eCQM Title | Chlamydia Screening in Women |
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eCQM Identifier (Measure Authoring Tool) | 153 | eCQM Version Number | 12.0.000 |
NQF Number | Not Applicable | GUID | c9930664-be3d-4ffe-ae4a-5cf4933ecb89 |
Measurement Period | January 1, 20XX through December 31, 20XX | ||
Measure Steward | National Committee for Quality Assurance | ||
Measure Developer | National Committee for Quality Assurance | ||
Endorsed By | None | ||
Description |
Percentage of women 16-24 years of age who were identified as sexually active at any time during the measurement period and who had at least one test for chlamydia during the measurement period |
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Copyright |
This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, 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. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2022 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2022. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. LOINC(R) copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 copyright 2022 World Health Organization. All Rights Reserved. |
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Disclaimer |
The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]. |
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Measure Scoring | Proportion | ||
Measure Type | Process | ||
Stratification |
Report a total score, and each of the following strata: Stratum 1: Patients age 16-20 by the end of the measurement period Stratum 2: Patients age 21-24 by the end of the measurement period |
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Risk Adjustment |
None |
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Rate Aggregation |
None |
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Rationale |
Chlamydia trachomatis is the most common sexually transmitted bacterial infection in the U.S., resulting in roughly 1.7 million cases (Centers for Disease Control and Prevention, 2019). Chlamydia infections are often asymptomatic, but, if left untreated, can lead to serious and irreversible complications (U.S. Preventive Services Task Force, 2014; Centers for Disease Control and Prevention, 2019). Women are particularly vulnerable when infected with chlamydia. Left untreated, chlamydia can cause pelvic inflammatory disease (PID), which can lead to chronic pelvic pain or infertility. Pregnant women may also transmit the infection to their infant, potentially resulting in neonatal pneumonia (Centers for Disease Control and Prevention, 2019). |
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Clinical Recommendation Statement |
U.S. Preventive Services Task Force (2021) recommends screening for chlamydia in all sexually active women aged 24 years or younger and in women 25 years or older who are at increased risk for infection (B recommendation) |
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Improvement Notation |
Higher score indicates better quality |
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Reference |
Reference Type: CITATION Reference Text: 'Centers for Disease Control and Prevention (CDC). (2019). Sexually Transmitted Disease Surveillance 2018. Atlanta: U.S. Department of Health and Human Services.' |
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Reference |
Reference Type: CITATION Reference Text: 'US Preventive Services Task Force, Davidson, K. W., Barry, M. J., Mangione, C. M., Cabana, M., Caughey, A. B., Davis, E. M., Donahue, K. E., Doubeni, C. A., Krist, A. H., Kubik, M., Li, L., Ogedegbe, G., Pbert, L., Silverstein, M., Simon, M. A., Stevermer, J., Tseng, C. W., & Wong, J. B. (2021). Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement. JAMA, 326(10), 949–956. https://doi.org/10.1001/jama.2021.14081' |
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Definition |
None |
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Guidance |
Codes to identify sexually active women include codes for: pregnancy, sexually transmitted infections, contraceptives or contraceptive devices, and infertility treatments. The denominator exclusion does not apply to patients who qualify for the initial population (IP) based on services other than the pregnancy test alone. These other services include services for sexually transmitted infections, contraceptives or contraceptive devices and infertility treatments. For example, a patient who has both a pregnancy test and a chlamydia diagnosis, either of which would qualify them for the IP, would not be eligible for this denominator exclusion. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. 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 |
