eCQM Title

Antithrombotic Therapy By End of Hospital Day 2

eCQM Identifier (Measure Authoring Tool)

eCQM Version Number

10.6.000

NQF Number

Not Applicable

GUID

93f3479f-75d8-4731-9a3f-b7749d8bcd37

Measurement Period

January 1, 20XX through December 31, 20XX

Measure Steward

The Joint Commission

Measure Developer

The Joint Commission

Endorsed By

None

Description

Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2

Measure specifications are in the Public Domain

LOINC(R) copyright 2004-2020 Regenstrief Institute, Inc. 
This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2020 International Health Terminology Standards Development Organisation. ICD-10 copyright 2020 World Health Organization. All Rights Reserved.

Disclaimer

These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.

Measure Scoring

Proportion

Measure Type

Process

Stratification

None

Risk Adjustment

None

Rate Aggregation

None

Rationale

The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist.

Anticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.

Clinical Recommendation Statement

Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist

Improvement Notation

Improvement noted as an increase in rate

Reference

Reference Type: CITATION

Reference Text: 'Adams, H., Adams, R., del Zoppo, G., et al. (2005, April). Guidelines for the early management of patients with ischemic stroke: 2005 guidelines update—A scientific statement from the Stroke Council of the American Heart Association/American Stroke Association. Stroke, 36(4): 916-923. '

Reference

Reference Type: CITATION

Reference Text: 'Adams, H. P., Jr., del Zoppo, G., Alberts, M. J., et al. (2007, May). Guidelines for the early management of adults with ischemic stroke: A guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke, 38(5), 1655-1711. '

Reference

Reference Type: CITATION

Reference Text: 'Albers, G. W, Amarenco, P., Easton, J. D., et al. (2001). Antithrombotic and thrombolytic therapy for ischemic stroke. Chest, 119, 300-320. '

Reference

Reference Type: CITATION

Reference Text: 'Antithrombotic Trialists’ Collaboration. (2002, January 12). Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high-risk patients. BMJ, 324(7329), 71-86. '

Reference

Reference Type: CITATION

Reference Text: 'Brott, T. G., Clark, W. M., Fagan, S. C., et al. (2000). Stroke: The first hours. Guidelines for acute treatment. Washington, DC: National Stroke Association. '

Reference

Reference Type: CITATION

Reference Text: 'Centers for Disease Control and Prevention. (2009, May 1). Prevalence and most common causes of disability among adults—United States, 2005. Morbidity and Mortality Weekly Report, 58(16), 421-426. '

Reference

Reference Type: CITATION

Reference Text: 'Chen, Z. M., Sandercock, P., Pan, H. C., et al. (2000, June). Indications for early aspirin use in acute ischemic stroke: A combined analysis of 40,000 randomized patients from the Chinese Acute Stroke Trial and the International Stroke Trial. Stroke, 31(6), 1240-1249. '

Reference

Reference Type: CITATION

Reference Text: 'Coull, B. M., Williams, L. S., Goldstein, L. B., et al. (2002, July). Anticoagulants and antiplatelet agents in acute ischemic stroke: Report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a Division of the American Heart Association). Stroke, 33(7), 1934-1942. '

Reference

Reference Type: CITATION

Reference Text: 'Eccles, M., Freemantle, N., & Mason, J. (1998, April 25). North of England Evidence-Based Guideline Development Project: Guideline on the use of aspirin as secondary prophylaxis for vascular disease in primary care. BMJ, 316(7140), 1303-1309. '

Reference

Reference Type: CITATION

Reference Text: 'ESPS Group. (1987, December 12). The European Stroke Prevention Study (ESPS): Principal end-points. Lancet, 2(8572), 1351-1354. '

Reference

Reference Type: CITATION

Reference Text: 'Furie, K. L., Kasner, S. E., Adams, R. J., et al. (2011, January). Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 42(1), 227-276. '

Reference

Reference Type: CITATION

Reference Text: 'Gaspoz, J. M., Coxson, P. G., Goldman, P. A., et al. (2002, June 6). Cost effectiveness of aspirin, clopidogrel, or both for secondary prevention of coronary heart disease. New England Journal of Medicine, 346(23), 1800-1806. '

