ACEI or ARB for LVSD (NQF 0137)
-
Initial Patient Population =
- AND: "Diagnosis, Active: Hospital Measures-AMI (ordinality: 'Hospital Measures-Principal')"
- AND: "Patient Characteristic: birth date" >= 18 year(s) starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient (admission datetime)"
- AND: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (length of stay <= 120 day(s))"
- AND: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (discharge datetime)" during "Measurement period"
-
Denominator =
- AND: "Initial Patient Population"
- AND:
- OR: "Diagnostic Study, Result: Ejection Fraction (result < 40 %)" during "Occurrence A of Encounter: Hospital Measures - Encounter
Inpatient"
- OR: "Diagnosis, Active: LVSD (severity: 'Hospital Measures-Moderate or severe')" during "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Diagnosis, Active: LVSD moderate or severe" during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
-
Denominator Exclusions =
- AND:
- OR: "Patient Characteristic: Clinical trial participant" during "Occurrence A of Encounter: Hospital Measures - Encounter
Inpatient"
- OR: "Intervention, Order: Hospital Measures-Comfort measure only intervention" during "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (discharge status: 'Hospital Measures-Left against
medical advice')"
- OR: "Transfer To: Hospital Measures-Inpatient hospice care" < 1 day(s) starts after end of "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Transfer To: Hospital Measures-Home hospice care" < 1 day(s) starts after end of "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient (discharge status: 'Hospital Measures-Expired')"
- OR:
- AND:
- AND: "Medication, Order not done: Medical reason" for "Hospital Measures-ACEI RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- AND:
- AND: "Medication, Order not done: Medical reason" for "Hospital Measures-ARB RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR:
- AND:
- AND: "Medication, Order not done: Patient reason" for "Hospital Measures-ACEI RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- AND:
- AND: "Medication, Order not done: Patient reason" for "Hospital Measures-ARB RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR:
- AND:
- AND: "Medication, Active not done: Medical reason" for "Hospital Measures-ACEI RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- AND:
- AND: "Medication, Active not done: Medical reason" for "Hospital Measures-ARB RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR:
- AND:
- AND: "Medication, Active not done: Patient reason" for "Hospital Measures-ACEI RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- AND:
- AND: "Medication, Active not done: Patient reason" for "Hospital Measures-ARB RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR:
- AND:
- AND: "Medication, Active not done: System reason" for "Hospital Measures-ACEI RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- AND:
- AND: "Medication, Active not done: System reason" for "Hospital Measures-ARB RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR:
- AND:
- AND: "Medication, Order not done: System reason" for "Hospital Measures-ACEI RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- AND:
- AND: "Medication, Order not done: System reason" for "Hospital Measures-ARB RxNorm Value Set"
- during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR:
- AND: "Medication, Allergy: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures -
Encounter Inpatient"
- AND:
- OR: "Medication, Allergy: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures - Encounter
Inpatient"
- OR: "Medication, Intolerance: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Medication, Adverse Effects: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR:
- AND: "Medication, Intolerance: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- AND:
- OR: "Medication, Allergy: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures - Encounter
Inpatient"
- OR: "Medication, Intolerance: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Medication, Adverse Effects: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR:
- AND: "Medication, Adverse Effects: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- AND:
