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  1. eCQM Issue Tracker
  2. CQM-4899

Improve specificity of timeframes allowed

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    • EP/EC eCQMs
    • Status: Open
    • Moderate
    • Resolution: Unresolved
    • None

    Description

      Brief Description of Measure:

      CMS124: Cervical Cancer Screening:
      Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:

      • Women age 21-64 who had cervical cytology performed within the last 3 years
      • Women age 30-64 who had cervical human papillomavirus (HPV) testing performed within the last 5 years

      CMS130: Colorectal Cancer Screening:
      Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

      Description of Issue:

      There is a one second difference from the intended screening timeframes indicated in CMS134 and CMS130.
       
      In CMS124, the logic for "Cervical Cytology Within 3 Years" uses the syntax "3 years or less on or before the end of measurement period", which could count 12/31/2019 11:59PM when the end of the measurement period is 12/31/2022 11:59PM. The intent of the measure is to count pap tests during the measurement period or two years prior to the measurement, which is 1/1/2020 12:00AM -12/31/2022 11:59PM.
       
      Similarly, in CMS130, the logic for "CT Colonography Performed" uses the syntax "5 years or less on or before end of measurement period", which could count 12/31/2017 11:59PM when the end of the measurement period is 12/31/2022 11:59PM. The intent of the measure is to count CT colonography during the measurement period or 4 years prior to the measurement period, which is 1/1/2018 12:00AM - 12/31/2022 11:59PM.
       
      To improve the precision of the screening timeframe, we propose to specify with "intervals" instead of using the syntax "X years or less on or before...".

      Proposed Solution:

      ​CMS124

      Current:
      Cervical Cytology Within 3 Years =
        ["Laboratory Test, Performed": "Pap Test"] CervicalCytology
          where Global."LatestOf" ( CervicalCytology.relevantDatetime, CervicalCytology.relevantPeriod ) 3 years or less on or before
          end of "Measurement Period"
            and CervicalCytology.result is not null

      HPV Test Within 5 Years for Women Age 30 and Older =
        ["Laboratory Test, Performed": "HPV Test"] HPVTest
          with ["Patient Characteristic Birthdate": "Birth date"] BirthDate
            such that Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, HPVTest.relevantDatetime ) >= 30
          where Global."LatestOf" ( HPVTest.relevantDatetime, HPVTest.relevantPeriod ) 5 years or less on or before
          end of "Measurement Period"
            and HPVTest.result is not null

      Proposed:
      Cervical Cytology Within 3 Years =
        ["Laboratory Test, Performed": "Pap Test"] CervicalCytology
          where Global."LatestOf" ( CervicalCytology.relevantDatetime, CervicalCytology.relevantPeriod ) during day of Interval[start of "Measurement Period" - 2 years,
          end of "Measurement Period"]
            and CervicalCytology.result is not null

      HPV Test Within 5 Years for Women Age 30 and Older =
        ["Laboratory Test, Performed": "HPV Test"] HPVTest
          with ["Patient Characteristic Birthdate": "Birth date"] BirthDate
            such that Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, HPVTest.relevantDatetime ) >= 30
          where Global."LatestOf" ( HPVTest.relevantDatetime, HPVTest.relevantPeriod ) during day of Interval[start of "Measurement Period" - 4 years,
          end of "Measurement Period"]
            and HPVTest.result is not null

      CMS130

      Current:
      Fecal Immunochemical Test DNA Performed =
        ["Laboratory Test, Performed": "FIT DNA"] FitDNA
          where FitDNA.result is not null
            and Global."LatestOf" ( FitDNA.relevantDatetime, FitDNA.relevantPeriod ) 3 years or less on or before
            end of "Measurement Period"

      CT Colonography Performed =
        ["Diagnostic Study, Performed": "CT Colonography"] Colonography
          where Global."NormalizeInterval" ( Colonography.relevantDatetime, Colonography.relevantPeriod ) ends 5 years or less on or before
          end of "Measurement Period"

      Flexible Sigmoidoscopy Performed =
        ["Procedure, Performed": "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy
          where Global."NormalizeInterval" ( FlexibleSigmoidoscopy.relevantDatetime, FlexibleSigmoidoscopy.relevantPeriod ) ends 5 years or less on or before
          end of "Measurement Period"

      Colonoscopy Performed =
        ["Procedure, Performed": "Colonoscopy"] Colonoscopy
          where Global."NormalizeInterval" ( Colonoscopy.relevantDatetime, Colonoscopy.relevantPeriod ) ends 10 years or less on or before
          end of "Measurement Period"

      Proposed:
      Fecal Immunochemical Test DNA Performed =
        ["Laboratory Test, Performed": "FIT DNA"] FitDNA
          where FitDNA.result is not null
            and Global."LatestOf" ( FitDNA.relevantDatetime, FitDNA.relevantPeriod ) during day of Interval[start of "Measurement Period" - 2 years,
            end of "Measurement Period"]

      CT Colonography Performed =
        ["Diagnostic Study, Performed": "CT Colonography"] Colonography
          where Global."NormalizeInterval" ( Colonography.relevantDatetime, Colonography.relevantPeriod ) ends during day of Interval[start of "Measurement Period" - 4 years,
          end of "Measurement Period"]

      Flexible Sigmoidoscopy Performed =
        ["Procedure, Performed": "Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy
          where Global."NormalizeInterval" ( FlexibleSigmoidoscopy.relevantDatetime, FlexibleSigmoidoscopy.relevantPeriod ) ends during day of Interval[start of "Measurement Period" - 4 years,
          end of "Measurement Period"]

      Colonoscopy Performed =
        ["Procedure, Performed": "Colonoscopy"] Colonoscopy
          where Global."NormalizeInterval" ( Colonoscopy.relevantDatetime, Colonoscopy.relevantPeriod ) ends during day of Interval[start of "Measurement Period" - 9 years,
          end of "Measurement Period"]

      Rationale for Change:

      This change would precisely express the intended screening timeframe required by the measures.

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            khancock Mathematica EC eCQM Team
            sgearhart Mathematica EH eCQM Team
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              Created:
              Updated: