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   <id value="QOLNeurologicConditions"></id>
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         <table class="narrative-table"> 
            <tbody> 
               <tr> 
                  <th colspan="2" scope="row" class="row-header">Metadata</th> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Title</th> 
                  <td class="content-container">Quality of Life Outcome for Patients with Neurologic Conditions</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Version</th> 
                  <td class="content-container">Draft based on 0.1.000</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Short Name</th> 
                  <td class="content-container">CMS1234QOLNeurologicConditions</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">GUID (Version Independent)</th> 
                  <td class="content-container">urn:uuid:772ddd9d-27e5-456d-87bb-7fe47aa2afb6</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">GUID (Version Specific)</th> 
                  <td class="content-container">urn:uuid:5def8f3e-8c71-411c-bcbf-460552aaa131</td> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Effective Period</th> 
                  <td class="content-container">2026-01-01 through 2026-12-31</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Status</th> 
                  <td class="content-container">draft</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Use Context</th> 
                  <td class="content-container">org.hl7.fhir.r5.model.UsageContext@42a7d630</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Steward (Publisher)</th> 
                  <td class="content-container">American Academy of Neurology</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Developer</th> 
                  <td class="content-container">American Academy of Neurology</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Developer</th> 
                  <td class="content-container">Lantana Consulting Group</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Description</th> 
                  <td class="content-container">Percentage of adult patients with a diagnosis of a neurologic condition whose quality of life assessment results are maintained or improved in the twelve months following the first Patient-Reported Outcomes Measurement Information System (PROMIS) score</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Copyright</th> 
                  <td class="content-container">Copyright: (C)2024 American Academy of Neurology Institute (AANI). All rights reserved.</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Disclaimer</th> 
                  <td class="content-container">Quality Measures published by the American Academy of Neurology and its affiliates are assessments of current scientific and clinical information provided as an educational service. The information: 1) should not be considered inclusive of all proper treatments, methods of care, or as a statement of the standard of care; 2) is not continually updated and may not reflect the most recent evidence (new evidence may emerge between the time information is developed and when it is published or read); 3) addresses only the question(s) or topic(s) specifically identified; 4) does not mandate any particular course of medical care; and 5) is not intended to substitute for the independent professional judgment of the treating provider, as the information does not account for individual variation among patients. In all cases, the selected course of action should be considered by the treating provider in the context of treating the individual patient. Use of the information is voluntary. AAN provides this information on an “as is” basis, and makes no warranty, expressed or implied, regarding the information. AAN specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. AAN assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions. Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary coding sets should obtain all necessary licenses from the owners of these code sets. The AAN and its members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specifications. ICD10 copyright 2025 International Health Terminology Standards Development Organization CPT(R) contained in the Measure specifications is copyright 2004-2025 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2025 World Health Organization. All Rights Reserved.</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Rationale</th> 
                  <td class="content-container">Measuring quality of life allows patients and providers to identify areas of concern and develop appropriate treatment plan adjustments and collecting quality of life data in a neurology ambulatory setting was found to be meaningful (Katzan, et al. 2018) (Moura, et al. 2016).</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Clinical Recommendation Statement</th> 
                  <td class="content-container">While there is no clinical guideline recommending that clinicians assess quality of life for patients with neurologic conditions, there is general support for the use of Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as a meaningful assessment to aid in assessing patient concerns (Hays, et al. 2009).</td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Etkind, S. N., Daveson, B. A., Kwok, W., Witt, J., Lovell, N., Bajwah, S., ... Higginson, I. J. (2015). Capture, transfer, and feedback of patient-centered outcomes data in palliative care populations: Does it make a difference? Journal of Pain and Symptom Management, 49(3), 611–624. https://doi.org/10.1016/j.jpainsymman.2014.07.010   </td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Hays, R. D., Bjorner, J. B., Revicki, D. A., Spritzer, K. L., &amp; Cella, D. (2009). Development of physical and mental health summary scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) global items. Quality of Life Research, 18(7), 873–880. https://doi.org/10.1007/s11136-009-9496-9    </td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Katzan, I. L., &amp; Lapin, B. (2018). PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) scale in stroke: A validation study. Stroke, 49(1), 147–154. https://doi.org/10.1161/STROKEAHA.117.018766    </td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Moura, L. M. V. R., Schwamm, E., Moura, V., Jr., Shubina, M., Cole, A. J., Kizer, J. S., &amp; Kent, D. M. (2016). Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic. Neurology, 87(1), 1–8. https://doi.org/10.1212/WNL.0000000000002801    </td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Sico, J. J., Sarwal, A., Benish, S. M., Lum, H. D., Damush, T. M., Bravata, D. M., &amp; Cheng, E. M. (2020). Quality improvement in neurology: Neurology Outcomes Quality Measurement Set. Neurology, 94(22), 982–990. https://doi.org/10.1212/WNL.0000000000009386    </td> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Definition</th> 
                  <td class="content-container">Denominator Identification Period: The period in which eligible patients can have an index event. The denominator identification period occurs prior to the measurement period and is defined as 14 months to two months prior to the start of the measurement period. For example, the denominator identification period for the 2023 measurement period is from 11/1/2021 to 10/31/2022. For patients with an index event, there needs to be enough time following index for the patients to have the opportunity to reach comparison twelve months +/- 60 days after the index event date.</td> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Definition</th> 
                  <td class="content-container">Index Event: An index event includes ALL of the following criteria 1) Outpatient and virtual visits during the Denominator Identification Period 2) Patients with an active diagnosis of a neurologic condition 3) and includes the first instance a PROMIS Global Health-10 score was recorded</td> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Definition</th> 
                  <td class="content-container">Index Event Date: The date the Index Event occurred</td> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Definition</th> 
                  <td class="content-container">Measure Assessment Period: The Index Event Date marks the start of the measurement assessment period and concludes at twelve months allowing a grace period of sixty days prior to and sixty days after this date (+/-60 days) for the follow-up PROMIS score. For patients with more than 2 scores present at twelve months (+/- 60 days) the last score recorded shall be compared to the Index Event score.</td> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Definition</th> 
                  <td class="content-container">PROMIS 10: A validated 10 question survey to assess physical and mental health.</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Guidance (Usage)</th> 
