eMeasure Name | Weight Assessment and Counseling for Children and Adolescents | eMeasure Id | BBB31C44-1A16-4F9D-A06D-A29290FC6ADB |
Version number | 1 | eMeasure Set Id | CDAE3B8A-DDBF-4B15-A585-A51F80DD5D5E |
Available Date | No information | Measurement Period | January 1, 20xx through December 31, 20xx |
Measure Steward | National Committee for Quality Assurance | ||
Endorsed by | National Quality Forum | ||
Description | The percentage of patients 2-17 years of age who had an outpatient visit with a PCP or OB/GYN and who had evidence of BMI percentile documentation, counseling for nutrition and counseling for physical activity during the measurement year. | ||
Copyright | © National Committee for Quality Assurance. All Rights Reserved |
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Measure scoring | Proportion | ||
Measure type | Process | ||
Stratification | Stratified by (i) age: 2-16, (ii) age: 2-10, (iii) 11-16, where the total is the sum of the two numerators divided by the sum of the two denominators. Note: The upper age limit of 16 before the measurement year will address all patients reaching the age of 17 during the measurement year. |
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Risk Adjustment | None |
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Data Aggregation | |||
Rationale | This measure assesses the percentage of age-appropriate patients who had an outpatient visit with a PCP or OB/GYN and who had evidence of a BMI percentile assessment, counseling for nutrition or counseling for physical activity. The prevalence of overweight and obesity has increased sharply for children over the last 30 years: from 5.0% to 13.9% for those aged 2-5 years; from 6.5% to 18.8% for those aged 6-11 years; and from 5.0% to 17.4% for those aged 12-19 years. This increasing prevalence has had significant economic ramifications, with economic costs correlated to obesity and related comorbidities estimated at over $70 billion, or 7% of the national health care budget. To address this problem and its long-term implications effectively, promotion of routine physical activity and healthy eating and lifestyle changes are essential (CDC 2007). This measure is important in efforts to improve long-term health outcomes and quality of life. |
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Clinical Recommendation Statement | U.S. Preventive Services Task Force (USPSTF): "I" Recommendation. Insufficient evidence to recommend for or against screening for overweight in children and adolescents reflects the paucity of strong evidence of the effectiveness of interventions for this problem in the clinical setting. The American Academy of Pediatrics (AAP): The child's height, weight and percentiles for age should be determined at the start of the physical examination. Because obesity is strongly linked to hypertension, BMI should be calculated from the height and weight, and the BMI percentile should be calculated. Poor growth may indicate an underlying chronic illness. The American Medical Association (AMA), Health Resources and Services Administration (HRSA), and Centers for Disease Control and Prevention (CDC): The Expert Committee recommends that physicians and allied healthcare providers perform, at a minimum, a yearly assessment of weight status in all children, and that this assessment include calculation of height, weight (measured appropriately), and body mass index (BMI) for age and plotting of those measures on standard growth charts. The American Academy of Pediatrics and the American College of Clinical Endocrinology (ACCE): The AAP and the ACCE recommend and encourage pediatric providers to screen children for obesity using BMI; examine overweight children for obesity-related diseases; initiate weight management practices to improve diet and physical activity habits; and increase frequency of visits to reinforce behavior changes. The Centers for Disease Control and Prevention (CDC): The CDC recommends using the percentile BMI for age and gender as the most appropriate and easily available method to screen for childhood overweight or at risk for overweight. BMI is calculated by dividing the weight in kilograms by the height in meters squared. Age and gender norms for BMI are readily accessible. BMI correlates with adiposity and with complications of childhood overweight such as hypercholesterolemia, hypertension and later development of cardiovascular disease. Although more precise measures of lean body mass and body fat such as dual x-ray absorptiometry (DEXA) may be appropriate for clinical studies, BMI norms are particularly helpful for screening in busy office practices and for population assessment. |
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Improvement notation | Higher score indicates better quality |
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Measurement duration | 12 month(s) |
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Reference | U.S. Preventive Services Task Force (USPSTF). Screening and interventions for overweight in children and adolescents: recommendation statement. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2005. p. 11. |
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Reference | National High Blood Pressure Education Program Working Group on High Blood Pressure in Children. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004 Aug; 114(2 Suppl):555-76. |
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Reference | AMA/HRSA/ CDC Expert Committee on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity. Recommendations on the assessment, prevention and treatment of child and adolescent overweight and obesity. Chicago (IL): AMA. 2007 Jun. 1. |
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Reference | Dorsey, K.B., C. Wells, H.M. Krumholz, J.C. Concato. Diagnosis, evaluation, and treatment of childhood obesity in pediatric practice. Arch Pediatr Adolesc Med. 2005. July; 159:632-638. |
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Reference | Baker, S., S. Barlow, W. Cochran, G. Fuchs, W. Klish, N. Krebs, R. Strauss, A. Tershakovec, J. Udall. Overweight children and adolescents: a clinical report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 2005. May; 40(5):533-43. |
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Definition | Initial Patient Population(s): All children 3 years of age to 17 years of age during measurement period |
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Definition | Denominator(s): Patients in the initial population who had an outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period |
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Definition | Denominator Exclusion(s): Patients who have a diagnosis of pregnancy or an ambulatory encounter related to pregnancy during the measurement period |
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Definition | Numerator(s): N1: The number of patients who had a body mass index (BMI) percentile recorded during the measurement period N2: The number of patients who had counseling for nutrition N3: The number of patients who had counseling for physical activity |
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Definition | Denominator Exception(s): N/A |
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Guidance | |||
Supplemental Data Elements | Report "Patient Characteristic: Gender" using "Gender HL7 Value Set (2.16.840.1.113883.1.11.1)"; Report "Patient Characteristic: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"; Report "Patient Characteristic: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"; Report "Patient Characteristic: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.113883.3.221.5)". |
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Measure set | CLINICAL QUALITY MEASURE SET 2011-2012 |