-
Initial Patient Population =
- AND: "Patient Characteristic Birthdate: birth date" >= 18 year(s) starts before start of "Occurrence A of Encounter, Performed:
Inpatient Encounter"
- AND: "Occurrence A of Encounter, Performed: Inpatient Encounter (length of stay <= 120 day(s))"
- AND: "Occurrence A of Encounter, Performed: Inpatient Encounter (discharge datetime)" during "Measurement Period"
- AND:
- OR: "Diagnosis, Active: Ischemic Stroke (ordinality: 'Principal Diagnosis')"
- OR: "Diagnosis, Active: Hemorrhagic Stroke (ordinality: 'Principal Diagnosis')"
- starts during "Occurrence A of Encounter, Performed: Inpatient Encounter"
-
Denominator =
- AND: "Initial Patient Population"
- AND: "Diagnosis, Active: Ischemic Stroke (ordinality: 'Principal Diagnosis')" starts during "Occurrence A of Encounter, Performed:
Inpatient Encounter"
- AND: "Occurrence A of Encounter, Performed: Inpatient Encounter (admission datetime)" <= 1 hour(s) starts after end of "Occurrence
A of Encounter, Performed: Emergency Department Visit"
- AND:
- OR: "Occurrence A of Symptom, Active: Neurologic Symptoms of Stroke (start datetime)"
- OR: "Occurrence A of Symptom, Active: Baseline State (stop datetime)"
- <= 120 minute(s) starts before start of "Occurrence A of Encounter, Performed: Emergency Department Visit (facility location
arrival datetime)"
-
Denominator Exclusions =
- AND:
- OR: "Occurrence A of Encounter, Performed: Inpatient Encounter (reason: 'Carotid Intervention')"
- OR: "Risk Category Assessment: National Institute of Health Stroke Scale (result = 0 )" <= 180 minute(s) starts after start
of
- OR: "Occurrence A of Symptom, Active: Neurologic Symptoms of Stroke (start datetime)"
- OR: "Occurrence A of Symptom, Active: Baseline State (stop datetime)"
- OR: "Medication, Administered: Thrombolytic (t-PA) Therapy" <= 2 day(s) starts before start of "Occurrence A of Encounter,
Performed: Emergency Department Visit (facility location arrival datetime)"
- OR:
- OR: "Medication, Order not done: Medical Reason" for "Thrombolytic (t-PA) Therapy RxNorm Value Set"
- OR: "Medication, Order not done: Patient Refusal" for "Thrombolytic (t-PA) Therapy RxNorm Value Set"
- OR: "Medication, Administered not done: Medical Reason" for "Thrombolytic (t-PA) Therapy RxNorm Value Set"
- OR: "Medication, Administered not done: Patient Refusal" for "Thrombolytic (t-PA) Therapy RxNorm Value Set"
- <= 180 minute(s) starts after start of "Occurrence A of Symptom, Active: Baseline State (stop datetime)"
- OR:
- OR: "Medication, Order not done: Medical Reason" for "Thrombolytic (t-PA) Therapy RxNorm Value Set"
- OR: "Medication, Order not done: Patient Refusal" for "Thrombolytic (t-PA) Therapy RxNorm Value Set"
- OR: "Medication, Administered not done: Medical Reason" for "Thrombolytic (t-PA) Therapy RxNorm Value Set"
- OR: "Medication, Administered not done: Patient Refusal" for "Thrombolytic (t-PA) Therapy RxNorm Value Set"
- <= 180 minute(s) starts after start of "Occurrence A of Symptom, Active: Neurologic Symptoms of Stroke (start datetime)"
-
Numerator =
- AND:
- OR: "Medication, Administered: Thrombolytic (t-PA) Therapy" <= 180 minute(s) starts after start of "Occurrence A of Symptom,
Active: Baseline State (stop datetime)"
- OR: "Medication, Administered: Thrombolytic (t-PA) Therapy" <= 180 minute(s) starts after start of "Occurrence A of Symptom,
Active: Neurologic Symptoms of Stroke (start datetime)"
-
Denominator Exceptions =
-
"Diagnosis, Active: Hemorrhagic Stroke" using "Hemorrhagic Stroke Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.212)"
-
"Diagnosis, Active: Ischemic Stroke" using "Ischemic Stroke Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.247)"
-
"Encounter, Performed: Emergency Department Visit" using "Emergency Department Visit Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.293)"
-
"Encounter, Performed: Inpatient Encounter" using "Inpatient Encounter SNOMED-CT Value Set (2.16.840.1.113883.3.117.1.7.1.23)"
-
"Medication, Administered: Thrombolytic (t-PA) Therapy" using "Thrombolytic (t-PA) Therapy RxNorm Value Set (2.16.840.1.113883.3.117.1.7.1.226)"
-
"Medication, Administered not done: Medical Reason" using "Medical Reason SNOMED-CT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Administered not done: Patient Refusal" using "Patient Refusal SNOMED-CT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Medication, Order: Thrombolytic (t-PA) Therapy" using "Thrombolytic (t-PA) Therapy RxNorm Value Set (2.16.840.1.113883.3.117.1.7.1.226)"
-
"Medication, Order not done: Medical Reason" using "Medical Reason SNOMED-CT Value Set (2.16.840.1.113883.3.117.1.7.1.473)"
-
"Medication, Order not done: Patient Refusal" using "Patient Refusal SNOMED-CT Value Set (2.16.840.1.113883.3.117.1.7.1.93)"
-
"Patient Characteristic Birthdate: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"
-
"Risk Category Assessment: National Institute of Health Stroke Scale" using "National Institute of Health Stroke Scale LOINC Value Set (2.16.840.1.113883.3.117.1.7.1.269)"
-
"Symptom, Active: Baseline State" using "Baseline State SNOMED-CT Value Set (2.16.840.1.113883.3.117.1.7.1.417)"
-
"Symptom, Active: Neurologic Symptoms of Stroke" using "Neurologic Symptoms of Stroke SNOMED-CT Value Set (2.16.840.1.113883.3.117.1.7.1.399)"
-
Attribute: "Ordinality: Principal Diagnosis" using "Principal Diagnosis SNOMED-CT Value Set (2.16.840.1.113883.3.117.2.7.1.14)"
-
Attribute: "Reason: Carotid Intervention" using "Carotid Intervention Grouping Value Set (2.16.840.1.113883.3.117.1.7.1.204)"
-
"Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity CDC Value Set (2.16.840.1.114222.4.11.837)"
-
"Patient Characteristic Payer: Payer" using "Payer Source of Payment Typology Value Set (2.16.840.1.114222.4.11.3591)"
-
"Patient Characteristic Race: Race" using "Race CDC Value Set (2.16.840.1.114222.4.11.836)"
-
"Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex Administrative Sex Value Set (2.16.840.1.113762.1.4.1)"