                  <td class="content-container">Patients meeting the Index event criteria are excluded from the measure regardless if both PROMIS Assessments are performed prior to death. The measure is not expected to have a 100% performance rate given the goal of implementing this quality measure is to establish an individual benchmark in the first measurement period and drive performance improvement over time in subsequent measurement periods. The work group discussed the potential value of exclusions and unintended consequences of excluding specific neurologic conditions such as ALS and Huntington disease. The work group ultimately determined that there would be value in the continued assessment of quality of life for those with a terminal illness and/or neurodegenerative disease. Existing data demonstrates that patient outcome measures reported within palliative care populations enhance patients’ quality of life (Etkind, et al. 2015), including patients with neurodegenerative diseases. There are opportunities to identify unmet or underappreciated patient needs and improve quality of life throughout disease stages. It was also noted that if a neurologist is working strictly with an ALS population, the benchmarks identified would be meaningful and could drive change over time (Sico, et al. 2020). Virtual visits are acceptable for this measure. This digital quality measure (dQM) is a patient-based measure. Regarding Index Event, the above criteria are required, and the patient is NOT in a prior index period. Regarding the exception, the work group recommends that clinics and providers reach out to all patients and their care partners to provide this information. The work group is aware that patients with advanced disease activity may not be able to provide accurate responses to this question, but efforts should be made to engage care partners to provide information. For example, some patients may be unable to hold a pen or type on a keyboard to answer the question while others may experience delusional beliefs preventing an accurate assessment of provider performance. These scenarios include patients with reduced cognitive ability. Providers are encouraged to gain proxy information on performance when possible, and the work group recognizes this is not always possible. The AAN will monitor the measure over time for unintended consequences of having such an exception.</td> 
               </tr>  
               <tr> 
                  <th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th> 
               </tr>   
               <tr> 
                  <th scope="row" class="row-header">Basis</th> 
                  <td class="content-container">boolean</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Scoring</th> 
                  <td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Type</th> 
                  <td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#outcome: 'Outcome']</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Improvement Notation</th> 
                  <td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td> 
               </tr>  
               <tr>  
                  <th scope="row" class="row-header">Initial Population</th> 
                  <td class="content-container"> 
                     <em>ID</em>: InitialPopulation_1 
                     <br></br>  
                     <em>Description</em>: 
                     <p style="white-space: pre-line" class="tab-one">Patients aged 18 years and older at the time of the first PROMIS assessment visit who have a diagnosis of a neurological condition</p>   
                     <em>Logic Definition</em>: 
                     <a href="#primary-qolneurologicconditions-initial-population">Initial Population</a>  
                  </td> 
               </tr>  
               <tr>  
                  <th scope="row" class="row-header">Denominator</th> 
                  <td class="content-container"> 
                     <em>ID</em>: Denominator_1 
                     <br></br>  
                     <em>Description</em>: 
                     <p style="white-space: pre-line" class="tab-one">Equals Initial Population</p>   
                     <em>Logic Definition</em>: 
                     <a href="#primary-qolneurologicconditions-denominator">Denominator</a>  
                  </td> 
               </tr>  
               <tr>  
                  <th scope="row" class="row-header">Denominator Exclusion</th> 
                  <td class="content-container"> 
                     <em>ID</em>: DenominatorExclusion_1 
                     <br></br>  
                     <em>Description</em>: 
                     <p style="white-space: pre-line" class="tab-one">*Patients who died *Second PROMIS Global Health-10 score not collected at twelve months (+/-60 days)</p>   
                     <em>Logic Definition</em>: 
                     <a href="#primary-qolneurologicconditions-denominator-exclusion">Denominator Exclusion</a>  
                  </td> 
               </tr>  
               <tr>  
                  <th scope="row" class="row-header">Numerator</th> 
                  <td class="content-container"> 
                     <em>ID</em>: Numerator_1 
                     <br></br>  
                     <em>Description</em>: 
                     <p style="white-space: pre-line" class="tab-one">Patients whose PROMIS Global Health-10 score at twelve months (+/-60 days) following the Index Event was maintained or improved from the index score</p>   
                     <em>Logic Definition</em>: 
                     <a href="#primary-qolneurologicconditions-numerator">Numerator</a>  
                  </td> 
               </tr>   
               <tr> 
                  <th scope="row" class="row-header">Supplemental Data Guidance</th> 
                  <td class="content-container">For every patient evaluated by this measure also identify payer, race, ethnicity and sex</td> 
               </tr> 
               <tr> 
                  <th colspan="2" scope="row" class="row-header">Supplemental Data Elements</th> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Supplemental Data Element</th> 
                  <td class="content-container"> 
                     <em>ID</em>: sde-ethnicity  
                     <br></br>   
                     <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]  
                     <br></br>  
                     <em>Description</em>: SDE Ethnicity   
                     <br></br> 
                     <em>Logic Definition</em>: 
                     <a href="#qolneurologicconditions-sde-ethnicity">SDE Ethnicity</a>  
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Supplemental Data Element</th> 
                  <td class="content-container"> 
                     <em>ID</em>: sde-payer  
                     <br></br>   
                     <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]  
                     <br></br>  
                     <em>Description</em>: SDE Payer   
                     <br></br> 
                     <em>Logic Definition</em>: 
                     <a href="#qolneurologicconditions-sde-payer">SDE Payer</a>  
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Supplemental Data Element</th> 
                  <td class="content-container"> 
                     <em>ID</em>: sde-race  
                     <br></br>   
                     <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]  
                     <br></br>  
                     <em>Description</em>: SDE Race   
                     <br></br> 
                     <em>Logic Definition</em>: 
                     <a href="#qolneurologicconditions-sde-race">SDE Race</a>  
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Supplemental Data Element</th> 
                  <td class="content-container"> 
                     <em>ID</em>: sde-sex  
                     <br></br>   
                     <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]  
                     <br></br>  
                     <em>Description</em>: SDE Sex   
                     <br></br> 
                     <em>Logic Definition</em>: 
                     <a href="#qolneurologicconditions-sde-sex">SDE Sex</a>  
                  </td> 
               </tr> 
               <tr> 
                  <th colspan="2" scope="row" class="row-header">Measure Logic</th> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Primary Library</th> 
                  <td class="content-container">https://madie.cms.gov/Library/QOLNeurologicConditions</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Contents</th> 
                  <td class="content-container"> 
                     <em>
                        <a href="#population-criteria">Population Criteria</a>
                     </em> 
                     <br></br> 
                     <em>
                        <a href="#definitions">Logic Definitions</a>
                     </em> 
                     <br></br> 
                     <em>
                        <a href="#terminology">Terminology</a>
                     </em> 
