| eCQM Title | Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%) |
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|---|---|---|---|
| eCQM Identifier (Measure Authoring Tool) | 145 | eCQM Version Number | 9.2.000 |
| NQF Number | 0070e | GUID | 80744ae2-de81-4b16-a71d-69522eb865c5 |
| Measurement Period | January 1, 20XX through December 31, 20XX | ||
| Measure Steward | PCPI(R) Foundation (PCPI[R]) | ||
| Measure Developer | American Medical Association (AMA) | ||
| Measure Developer | PCPI(R) Foundation (PCPI[R]) | ||
| Endorsed By | National Quality Forum | ||
| Description |
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior LVEF <40% who were prescribed beta-blocker therapy |
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| Copyright |
Copyright 2020 American College of Cardiology, American Heart Association and American Medical Association. All Rights Reserved. |
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| Disclaimer |
The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. The Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the Measure require a license agreement between the user and the American Medical Association (AMA), American College of Cardiology (ACC) or the American Heart Association (AHA). Neither the AMA, nor ACC, nor AHA, nor the former AMA-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI), nor the PCPI (R) Foundation (PCPI[R]), nor their members shall be responsible for any use of the Measure. AMA and PCPI encourage use of the Measure by other health care professionals, where appropriate. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Limited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The AMA, ACC, AHA, the PCPI and its members and former members of the AMA-PCPI disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT[R]) or other coding contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2019 American Medical Association. LOINC(R) is copyright 2004-2019 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2019 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2019 World Health Organization. All Rights Reserved. Due to technical limitations, registered trademarks are indicated by (R) or [R]. |
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| Measure Scoring | Proportion | ||
| Measure Type | Process | ||
| Stratification |
None |
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| Risk Adjustment |
None |
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| Rate Aggregation |
This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: - Population 1: Patients with left ventricular systolic dysfunction (LVEF <40%) - Population 2: Patients with a prior (within the past 3 years) myocardial infarction For the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2)/ [(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)] |
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| Rationale |
For patients with coronary artery disease (CAD), beta-blockers are recommended for 3 years after myocardial infarction or acute coronary syndrome. Beta-blockers, particularly carvedilol, metoprolol succinate, or bisoprolol which have been shown to reduce risk of death, are recommended indefinitely for patients with CAD and LV systolic dysfunction. These agents have proven efficacy in reducing angina onset and improving the ischemic threshold during exercise. In patients who have suffered an MI, beta-blockers significantly reduce deaths and recurrent MIs (ACCF/AHA/ACP/AATS/PCNA/SCAI/STS, 2012). Nonadherence to cardioprotective medications is prevalent among outpatients with CAD and can be associated with a broad range of adverse outcomes, including all-cause and cardiovascular mortality, cardiovascular hospitalizations, and the need for revascularization procedures (ACC/AHA, 2002). This measure is intended to promote beta-blocker usage in select patients with CAD. |
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| Clinical Recommendation Statement |
Beta-blocker therapy should be started and continued for 3 years in all patients with normal LV function after MI or ACS (Class I, Level of Evidence: B) (ACCF/AHA/ACP/AATS/PCNA/SCAI/STS, 2012). Beta-blocker therapy should be used in all patients with LV systolic dysfunction (EF <= 40%) with heart failure or prior MI, unless contraindicated. (Use should be limited to carvedilol, metoprolol succinate, or bisoprolol, which have been shown to reduce risk of death.) (Class I, Level of Evidence: A) (ACCF/AHA/ACP/AATS/PCNA/SCAI/STS, 2012). |
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| Improvement Notation |
Higher score indicates better quality |
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| Reference |
Fihn, S. D., Gardin, J. M., Abrams, J., Berra, K., Blankenship, J. C., Dallas, A. P., … Williams, S. V. (2012). 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease. Circulation, 126(25), e354–e471. doi: 10.1161/cir.0b013e318277d6a0 |
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| Reference |
Gibbons, R. J., Abrams, J., Chatterjee, K., Daley, J., Deedwania, P.K, Douglas J.S., … Smith Jr., S.C. (2002). ACC/AHA 2002 Guideline Update for the Management of Patients with Chronic StableAangina: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for the Management of Patients with Chronic Stable Angina). Circulation, 107(1), 149-158. doi:10.1161/01.CIR.0000047041.66447.29 |
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| Definition |
Prescribed may include prescription given to the patient for beta-blocker therapy at one or more visits in the measurement period OR patient already taking beta-blocker therapy as documented in current medication list. Prior Myocardial Infarction (MI) for denominator 2 is limited to those occurring within the past 3 years. |
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| Guidance |
Beta-blocker therapy: - For patients with prior MI, beta-blocker therapy includes any agent within the beta-blocker drug class. As of 2015, no recommendations or evidence are cited in current stable ischemic heart disease guidelines for preferential use of specific agents - For patients with prior LVEF <40%, beta-blocker therapy includes the following: bisoprolol, carvedilol, or sustained release metoprolol succinate The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than 40% threshold noted in the denominator logic. A range that is inclusive of or greater than 40% would not meet the measure requirement. If a patient has had a myocardial infarction (MI) within the past 3 years and a current or prior LVEF < 40% (or moderate or severe LVSD), the patient should only be counted in Population Criteria 1. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM. |
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| Transmission Format |
TBD |
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| Initial Population |
All patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period |
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| Denominator |
Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <40% |
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| Denominator Exclusions |
None |
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| Numerator |
Patients who were prescribed beta-blocker therapy |
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| Numerator Exclusions |
Not Applicable |
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| Denominator Exceptions |
Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., allergy, intolerance, other medical reasons). Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons). Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the health care system). |
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| Supplemental Data Elements |
For every patient evaluated by this measure also identify payer, race, ethnicity and sex |
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exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 18
)
and Count("Qualifying Encounter During Measurement Period")>= 2
and ( exists "Qualifying CAD Encounter" )
"Initial Population" and exists "Qualifying CAD Encounter and Moderate or Severe LVSD"
None
exists "Beta Blocker Therapy for LVSD Ordered" or exists "Currently Taking Beta Blocker Therapy for LVSD"
None
exists "Arrhythmia with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Asthma with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Bradycardia with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Hypotension with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker for LVSD" or "Atrioventricular Block with Qualifying CAD Encounter and Moderate or Severe LVSD without Cardiac Pacer"
None
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 18
)
and Count("Qualifying Encounter During Measurement Period")>= 2
and ( exists "Qualifying CAD Encounter" )
"Initial Population" and exists "Qualifying CAD Encounter and Prior MI"
None
exists "Beta Blocker Therapy Ordered" or exists "Currently Taking Beta Blocker Therapy"
None
exists "Arrhythmia with Qualifying CAD Encounter and Prior MI" or exists "Asthma with Qualifying CAD Encounter and Prior MI" or exists "Bradycardia with Qualifying CAD Encounter and Prior MI" or exists "Hypotension with Qualifying CAD Encounter and Prior MI" or exists "Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI" or exists "Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker Therapy" or "Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer"
None
( ["Allergy/Intolerance": "Beta Blocker Therapy Ingredient"]
union ["Allergy/Intolerance": "Substance with beta adrenergic receptor antagonist mechanism of action (substance)"] ) BetaBlockerAllergyIntolerance
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that BetaBlockerAllergyIntolerance.prevalencePeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
( ["Allergy/Intolerance": "Beta Blocker Therapy Ingredient"]
union ["Allergy/Intolerance": "Substance with beta adrenergic receptor antagonist mechanism of action (substance)"] ) BetaBlockerAllergyIntolerance
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that BetaBlockerAllergyIntolerance.prevalencePeriod overlaps after CADEncounterMI.relevantPeriod
["Diagnosis": "Arrhythmia"] Arrhythmia
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that Arrhythmia.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Arrhythmia"] Arrhythmia
