Quality Measure Implementation Guide (STU4)
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Quality Measure Implementation Guide (STU4), published by Clinical Quality Information WG. This is not an authorized publication; it is the continuous build for version 4.0.0-ballot). This version is based on the current content of https://github.com/HL7/cqf-measures/ and changes regularly. See the Directory of published versions

Example Measure: EXM146 - Appropriate Testing for Children with Pharyngitis

Active as of 2022-02-22
Id: measure-exm146-FHIR
Url: http://hl7.org/fhir/us/cqfmeasures/Measure/measure-exm146-FHIR
Version: 4.0.0

value: 146

Name: EXM146
Title: EXM146 - Appropriate Testing for Children with Pharyngitis
Status: active
Experimental: true

system: http://terminology.hl7.org/CodeSystem/measure-scoring

code: proportion

display: Proportion

Improvement Notation:

system: http://terminology.hl7.org/CodeSystem/measure-improvement-notation

code: increase

display: Increased score indicates improvement


system: http://terminology.hl7.org/CodeSystem/measure-type

code: process

Date: 2022-02-22
Publisher: Clinical Quality Information WG

Percentage of children 2-18 years of age who were diagnosed with pharyngitis, ordered an antibiotic and received a group A streptococcus (strep) test for the episode.

Use Context:
Jurisdiction: US
Topic: 57024-2

Group A streptococcal bacterial infections and other infections that cause pharyngitis (which are most often viral) often produce the same signs and symptoms (IDSA 2002). The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the Infectious Diseases Society of America all recommend a diagnostic test for Strep A to improve diagnostic accuracy and avoid unnecessary antibiotic treatment (Linder et al. 2005). A study on antibiotic treatment of children with sore throat found that although only 15 to 36 percent of children with sore throat have Strep A pharyngitis, physicians prescribed antibiotics to 53 percent of children with a chief complaint of sore throat between 1995 and 2003 (Linder et al. 2005).


Physician Performance Measure (Measures) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). The Measures are copyrighted but can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices). Commercial use is defined as the sale, licensing, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial use of the Measures requires a license agreement between the user and NCQA. NCQA is not responsible for any use of the Measures. (c) 2008 -2014 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2013 American Medical Association. LOINC(R) copyright 2004-2013 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2013 International Health Terminology Standards Development Organisation. ICD-10 copyright 2013 World Health Organization. All Rights Reserved.


The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

Approval Date: 2016-01-01
Last Review Date: 2016-09-01
Effective Period: 2018-01-01..2018-12-31

Contained resources