- OR: "Medication, Allergy: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures - Encounter
Inpatient"
- OR: "Medication, Intolerance: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Medication, Adverse Effects: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR:
- AND: "Medication, Allergy: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures -
Encounter Inpatient"
- AND:
- OR: "Medication, Allergy: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures -
Encounter Inpatient"
- OR: "Medication, Intolerance: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Medication, Adverse Effects: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR:
- AND: "Medication, Intolerance: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- AND:
- OR: "Medication, Allergy: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures -
Encounter Inpatient"
- OR: "Medication, Intolerance: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Medication, Adverse Effects: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR:
- AND: "Medication, Adverse Effects: Hospital Measures-ARB" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- AND:
- OR: "Medication, Allergy: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures -
Encounter Inpatient"
- OR: "Medication, Intolerance: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Medication, Adverse Effects: Hospital Measures-ACEI" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR:
- AND: "Diagnosis, Active: Hospital Measures-Aortic stenosis" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- AND NOT:
- OR: "Procedure, Performed: Hospital Measures-Aortic repair" starts before or during "Measurement period"
- OR: "Procedure, Performed: Hospital Measures-Valvuloplasty" starts before or during "Measurement period"
- OR: "Procedure, Performed: Hospital Measures-Aortic commissurotomy" starts before or during "Measurement period"
- OR:
- AND: "Diagnosis, Inactive: Hospital Measures-Aortic stenosis" starts before or during "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- AND NOT:
- OR: "Procedure, Performed: Hospital Measures-Aortic repair" starts before or during "Measurement period"
- OR: "Procedure, Performed: Hospital Measures-Valvuloplasty" starts before or during "Measurement period"
- OR: "Procedure, Performed: Hospital Measures-Aortic commissurotomy" starts before or during "Measurement period"
- OR:
- AND: "Diagnosis, Resolved: Hospital Measures-Aortic stenosis (severity: 'Hospital Measures-Moderate or severe')" starts before
or during "Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- AND NOT:
- OR: "Procedure, Performed: Hospital Measures-Aortic repair" starts before or during "Measurement period"
- OR: "Procedure, Performed: Hospital Measures-Valvuloplasty" starts before or during "Measurement period"
- OR: "Procedure, Performed: Hospital Measures-Aortic commissurotomy" starts before or during "Measurement period"
- OR: "Diagnosis, Active: Hospital Measures-Angioedema" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Physical Exam, Finding: Hospital Measures-Angioneurotic edema" starts before or during "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Physical Exam, Finding: Hospital Measures-Edema of eyelid" starts before or during "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Physical Exam, Finding: Hospital Measures-Edema of glottis, larynx, nasopharynx, or pharynx" starts before or during
"Occurrence A of Encounter: Hospital Measures - Encounter Inpatient"
- OR: "Physical Exam, Finding: Hospital Measures-Acute periorbital edema" starts before or during "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient"
- OR: "Diagnosis, Active: Hospital Measures-Renal artery stenosis" starts before or during "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Diagnosis, Active: Hospital Measures-Renal disease/dysfunction" starts before or during "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Diagnosis, Active: Hospital Measures-Chronic kidney disease" starts before or during "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
- OR: "Procedure, Performed: Hospital Measures-Dialysis" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Diagnosis, Active: End Stage Renal Disease" starts before or during "Occurrence A of Encounter: Hospital Measures - Encounter
Inpatient"