Reference

Reference Type: CITATION

Reference Text: 'Guyatt, G. H., Akl, E. A., Crowther, M., et al. (2012, February). Executive summary: Antithrombotic therapy and prevention of thrombosis, 9th ed.: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 141(2 Suppl.), 7S-47S. '

Reference

Reference Type: CITATION

Reference Text: 'International Stroke Trial Collaborative Group. (1997, May 31). The International Stroke Trial (IST): A randomised trial of aspirin, subcutaneous heparin, both, or neither among 19,435 patients with acute ischaemic stroke. Lancet, 349(9065), 1569-1581. '

Reference

Reference Type: CITATION

Reference Text: 'Jauch, E. C., Saver, J. L., Adams, H. P., Jr., et al. (2013). Guidelines for the early management of patients with acute ischemic stroke: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 44(3), 870-947. '

Reference

Reference Type: CITATION

Reference Text: 'Johnson, E. S., Lanes, S. F., Wentworth, C. E., III, et al. (1999, June 14). A metaregression analysis of the dose-response effect of aspirin on stroke. Archives of Internal Medicine, 159(11), 1248-1253. '

Reference

Reference Type: CITATION

Reference Text: 'Powers, W. J., Rabinstein, A. A., Ackerson, T., et al. (2018, January). 2018 guidelines for the early management of patients with acute ischemic stroke: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 49,'

Reference

Reference Type: CITATION

Reference Text: 'Roger, V. L., Go, A. S., Lloyd-Jones, D. M., et al. (2012, January 3). Heart disease and stroke statistics—2012 update: A report from the American Heart Association. Circulation, 125(1), e2-e220. '

Reference

Reference Type: CITATION

Reference Text: 'Sacco, R. L., Adams, R., Albers, G., et al. (2006, February). Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: A statement for health care professionals from the American Heart Association/American Stroke Association Council on Stroke: Co-sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Stroke, 37(2), 577-617. '

Definition

None

Guidance

The "Non-elective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Inpatient Encounter" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective Inpatient Encounters include emergency, urgent, and unplanned admissions. 

NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e. rectal or intravenous).  

In the denominator exclusions, the intent is to only exclude patients with a total length of stay of <2 days, including ED visit (if there is one). For the eCQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits.

This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.

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.

Transmission Format

TBD

Initial Population

Inpatient hospitalization for patients age 18 and older discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends during measurement period

Denominator

Inpatient hospitalizations for patients with a principal diagnosis of ischemic stroke

Denominator Exclusions

Inpatient hospitalizations for patients who have a duration of stay less than 2 days.
Inpatient hospitalization for patients with comfort measures documented day of or the day after arrival.
Inpatient hospitalization for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization.

Numerator

Inpatient hospitalization for patients who had antithrombotic therapy administered the day of or day after hospital arrival

Numerator Exclusions

Not Applicable

Denominator Exceptions

Inpatient hospitalization for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival.
Inpatient hospitalization for patients who receive Ticagrelor or Prasugrel as an antithrombotic therapy the day of or day after hospital arrival.
Inpatient hospitalization for patients with an INR greater than 3.5.

Supplemental Data Elements

For every patient evaluated by this measure also identify payer, race, ethnicity and sex

Population Criteria
Definitions
Functions
Terminology
Data Criteria (QDM Data Elements)
Supplemental Data Elements
Risk Adjustment Variables

Population Criteria

Initial Population

TJC."Encounter with Principal Diagnosis and Age"

- Denominator
  - TJC."Ischemic Stroke Encounter"

Denominator Exclusions

"Encounter Less Than Two Days"
  union "Encounter with Comfort Measures during Hospitalization"
  union "Encounter with Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization"

- Numerator
  - "Encounter with Antithrombotic Therapy"

- Numerator Exclusions
  - None

Denominator Exceptions

"No Antithrombotic Ordered Day Of or Day After Hospital Arrival"
  union "Encounter With Pharmacological Contraindications for Antithrombotic Therapy Given Day Of or Day After Hospital Arrival"
  union "Encounter With An INR Greater Than 3.5"

- Stratification
  - None

Definitions

Denominator
- - TJC."Ischemic Stroke Encounter"