                     <br></br> 
                     <em>
                        <a href="#dependencies">Dependencies</a>
                     </em> 
                     <br></br> 
                     <em>
                        <a href="#data-requirements">Data Requirements</a>
                     </em> 
                     <br></br> 
                  </td> 
               </tr> 
               <tr> 
                  <th colspan="2" scope="row" class="row-header">
                     <a name="population-criteria"> </a>Population Criteria
                  </th> 
               </tr>   
               <tr> 
                  <th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th> 
               </tr>                   
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="primary-qolneurologicconditions-initial-population"> </a>  Initial Population  
                  </th> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
  "Age 18 Or Older At Time Of First PROMIS"</code></pre> 
                  </td> 
               </tr>                                    
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="primary-qolneurologicconditions-denominator"> </a>  Denominator  
                  </th> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
  "Initial Population"</code></pre> 
                  </td> 
               </tr>                                          
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="primary-qolneurologicconditions-denominator-exclusion"> </a>  Denominator Exclusion  
                  </th> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusion":
  "Patient Expired"
    or "Second PROMIS Not Collected"</code></pre> 
                  </td> 
               </tr>                         
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="primary-qolneurologicconditions-numerator"> </a>  Numerator  
                  </th> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
  "Last PROMIS Same Or Higher Score Compared To First PROMIS"</code></pre> 
                  </td> 
               </tr>                      
               <tr> 
                  <th colspan="2" scope="row" class="row-header">
                     <a name="definitions"> </a>Logic Definitions
                  </th> 
               </tr>   
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="supplementaldataelements-sde-sex"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> SupplementalDataElements
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
  case
    when Patient.sex = '248153007' then "Male (finding)"
    when Patient.sex = '248152002' then "Female (finding)"
    else null
  end</code></pre> 
                  </td> 
               </tr>        
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="supplementaldataelements-sde-payer"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> SupplementalDataElements
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
  [Coverage: type in "Payer Type"] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }</code></pre> 
                  </td> 
               </tr>  
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="supplementaldataelements-sde-ethnicity"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> SupplementalDataElements
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }</code></pre> 
                  </td> 
               </tr>   
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="supplementaldataelements-sde-race"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> SupplementalDataElements
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }</code></pre> 
                  </td> 
               </tr>     
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-sde-sex"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
  SDE."SDE Sex"</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-promis-10-global-health"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "PROMIS 10 Global Health":
  ( [ObservationScreeningAssessment: "Global Health 10 (LOINC)"] PROMISAssessment
      where PROMISAssessment.effective.toInterval ( ) is not null
        and PROMISAssessment.value is not null
        and PROMISAssessment.status ~ 'final'
  )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-encounters-with-neurologic-disorders-during-id-period"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Encounters With Neurologic Disorders During ID Period":
  ( [Encounter: "Office Visit"]
    union [Encounter: "Outpatient Consultation"]
    union [Encounter: "Online Evaluation and Management Encounters"]
    union [Encounter: "Telephone Visits All"] ) ValidEncounter
    where ValidEncounter."encounterDiagnosis" ( ).code in "Neurologic Disorders"</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-outpatient-encounters-with-neurologic-disorders-during-id-period"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Outpatient Encounters With Neurologic Disorders During ID Period":
  "Encounters With Neurologic Disorders During ID Period"</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-denominator-identification-period"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Identification Period":
  Interval[start of "Measurement Period" - 14 months, start of "Measurement Period" - 2 months )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-first-index-promis-assessment-score"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "First Index PROMIS Assessment Score":
  First("PROMIS 10 Global Health" PROMISAssessment
      with "Outpatient Encounters With Neurologic Disorders During ID Period" QualifyingEncounter
        such that PROMISAssessment.effective.toInterval() starts during day of "Denominator Identification Period"
      sort by start of effective.toInterval()
  ).value as Integer</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-first-index-promis-assessment-with-encounter-during-id-period"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "First Index PROMIS Assessment With Encounter During ID Period":
  First("PROMIS 10 Global Health" PROMISAssessment
      with "Outpatient Encounters With Neurologic Disorders During ID Period" QualifyingEncounter
        such that PROMISAssessment.effective.toInterval() starts during day of "Denominator Identification Period"
      sort by start of effective.toInterval()
  )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-measure-assessment-period"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Measure Assessment Period":
  "First Index PROMIS Assessment With Encounter During ID Period" FirstIndexAssessment
    let YearAfterIndexAssessment: date from start of FirstIndexAssessment.effective.toInterval ( ) + 12 months
    return Interval[YearAfterIndexAssessment - 60 days, YearAfterIndexAssessment + 60 days]</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-last-promis-assessment"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Last PROMIS Assessment":
  Last("PROMIS 10 Global Health" PROMISAssessment
      where start of PROMISAssessment.effective.toInterval() during day of "Measure Assessment Period"
      sort by start of effective.toInterval()
  ).value as Integer</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-last-promis-same-or-higher-score-compared-to-first-promis"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Last PROMIS Same Or Higher Score Compared To First PROMIS":
  ( "First Index PROMIS Assessment Score" IndexScore
      with "Last PROMIS Assessment" MeasureAssessmentScore
        such that MeasureAssessmentScore &gt;= IndexScore
  ) is not null</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-numerator"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
  "Last PROMIS Same Or Higher Score Compared To First PROMIS"</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-age-18-or-older-at-time-of-first-promis"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Age 18 Or Older At Time Of First PROMIS":
  AgeInYearsAt(date from start of "First Index PROMIS Assessment With Encounter During ID Period".effective) &gt;= 18</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-initial-population"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
  "Age 18 Or Older At Time Of First PROMIS"</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-denominator"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
  "Initial Population"</code></pre> 
                  </td> 
               </tr>  
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-sde-payer"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
  SDE."SDE Payer"</code></pre> 
                  </td> 
               </tr>  
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-sde-ethnicity"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
  SDE."SDE Ethnicity"</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-patient-expired"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Patient Expired":
  Patient.deceased as DateTime on or before end of "Measure Assessment Period"</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-second-promis-not-collected"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Second PROMIS Not Collected":
  not exists ( ( "PROMIS 10 Global Health" PROMISAssessment
        where start of PROMISAssessment.effective.toInterval ( ) during day of "Measure Assessment Period"
        sort by start of effective.toInterval ( )
    )
  )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-denominator-exclusion"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusion":
  "Patient Expired"
    or "Second PROMIS Not Collected"</code></pre> 
                  </td> 
               </tr>  
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qolneurologicconditions-sde-race"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QOLNeurologicConditions
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
  SDE."SDE Race"</code></pre> 
                  </td> 
               </tr>                 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="cqmcommon-encounterdiagnosis"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> CQMCommon
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*  
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter  
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
  Encounter.reasonReference D
    return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))</code></pre> 
                  </td> 
               </tr>                
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="qicorecommon-references"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> QICoreCommon
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given reference is to the given resourceId
@comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resourceId String):
  resourceId = Last(Split(reference.reference, '/'))</code></pre> 
                  </td> 
               </tr>               
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="fhirhelpers-tostring"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> FHIRHelpers
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre> 
                  </td> 
               </tr>  
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="fhirhelpers-tointerval"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> FHIRHelpers
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="fhirhelpers-tocode"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> FHIRHelpers
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }</code></pre> 
                  </td> 
               </tr>  
               <tr> 
                  <th colspan="2" scope="row" class="row-header">
                     <a name="terminology"> </a>Terminology
                  </th> 
               </tr>     
               <tr>  
                  <th scope="row" class="row-header">Code System</th> 
                  <td class="content-container"> 
                     <em>Description</em>: Code system SNOMEDCT  
                     <br></br>    
                     <em>Resource</em>: http://snomed.info/sct 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://snomed.info/sct</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Global Health 10 (LOINC)  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.595 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.595</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Office Visit  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1005 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1005</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Outpatient Consultation  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1040 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1040</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Online Evaluation and Management Encounters  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.539 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.539</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Telephone Visits All  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1260.161 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1260.161</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Neurologic Disorders  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.640 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.640</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Payer Type  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt> 
                  </td> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Direct Reference Code</th> 
                  <td class="content-container"> 
                     <em>Display</em>: Male (finding) 
                     <br></br> 
                     <em>Code</em>: 248153007 
                     <br></br> 
                     <em>System</em>: 
                     <tt>http://snomed.info/sct</tt> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Direct Reference Code</th> 
                  <td class="content-container"> 
                     <em>Display</em>: Female (finding) 
                     <br></br> 
                     <em>Code</em>: 248152002 
                     <br></br> 
                     <em>System</em>: 
                     <tt>http://snomed.info/sct</tt> 
                  </td> 
               </tr>  
               <tr> 
                  <th colspan="2" scope="row" class="row-header">
                     <a name="dependencies"> </a>Dependencies
                  </th> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Dependency</th> 
                  <td class="content-container"> 
                     <em>Description</em>: QICore model information  
                     <br></br>    
                     <em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Dependency</th> 
                  <td class="content-container"> 
                     <em>Description</em>: Library SDE  
                     <br></br>    
                     <em>Resource</em>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</tt> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Dependency</th> 
                  <td class="content-container"> 
                     <em>Description</em>: Library FHIRHelpers  
                     <br></br>    
                     <em>Resource</em>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Dependency</th> 
                  <td class="content-container"> 
                     <em>Description</em>: Library QICoreCommon  
                     <br></br>    
                     <em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Dependency</th> 
                  <td class="content-container"> 
                     <em>Description</em>: Library CQMCommon  
                     <br></br>    
                     <em>Resource</em>: https://madie.cms.gov/Library/CQMCommon|4.1.000 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>https://madie.cms.gov/Library/CQMCommon|4.1.000</tt> 
                  </td> 
               </tr>      
               <tr> 
                  <th colspan="2" scope="row" class="row-header">
                     <a name="data-requirements"> </a>Data Requirements
                  </th> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Patient 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient 
                     <br></br>   
                     <em>Must Support Elements</em>: extension, url, deceased 
                     <br></br>  
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Observation 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment 
                     <br></br>   
                     <em>Must Support Elements</em>: value, effective 
                     <br></br>  
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Observation 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment 
                     <br></br>   
                     <em>Must Support Elements</em>: code, effective, value, status, status.value 
                     <br></br>  
                     <em>Code Filter(s)</em>: 
                     <br></br>  
                     <span class="tab-one">
                        <em>Path</em>: code
                     </span> 
                     <br></br>  
                     <span class="tab-one">
                        <em>ValueSet</em>:
                     </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.595 
                     <br></br>   
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Condition 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                     <br></br>   
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Condition 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                     <br></br>   
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Encounter 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                     <br></br>   
                     <em>Must Support Elements</em>: type 
                     <br></br>  
                     <em>Code Filter(s)</em>: 
                     <br></br>  
                     <span class="tab-one">
                        <em>Path</em>: type
                     </span> 
