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  2. CQM-452

PN6 Perpetuation of redundant antibiotic regimen?

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
    • Resolution: Answered
    • Icon: Minor Minor
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    • Pop 1 Antibiotic Reg: 3b redundant
    • Tamara Bailey
    • 520.750.4324
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      The statement "Regimen 3b's final point in the algorithm logic cannot be reached because the patient would already qualify as having met regimen 1b or 2b" is TRUE. It may sound like a redundant logic, but it was intentionally designed like this to reflect the clinical guidelines. The algorithms are designed not only for the programmers and data analysts but also for the clinical personnel. The latter wanted to see all the recommended regimens listed in the algorithm to avoid sending a wrong message that CMS is omitting an appropriate treatment for quality performance purposes. The second reason is that if a programmer/analyst reverses the order of the regimens, for example to estimate the number of patients that meet each regimen, the algorithm would still work, in which case regimen 3b becomes relevant. From an analytic/programmatic standpoint, this apparent redundancy does NOT create any erroneous results at all.
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      The statement "Regimen 3b's final point in the algorithm logic cannot be reached because the patient would already qualify as having met regimen 1b or 2b" is TRUE. It may sound like a redundant logic, but it was intentionally designed like this to reflect the clinical guidelines. The algorithms are designed not only for the programmers and data analysts but also for the clinical personnel. The latter wanted to see all the recommended regimens listed in the algorithm to avoid sending a wrong message that CMS is omitting an appropriate treatment for quality performance purposes. The second reason is that if a programmer/analyst reverses the order of the regimens, for example to estimate the number of patients that meet each regimen, the algorithm would still work, in which case regimen 3b becomes relevant. From an analytic/programmatic standpoint, this apparent redundancy does NOT create any erroneous results at all.
    • CMS188v1/NQF0147

      PN6, Population 1 (the ICU population) has 4 drug regimens in it:

      1. IV Macrolides AND (IV Beta Lactams OR IV Antipneumoccal/Antipsuedomonal Beta Lactams) (Corresponds to Regimen 1b of the legacy measures)
      2. IV Quinolones Antipneumococcal AND (IV Beta Lactams OR IV Antipneumoccal/Antipsuedomonal Beta Lactams) (Corresponds to Regimen 2b of the legacy measures)
      3. IV Antipseudomonal Quinolones AND (IV Beta Lactams OR IV Antipneumoccal/Antipsuedomonal Beta Lactams) (Also corresponds to Regimen 2b of the legacy measures)
      4. IV Antipneumoccal/Antipsuedomonal Beta Lactams AND IV Aminoglycosides AND (IV Quinolones Antipneumococcal OR IV Macrolides) (Corresponds to Regimen 3b of the legacy measures)

      For several years, it has been acknowledged in a note on the legacy measures that Regimen 3b's final point in the algorithm logic cannot be reached because the patient will already qualify as having gotten regimen 1b or 2b. This also occurs in the new format. Why is this redundant logic being continued, especially in the new format?

            abt.associate Abt Associate (Inactive)
            tamarabailey Tamara Bailey (Inactive)
            Deborah Krauss (Inactive)
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