Women 16 to 24 years of age by the end of the measurement period who are sexually active and who had a visit in the measurement period |
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Denominator |
Equals Initial Population |
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Denominator Exclusions |
Women who are only eligible for the initial population due to a pregnancy test during the measurement period, and who had an order for an x-ray or for a specified medication on the date of the pregnancy test or the six days after the pregnancy test. Exclude patients who are in hospice care for any part of the measurement period. |
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Numerator |
Women with at least one chlamydia test during the measurement period |
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Numerator Exclusions |
Not Applicable |
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Denominator Exceptions |
None |
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Supplemental Data Elements |
For every patient evaluated by this measure also identify payer, race, ethnicity and sex |
AgeInYearsAt(date from end of "Measurement Period" )in Interval[16, 24] and exists ( ["Patient Characteristic Sex": "Female"] ) and exists ( "Qualifying Encounters" ) and ( ( "Has Assessments Identifying Sexual Activity" ) or ( "Has Diagnoses Identifying Sexual Activity" ) or ( "Has Active Contraceptive Medications" ) or ( "Has Ordered Contraceptive Medications" ) or ( "Has Laboratory Tests Identifying Sexual Activity" ) or ( "Has Diagnostic Studies Identifying Sexual Activity" ) or ( "Has Procedures Identifying Sexual Activity" ) )
"Initial Population"
Hospice."Has Hospice Services" or ( ( "Has Pregnancy Test Exclusion" ) and not ( "Has Assessments Identifying Sexual Activity" ) and not ( "Has Diagnoses Identifying Sexual Activity" ) and not ( "Has Active Contraceptive Medications" ) and not ( "Has Ordered Contraceptive Medications" ) and not ( "Has Laboratory Tests Identifying Sexual Activity But Not Pregnancy" ) and not ( "Has Diagnostic Studies Identifying Sexual Activity" ) and not ( "Has Procedures Identifying Sexual Activity" ) )
exists ( ["Laboratory Test, Performed": "Chlamydia Screening"] ChlamydiaTest where Global."LatestOf" ( ChlamydiaTest.relevantDatetime, ChlamydiaTest.relevantPeriod ) during day of "Measurement Period" and ChlamydiaTest.result is not null )
None
None
AgeInYearsAt(date from end of "Measurement Period" )in Interval[16, 20]
AgeInYearsAt(date from end of "Measurement Period" )in Interval[21, 24]
"Initial Population"
Hospice."Has Hospice Services" or ( ( "Has Pregnancy Test Exclusion" ) and not ( "Has Assessments Identifying Sexual Activity" ) and not ( "Has Diagnoses Identifying Sexual Activity" ) and not ( "Has Active Contraceptive Medications" ) and not ( "Has Ordered Contraceptive Medications" ) and not ( "Has Laboratory Tests Identifying Sexual Activity But Not Pregnancy" ) and not ( "Has Diagnostic Studies Identifying Sexual Activity" ) and not ( "Has Procedures Identifying Sexual Activity" ) )
exists ( ["Medication, Active": "Contraceptive Medications"] ActiveContraceptives where ActiveContraceptives.relevantPeriod overlaps "Measurement Period" )
exists ( ["Assessment, Performed": "Have you ever had vaginal intercourse [PhenX]"] SexualActivityAssessment where SexualActivityAssessment.result ~ "Yes (qualifier value)" and Global."NormalizeInterval" ( SexualActivityAssessment.relevantDatetime, SexualActivityAssessment.relevantPeriod ) on or before end of "Measurement Period" )
exists ( ( ["Diagnosis": "Diagnoses Used to Indicate Sexual Activity"] union ["Diagnosis": "HIV"] union ["Diagnosis": "Complications of Pregnancy, Childbirth and the Puerperium"] ) SexualActivityDiagnosis where SexualActivityDiagnosis.prevalencePeriod overlaps "Measurement Period" )
exists ( ["Diagnostic Study, Order": "Diagnostic Studies During Pregnancy"] SexualActivityDiagnostics where SexualActivityDiagnostics.authorDatetime during day of "Measurement Period" )
exists ( ["Laboratory Test, Order": "Pregnancy Test"] PregnancyTest where PregnancyTest.authorDatetime during day of "Measurement Period" ) or "Has Laboratory Tests Identifying Sexual Activity But Not Pregnancy"
exists ( ( ["Laboratory Test, Order": "Pap Test"] union ["Laboratory Test, Order": "Lab Tests During Pregnancy"] union ["Laboratory Test, Order": "Lab Tests for Sexually Transmitted Infections"] ) LabOrders where LabOrders.authorDatetime during day of "Measurement Period" )
exists ( ["Medication, Order": "Contraceptive Medications"] OrderedContraceptives where OrderedContraceptives.authorDatetime during day of "Measurement Period" )
exists ( ( ["Laboratory Test, Order": "Pregnancy Test"] PregnancyTest with ["Diagnostic Study, Order": "XRay Study"] XrayOrder such that XrayOrder.authorDatetime occurs 6 days or less on or after day of PregnancyTest.authorDatetime where PregnancyTest.authorDatetime during "Measurement Period" ) union ( ["Laboratory Test, Order": "Pregnancy Test"] PregnancyTestOrder with ["Medication, Order": "Isotretinoin"] AccutaneOrder such that AccutaneOrder.authorDatetime occurs 6 days or less on or after day of PregnancyTestOrder.authorDatetime where PregnancyTestOrder.authorDatetime during "Measurement Period" ) )
exists ( ["Procedure, Performed": "Procedures Used to Indicate Sexual Activity"] ProceduresForSexualActivity where Global."NormalizeInterval" ( ProceduresForSexualActivity.relevantDatetime, ProceduresForSexualActivity.relevantPeriod ) during day of "Measurement Period" )
exists ( ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter where ( InpatientEncounter.dischargeDisposition ~ "Discharge to home for hospice care (procedure)" or InpatientEncounter.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)" ) and InpatientEncounter.relevantPeriod ends during day of "Measurement Period" ) or exists ( ["Encounter, Performed": "Hospice Encounter"] HospiceEncounter where HospiceEncounter.relevantPeriod overlaps day of "Measurement Period" ) or exists ( ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment where HospiceAssessment.result ~ "Yes (qualifier value)" and Global."NormalizeInterval" ( HospiceAssessment.relevantDatetime, HospiceAssessment.relevantPeriod ) overlaps day of "Measurement Period" ) or exists ( ["Intervention, Order": "Hospice Care Ambulatory"] HospiceOrder where HospiceOrder.authorDatetime during day of "Measurement Period" ) or exists ( ["Intervention, Performed": "Hospice Care Ambulatory"] HospicePerformed where Global."NormalizeInterval" ( HospicePerformed.relevantDatetime, HospicePerformed.relevantPeriod ) overlaps day of "Measurement Period" ) or exists ( ["Diagnosis": "Hospice Diagnosis"] HospiceCareDiagnosis where HospiceCareDiagnosis.prevalencePeriod overlaps day of "Measurement Period" )
AgeInYearsAt(date from end of "Measurement Period" )in Interval[16, 24] and exists ( ["Patient Characteristic Sex": "Female"] ) and exists ( "Qualifying Encounters" ) and ( ( "Has Assessments Identifying Sexual Activity" ) or ( "Has Diagnoses Identifying Sexual Activity" ) or ( "Has Active Contraceptive Medications" ) or ( "Has Ordered Contraceptive Medications" ) or ( "Has Laboratory Tests Identifying Sexual Activity" ) or ( "Has Diagnostic Studies Identifying Sexual Activity" ) or ( "Has Procedures Identifying Sexual Activity" ) )
exists ( ["Laboratory Test, Performed": "Chlamydia Screening"] ChlamydiaTest where Global."LatestOf" ( ChlamydiaTest.relevantDatetime, ChlamydiaTest.relevantPeriod ) during day of "Measurement Period" and ChlamydiaTest.result is not null )
( ( ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Preventive Care Services Established Office Visit, 18 and Up"] union ["Encounter, Performed": "Preventive Care Services Initial Office Visit, 18 and Up"] union ["Encounter, Performed": "Preventive Care Services, Initial Office Visit, 0 to 17"] union ["Encounter, Performed": "Preventive Care, Established Office Visit, 0 to 17"] union ["Encounter, Performed": "Home Healthcare Services"] union ["Encounter, Performed": "Telephone Visits"] union ["Encounter, Performed": "Online Assessments"] ) ValidEncounters where ValidEncounters.relevantPeriod during day of "Measurement Period" )
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
AgeInYearsAt(date from end of "Measurement Period" )in Interval[16, 20]
AgeInYearsAt(date from end of "Measurement Period" )in Interval[21, 24]
not ( end of period is null or end of period = maximum DateTime )
if ( HasEnd(period)) then end of period else start of period
Latest(NormalizeInterval(pointInTime, period))
if pointInTime is not null then Interval[pointInTime, pointInTime] else if period is not null then period else null as Interval<DateTime>
["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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