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  2. CQM-944

Inaccurate and/or inconsistent results from measure reports

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    • Floyd Eisenberg
    • 202 643-6350
    • ESAC
    • Determine changes required to the value set.
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      Have the measure steward reassess the value set to assure at least some parity of the meaning (intent) and clarify the intent in the value set metadata.

      RESPONSE FROM MEASURE DEVELOPER: The intent of the measure is to include uncomplicated, benign hypertension. The different coding systems use different terms to express that concept. For example, In ICD-9 the code description is essential hypertension but this includes the terms labile, low renin, fluctuating, orthostatic, paroxysmal, etc.
      Show
      Have the measure steward reassess the value set to assure at least some parity of the meaning (intent) and clarify the intent in the value set metadata. RESPONSE FROM MEASURE DEVELOPER: The intent of the measure is to include uncomplicated, benign hypertension. The different coding systems use different terms to express that concept. For example, In ICD-9 the code description is essential hypertension but this includes the terms labile, low renin, fluctuating, orthostatic, paroxysmal, etc.
    • Hide

      Incorrect interpretation of measure results because the denominator will be inconsistent with the measure intent and specifically inconsistent depending on the terminology used. In developing an HeD rule (ESAC work effort for QIR) the value set should be reviewed by the measure developer / owner (NCQA).
      Show
      Incorrect interpretation of measure results because the denominator will be inconsistent with the measure intent and specifically inconsistent depending on the terminology used. In developing an HeD rule (ESAC work effort for QIR) the value set should be reviewed by the measure developer / owner (NCQA).

      The value set for "Occurrence A of Diagnosis, Active: Essential Hypertension" [2.16.840.1.113883.3.464.1003.104.12.1011]" contains of 19 elements, 1 ICD-10, 3 ICD-9, and 15 SNOMED-CT concepts (all SNOMED-CT are disorders) It is not clear that the meaning of the concepts in the three classification systems are identical.
      1) ICD-10 lists only Essential (primary) hypertension (I10)
      2) ICD-9 lists Malignant essential hypertension (401.0), Benign essential hypertension (401.1), and Unspecified hypertension (401.9)
      3) SNOMED-CT concepts include transient, low-renin, labile and other types of hypertension.
      The value set might be worth re-assessing to achieve the intent of the measure and at least some parity in evaluating results across practices.

            edave Mathematica EC eCQM Team
            FEisenberg Floyd Eisenberg
            Rob McClure
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