- Initial Population =
- AND: Age >= 18 year(s) at: Occurrence A of $EncounterInpatient
- AND:
- OR: $DiagnosisVTE starts during Occurrence A of $EncounterInpatient
- OR: $DiagnosisVTE starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- Denominator =
- AND: "Occurrence A of Diagnostic Study, Performed: VTE Diagnostic Test" satisfies all
- (result: VTE Confirmed)
- satisfies any
- starts during Occurrence A of $EncounterInpatient
- <= 4 day(s) starts before start of Occurrence A of $EncounterInpatient
- <= 4 day(s) starts before start of
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- AND: "Medication, Administered: Warfarin" satisfies any
- starts during Occurrence A of $EncounterInpatient
- starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- Denominator Exclusions =
- OR: $InterventionComfortMeasures starts during Occurrence A of $EncounterInpatient
- OR: $InterventionComfortMeasures starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- OR: Intersection of:
- Occurrence A of $EncounterInpatient
- "Encounter, Performed: Encounter Inpatient" satisfies any
- (discharge status: Discharge To Acute Care Facility)
- (discharge status: Discharged to Home for Hospice Care)
- (discharge status: Patient Expired)
- (discharge status: Discharged to Health Care Facility for Hospice Care)
- (discharge status: Left Against Medical Advice)
- Numerator =
- AND:
- OR:
- AND:
- First: Union of:
- $MedicationWarfarinParenteralAnticoagulantOverlap starts during Occurrence A of $EncounterInpatient
- $MedicationWarfarinParenteralAnticoagulantOverlap starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- >= 4 day(s) starts before start of
- Most recent: "Occurrence A of Medication, Administered: Parenteral Anticoagulant" starts during Occurrence A of $EncounterInpatient
- AND:
- OR: "Laboratory Test, Performed: INR (result >= 2.0 )" <= 1 day(s) starts after start of "Occurrence A of Medication, Administered: Parenteral Anticoagulant"
- OR:
- AND: "Laboratory Test, Performed: INR (result < 2.0 )" <= 1 day(s) starts after start of "Occurrence A of Medication, Administered: Parenteral Anticoagulant"
- AND: Union of:
- "Medication, Discharge: Parenteral Anticoagulant" starts during Occurrence A of $EncounterInpatient
- $MedicationReasonForNoParenteralAnticoagulantAtDischarge starts during Occurrence A of $EncounterInpatient
- $MedicationReasonForNotAdministeringParenteralAnticoagulantDose <= 1 day(s) starts after start of "Occurrence A of Medication, Administered: Parenteral Anticoagulant"
- OR: "Diagnosis, Active: Thrombocytopenia" <= 1 day(s) starts after start of "Occurrence A of Medication, Administered: Parenteral Anticoagulant"
- OR:
- AND:
- First: Union of:
- $MedicationWarfarinParenteralAnticoagulantOverlap starts during Occurrence A of $EncounterInpatient
- $MedicationWarfarinParenteralAnticoagulantOverlap starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- < 4 day(s) starts before start of
- Most recent: Union of:
- "Occurrence A of Medication, Administered: Parenteral Anticoagulant" starts during Occurrence A of $EncounterInpatient
- "Occurrence A of Medication, Administered: Parenteral Anticoagulant" starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- AND:
- OR: Union of:
- "Medication, Discharge: Parenteral Anticoagulant" starts during Occurrence A of $EncounterInpatient
- $MedicationReasonForNoParenteralAnticoagulantAtDischarge starts during Occurrence A of $EncounterInpatient
- $MedicationReasonForNotAdministeringParenteralAnticoagulantDose <= 1 day(s) starts after start of "Occurrence A of Medication, Administered: Parenteral Anticoagulant"
- OR: "Diagnosis, Active: Thrombocytopenia" <= 1 day(s) starts after start of "Occurrence A of Medication, Administered: Parenteral Anticoagulant"
- OR: Union of:
- $MedicationReasonForNoParenteralAnticoagulant
- $MedicationReasonForNotAdministeringParenteralAnticoagulantDose
- <= 1 day(s) starts after start of
- "Occurrence A of Diagnostic Study, Performed: VTE Diagnostic Test" during Occurrence A of $EncounterInpatient
- OR: Union of:
- $MedicationReasonForNoParenteralAnticoagulant
- $MedicationReasonForNotAdministeringParenteralAnticoagulantDose
- <= 1 day(s) starts after start of
- "Occurrence A of Diagnostic Study, Performed: VTE Diagnostic Test" starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- OR:
- AND: "Occurrence A of Diagnostic Study, Performed: VTE Diagnostic Test" <= 4 day(s) starts before start of Occurrence A of $EncounterInpatient
- AND: Union of:
- $MedicationReasonForNoParenteralAnticoagulant
- $MedicationReasonForNotAdministeringParenteralAnticoagulantDose
- <= 1 day(s) starts after start of Occurrence A of $EncounterInpatient
- OR:
- AND: "Occurrence A of Diagnostic Study, Performed: VTE Diagnostic Test" <= 4 day(s) starts before start of
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- AND: Union of:
- $MedicationReasonForNoParenteralAnticoagulant
- $MedicationReasonForNotAdministeringParenteralAnticoagulantDose
- <= 1 day(s) starts after start of
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- OR: Union of:
- Union of:
- "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"
- "Medication, Administered: Dabigatran"
- starts during Occurrence A of $EncounterInpatient
- Union of:
- "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment"
- "Medication, Administered: Dabigatran"
- starts during
- "Encounter, Performed: Emergency Department Visit" <= 1 hour(s) ends before or concurrent with start of Occurrence A of $EncounterInpatient
