Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control (NQF 0075)

EMeasure Name Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control EMeasure Id 3f511433-9c5e-44bc-a533-a269977c0b5b
Version number 1 Set Id 35d0927e-bc5f-4a76-b168-4813411fce36
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 18 years of age and older who were discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from January 1st to November 1st of the year prior to the measurement year, or who had a diagnosis of ischemic vascular disease (IVD) during the measurement year and the year prior to the measurement year and who had a complete lipid profile performed during the measurement year and whose LDL-C was < 100 mg/dL.
Copyright
© National Committee for Quality Assurance. All Rights Reserved
Measure scoring Proportion
Measure type Process
Stratification
None
Risk Adjustment
None
Data Aggregation
Rationale
This measure evaluates the percentage of patients in a specific age demographic who had a diagnosis of IVD and demonstrated adequate LDL cholesterol management. IVD and related conditions had an estimated cost burden of $393.5 billion in 2005 (AHA 2005). From 1988-1994 and from 1999-2002, adults 20 and older demonstrated lower age-adjusted total serum cholesterol levels (Carroll 2005), but there is significant room for improvement. Literature reviews and clinical guidelines advise that individuals with coronary artery disease can reduce their risk of subsequent morbidity and premature mortality by managing their cholesterol level through limitations on dietary fat and cholesterol, or in certain cases, through cholesterol lowering medications. A 10% decline in total cholesterol levels (population-wide) can result in a nearly 30% reduction in the incidence of CHD (CDC 2000). This measure facilitates the long-term management of LDL cholesterol levels for patients with IVD.
Clinical Recommendation Statement
Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). (2001) AND Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines (2004): In highrisk persons, the recommended LDL-C goal is < 100 mg/dL.
                
[1]An LDL-C goal of < 70 mg/dL is a therapeutic option on the basis of available clinical trial evidence, especially for patients at very high risk.	

[2]If LDL-C is > 100 mg/dL, an LDL-lowering drug is indicated simultaneously with lifestyle changes.

[3]If baseline LDL-C is < 100 mg/dL, institution of an LDL-lowering drug to achieve an LDL-C level < 70 mg/dL is a therapeutic option on the basis of available clinical trial evidence.

[4]If a high-risk person has high triglycerides or low HDL-C, consideration can be given to combining a fibrate or nicotinic acid with an LDL-lowering drug. When triglycerides are > 200 mg/dL, non-HDLC is a secondary target of therapy, with a goal 30 mg/dL higher than the identified LDL-C goal.
Improvement notation
Higher score indicates better quality
Measurement duration
12 month(s)
Reference
National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services. Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda (MD): U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Heart, Lung and Blood Institute; 2001 May. 
Definition
Guidance
The measure expects an LDL test result (Numerator 1) and an LDL value <= 100 mg/dL (Numerator 2). LDL results are acceptable if directly reported from the laboratory, or if calculated using the following logic, but calculation is only acceptable if the Triglyceride value is <=400 mg/dL:

[Total Cholesterol value –High Density Lipoprotein (HDL) value – (Triglyceride value/5)]
        
In the second part of the Numerator 2, the calculated LDL value must use results of total cholesterol, HDL and triglycerides all from the same date.

Table of Contents


Population criteria

Data criteria (QDS Data Elements)

Summary Calculation

Calculation is generic to all measures:



Measure set CLINICAL QUALITY MEASURE SET 2011-2012