Denominator Exceptions

"No Antithrombotic Ordered Day Of or Day After Hospital Arrival"
  union "Encounter With Pharmacological Contraindications for Antithrombotic Therapy Given Day Of or Day After Hospital Arrival"
  union "Encounter With An INR Greater Than 3.5"

Denominator Exclusions

"Encounter Less Than Two Days"
  union "Encounter with Comfort Measures during Hospitalization"
  union "Encounter with Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization"

Encounter Less Than Two Days

TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
  where Global."HospitalizationWithObservationLengthofStay" ( IschemicStrokeEncounter ) < 2

Encounter With An INR Greater Than 3.5

TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
  with ["Laboratory Test, Performed": "INR"] INR
    such that INR.resultDatetime during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )
      and INR.result > 3.5

Encounter with Antithrombotic Therapy

TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
  with ["Medication, Administered": "Antithrombotic Therapy"] Antithrombotic
    such that Global."NormalizeInterval" ( Antithrombotic.relevantDatetime, Antithrombotic.relevantPeriod ) starts during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

Encounter with Comfort Measures during Hospitalization

TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
  with TJC."Intervention Comfort Measures" ComfortMeasures
    such that Coalesce(start of Global."NormalizeInterval"(ComfortMeasures.relevantDatetime, ComfortMeasures.relevantPeriod), ComfortMeasures.authorDatetime)during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

Encounter With Pharmacological Contraindications for Antithrombotic Therapy Given Day Of or Day After Hospital Arrival

TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
  with ["Medication, Administered": "Pharmacological Contraindications For Antithrombotic Therapy"] PharmacologicalContraindications
    such that Global."NormalizeInterval" ( PharmacologicalContraindications.relevantDatetime, PharmacologicalContraindications.relevantPeriod ) starts during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

Encounter With Thrombolytic Therapy Documented As Already Given

TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
  with [Diagnosis: "Intravenous or Intra arterial Thrombolytic (tPA) Therapy Prior to Arrival"] PriorTPA
    such that PriorTPA.authorDatetime during Global."HospitalizationWithObservation" ( IschemicStrokeEncounter )

Encounter with Thrombolytic Therapy Given Prior To Arrival Or During Hospitalization

"Encounter with Thrombolytic Therapy Medication or Procedures"
  union "Encounter With Thrombolytic Therapy Prior to Arrival"
  union "Encounter With Thrombolytic Therapy Documented As Already Given"

Encounter with Thrombolytic Therapy Medication or Procedures

TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
  with "Thrombolytic Therapy Medication or Procedures" ThrombolyticTherapy
    such that Global."NormalizeInterval" ( ThrombolyticTherapy.relevantDatetime, ThrombolyticTherapy.relevantPeriod ) starts during Interval[start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) - 24 hours, 
    end of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

Encounter With Thrombolytic Therapy Prior to Arrival

TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
  where exists IschemicStrokeEncounter.diagnoses Diagnosis
    where Diagnosis.code in "Intravenous or Intra arterial Thrombolytic (tPA) Therapy Prior to Arrival"

Initial Population

TJC."Encounter with Principal Diagnosis and Age"

No Antithrombotic Administered

["Medication, Not Administered": "Antithrombotic Therapy"] NoAntithromboticGiven
  where NoAntithromboticGiven.negationRationale in "Medical Reason"
    or NoAntithromboticGiven.negationRationale in "Patient Refusal"

No Antithrombotic Ordered

"No Antithrombotic Ordered for Medical Reason or Patient Refusal"
  union "No Antithrombotic Administered"

No Antithrombotic Ordered Day Of or Day After Hospital Arrival

TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
  with "No Antithrombotic Ordered" NoAntithrombotic
    such that NoAntithrombotic.authorDatetime during TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )

No Antithrombotic Ordered for Medical Reason or Patient Refusal

["Medication, Not Ordered": "Antithrombotic Therapy"] NoAntithromboticOrder
  where NoAntithromboticOrder.negationRationale in "Medical Reason"
    or NoAntithromboticOrder.negationRationale in "Patient Refusal"

Numerator
- - "Encounter with Antithrombotic Therapy"

SDE Ethnicity

["Patient Characteristic Ethnicity": "Ethnicity"]

SDE Payer

["Patient Characteristic Payer": "Payer"]

SDE Race
- - ["Patient Characteristic Race": "Race"]

SDE Sex

["Patient Characteristic Sex": "ONC Administrative Sex"]

Thrombolytic Therapy Medication or Procedures

["Medication, Administered": "Thrombolytic (t-PA) Therapy"]
  union ["Procedure, Performed": "Intravenous or Intra-arterial Thrombolytic (t-PA) Therapy"]

TJC.All Stroke Encounter

"Non Elective Inpatient Encounter" NonElectiveEncounter
  where exists ( NonElectiveEncounter.diagnoses Diagnosis
      where Diagnosis.rank = 1
        and ( Diagnosis.code in "Hemorrhagic Stroke"
            or Diagnosis.code in "Ischemic Stroke"
        )
  )

TJC.Encounter with Principal Diagnosis and Age

"All Stroke Encounter" AllStrokeEncounter
  with ["Patient Characteristic Birthdate": "Birth date"] BirthDate
    such that Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of AllStrokeEncounter.relevantPeriod ) >= 18

TJC.Intervention Comfort Measures

["Intervention, Order": "Comfort Measures"]
  union ["Intervention, Performed": "Comfort Measures"]

TJC.Ischemic Stroke Encounter

"Encounter with Principal Diagnosis and Age" EncounterWithAge
  where exists ( EncounterWithAge.diagnoses Diagnosis
      where Diagnosis.code in "Ischemic Stroke"
        and Diagnosis.rank = 1
  )

TJC.Non Elective Inpatient Encounter

["Encounter, Performed": "Non-Elective Inpatient Encounter"] NonElectiveEncounter
  where Global."LengthInDays" ( NonElectiveEncounter.relevantPeriod ) <= 120
    and NonElectiveEncounter.relevantPeriod ends during day of "Measurement Period"

Functions

Global.CalendarAgeInYearsAt(BirthDateTime DateTime, AsOf DateTime)
- - years between ToDate(BirthDateTime)and ToDate(AsOf)

Global.HospitalizationWithObservation(Encounter "Encounter, Performed")

Encounter Visit
	let ObsVisit: Last(["Encounter, Performed": "Observation Services"] LastObs
			where LastObs.relevantPeriod ends 1 hour or less on or before start of Visit.relevantPeriod
			sort by 
			end of relevantPeriod
	),
	VisitStart: Coalesce(start of ObsVisit.relevantPeriod, start of Visit.relevantPeriod),
	EDVisit: Last(["Encounter, Performed": "Emergency Department Visit"] LastED
			where LastED.relevantPeriod ends 1 hour or less on or before VisitStart
			sort by 
			end of relevantPeriod
	)
	return Interval[Coalesce(start of EDVisit.relevantPeriod, VisitStart), 
	end of Visit.relevantPeriod]

Global.HospitalizationWithObservationLengthofStay(Encounter "Encounter, Performed")
- - "LengthInDays"("HospitalizationWithObservation"(Encounter))

Global.LengthInDays(Value Interval<DateTime>)

difference in days between start of Value and end of Value

Global.NormalizeInterval(pointInTime DateTime, period Interval<DateTime>)

if pointInTime is not null then Interval[pointInTime, pointInTime]
  else if period is not null then period 
  else null as Interval<DateTime>

Global.ToDate(Value DateTime)

DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)

TJC.CalendarDayOfOrDayAfter(StartValue DateTime)

Interval[Global."ToDate" ( StartValue ), Global."ToDate" ( StartValue + 2 days ) )

