Asthma Assessment (NQF 0001)

©2010 American Medical Association.  All Rights Reserved

Appropriate treatment of asthma patients requires accurate classification of asthma severity. Physician assessment of the frequency of asthma symptoms is the first step in classifying asthma severity.

To determine whether the goals of therapy are being met, monitoring is recommended in the 6 areas listed below: 
• Signs and symptoms (daytime; nocturnal awakening) of asthma
• Pulmonary function (spirometry; peak flow monitoring)
• Quality of life/functional status
• History of asthma exacerbations
• Pharmacotherapy (as-needed use of inhaled short-acting beta2-agonist, adherence to regimen of long-term-control medications)
• Patient-provider communication and patient satisfaction (NAEPP/NHLBI)

Higher score indicates better quality

National Asthma Education and Prevention Program Expert Panel Report 2: Guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute, National Institutes of Health; July 1997. NIH Publication No. 97-4051. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed August 2002.

National Asthma Education and Prevention Program Expert Panel Report 2 Update: Guidelines for the diagnosis and management of asthma – update on selected topics 2002. National Heart, Lung, and Blood Institute, National Institutes of Health; August 2002. NIH Publication No. 97-4051. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.htm. Accessed September 2002.

Initial Patient Population =
- AND:
  - AND: "Patient characteristic: birth date" >= 5 year(s) starts before start of "Measurement period"
  - AND: "Patient characteristic: birth date" <= 40 year(s) starts before start of "Measurement period"
- AND: "Diagnosis active: Asthma" starts before or during ("Encounter: Encounter Office & Outpatient Consult" during "Measurement period")
- AND: >= 2 count(s) of
  - AND: "Encounter: Encounter Office & Outpatient Consult" during "Measurement period"
Denominator =
- AND: "Initial Patient Population"
Numerator =
- AND:
  - OR:
    - AND: "Symptom assessed: Asthma Daytime Symptoms Quantified"
    - AND: "Symptom assessed: Asthma Nighttime Symptoms Quantified"
    - starts before or during ("Encounter: Encounter Office & Outpatient Consult" during "Measurement period")
  - OR:
    - AND: "Symptom active: Asthma Daytime Symptoms"
    - AND: "Symptom active: Asthma Nighttime Symptoms"
    - starts before or during ("Encounter: Encounter Office & Outpatient Consult" during "Measurement period")
  - OR: "Risk category / assessment: Asthma Symptom Assessment Tool" starts before or during ("Encounter: Encounter Office & Outpatient Consult" during "Measurement period")
Exclusions =
- None

"Diagnosis active: Asthma" using "Asthma Code List GROUPING (2.16.840.1.113883.3.526.03.362)"
"Encounter: Encounter Office & Outpatient Consult" using "Encounter Office & Outpatient Consult CPT Code List (2.16.840.1.113883.3.526.02.99)"
"Patient characteristic: birth date" (age) using "birth date HL7 Code List (2.16.840.1.113883.3.526.02.8)"
"Risk category / assessment: Asthma Symptom Assessment Tool" using "Asthma Symptom Assessment Tool SNOMED-CT Code List (2.16.840.1.113883.3.526.02.143)"
"Symptom active: Asthma Daytime Symptoms" using "Asthma Daytime Symptoms SNOMED-CT Code List (2.16.840.1.113883.3.526.02.440)"
"Symptom active: Asthma Nighttime Symptoms" using "Asthma Nighttime Symptoms SNOMED-CT Code List (2.16.840.1.113883.3.526.02.441)"
"Symptom assessed: Asthma Daytime Symptoms Quantified" using "Asthma Daytime Symptoms Quantified SNOMED-CT Code List (2.16.840.1.113883.3.526.02.141)"
"Symptom assessed: Asthma Nighttime Symptoms Quantified" using "Asthma Nighttime Symptoms Quantified SNOMED-CT Code List (2.16.840.1.113883.3.526.02.142)"

Calculation is generic to all measures:

Calculate the final denominator by adding all that meet denominator criteria.
Subtract from the final denominator all that do not meet numerator criteria yet also meet exclusion criteria. Note some measures do not have exclusion criteria.
The performance calculation is based on the "Measure scoring" from header information above:
- For "Proportion" measures, the calculation is the number meeting numerator criteria divided by the final denominator.
- For "Ratio" and "Continuous Variable" measures, follow the calculation instructions in the Data Aggregation header information above, if present.
For measures with multiple denominators, repeat this process for each denominator and report each result separately.
For measures with multiple patient populations, repeat this process for each patient population and report each result separately.
For measures with multiple numerators, calculate each numerator separately within each population using the paired exclusion.

EMeasure Name	Asthma Assessment	EMeasure Id	59B24505-B9D1-48B8-BEB2-AF35219AA689
Version number	1	Set Id	876C00EF-5669-424D-8998-391DF9C41C59
Available Date	No information	Measurement Period	January 1, 20xx through December 31, 20xx
Measure Steward	American Medical Association - Physician Consortium for Performance Improvement
Endorsed by	National Quality Forum
Description	Percentage of patients aged 5 through 40 years with a diagnosis of asthma who were evaluated during at least one office visit within 12 months for the frequency (numeric) of daytime and nocturnal asthma symptoms.
Copyright	©2010 American Medical Association. All Rights Reserved
Measure scoring	Proportion
Measure type	Process
Stratification	None
Risk Adjustment	None
Data Aggregation
Rationale	Appropriate treatment of asthma patients requires accurate classification of asthma severity. Physician assessment of the frequency of asthma symptoms is the first step in classifying asthma severity.
Clinical Recommendation Statement	To determine whether the goals of therapy are being met, monitoring is recommended in the 6 areas listed below: • Signs and symptoms (daytime; nocturnal awakening) of asthma • Pulmonary function (spirometry; peak flow monitoring) • Quality of life/functional status • History of asthma exacerbations • Pharmacotherapy (as-needed use of inhaled short-acting beta2-agonist, adherence to regimen of long-term-control medications) • Patient-provider communication and patient satisfaction (NAEPP/NHLBI)
Improvement notation	Higher score indicates better quality
Measurement duration	12 month(s)
Reference	National Asthma Education and Prevention Program Expert Panel Report 2: Guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute, National Institutes of Health; July 1997. NIH Publication No. 97-4051. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed August 2002.
Reference	National Asthma Education and Prevention Program Expert Panel Report 2 Update: Guidelines for the diagnosis and management of asthma – update on selected topics 2002. National Heart, Lung, and Blood Institute, National Institutes of Health; August 2002. NIH Publication No. 97-4051. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.htm. Accessed September 2002.
Definition
Guidance

Asthma Assessment (NQF 0001)

Table of Contents

Population criteria

Data criteria (QDS Data Elements)

Summary Calculation