- starts after start of "Occurrence A of Diagnostic Study, Performed: VTE Diagnostic Test"
- Numerator Exclusions =
- Denominator Exceptions =
- Stratification =
- $EncounterInpatient =
- "Encounter, Performed: Encounter Inpatient" satisfies all
- (length of stay <= 120 day(s))
- ends during "Measurement Period"
- $DiagnosisVTE =
- Union of:
- "Diagnosis, Active: Venous Thromboembolism"
- "Diagnosis, Active: Obstetrics VTE"
- $InterventionComfortMeasures =
- Union of:
- "Intervention, Order: Comfort Measures"
- "Intervention, Performed: Comfort Measures"
- $MedicationReasonForNotAdministeringParenteralAnticoagulantDose =
- Union of:
- "Medication, Administered not done: Medical Reason" for "Parenteral Anticoagulant"
- "Medication, Administered not done: Patient Refusal" for "Parenteral Anticoagulant"
- $MedicationReasonForNoParenteralAnticoagulant =
- Union of:
- "Medication, Order not done: Medical Reason" for "Parenteral anticoagulant ingredient specific"
- "Medication, Order not done: Patient Refusal" for "Parenteral anticoagulant ingredient specific"
- $MedicationReasonForNoParenteralAnticoagulantAtDischarge =
- Union of:
- "Medication, Discharge not done: Medical Reason" for "Parenteral anticoagulant ingredient specific"
- "Medication, Discharge not done: Patient Refusal" for "Parenteral anticoagulant ingredient specific"
- $MedicationWarfarinParenteralAnticoagulantOverlap =
- Union of:
- "Medication, Administered: Parenteral Anticoagulant" < 1 day(s) starts after start of "Medication, Administered: Warfarin"
- "Medication, Administered: Parenteral Anticoagulant" < 1 day(s) starts before start of "Medication, Administered: Warfarin"
- "Diagnosis, Active: Obstetrics VTE" using "Obstetrics VTE Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.264)"
- "Diagnosis, Active: Thrombocytopenia" using "Thrombocytopenia Grouping Value Set (2.16.840.1.113762.1.4.1045.45)"
- "Diagnosis, Active: Venous Thromboembolism" using "Venous Thromboembolism Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.279)"
- "Diagnostic Study, Performed: VTE Diagnostic Test" using "VTE Diagnostic Test Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.276)"
- "Encounter, Performed: Emergency Department Visit" using "Emergency Department Visit SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.292)"
- "Encounter, Performed: Encounter Inpatient" using "Encounter Inpatient SNOMEDCT Value Set (2.16.840.1.113883.3.666.5.307)"
- "Intervention, Order: Comfort Measures " using "Comfort Measures SNOMEDCT Value Set (1.3.6.1.4.1.33895.1.3.0.45)"
- "Intervention, Performed: Comfort Measures " using "Comfort Measures SNOMEDCT Value Set (1.3.6.1.4.1.33895.1.3.0.45)"
- "Laboratory Test, Performed: INR" using "INR LOINC Value Set (2.16.840.1.113883.3.117.1.7.1.213)"
- "Medication, Administered: Dabigatran" using "Dabigatran RXNORM Value Set (2.16.840.1.113762.1.4.1110.4)"
- "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" using "Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.134)"
- "Medication, Administered: Parenteral Anticoagulant" using "Parenteral Anticoagulant RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.266)"
- "Medication, Administered: Warfarin" using "Warfarin RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.232)"
- "Medication, Administered not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
- "Medication, Administered not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
- "Medication, Discharge: Parenteral Anticoagulant" using "Parenteral Anticoagulant RXNORM Value Set (2.16.840.1.113883.3.117.1.7.1.266)"
- "Medication, Discharge: Parenteral anticoagulant ingredient specific" using "Parenteral anticoagulant ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.4)"
- "Medication, Discharge not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
- "Medication, Discharge not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
- "Medication, Order: Parenteral anticoagulant ingredient specific" using "Parenteral anticoagulant ingredient specific RXNORM Value Set (2.16.840.1.113762.1.4.1021.4)"
- "Medication, Order not done: Medical Reason" using "Medical Reason SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
- "Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
- Attribute: "Discharge status: Left Against Medical Advice" using "Left Against Medical Advice SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.308)"
- Attribute: "Discharge status: Patient Expired" using "Patient Expired SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.309)"
- Attribute: "Discharge status: Discharge To Acute Care Facility" using "Discharge To Acute Care Facility SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.87)"
- Attribute: "Discharge status: Discharged to Home for Hospice Care" using "Discharged to Home for Hospice Care SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.209)"
- Attribute: "Discharge status: Discharged to Health Care Facility for Hospice Care" using "Discharged to Health Care Facility for Hospice Care SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.207)"
- Attribute: "Result: VTE Confirmed" using "VTE Confirmed SNOMEDCT Value Set (2.16.840.1.113883.3.117.1.7.1.407)"
- "Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity CDCREC Value Set (2.16.840.1.114222.4.11.837)"
- "Patient Characteristic Payer: Payer" using "Payer SOP Value Set (2.16.840.1.114222.4.11.3591)"
- "Patient Characteristic Race: Race" using "Race CDCREC Value Set (2.16.840.1.114222.4.11.836)"
- "Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex AdministrativeGender Value Set (2.16.840.1.113762.1.4.1)"