                     <br></br>  
                     <span class="tab-one">
                        <em>ValueSet</em>:
                     </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1005 
                     <br></br>   
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Encounter 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                     <br></br>   
                     <em>Must Support Elements</em>: type 
                     <br></br>  
                     <em>Code Filter(s)</em>: 
                     <br></br>  
                     <span class="tab-one">
                        <em>Path</em>: type
                     </span> 
                     <br></br>  
                     <span class="tab-one">
                        <em>ValueSet</em>:
                     </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1040 
                     <br></br>   
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Encounter 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                     <br></br>   
                     <em>Must Support Elements</em>: type 
                     <br></br>  
                     <em>Code Filter(s)</em>: 
                     <br></br>  
                     <span class="tab-one">
                        <em>Path</em>: type
                     </span> 
                     <br></br>  
                     <span class="tab-one">
                        <em>ValueSet</em>:
                     </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.539 
                     <br></br>   
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Encounter 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                     <br></br>   
                     <em>Must Support Elements</em>: type 
                     <br></br>  
                     <em>Code Filter(s)</em>: 
                     <br></br>  
                     <span class="tab-one">
                        <em>Path</em>: type
                     </span> 
                     <br></br>  
                     <span class="tab-one">
                        <em>ValueSet</em>:
                     </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1260.161 
                     <br></br>   
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Coverage 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage 
                     <br></br>   
                     <em>Must Support Elements</em>: type, period 
                     <br></br>  
                     <em>Code Filter(s)</em>: 
                     <br></br>  
                     <span class="tab-one">
                        <em>Path</em>: type
                     </span> 
                     <br></br>  
                     <span class="tab-one">
                        <em>ValueSet</em>:
                     </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591 
                     <br></br>   
                  </td> 
               </tr>  
               <tr> 
                  <th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th> 
               </tr> 
            </tbody> 
         </table> 
      </div>
   </text>
   <contained>
      <Library xmlns="http://hl7.org/fhir">
         <id value="effective-data-requirements"></id>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
               <system value="http://snomed.info/sct"></system>
               <code value="248153007"></code>
               <display value="Male (finding)"></display>
            </valueCoding>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
               <system value="http://snomed.info/sct"></system>
               <code value="248152002"></code>
               <display value="Female (finding)"></display>
            </valueCoding>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="SupplementalDataElements"></valueString>
            </extension>
            <extension url="name">
               <valueString value="SDE Sex"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;SDE Sex&quot;:
  case
    when Patient.sex = '248153007' then &quot;Male (finding)&quot;
    when Patient.sex = '248152002' then &quot;Female (finding)&quot;
    else null
  end"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="0"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="SDE Sex"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="1"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="PROMIS 10 Global Health"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;PROMIS 10 Global Health&quot;:
  ( [ObservationScreeningAssessment: &quot;Global Health 10 (LOINC)&quot;] PROMISAssessment
      where PROMISAssessment.effective.toInterval ( ) is not null
        and PROMISAssessment.value is not null
        and PROMISAssessment.status ~ 'final'
  )"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="2"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Encounters With Neurologic Disorders During ID Period"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Encounters With Neurologic Disorders During ID Period&quot;:
  ( [Encounter: &quot;Office Visit&quot;]
    union [Encounter: &quot;Outpatient Consultation&quot;]
    union [Encounter: &quot;Online Evaluation and Management Encounters&quot;]
    union [Encounter: &quot;Telephone Visits All&quot;] ) ValidEncounter
    where ValidEncounter.&quot;encounterDiagnosis&quot; ( ).code in &quot;Neurologic Disorders&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="3"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Outpatient Encounters With Neurologic Disorders During ID Period"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Outpatient Encounters With Neurologic Disorders During ID Period&quot;:
  &quot;Encounters With Neurologic Disorders During ID Period&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="4"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Denominator Identification Period"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Denominator Identification Period&quot;:
  Interval[start of &quot;Measurement Period&quot; - 14 months, start of &quot;Measurement Period&quot; - 2 months )"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="5"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="First Index PROMIS Assessment Score"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;First Index PROMIS Assessment Score&quot;:
  First(&quot;PROMIS 10 Global Health&quot; PROMISAssessment
      with &quot;Outpatient Encounters With Neurologic Disorders During ID Period&quot; QualifyingEncounter
        such that PROMISAssessment.effective.toInterval() starts during day of &quot;Denominator Identification Period&quot;
      sort by start of effective.toInterval()
  ).value as Integer"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="6"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="First Index PROMIS Assessment With Encounter During ID Period"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;First Index PROMIS Assessment With Encounter During ID Period&quot;:
  First(&quot;PROMIS 10 Global Health&quot; PROMISAssessment
      with &quot;Outpatient Encounters With Neurologic Disorders During ID Period&quot; QualifyingEncounter
        such that PROMISAssessment.effective.toInterval() starts during day of &quot;Denominator Identification Period&quot;
      sort by start of effective.toInterval()
  )"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="7"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Measure Assessment Period"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Measure Assessment Period&quot;:
  &quot;First Index PROMIS Assessment With Encounter During ID Period&quot; FirstIndexAssessment
    let YearAfterIndexAssessment: date from start of FirstIndexAssessment.effective.toInterval ( ) + 12 months
    return Interval[YearAfterIndexAssessment - 60 days, YearAfterIndexAssessment + 60 days]"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="8"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Last PROMIS Assessment"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Last PROMIS Assessment&quot;:
  Last(&quot;PROMIS 10 Global Health&quot; PROMISAssessment
      where start of PROMISAssessment.effective.toInterval() during day of &quot;Measure Assessment Period&quot;
      sort by start of effective.toInterval()
  ).value as Integer"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="9"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Last PROMIS Same Or Higher Score Compared To First PROMIS"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Last PROMIS Same Or Higher Score Compared To First PROMIS&quot;:
  ( &quot;First Index PROMIS Assessment Score&quot; IndexScore
      with &quot;Last PROMIS Assessment&quot; MeasureAssessmentScore
        such that MeasureAssessmentScore &gt;= IndexScore
  ) is not null"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="10"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Numerator"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Numerator&quot;:
  &quot;Last PROMIS Same Or Higher Score Compared To First PROMIS&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="11"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Age 18 Or Older At Time Of First PROMIS"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Age 18 Or Older At Time Of First PROMIS&quot;:
  AgeInYearsAt(date from start of &quot;First Index PROMIS Assessment With Encounter During ID Period&quot;.effective) &gt;= 18"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="12"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Initial Population"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Initial Population&quot;:
  &quot;Age 18 Or Older At Time Of First PROMIS&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="13"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Denominator"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Denominator&quot;:
  &quot;Initial Population&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="14"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="SupplementalDataElements"></valueString>
            </extension>
            <extension url="name">
               <valueString value="SDE Payer"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;SDE Payer&quot;:
  [Coverage: type in &quot;Payer Type&quot;] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="15"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="SDE Payer"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="16"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="SupplementalDataElements"></valueString>
            </extension>
            <extension url="name">
               <valueString value="SDE Ethnicity"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;SDE Ethnicity&quot;:
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="17"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="SDE Ethnicity"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="18"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Patient Expired"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Patient Expired&quot;:
  Patient.deceased as DateTime on or before end of &quot;Measure Assessment Period&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="19"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Second PROMIS Not Collected"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Second PROMIS Not Collected&quot;:
  not exists ( ( &quot;PROMIS 10 Global Health&quot; PROMISAssessment
        where start of PROMISAssessment.effective.toInterval ( ) during day of &quot;Measure Assessment Period&quot;
        sort by start of effective.toInterval ( )
    )
  )"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="20"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Denominator Exclusion"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Denominator Exclusion&quot;:
  &quot;Patient Expired&quot;
    or &quot;Second PROMIS Not Collected&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="21"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="SupplementalDataElements"></valueString>
            </extension>
            <extension url="name">
               <valueString value="SDE Race"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;SDE Race&quot;:
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="22"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QOLNeurologicConditions"></valueString>
            </extension>
            <extension url="name">
               <valueString value="SDE Race"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="23"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="FHIRHelpers"></valueString>
            </extension>
            <extension url="name">
               <valueString value="ToString"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define function ToString(value uri): value.value"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="24"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="CQMCommon"></valueString>
            </extension>
            <extension url="name">
               <valueString value="encounterDiagnosis"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="/*  
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter  
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
  Encounter.reasonReference D
    return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="25"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="QICoreCommon"></valueString>
            </extension>
            <extension url="name">
               <valueString value="references"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="/*
@description: Returns true if the given reference is to the given resourceId
@comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resourceId String):
  resourceId = Last(Split(reference.reference, '/'))"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="26"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="FHIRHelpers"></valueString>
            </extension>
            <extension url="name">
               <valueString value="ToInterval"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period.&quot;start&quot; is null then
            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]
        else
            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="27"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="FHIRHelpers"></valueString>
            </extension>
            <extension url="name">
               <valueString value="ToCode"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }"></valueString>
            </extension>
            <extension url="displaySequence">
               <valueInteger value="28"></valueInteger>
            </extension>
         </extension>
         <name value="EffectiveDataRequirements"></name>
         <status value="active"></status>
         <type>
            <coding>
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         </relatedArtifact>
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         <relatedArtifact>
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            <type value="boolean"></type>
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            <type value="boolean"></type>
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            <name value="Denominator Exclusion"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="boolean"></type>
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            <min value="0"></min>
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            <type value="Coding"></type>
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            <max value="*"></max>
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            <name value="SDE Ethnicity"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="Resource"></type>
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         <parameter>
            <name value="SDE Race"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="Resource"></type>
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            <type value="Patient"></type>
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            <mustSupport value="extension"></mustSupport>
            <mustSupport value="url"></mustSupport>
            <mustSupport value="deceased"></mustSupport>
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            <mustSupport value="value"></mustSupport>
            <mustSupport value="effective"></mustSupport>
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            <mustSupport value="effective"></mustSupport>
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            <mustSupport value="status"></mustSupport>
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            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"></profile>
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            <type value="Condition"></type>
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            <mustSupport value="period"></mustSupport>
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      <extension url="guidance">
         <valueString value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex"></valueString>
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      <extension url="usage">
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            <text value="Supplemental Data Guidance"></text>
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   </extension>
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      <extension url="term">
         <valueString value="Denominator Identification Period"></valueString>
      </extension>
      <extension url="definition">
         <valueMarkdown value="The period in which eligible patients can have an index event. The denominator identification period occurs prior to the measurement period and is defined as 14 months to two months prior to the start of the measurement period. For example, the denominator identification period for the 2023 measurement period is from 11/1/2021 to 10/31/2022. For patients with an index event, there needs to be enough time following index for the patients to have the opportunity to reach comparison twelve months +/- 60 days after the index event date."></valueMarkdown>
      </extension>
   </extension>
   <extension url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
      <extension url="term">
         <valueString value="Index Event"></valueString>
      </extension>
      <extension url="definition">
         <valueMarkdown value="An index event includes ALL of the following criteria 1) Outpatient and virtual visits during the Denominator Identification Period 2) Patients with an active diagnosis of a neurologic condition 3) and includes the first instance a PROMIS Global Health-10 score was recorded"></valueMarkdown>
      </extension>
   </extension>
   <extension url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
      <extension url="term">
         <valueString value="Index Event Date"></valueString>
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      <extension url="definition">
         <valueMarkdown value="The date the Index Event occurred"></valueMarkdown>
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      <extension url="term">
         <valueString value="Measure Assessment Period"></valueString>
      </extension>
      <extension url="definition">
         <valueMarkdown value="The Index Event Date marks the start of the measurement assessment period and concludes at twelve months allowing a grace period of sixty days prior to and sixty days after this date (+/-60 days) for the follow-up PROMIS score. For patients with more than 2 scores present at twelve months (+/- 60 days) the last score recorded shall be compared to the Index Event score."></valueMarkdown>
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      <extension url="term">
         <valueString value="PROMIS 10"></valueString>
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         <valueMarkdown value="A validated 10 question survey to assess physical and mental health."></valueMarkdown>
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   <url value="https://madie.cms.gov/Measure/QOLNeurologicConditions"></url>
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      <value value="CMS1234QOLNeurologicConditions"></value>
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      <system value="urn:ietf:rfc:3986"></system>
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   </identifier>
   <version value="Draft based on 0.1.000"></version>
   <name value="QOLNeurologicConditions"></name>
   <title value="Quality of Life Outcome for Patients with Neurologic Conditions"></title>
   <status value="draft"></status>
   <experimental value="false"></experimental>
   <date value="2025-07-21T20:11:19+00:00"></date>
   <publisher value="American Academy of Neurology"></publisher>
   <contact>
      <telecom>
         <system value="url"></system>
         <value value="www.aan.com"></value>
      </telecom>
   </contact>
   <description value="Percentage of adult patients with a diagnosis of a neurologic condition whose quality of life assessment results are maintained or improved in the twelve months following the first Patient-Reported Outcomes Measurement Information System (PROMIS) score"></description>
   <useContext>
      <code>
         <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"></system>
         <code value="venue"></code>
         <display value="Venue"></display>
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      <valueCodeableConcept>
         <coding>
            <system value="http://hl7.org/fhir/us/cqfmeasures/CodeSystem/intended-venue-codes"></system>
            <code value="ec"></code>
            <display value="EC"></display>
         </coding>
      </valueCodeableConcept>
   </useContext>
   <usage value="Patients meeting the Index event criteria are excluded from the measure regardless if both PROMIS Assessments are performed prior to death. The measure is not expected to have a 100% performance rate given the goal of implementing this quality measure is to establish an individual benchmark in the first measurement period and drive performance improvement over time in subsequent measurement periods. The work group discussed the potential value of exclusions and unintended consequences of excluding specific neurologic conditions such as ALS and Huntington disease. The work group ultimately determined that there would be value in the continued assessment of quality of life for those with a terminal illness and/or neurodegenerative disease. Existing data demonstrates that patient outcome measures reported within palliative care populations enhance patients’ quality of life (Etkind, et al. 2015), including patients with neurodegenerative diseases. There are opportunities to identify unmet or underappreciated patient needs and improve quality of life throughout disease stages. It was also noted that if a neurologist is working strictly with an ALS population, the benchmarks identified would be meaningful and could drive change over time (Sico, et al. 2020). Virtual visits are acceptable for this measure. This digital quality measure (dQM) is a patient-based measure. Regarding Index Event, the above criteria are required, and the patient is NOT in a prior index period. Regarding the exception, the work group recommends that clinics and providers reach out to all patients and their care partners to provide this information. The work group is aware that patients with advanced disease activity may not be able to provide accurate responses to this question, but efforts should be made to engage care partners to provide information. For example, some patients may be unable to hold a pen or type on a keyboard to answer the question while others may experience delusional beliefs preventing an accurate assessment of provider performance. These scenarios include patients with reduced cognitive ability. Providers are encouraged to gain proxy information on performance when possible, and the work group recognizes this is not always possible. The AAN will monitor the measure over time for unintended consequences of having such an exception."></usage>
   <copyright value="Copyright: (C)2024 American Academy of Neurology Institute (AANI). All rights reserved."></copyright>
   <effectivePeriod>
      <start value="2026-01-01"></start>
      <end value="2026-12-31"></end>
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   <author>
      <name value="American Academy of Neurology"></name>
      <telecom>
         <system value="url"></system>
         <value value="www.aan.com"></value>
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   </author>
   <author>
      <name value="Lantana Consulting Group"></name>
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   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Etkind, S. N., Daveson, B. A., Kwok, W., Witt, J., Lovell, N., Bajwah, S., ... Higginson, I. J. (2015). Capture, transfer, and feedback of patient-centered outcomes data in palliative care populations: Does it make a difference? Journal of Pain and Symptom Management, 49(3), 611–624. https://doi.org/10.1016/j.jpainsymman.2014.07.010"></citation>
   </relatedArtifact>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Hays, R. D., Bjorner, J. B., Revicki, D. A., Spritzer, K. L., &amp;amp; Cella, D. (2009). Development of physical and mental health summary scores from the Patient-Reported Outcomes Measurement Information System (PROMIS) global items. Quality of Life Research, 18(7), 873–880. https://doi.org/10.1007/s11136-009-9496-9"></citation>
   </relatedArtifact>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Katzan, I. L., &amp;amp; Lapin, B. (2018). PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) scale in stroke: A validation study. Stroke, 49(1), 147–154. https://doi.org/10.1161/STROKEAHA.117.018766"></citation>
   </relatedArtifact>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Moura, L. M. V. R., Schwamm, E., Moura, V., Jr., Shubina, M., Cole, A. J., Kizer, J. S., &amp;amp; Kent, D. M. (2016). Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic. Neurology, 87(1), 1–8. https://doi.org/10.1212/WNL.0000000000002801"></citation>
   </relatedArtifact>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Sico, J. J., Sarwal, A., Benish, S. M., Lum, H. D., Damush, T. M., Bravata, D. M., &amp;amp; Cheng, E. M. (2020). Quality improvement in neurology: Neurology Outcomes Quality Measurement Set. Neurology, 94(22), 982–990. https://doi.org/10.1212/WNL.0000000000009386"></citation>
   </relatedArtifact>
   <library value="https://madie.cms.gov/Library/QOLNeurologicConditions"></library>