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that Arrhythmia.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
["Diagnosis": "Asthma"] Asthma
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that Asthma.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Asthma"] Asthma
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that Asthma.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
["Diagnosis": "Atrioventricular Block"] AtrioventricularBlock
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that AtrioventricularBlock.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
exists "Atrioventricular Block with Qualifying CAD Encounter and Moderate or Severe LVSD" and not exists "Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Moderate or Severe LVSD" and not exists "Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Moderate or Severe LVSD"
["Diagnosis": "Atrioventricular Block"] AtrioventricularBlock
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that AtrioventricularBlock.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
exists "Atrioventricular Block with Qualifying CAD Encounter and Prior MI" and not exists "Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI" and not exists "Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI"
["Medication, Order": "Beta Blocker Therapy for LVSD"] BetaBlockerForLVSDOrdered
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that BetaBlockerForLVSDOrdered.authorDatetime during CADEncounterModerateOrSevereLVSD.relevantPeriod
["Medication, Order": "Beta Blocker Therapy"] BetaBlockerOrdered
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that BetaBlockerOrdered.authorDatetime during CADEncounterMI.relevantPeriod
["Diagnosis": "Bradycardia"] Bradycardia
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that Bradycardia.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Bradycardia"] Bradycardia
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that Bradycardia.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
["Device, Applied": "Cardiac Pacer"] ImplantedCardiacPacer
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that ImplantedCardiacPacer.relevantPeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
["Device, Applied": "Cardiac Pacer"] ImplantedCardiacPacer
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that ImplantedCardiacPacer.relevantPeriod overlaps after CADEncounterMI.relevantPeriod
from
["Physical Exam, Performed": "Heart Rate"] HeartRate,
"Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
let PriorHeartRate: Last(["Physical Exam, Performed": "Heart Rate"] MostRecentPriorHeartRate
where MostRecentPriorHeartRate.relevantDatetime during CADEncounterModerateOrSevereLVSD.relevantPeriod
and MostRecentPriorHeartRate.relevantDatetime before HeartRate.relevantDatetime
sort by relevantDatetime
)
where HeartRate.relevantDatetime during CADEncounterModerateOrSevereLVSD.relevantPeriod
and HeartRate.result < 50 '{beats}/min'
and PriorHeartRate.result < 50 '{beats}/min'
from
["Physical Exam, Performed": "Heart Rate"] HeartRate,
"Qualifying CAD Encounter and Prior MI" CADEncounterMI
let PriorHeartRate: Last(["Physical Exam, Performed": "Heart Rate"] MostRecentPriorHeartRate
where MostRecentPriorHeartRate.relevantDatetime during CADEncounterMI.relevantPeriod
and MostRecentPriorHeartRate.relevantDatetime before HeartRate.relevantDatetime
sort by relevantDatetime
)
where HeartRate.relevantDatetime during CADEncounterMI.relevantPeriod
and HeartRate.result < 50 '{beats}/min'
and PriorHeartRate.result < 50 '{beats}/min'
"Face to Face Encounter During Measurement Period" ValidFaceToFaceEncounter
with ["Diagnosis": "Coronary Artery Disease No MI"] CoronaryArteryDisease
such that CoronaryArteryDisease.prevalencePeriod overlaps ValidFaceToFaceEncounter.relevantPeriod
["Medication, Active": "Beta Blocker Therapy"] ActiveBetaBlocker
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that ActiveBetaBlocker.relevantPeriod overlaps after CADEncounterMI.relevantPeriod
["Medication, Active": "Beta Blocker Therapy for LVSD"] ActiveBetaBlockerForLVSD
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that ActiveBetaBlockerForLVSD.relevantPeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
"Initial Population" and exists "Qualifying CAD Encounter and Moderate or Severe LVSD"
"Initial Population" and exists "Qualifying CAD Encounter and Prior MI"
exists "Arrhythmia with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Asthma with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Bradycardia with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Hypotension with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Moderate or Severe LVSD" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker for LVSD" or "Atrioventricular Block with Qualifying CAD Encounter and Moderate or Severe LVSD without Cardiac Pacer"
exists "Arrhythmia with Qualifying CAD Encounter and Prior MI" or exists "Asthma with Qualifying CAD Encounter and Prior MI" or exists "Bradycardia with Qualifying CAD Encounter and Prior MI" or exists "Hypotension with Qualifying CAD Encounter and Prior MI" or exists "Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI" or exists "Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI" or exists "Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI" or exists "Medical Patient or System Reason for Not Ordering Beta Blocker Therapy" or "Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer"
