Brief description of measure CMS645: Bone density evaluation for patients with prostate cancer and receiving androgen deprivation therapy: Patients determined as having prostate cancer who are currently starting or undergoing androgen deprivation therapy (ADT), for an anticipated period of 12 months or greater and who receive an initial bone density evaluation. The bone density evaluation must be prior to the start of ADT or within 3 months of the start of ADT. Description of issue ​The current measure logic does not limit collection of data to the calendar/performance year. A user may miss counting a patient as the measurement could extend into the following calendar year. To alleviate this and align with CMS' preference to collect data through the end of the performance year/measurement period, the measure developer will constrain the timing of the androgen deprivation therapy to the measurement period or the year prior.  Goal of review Obtain clinical and technical feedback

Proposed solution ​​Change the timing and the logic to anchor all data into the measurement period or the prior year. CURRENT LOGIC:  define "Androgen Deprivation Therapy for Urology Care Medication Active Start Dates"    ["Medication, Active": "Androgen deprivation therapy for Urology Care"] ADTActive      return Global.EarliestOf ( ADTActive.relevantDatetime, ADTActive.relevantPeriod )   define "Androgen Deprivation Therapy for Urology Care Medication Order Start Dates"    ["Medication, Order": "Androgen deprivation therapy for Urology Care"] ADTOrder      return Global.EarliestOf ( ADTOrder.authorDatetime, ADTOrder.relevantPeriod ) PROPOSED LOGIC:  define "Androgen Deprivation Therapy for Urology Care Medication Active Start Dates"     ["Medication, Active": "Androgen deprivation therapy for Urology Care"] ADTActive         where Global."NormalizeInterval" ( ADTActive.relevantDatetime, ADTActive.relevantPeriod )starts 12 months or less before start of "Measurement Period"       or Global."NormalizeInterval" ( ADTActive.relevantDatetime, ADTActive.relevantPeriod ) during day of "Measurement Period"    return Global.EarliestOf ( ADTActive.relevantDatetime, ADTActive.relevantPeriod ) define "Androgen Deprivation Therapy for Urology Care Medication Order Start Dates"      ["Medication, Order": "Androgen deprivation therapy for Urology Care"] ADTOrder          where Global."NormalizeInterval" ( ADTOrder.authorDatetime, ADTOrder.relevantPeriod ) starts 12 months or less before start of "Measurement Period"            or Global."NormalizeInterval" ( ADTOrder.authorDatetime, ADTOrder.relevantPeriod ) during day of "Measurement Period"    return Global.EarliestOf ( ADTOrder.authorDatetime, ADTOrder.relevantPeriod )  Rationale for change Anchoring the timing of the ADT through the end of the measurement period will align with CMS' preference to not collect data after the end of a performance period and still align with the measure intent.