Colorectal Cancer Concepts
0.1.0 - CI Build
Colorectal Cancer Concepts
0.1.0 - CI Build
Colorectal Cancer Concepts, published by Clinical Quality Framework. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cqf-ccc/ and changes regularly. See the Directory of published versions
| Draft as of 2024-05-14 |
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🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"🔗 ,
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"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Colorectal Cancer Screening CQM</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">ColorectalCancerScreeningCQM</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.1.0</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"Measure-ColorectalCancerScreeningCQM.html\">Colorectal Cancer Screening CQM</a></td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2022-01-01\n ..2022-12-31</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">draft</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Experimental: </b></th>\n <td style=\"padding-left: 4px;\">true</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Date: </b></th>\n <td style=\"padding-left: 4px;\">2024-05-14 12:25:12-0600</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">Clinical Quality Framework</td>\n </tr>\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Jurisdiction: </b></th>\n <td style=\"padding-left: 4px;\">001</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Illustration</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Copyright: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2020 National Committee for Quality Assurance. All Rights Reserved.</p>\n<p>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 third party codes contained in the specifications.</p>\n<p>CPT(R) contained in the Measure specifications is copyright 2004-2020 American Medical Association. LOINC(R) copyright 2004-2020 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2020 International Health Terminology Standards Development Organisation. ICD-10 copyright 2020 World Health Organization. All Rights Reserved.</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Disclaimer: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>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.</p>\n<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>\n</div></td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Basis: </b></th>\n <td style=\"padding-left: 4px;\">\n boolean\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Scoring: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion </span>\n </p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>process </span>\n </p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rationale: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Colorectal cancer represents eight percent of all new cancer cases in the United States. In 2020, there were an estimated 147,950 new cases of colorectal cancer and an estimated 53,200 deaths attributed to it. According to the National Cancer Institute, about 4.2 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (National Cancer Institute, 2020).</p>\n<p>Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society, 2020).</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Clinical recommendation statement: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>The U.S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force, 2016).\nAppropriate screenings are defined by any one of the following:\n-Colonoscopy (every 10 years)\n-Flexible sigmoidoscopy (every 5 years)\n-Fecal occult blood test (annually)\n-FIT-DNA (every 3 years)\n-Computed tomographic colonography (every 5 years)</p>\n</div></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Improvement Notation: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>increase </span>\n </p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n \n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-ColorectalCancerScreeningCQM.html\">Colorectal Cancer Screening CQM</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Related Artifact Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><a href=\"Library-ColorectalCancerElements.html\">Colorectal Cancer Elements</a></li>\n \n <li><a href=\"Library-ColorectalCancerConcepts.html\">Colorectal Cancer Concepts</a></li>\n \n <li><code>http://fhir.org/guides/cqf/ccc/Library/FHIRHelpers|4.0.1</code></li>\n \n <li><code>http://fhir.org/guides/cqf/ccc/Library/FHIRCommon|4.0.1</code></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1011/expansion\">Fecal Occult Blood Test (FOBT)</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1039/expansion\">FIT DNA</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1038/expansion\">CT Colonography</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1010/expansion\">Flexible Sigmoidoscopy</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1020/expansion\">Colonoscopy</a></li>\n \n </td>\n </tr>\n <tr>\n <th scope=\"row\"><b>Parameters:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>name</b></th>\n <th><b>use</b></th>\n <th><b>min</b></th>\n <th><b>max</b></th>\n <th><b>type</b></th>\n </tr>\n \n <tr>\n <td>Measurement Period</td>\n <td>In</td>\n <td>0</td>\n <td>1</td>\n <td>Period</td>\n </tr>\n \n <tr>\n <td>Numerator</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Denominator</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>Initial Population</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n </table>\n </td>\n </tr>\n\n <tr>\n <th scope=\"row\"><b>DataRequirements:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>Type</b></th>\n <th><b>Elements</b></th>\n <th><b>Valueset Name</b></th>\n <th><b>Valueset</b></th>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/R4/observation.html\">Observation</a>)</td>\n <td>\n \n code\n \n status\n \n value\n \n issued\n \n </td>\n <td>\n \n \n Fecal Occult Blood Test (FOBT)\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1011/expansion\">Fecal Occult Blood Test (FOBT)</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/R4/observation.html\">Observation</a>)</td>\n <td>\n \n code\n \n status\n \n value\n \n issued\n \n </td>\n <td>\n \n \n FIT DNA\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1039/expansion\">FIT DNA</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/R4/procedure.html\">Procedure</a>)</td>\n <td>\n \n code\n \n status\n \n performed\n \n </td>\n <td>\n \n \n CT Colonography\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1038/expansion\">CT Colonography</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/R4/procedure.html\">Procedure</a>)</td>\n <td>\n \n code\n \n status\n \n performed\n \n </td>\n <td>\n \n \n Flexible