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  2. CQM-5710

CRP: Add upper age boundary of 75 years to align with guidelines

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    • Resolution: Resolved
    • Moderate
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      Brief description of measure
      CMS347: Statin Therapy for the Prevention and Treatment of Cardiovascular Disease:
      Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period:
      *All patients with an active diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD) or ever had an ASCVD procedure; OR
      *Patients aged >= 20 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; OR
      *Patients aged 40-75 years with a diagnosis of diabetes

      Description of issue
      ​​The current age range for Population 2 is patients aged >= 20 years at the beginning of the measurement period which is inconsistent with2018 Guideline on the Management of Blood Cholesterol that caps the age range at 75 years.  

      The measure steward and expert workgroup supports aligning with the 2018 guidelines and changing the age range to 20 to 75 years of age.

      Goal of review
      Obtain clinical and technical feedback
      Show
      Brief description of measure CMS347: Statin Therapy for the Prevention and Treatment of Cardiovascular Disease: Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: *All patients with an active diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD) or ever had an ASCVD procedure; OR *Patients aged >= 20 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; OR *Patients aged 40-75 years with a diagnosis of diabetes Description of issue ​​The current age range for Population 2 is patients aged >= 20 years at the beginning of the measurement period which is inconsistent with2018 Guideline on the Management of Blood Cholesterol that caps the age range at 75 years.   The measure steward and expert workgroup supports aligning with the 2018 guidelines and changing the age range to 20 to 75 years of age. Goal of review Obtain clinical and technical feedback
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      Proposed solution
      ​//HEADER CHANGES//

      DESCRIPTION:
      Before: Patients aged >= 20 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia;

      After: Patients aged 20 to 75 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia;

      RATE AGGREGATION:
      Before: Population 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.

      After: Population 2: Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.

      GUIDANCE:
      Before: 
      Initial Population 2:
      Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia
         -If YES, meets Initial Population 2 risk category
         -If NO, screen for next risk category

      After: 
      Initial Population 2:
      Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia
      -If YES, meets Initial Population 2 risk category
      -If NO, screen for next risk category

      INITIAL POPULATION: 
      Before: 
      Population 2:
      Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.

      After: 
      Population 2:
      Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia

      LOGIC
      Before:
      define "Initial Population"
         "Patients Age 20 Years and Older with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"
           and exists "Qualifying Encounter during Measurement Period"

      define "Patients Age 20 or Older at Start of Measurement Period"
         AgeInYearsAt(date from start of "Measurement Period")>= 20

      After:
      define "Initial Population"
         "Patients Age 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"
           and exists "Qualifying Encounter during Day of Measurement Period"

      define "Patients Aged 20 to 75 at Start of Measurement Period"
         AgeInYearsAt(date from start of "Measurement Period")in Interval[20, 75]

      Rationale for change
      The measure steward and expert workgroup supported aligning with the 2018 guidelines and changing the age range to 20 to 75 years of age.
      Show
      Proposed solution ​//HEADER CHANGES// DESCRIPTION: Before: Patients aged >= 20 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; After: Patients aged 20 to 75 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; RATE AGGREGATION: Before: Population 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. After: Population 2: Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. GUIDANCE: Before:  Initial Population 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia    -If YES, meets Initial Population 2 risk category    -If NO, screen for next risk category After:  Initial Population 2: Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia -If YES, meets Initial Population 2 risk category -If NO, screen for next risk category INITIAL POPULATION:  Before:  Population 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. After:  Population 2: Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia LOGIC Before: define "Initial Population"    "Patients Age 20 Years and Older with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"      and exists "Qualifying Encounter during Measurement Period" define "Patients Age 20 or Older at Start of Measurement Period"    AgeInYearsAt(date from start of "Measurement Period")>= 20 After: define "Initial Population"    "Patients Age 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"      and exists "Qualifying Encounter during Day of Measurement Period" define "Patients Aged 20 to 75 at Start of Measurement Period"    AgeInYearsAt(date from start of "Measurement Period")in Interval[20, 75] Rationale for change The measure steward and expert workgroup supported aligning with the 2018 guidelines and changing the age range to 20 to 75 years of age.

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          edave Mathematica EC eCQM Team
          edave Mathematica EC eCQM Team
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