- OR: "Diagnosis, Active: Hospital Measures-Nephritis" starts before or during "Occurrence A of Encounter: Hospital Measures
- Encounter Inpatient"
- OR: "Diagnosis, Active: Hospital Measures-Renal failure (acute and chronic)" starts before or during "Occurrence A of Encounter:
Hospital Measures - Encounter Inpatient"
- OR: "Procedure, Performed: Hospital Measures-Kidney transplant" starts before or during "Occurrence A of Encounter: Hospital
Measures - Encounter Inpatient"
-
Numerator =
- AND:
- OR: "Medication, Order: Hospital Measures-ACEI" ends concurrent with "Occurrence A of Encounter: Hospital Measures - Encounter
Inpatient (discharge datetime)"
- OR: "Medication, Order: Hospital Measures-ARB" ends concurrent with "Occurrence A of Encounter: Hospital Measures - Encounter
Inpatient (discharge datetime)"
- OR: "Medication, Active: Hospital Measures-ACEI (Health Record Field: 'Discharge Medications')" starts after start of "Occurrence
A of Encounter: Hospital Measures - Encounter Inpatient (discharge datetime)"
- OR: "Medication, Active: Hospital Measures-ARB (Health Record Field: 'Discharge Medications')" starts after start of "Occurrence
A of Encounter: Hospital Measures - Encounter Inpatient (discharge datetime)"
-
Denominator Exceptions =
-
"Diagnosis, Active: End Stage Renal Disease" using "End Stage Renal Disease Value Set GROUPING (2.16.840.1.113883.3.526.02.589)"
-
"Diagnosis, Active: Hospital Measures-AMI" using "Hospital Measures-AMI Value Set GROUPING (2.16.840.1.113883.3.666.05.624)"
-
"Diagnosis, Active: Hospital Measures-Angioedema" using "Hospital Measures-Angioedema Value Set GROUPING (2.16.840.1.113883.3.666.05.653)"
-
"Diagnosis, Active: Hospital Measures-Aortic stenosis" using "Hospital Measures-Aortic stenosis Value Set GROUPING (2.16.840.1.113883.3.666.05.664)"
-
"Diagnosis, Active: Hospital Measures-Chronic kidney disease" using "Hospital Measures-Chronic kidney disease Value Set GROUPING (2.16.840.1.113883.3.666.05.666)"
-
"Diagnosis, Active: Hospital Measures-Nephritis" using "Hospital Measures-Nephritis Value Set GROUPING (2.16.840.1.113883.3.666.05.659)"
-
"Diagnosis, Active: Hospital Measures-Renal artery stenosis" using "Hospital Measures-Renal artery stenosis Value Set GROUPING (2.16.840.1.113883.3.666.05.665)"
-
"Diagnosis, Active: Hospital Measures-Renal disease/dysfunction" using "Hospital Measures-Renal disease/dysfunction Value Set GROUPING (2.16.840.1.113883.3.666.05.656)"
-
"Diagnosis, Active: Hospital Measures-Renal failure (acute and chronic)" using "Hospital Measures-Renal failure (acute and chronic) Value Set GROUPING (2.16.840.1.113883.3.666.05.660)"
-
"Diagnosis, Active: LVSD" using "LVSD SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.644)"
-
"Diagnosis, Active: LVSD moderate or severe" using "LVSD moderate or severe Value Set GROUPING (2.16.840.1.113883.3.666.05.749)"
-
"Diagnosis, Inactive: Hospital Measures-Aortic stenosis" using "Hospital Measures-Aortic stenosis Value Set GROUPING (2.16.840.1.113883.3.666.05.664)"
-
"Diagnosis, Resolved: Hospital Measures-Aortic stenosis" using "Hospital Measures-Aortic stenosis Value Set GROUPING (2.16.840.1.113883.3.666.05.664)"
-
"Diagnostic Study, Result: Ejection Fraction" using "Ejection Fraction SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.29)"
-
"Encounter: Hospital Measures-Encounter Inpatient" using "Hospital Measures-Encounter Inpatient SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.625)"
-
"Intervention, Order: Hospital Measures-Comfort measure only intervention" using "Hospital Measures-Comfort measure only intervention SNOMED-CT Value Set (1.3.6.1.4.1.33895.1.3.0.45)"
-
"Medication, Active: Hospital Measures-ACEI" using "Hospital Measures-ACEI RxNorm Value Set (2.16.840.1.113883.3.666.05.645)"
-
"Medication, Active: Hospital Measures-ARB" using "Hospital Measures-ARB RxNorm Value Set (2.16.840.1.113883.3.666.05.646)"
-
"Medication, Active not done: Medical reason" using "Medical reason HL7 Value Set (2.16.840.1.113883.3.526.02.313)"
-
"Medication, Active not done: Patient reason" using "Patient reason Value Set GROUPING (2.16.840.1.113883.3.526.02.311)"
-
"Medication, Active not done: System reason" using "System reason HL7 Value Set (2.16.840.1.113883.3.526.02.310)"
-