Terminology

code "Birth date" ("LOINC Code (21112-8)")
valueset "Antithrombotic Therapy" (2.16.840.1.113762.1.4.1110.62)
valueset "Comfort Measures" (1.3.6.1.4.1.33895.1.3.0.45)
valueset "Emergency Department Visit" (2.16.840.1.113883.3.117.1.7.1.292)
valueset "Ethnicity" (2.16.840.1.114222.4.11.837)
valueset "Hemorrhagic Stroke" (2.16.840.1.113883.3.117.1.7.1.212)
valueset "INR" (2.16.840.1.113883.3.117.1.7.1.213)
valueset "Intravenous or Intra arterial Thrombolytic (tPA) Therapy Prior to Arrival" (2.16.840.1.113762.1.4.1110.21)
valueset "Intravenous or Intra-arterial Thrombolytic (t-PA) Therapy" (2.16.840.1.113762.1.4.1045.21)
valueset "Ischemic Stroke" (2.16.840.1.113883.3.117.1.7.1.247)
valueset "Medical Reason" (2.16.840.1.113883.3.117.1.7.1.473)
valueset "Non-Elective Inpatient Encounter" (2.16.840.1.113883.3.117.1.7.1.424)
valueset "Observation Services" (2.16.840.1.113762.1.4.1111.143)
valueset "ONC Administrative Sex" (2.16.840.1.113762.1.4.1)
valueset "Patient Refusal" (2.16.840.1.113883.3.117.1.7.1.93)
valueset "Payer" (2.16.840.1.114222.4.11.3591)
valueset "Pharmacological Contraindications For Antithrombotic Therapy" (2.16.840.1.113762.1.4.1110.52)
valueset "Race" (2.16.840.1.114222.4.11.836)
valueset "Thrombolytic (t-PA) Therapy" (2.16.840.1.113883.3.117.1.7.1.226)

Data Criteria (QDM Data Elements)

"Diagnosis: Intravenous or Intra arterial Thrombolytic (tPA) Therapy Prior to Arrival" using "Intravenous or Intra arterial Thrombolytic (tPA) Therapy Prior to Arrival (2.16.840.1.113762.1.4.1110.21)"
"Encounter, Performed: Emergency Department Visit" using "Emergency Department Visit (2.16.840.1.113883.3.117.1.7.1.292)"
"Encounter, Performed: Non-Elective Inpatient Encounter" using "Non-Elective Inpatient Encounter (2.16.840.1.113883.3.117.1.7.1.424)"
"Encounter, Performed: Observation Services" using "Observation Services (2.16.840.1.113762.1.4.1111.143)"
"Intervention, Order: Comfort Measures" using "Comfort Measures (1.3.6.1.4.1.33895.1.3.0.45)"
"Intervention, Performed: Comfort Measures" using "Comfort Measures (1.3.6.1.4.1.33895.1.3.0.45)"
"Laboratory Test, Performed: INR" using "INR (2.16.840.1.113883.3.117.1.7.1.213)"
"Medication, Administered: Antithrombotic Therapy" using "Antithrombotic Therapy (2.16.840.1.113762.1.4.1110.62)"
"Medication, Administered: Pharmacological Contraindications For Antithrombotic Therapy" using "Pharmacological Contraindications For Antithrombotic Therapy (2.16.840.1.113762.1.4.1110.52)"
"Medication, Administered: Thrombolytic (t-PA) Therapy" using "Thrombolytic (t-PA) Therapy (2.16.840.1.113883.3.117.1.7.1.226)"
"Medication, Not Administered: Antithrombotic Therapy" using "Antithrombotic Therapy (2.16.840.1.113762.1.4.1110.62)"
"Medication, Not Ordered: Antithrombotic Therapy" using "Antithrombotic Therapy (2.16.840.1.113762.1.4.1110.62)"
"Patient Characteristic Birthdate: Birth date" using "Birth date (LOINC Code 21112-8)"
"Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity (2.16.840.1.114222.4.11.837)"
"Patient Characteristic Payer: Payer" using "Payer (2.16.840.1.114222.4.11.3591)"
"Patient Characteristic Race: Race" using "Race (2.16.840.1.114222.4.11.836)"
"Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex (2.16.840.1.113762.1.4.1)"
"Procedure, Performed: Intravenous or Intra-arterial Thrombolytic (t-PA) Therapy" using "Intravenous or Intra-arterial Thrombolytic (t-PA) Therapy (2.16.840.1.113762.1.4.1045.21)"

Supplemental Data Elements

SDE Ethnicity

["Patient Characteristic Ethnicity": "Ethnicity"]

SDE Payer

["Patient Characteristic Payer": "Payer"]

SDE Race
- - ["Patient Characteristic Race": "Race"]

SDE Sex

["Patient Characteristic Sex": "ONC Administrative Sex"]

Risk Adjustment Variables

None

Measure Set

eMeasure Stroke (eSTK)