabetes Mellitus and Diabetic Complications Value Set GROUPING (2.16.840.1.113883.3.526.03.564)"
-
"Diagnosis, Active: Disease of aortic and mitral valves" using "Disease of aortic and mitral valves Value Set GROUPING (2.16.840.1.113883.3.526.03.41)"
-
"Diagnosis, Active: Hypertensive renal disease with renal failure" using "Hypertensive renal disease with renal failure Value Set GROUPING (2.16.840.1.113883.3.526.03.236)"
-
"Diagnosis, Active: Left ventricular systolic dysfunction" using "Left ventricular systolic dysfunction SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.859)"
-
"Diagnosis, Active: Moderate or Severe LVSD" using "Moderate or Severe LVSD SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.861)"
-
"Diagnosis, Active: Nonrheumatic mitral (valve) disease" using "Nonrheumatic mitral (valve) disease Value Set GROUPING (2.16.840.1.113883.3.526.03.237)"
-
"Diagnosis, Active: Pregnancy" using "Pregnancy Value Set GROUPING (2.16.840.1.113883.3.526.03.378)"
-
"Diagnosis, Active: Renal failure and ESRD" using "Renal failure and ESRD Value Set GROUPING (2.16.840.1.113883.3.526.03.46)"
-
"Diagnostic Study, Result: Ejection Fraction" using "Ejection Fraction SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.29)"
-
"Diagnostic Study, Result: LVF ASSMT" using "LVF ASSMT CPT Value Set (2.16.840.1.113883.3.526.02.31)"
-
"Encounter: Encounter Nursing Facility" using "Encounter Nursing Facility CPT Value Set (2.16.840.1.113883.3.526.02.28)"
-
"Encounter: Encounter Outpatient" using "Encounter Outpatient CPT Value Set (2.16.840.1.113883.3.526.02.26)"
-
"Medication, Active: ACE inhibitor or ARB" using "ACE inhibitor or ARB RxNorm Value Set (2.16.840.1.113883.3.526.02.39)"
-
"Medication, Active not done: Medical reason" using "Medical reason SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.313)"
-
"Medication, Active not done: Patient reason" using "Patient reason SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.311)"
-
"Medication, Active not done: Patient reason for ACE inhibitor or ARB decline" using "Patient reason for ACE inhibitor or ARB decline SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.305)"
-
"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: ACE inhibitor or ARB" using "ACE inhibitor or ARB RxNorm Value Set (2.16.840.1.113883.3.526.02.39)"
-
"Medication, Allergy: ACE inhibitor or ARB" using "ACE inhibitor or ARB RxNorm Value Set (2.16.840.1.113883.3.526.02.39)"
-
"Medication, Intolerance: ACE inhibitor or ARB" using "ACE inhibitor or ARB RxNorm Value Set (2.16.840.1.113883.3.526.02.39)"
-
"Medication, Order: ACE inhibitor or ARB" using "ACE inhibitor or ARB RxNorm Value Set (2.16.840.1.113883.3.526.02.39)"
-
"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: Patient reason for ACE inhibitor or ARB decline" using "Patient reason for ACE inhibitor or ARB decline SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.305)"
-
"Medication, Order not done: System reason" using "System reason SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.310)"
-
"Patient Characteristic: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"
-
"Procedure, Performed: Cardiac Surgery" using "Cardiac Surgery Value Set GROUPING (2.16.840.1.113883.3.526.03.371)"
-
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)"