   <disclaimer value="Quality Measures published by the American Academy of Neurology and its affiliates are assessments of current scientific and clinical information provided as an educational service. The information: 1) should not be considered inclusive of all proper treatments, methods of care, or as a statement of the standard of care; 2) is not continually updated and may not reflect the most recent evidence (new evidence may emerge between the time information is developed and when it is published or read); 3) addresses only the question(s) or topic(s) specifically identified; 4) does not mandate any particular course of medical care; and 5) is not intended to substitute for the independent professional judgment of the treating provider, as the information does not account for individual variation among patients. In all cases, the selected course of action should be considered by the treating provider in the context of treating the individual patient. Use of the information is voluntary. AAN provides this information on an “as is” basis, and makes no warranty, expressed or implied, regarding the information. AAN specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. AAN assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions. Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary coding sets should obtain all necessary licenses from the owners of these code sets. The AAN and its members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specifications. ICD10 copyright 2025 International Health Terminology Standards Development Organization CPT(R) contained in the Measure specifications is copyright 2004-2025 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2025 World Health Organization. All Rights Reserved."></disclaimer>
   <rationale value="Measuring quality of life allows patients and providers to identify areas of concern and develop appropriate treatment plan adjustments and collecting quality of life data in a neurology ambulatory setting was found to be meaningful (Katzan, et al. 2018) (Moura, et al. 2016)."></rationale>
   <clinicalRecommendationStatement value="While there is no clinical guideline recommending that clinicians assess quality of life for patients with neurologic conditions, there is general support for the use of Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as a meaningful assessment to aid in assessing patient concerns (Hays, et al. 2009)."></clinicalRecommendationStatement>
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      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
         <valueCodeableConcept>
            <coding>
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               <code value="proportion"></code>
               <display value="Proportion"></display>
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         <valueCode value="boolean"></valueCode>
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      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
         <valueCodeableConcept>
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               <system value="http://terminology.hl7.org/CodeSystem/measure-type"></system>
               <code value="outcome"></code>
               <display value="Outcome"></display>
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         </valueCodeableConcept>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
         <valueCodeableConcept>
            <coding>
               <system value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"></system>
               <code value="increase"></code>
               <display value="Increased score indicates improvement"></display>
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      <population id="InitialPopulation_1">
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               <display value="Initial Population"></display>
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         </code>
         <description value="Patients aged 18 years and older at the time of the first PROMIS assessment visit who have a diagnosis of a neurological condition"></description>
         <criteria>
            <language value="text/cql-identifier"></language>
            <expression value="Initial Population"></expression>
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      <population id="Denominator_1">
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               <system value="http://terminology.hl7.org/CodeSystem/measure-population"></system>
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               <display value="Denominator"></display>
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         </code>
         <description value="Equals Initial Population"></description>
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            <language value="text/cql-identifier"></language>
            <expression value="Denominator"></expression>
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         <code>
            <coding>
               <system value="http://terminology.hl7.org/CodeSystem/measure-population"></system>
               <code value="denominator-exclusion"></code>
               <display value="Denominator Exclusion"></display>
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         </code>
         <description value="*Patients who died *Second PROMIS Global Health-10 score not collected at twelve months (+/-60 days)"></description>
         <criteria>
            <language value="text/cql-identifier"></language>
            <expression value="Denominator Exclusion"></expression>
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      </population>
      <population id="Numerator_1">
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               <system value="http://terminology.hl7.org/CodeSystem/measure-population"></system>
               <code value="numerator"></code>
               <display value="Numerator"></display>
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         </code>
         <description value="Patients whose PROMIS Global Health-10 score at twelve months (+/-60 days) following the Index Event was maintained or improved from the index score"></description>
         <criteria>
            <language value="text/cql-identifier"></language>
            <expression value="Numerator"></expression>
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      </population>
   </group>
   <supplementalData id="sde-ethnicity">
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="individual"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="subject-list"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="summary"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="data-collection"></valueCode>
      </extension>
      <usage>
         <coding>
            <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
            <code value="supplemental-data"></code>
         </coding>
      </usage>
      <description value="SDE Ethnicity"></description>
      <criteria>
         <language value="text/cql-identifier"></language>
         <expression value="SDE Ethnicity"></expression>
      </criteria>
   </supplementalData>
   <supplementalData id="sde-payer">
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="individual"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="subject-list"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="summary"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="data-collection"></valueCode>
      </extension>
      <usage>
         <coding>
            <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
            <code value="supplemental-data"></code>
         </coding>
      </usage>
      <description value="SDE Payer"></description>
      <criteria>
         <language value="text/cql-identifier"></language>
         <expression value="SDE Payer"></expression>
      </criteria>
   </supplementalData>
   <supplementalData id="sde-race">
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="individual"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="subject-list"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="summary"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="data-collection"></valueCode>
      </extension>
      <usage>
         <coding>
            <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
            <code value="supplemental-data"></code>
         </coding>
      </usage>
      <description value="SDE Race"></description>
      <criteria>
         <language value="text/cql-identifier"></language>
         <expression value="SDE Race"></expression>
      </criteria>
   </supplementalData>
   <supplementalData id="sde-sex">
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="individual"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="subject-list"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="summary"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="data-collection"></valueCode>
      </extension>
      <usage>
         <coding>
            <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
            <code value="supplemental-data"></code>
         </coding>
      </usage>
      <description value="SDE Sex"></description>
      <criteria>
         <language value="text/cql-identifier"></language>
         <expression value="SDE Sex"></expression>
      </criteria>
   </supplementalData>
</Measure>