Brief Description of Measure:

​CMS117: Childhood Immunization Status:
Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); three or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday

Description of Issue:

​Our measure team have noticed that the value set Anaphylactic Reaction to Common Baker's Yeast Grouping OID (2.16.840.1.113883.3.464.1003.199.12.1032) does not meet the intent of the measure. There are no codes that specifically identify “anaphylactic reaction to common baker’s yeast.” The two codes that were included in the value set do NOT identify “anaphylaxis to common baker’s yeast.” The value set and the codes within are not contraindications to vaccination, therefore, they are being removed from the measure. 

Proposed Solution:

​Current valueset:
Anaphylactic Reaction to Common Baker's Yeast Grouping OID (2.16.840.1.113883.3.464.1003.199.12.1032)

Proposed value set:
Remove Anaphylactic Reaction to Common Baker's Yeast Grouping OID (2.16.840.1.113883.3.464.1003.199.12.1032)

Current logic:
Hepatitis B Numerator Inclusion Conditions
( ( ["Laboratory Test, Performed": "Anti Hepatitis B Virus Surface Ab"] HepatitisBAntigenTest
    where HepatitisBAntigenTest.result as Code in "Positive Finding"
)
  union ( ["Diagnosis": "Anaphylaxis due to Hepatitis B vaccine (disorder)"] HepatitisBReaction
      return "Laboratory Test, Performed" { relevantDatetime: start of HepatitisBReaction.prevalencePeriod }
  )
  union ( ["Diagnosis": "Anaphylactic Reaction to Common Baker's Yeast"] YeastReaction
      return "Laboratory Test, Performed" { relevantDatetime: start of YeastReaction.prevalencePeriod }
  )
  union ( ["Diagnosis": "Hepatitis B"] HepatitisBDiagnosis
      return "Laboratory Test, Performed" { relevantDatetime: start of HepatitisBDiagnosis.prevalencePeriod }
  ) ) HepBConditions
  where Global."NormalizeInterval" ( HepBConditions.relevantDatetime, HepBConditions.relevantPeriod ) ends during "First Two Years"

Proposed logic:
Hepatitis B Numerator Inclusion Conditions
( ( ["Laboratory Test, Performed": "Anti Hepatitis B Virus Surface Ab"] HepatitisBAntigenTest
    where HepatitisBAntigenTest.result as Code in "Positive Finding"
)
  union ( ["Diagnosis": "Anaphylaxis due to Hepatitis B vaccine (disorder)"] HepatitisBReaction
      return "Laboratory Test, Performed" { relevantDatetime: start of HepatitisBReaction.prevalencePeriod }
  )
  union ( ["Diagnosis": "Hepatitis B"] HepatitisBDiagnosis
      return "Laboratory Test, Performed" { relevantDatetime: start of HepatitisBDiagnosis.prevalencePeriod }
  ) ) HepBConditions
  where Global."NormalizeInterval" ( HepBConditions.relevantDatetime, HepBConditions.relevantPeriod ) ends during "First Two Years"

Rationale for Change:

​​We plan to remove the value set Anaphylactic Reaction to Common Baker's Yeast Grouping OID (2.16.840.1.113883.3.464.1003.199.12.1032) because it current content and available coding does not meet the intent of the measure.