[CYPRESS-132] NQF0164 - Issue how to determine the presence of an attribute if the values set is missing Created: 06/26/13  Updated: 06/20/18  Resolved: 08/12/13

Status: Closed
Project: CYPRESS Issue Tracker
Component/s: None

Type: Question Priority: Minor
Reporter: Robert Allsbrooks (Inactive) Assignee: Robert Dingwell (Inactive)
Resolution: Answered Votes: 0
Labels: QRDA-I, ValueSet

Issue Links:
Duplicate
is duplicated by CYPRESS-185 Eye_Adult B seems to give incorect re... Closed
Solution: This issue will be fixed in the Cypress v2.4. The Cypress Team will add the procedure result that is tied to the attribute in the HTML that is generated. See the Release Notes at the following link - http://projectcypress.org/release.html.
Previous Issue Type: Value Sets

 Description   

For measure 60, NQF0164, in the first part of the denominator, it has:

Denominator =
AND: "Initial Patient Population"
AND:
AND: FIRST:"Occurrence A of Diagnostic Study, Result: Hospital Measures-ECG" during
OR: "Occurrence A of Encounter, Performed: Hospital Measures-Encounter Inpatient"
OR: "Occurrence A of Encounter, Performed: Hospital Measures-Encounter ED" <= 1 day(s) starts before start of "Occurrence A of Encounter, Performed: Hospital Measures-Encounter Inpatient"
AND:
OR: "Occurrence A of Diagnostic Study, Result: Hospital Measures-ECG (result: 'Hospital Measures-ST-segment elevation')"
OR: "Occurrence A of Diagnostic Study, Result: Hospital Measures-ECG (result: 'Hospital Measures - Acute or Evolving MI')"
OR: "Occurrence A of Diagnostic Study, Result: Hospital Measures-ECG (result: 'Hospital Measures-LBBB')"
In the specifications, for the attribute about acute or evolving MI, it has this listed as the criteria:
Attribute: "Result: Hospital Measures-Acute or Evolving MI" using "Hospital Measures-Acute or Evolving MI Grouping Value Set (2.16.840.1.113883.3.666.5.3022)"

However, in the QRDA Cat 1 file for the patient, if you look at the value element below, the only way to know that it is acute or evolving MI is by the text. The *.3022 code for that attribute is nowhere in the file. So my question is: How can we determine the presence of an attribute?

Below is the section of the QRDA Cat 1 patient data file in question.

<entry>
<observation classCode="OBS" moodCode="EVN" >
<!-- Consolidated Result Observation templateId (Implied Template) -->
<templateId root="2.16.840.1.113883.10.20.22.4.2"/>
<!-- Diagnostic Study, Result template -->
<templateId root="2.16.840.1.113883.10.20.24.3.20"/>
<id root="1.3.6.1.4.1.115" extension="51a647876debeaf8d1000010"/>
<code code="8601-7" codeSystem="2.16.840.1.113883.6.1" xsi:type="CD" sdtc:valueSet="2.16.840.1.113883.3.666.5.3018"><originalText>Diagnostic Study, Result: Hospital Measures-ECG Impression (Code List: 2.16.840.1.113883.3.666.5.3018)</originalText></code>
<text>Diagnostic Study, Result: Hospital Measures-ECG Impression (Code List: 2.16.840.1.113883.3.666.5.3018)</text>
<statusCode code="completed"/>

<effectiveTime>
<low value='20120430131000'/>
<high value='20120430131000'/>
</effectiveTime>
<value code="10273003" codeSystem="2.16.840.1.113883.6.96" xsi:type="CD"><originalText>Hospital Measures-Acute or Evolving MI</originalText><translation code="410.00" codeSystem="2.16.840.1.113883.6.103"/>
<translation code="I21.01" codeSystem="2.16.840.1.113883.6.90"/>
</value>

</observation>
</entry>

 Comments   
Comment by Rumpa Giri (Inactive) [ 11/21/13 ]

We are still facing the issue in cypress 2.4.

------------------------------------------------------------
the first AND condition Codes for severity:

Attribute: "Result: Level of Severity of Retinopathy Findings" using "Level of Severity of Retinopathy Findings Grouping Value Set (2.16.840.1.113883.3.526.3.1283)"

['193349004', '312903003', '312904009', '312905005', '390834004', '408411003', '408412005']

We do see the 193349004 in the HTML but its missing from the QRDA I downloaded.

-------------------------------------------------------------------------

We consume QRDA I to import patient data into the system.
Lack of this information marks the patient only as denominator.

We did post the same question on google groups as well; awaiting response from cypress team.
https://groups.google.com/forum/#!topic/project-cypress-talk/9j73XJ_vrvs

We will be testing soon and any guidance is greatly appreciated.

Thanks,
Rumpa Giri

Comment by Renee Rookwood (Inactive) [ 08/12/13 ]

This issue will be fixed in the Cypress v2.4. The Cypress Team will add the procedure result that is tied to the attribute in the HTML that is generated. See the Release Notes at the following link - http://projectcypress.org/release.html.

Comment by Dan Collier (Inactive) [ 06/27/13 ]

Could you elaborate and possibly give an example here? I'm a bit confused by your explanation. Are you saying the attribute we are looking for in this patient data file is in the value xml element? This guy:
<value code="10273003" codeSystem="2.16.840.1.113883.6.96" xsi:type="CD"><originalText>Hospital Measures-Acute or Evolving MI</originalText><translation code="410.00" codeSystem="2.16.840.1.113883.6.103"/>

Why wouldn't the attribute code, 2.16.840.1.113883.3.666.5.3022, be in the qrda cat 1 file? Do we have to deduce it from the originalText element? I don't understand how we can be expected to determine this user has this attribute.

In the next entry element, it has the following value:
<value code="10273003" codeSystem="2.16.840.1.113883.6.96" xsi:type="CD" sdtc:valueSet="2.16.840.1.113883.3.666.5.3011"><originalText>Diagnosis, Active: Hospital Measures - AMI (Code List: 2.16.840.1.113883.3.666.5.3011)</originalText><translation code="410.00" codeSystem="2.16.840.1.113883.6.103"/>

These are identical except for the sdtc:valueSet, originalText and the fact that they are in different parent entries. So how are we supposed to read these? For the second one, I can read the valueSet, but it seems like the only unique part of the first value element is its originalText. It would be rather hokey to have to parse the text description instead of actually looking at the code for the attribute.

Is this just a missing feature or bug from Cypress? Is that what you mean when you say that Cypress doesn't current support adding valueset attributes on attributes? Many measures have attributes, so this would seem like a rather significant issue if that is the case.

Please advise. Thanks!

Dan

Comment by Robert Dingwell (Inactive) [ 06/26/13 ]

Cypress does not currently support adding valueset attributes on items like attributes. For the example that you give above seeing who it is a diagnostic study result the result attribute would be the value of the result which would be in the value element. This would be a general case for most situations like this that surround a result template as the value element is the value of the result.

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