"Symptom"
Data elements that meet criteria using this datatype should document the symptom and its corresponding value set.
Timing:
- The prevalencePeriod references the time from the onset date to the abatement date.
- The onset dateTime corresponds to the implicit start dateTime of the datatype and the abatement dateTime corresponds to the implicit stop dateTime of the datatype. If the abatement dateTime is null, then the symptom is considered to still be active. When this datatype is used with timing relationships, the criterion is looking for whether the symptom was active for the time frame indicated by the timing relationships.
Symptom
Symptom represents an indication that a person has a condition or disease. Some examples are headache, fever, fatigue, nausea, vomiting, and pain. Also, symptoms are subjective manifestations of the disease perceived by the patient. As an example to differentiate symptom from finding, the patient's subjective symptom of fever is distinguished from the temperature (a finding). A finding could reference a temperature-measuring device and a recorder. The recorder could be the device (with electronic data capture) or an individual (healthcare provider, patient, etc.).
Note that while many symptoms are entered as findings as part of assessments and, therefore, may not be included in a specific EHR "symptom" section, QDM 5.6 retains the QDM datatype, "Symptom", for clarity of expression in the human readable eCQM.
prevalencePeriod
recorder
The recorder indicates who recorded (or documented) the information (e.g., the individual or organization documenting the information). Note that FHIR modeling includes reference to asserter for concepts such as diagnosis and allergy/intolerance. Feedback from implementers and EHR vendors suggest that asserter fields default to the individual entering the information without clear evidence about how often clinicians change the default to the person who reported the information. Therefore, QDM retains a recorder attribute for the referenced QDM datatypes.
The prescriber attribute references the new QDM entities (Patient, Care Partner, Practitioner, or Organization) and any or all of the attributes of the respective QDM entity. For example, to reference that a physician who recorded a diagnosis is the same person who was the primary participant in an "Encounter, Performed" and to assure the physician’s specialty meets the measure’s requirements, the eCQM can use the Practitioner entity and its attributes. Should the eCQM choose to reference a physician practice or a hospital, the performer can reference the Organization entity and indicate the identifier and/or the organization type.
[See Section 2.6 for description of QDM entities]