( ["Diagnosis": "Allergy to Beta Blocker Therapy"]
union ["Diagnosis": "Intolerance to Beta Blocker Therapy"] ) BetaBlockerAllergyOrIntoleranceDiagnosis
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that BetaBlockerAllergyOrIntoleranceDiagnosis.prevalencePeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
( ["Diagnosis": "Allergy to Beta Blocker Therapy"]
union ["Diagnosis": "Intolerance to Beta Blocker Therapy"] ) BetaBlockerAllergyOrIntoleranceDiagnosis
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that BetaBlockerAllergyOrIntoleranceDiagnosis.prevalencePeriod overlaps after CADEncounterMI.relevantPeriod
["Diagnosis": "Cardiac Pacer in Situ"] CardiacPacerDiagnosis
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that CardiacPacerDiagnosis.prevalencePeriod overlaps after CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Cardiac Pacer in Situ"] CardiacPacerDiagnosis
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that CardiacPacerDiagnosis.prevalencePeriod overlaps after CADEncounterMI.relevantPeriod
( ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Outpatient Consultation"] union ["Encounter, Performed": "Care Services in Long-Term Residential Facility"] union ["Encounter, Performed": "Home Healthcare Services"] union ["Encounter, Performed": "Nursing Facility Visit"] ) FaceToFaceEncounter where FaceToFaceEncounter.relevantPeriod during "Measurement Period"
"Face to Face Encounter During Measurement Period" ValidFaceToFaceEncounter
with ["Procedure, Performed": "Cardiac Surgery"] CardiacSurgery
such that CardiacSurgery.relevantPeriod starts before
end of ValidFaceToFaceEncounter.relevantPeriod
["Diagnosis": "Hypotension"] Hypotension
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that Hypotension.prevalencePeriod overlaps CADEncounterModerateOrSevereLVSD.relevantPeriod
["Diagnosis": "Hypotension"] Hypotension
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that Hypotension.prevalencePeriod overlaps CADEncounterMI.relevantPeriod
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 18
)
and Count("Qualifying Encounter During Measurement Period")>= 2
and ( exists "Qualifying CAD Encounter" )
["Medication, Not Ordered": "Beta Blocker Therapy for LVSD"] NoBetaBlockerForLVSDOrdered
with "Qualifying CAD Encounter and Moderate or Severe LVSD" CADEncounterModerateOrSevereLVSD
such that NoBetaBlockerForLVSDOrdered.authorDatetime during CADEncounterModerateOrSevereLVSD.relevantPeriod
where ( NoBetaBlockerForLVSDOrdered.negationRationale in "Medical Reason"
or NoBetaBlockerForLVSDOrdered.negationRationale in "Patient Reason"
or NoBetaBlockerForLVSDOrdered.negationRationale in "System Reason"
)
["Medication, Not Ordered": "Beta Blocker Therapy"] NoBetaBlockerOrdered
with "Qualifying CAD Encounter and Prior MI" CADEncounterMI
such that NoBetaBlockerOrdered.authorDatetime during CADEncounterMI.relevantPeriod
where ( NoBetaBlockerOrdered.negationRationale in "Medical Reason"
or NoBetaBlockerOrdered.negationRationale in "Patient Reason"
or NoBetaBlockerOrdered.negationRationale in "System Reason"
)
( ["Diagnostic Study, Performed": "Ejection Fraction"] EjectionFraction
where EjectionFraction.result < 40 '%'
)
union ["Diagnosis": "Moderate or Severe LVSD"]
union ( ["Diagnosis": "Left Ventricular Systolic Dysfunction"] LVSD
where LVSD.severity in "Moderate or Severe"
)
exists "Beta Blocker Therapy for LVSD Ordered" or exists "Currently Taking Beta Blocker Therapy for LVSD"
exists "Beta Blocker Therapy Ordered" or exists "Currently Taking Beta Blocker Therapy"
"Coronary Artery Disease Encounter" union "History of Cardiac Surgery"
"Qualifying CAD Encounter" EncounterWithCADProxy
with "Moderate or Severe LVSD Findings" LVSDFindings
such that LVSDFindings.prevalencePeriod starts before
end of EncounterWithCADProxy.relevantPeriod
or LVSDFindings.relevantDatetime before
end of EncounterWithCADProxy.relevantPeriod
"Qualifying CAD Encounter" EncounterWithCADProxy
with ["Diagnosis": "Myocardial Infarction"] MyocardialInfarction
such that MyocardialInfarction.prevalencePeriod ends 3 years or less before day of ( start of EncounterWithCADProxy.relevantPeriod - 1 day )
without "Moderate or Severe LVSD Findings" LVSDFindings
such that LVSDFindings.prevalencePeriod starts before
end of EncounterWithCADProxy.relevantPeriod
or LVSDFindings.relevantDatetime before
end of EncounterWithCADProxy.relevantPeriod
( ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Outpatient Consultation"] union ["Encounter, Performed": "Nursing Facility Visit"] union ["Encounter, Performed": "Care Services in Long-Term Residential Facility"] union ["Encounter, Performed": "Home Healthcare Services"] union ["Encounter, Performed": "Patient Provider Interaction"] ) ValidEncounter where ValidEncounter.relevantPeriod during "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
years between ToDate(BirthDateTime)and ToDate(AsOf)
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
| Measure Set |
None |
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|---|---|---|---|