"Medication, Adverse Effects: Hospital Measures-ACEI" using "Hospital Measures-ACEI RxNorm Value Set (2.16.840.1.113883.3.666.05.645)"
-
"Medication, Adverse Effects: Hospital Measures-ARB" using "Hospital Measures-ARB RxNorm Value Set (2.16.840.1.113883.3.666.05.646)"
-
"Medication, Allergy: Hospital Measures-ACEI" using "Hospital Measures-ACEI RxNorm Value Set (2.16.840.1.113883.3.666.05.645)"
-
"Medication, Allergy: Hospital Measures-ARB" using "Hospital Measures-ARB RxNorm Value Set (2.16.840.1.113883.3.666.05.646)"
-
"Medication, Intolerance: Hospital Measures-ACEI" using "Hospital Measures-ACEI RxNorm Value Set (2.16.840.1.113883.3.666.05.645)"
-
"Medication, Intolerance: Hospital Measures-ARB" using "Hospital Measures-ARB RxNorm Value Set (2.16.840.1.113883.3.666.05.646)"
-
"Medication, Intolerance: Hospital Measures-ARB" using "Hospital Measures-ARB RxNorm Value Set (2.16.840.1.113883.3.666.05.646)"
-
"Medication, Order: Hospital Measures-ACEI" using "Hospital Measures-ACEI RxNorm Value Set (2.16.840.1.113883.3.666.05.645)"
-
"Medication, Order: Hospital Measures-ARB" using "Hospital Measures-ARB RxNorm Value Set (2.16.840.1.113883.3.666.05.646)"
-
"Medication, Order not done: Medical reason" using "Medical reason HL7 Value Set (2.16.840.1.113883.3.526.02.313)"
-
"Medication, Order not done: Patient reason" using "Patient reason Value Set GROUPING (2.16.840.1.113883.3.526.02.311)"
-
"Medication, Order not done: System reason" using "System reason HL7 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)"
-
"Patient Characteristic: Clinical trial participant" using "Clinical trial participant SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.643)"
-
"Physical Exam, Finding: Hospital Measures-Acute periorbital edema" using "Hospital Measures-Acute periorbital edema Value Set GROUPING (2.16.840.1.113883.3.666.05.669)"
-
"Physical Exam, Finding: Hospital Measures-Angioneurotic edema" using "Hospital Measures-Angioneurotic edema Value Set GROUPING (2.16.840.1.113883.3.666.05.654)"
-
"Physical Exam, Finding: Hospital Measures-Edema of eyelid" using "Hospital Measures-Edema of eyelid Value Set GROUPING (2.16.840.1.113883.3.666.05.655)"
-
"Physical Exam, Finding: Hospital Measures-Edema of glottis, larynx, nasopharynx, or pharynx" using "Hospital Measures-Edema of glottis, larynx, nasopharynx, or pharynx Value Set GROUPING (2.16.840.1.113883.3.666.05.668)"
-
"Procedure, Performed: Hospital Measures-Aortic commissurotomy" using "Hospital Measures-Aortic commissurotomy Value Set GROUPING (2.16.840.1.113883.3.666.05.652)"
-
"Procedure, Performed: Hospital Measures-Aortic repair" using "Hospital Measures-Aortic repair Value Set GROUPING (2.16.840.1.113883.3.666.05.650)"
-
"Procedure, Performed: Hospital Measures-Dialysis" using "Hospital Measures-Dialysis Value Set GROUPING (2.16.840.1.113883.3.666.05.658)"
-
"Procedure, Performed: Hospital Measures-Kidney transplant" using "Hospital Measures-Kidney transplant ICD-9-CM Value Set (2.16.840.1.113883.3.666.05.662)"
-
"Procedure, Performed: Hospital Measures-Valvuloplasty" using "Hospital Measures-Valvuloplasty ICD-9-CM Value Set (2.16.840.1.113883.3.666.05.651)"
-
"Transfer To: Hospital Measures-Home hospice care" using "Hospital Measures-Home hospice care SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.648)"
-
"Transfer To: Hospital Measures-Inpatient hospice care" using "Hospital Measures-Inpatient hospice care SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.647)"
-
Attribute: "Severity: Hospital Measures-Moderate or severe" using "Hospital Measures-Moderate or severe SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.750)"
-
Attribute: "Ordinality: Hospital Measures-Principal" using "Hospital Measures-Principal SNOMED-CT Value Set (2.16.840.1.113883.3.526.02.8001)"
-
Attribute: "Discharge status: Hospital Measures-Left against medical advice" using "Hospital Measures-Left against medical advice SNOMED-CT Value Set (2.16.840.1.113883.3.666.05.1106)"
-
Attribute: "Discharge status: Hospital Measures-Expired" using "Hospital Measures-Expired Value Set GROUPING (2.16.840.1.113883.3.666.05.1146)"
-
Attribute: "Health Record Field: Discharge Medications" using "Discharge Medications Value Set (2.16.840.1.113883.3.526.02.3000)"
- "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)"