Sigmoidoscopy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1010/expansion\">Flexible Sigmoidoscopy</a></td>\n </tr>\n \n <tr>\n <td>Procedure(<a href=\"http://hl7.org/fhir/R4/procedure.html\">Procedure</a>)</td>\n <td>\n \n code\n \n status\n \n performed\n \n </td>\n <td>\n \n \n Colonoscopy\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1020/expansion\">Colonoscopy</a></td>\n </tr>\n \n <tr>\n <td>Patient(<a href=\"http://hl7.org/fhir/R4/patient.html\">Patient</a>)</td>\n <td>\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n </table>\n </td>\n </tr>\n\n \n\n \n <tr>\n <th scope=\"row\"><b>Logic Definitions:</b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n <tr>\n <th><b>Group</b></th>\n <th><b>Scoring</b></th>\n <th><b>Population Criteria</b></th>\n <th><b>Expression</b></th>\n </tr>\n <tr>\n \n <td> </td>\n <td>\n \n\n \n\n \n <b>Measure scoring:</b>\n \n <p style=\"margin-bottom: 5px;\">\n <span>Proportion</span>\n </p>\n \n \n\n \n\n \n\n \n\n \n\n \n\n </td>\n \n <tr>\n <td/>\n <td/>\n <td>Initial Population</td>\n <td>\n \n <pre><code class=\"language-cql\">/*\nNOTE: Removed qualifying encounters criteria to simplify for demonstration purposes\n*/\ndefine "Initial Population":\n AgeInYearsAt(start of "Measurement Period") in Interval[50, 75]</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Denominator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n \n </td>\n </tr>\n \n <tr>\n <td/>\n <td/>\n <td>Numerator</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Numerator":\n CCE."Has Appropriate Colorectal Cancer Screening"</code></pre>\n \n </td>\n </tr>\n \n \n \n </tr>\n </table>\n \n\n <table class=\"grid-dict\">\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>Fecal Occult Blood Test Result</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Fecal Occult Blood Test Result":\n [Observation: Cx."Fecal Occult Blood Test (FOBT)"] FecalOccultResult\n\t\twhere FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}\n\t\t\tand FecalOccultResult.value is not null</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>AsOf</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define AsOf:\n end of "Measurement Period"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>Fecal Occult Blood Test Result Within 1 Year</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Fecal Occult Blood Test Result Within 1 Year":\n "Fecal Occult Blood Test Result" R\n where R.issued 1 year or less on or before AsOf</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>Fecal Immunochemical Test DNA Result</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Fecal Immunochemical Test DNA Result":\n [Observation: Cx."FIT DNA"] FitDNA\n\t\twhere FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}\n\t\t\tand FitDNA.value is not null</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>Fecal Immunochemical Test DNA Result Within 3 Years</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Fecal Immunochemical Test DNA Result Within 3 Years":\n "Fecal Immunochemical Test DNA Result" R\n where R.issued 3 years or less on or before AsOf</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>CT Colonography Performed</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "CT Colonography Performed":\n [Procedure: Cx."CT Colonography"] Colonography\n where Colonography.status = 'completed'</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>CT Colonography Performed Within 5 Years</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "CT Colonography Performed Within 5 Years":\n "CT Colonography Performed" P\n where FC.ToInterval(P.performed) ends 5 years or less on or before AsOf</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>Flexible Sigmoidoscopy Performed</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Completed Flexible Sigmoidoscopy Procedures\n*/\ndefine "Flexible Sigmoidoscopy Performed":\n [Procedure: Cx."Flexible Sigmoidoscopy"] FlexibleSigmoidoscopy\n\t\twhere FlexibleSigmoidoscopy.status = 'completed'</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>Flexible Sigmoidoscopy Performed Within 5 Years</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Flexible Sigmoidoscopy Performed Within 5 Years":\n "Flexible Sigmoidoscopy Performed" P\n where FC.ToInterval(P.performed) ends 5 years or less on or before AsOf</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>Colonoscopy Performed</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Colonoscopy Performed":\n [Procedure: Cx."Colonoscopy"] Colonoscopy\n\t\twhere Colonoscopy.status = 'completed'</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>Colonoscopy Performed Within 10 Years</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Colonoscopy Performed Within 10 Years":\n "Colonoscopy Performed" P\n where FC.ToInterval(P.performed) ends 10 years or less on or before AsOf</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerElements</td>\n \n \n <td>Has Appropriate Colorectal Cancer Screening</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n FOBT within 1 year\n or FIT DNA within 3 years\n or CT Colonography within 5 years\n or Flexible Sigmoidoscopy within 5 years\n or Colonoscopy within 10 years\n*/\ndefine "Has Appropriate Colorectal Cancer Screening":\n exists "Fecal Occult Blood Test Result Within 1 Year"\n or exists "Fecal Immunochemical Test DNA Result Within 3 Years"\n or exists "CT Colonography Performed Within 5 Years"\n or exists "Flexible Sigmoidoscopy Performed Within 5 Years"\n or exists "Colonoscopy Performed Within 10 Years"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerScreeningCQM</td>\n \n \n <td>Numerator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Numerator":\n CCE."Has Appropriate Colorectal Cancer Screening"</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerScreeningCQM</td>\n \n \n <td>Initial Population</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\nNOTE: Removed qualifying encounters criteria to simplify for demonstration purposes\n*/\ndefine "Initial Population":\n AgeInYearsAt(start of "Measurement Period") in Interval[50, 75]</code></pre>\n </td>\n \n </tr>\n \n <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>ColorectalCancerScreeningCQM</td>\n \n \n <td>Denominator</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator":\n "Initial Population"</code></pre>\n </td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n\n </table>\n</div>"
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"valueString" : "define \"Fecal Occult Blood Test Result\":\n [Observation: Cx.\"Fecal Occult Blood Test (FOBT)\"] FecalOccultResult\n\t\twhere FecalOccultResult.status in {'final', 'amended', 'corrected', 'preliminary'}\n\t\t\tand FecalOccultResult.value is not null"
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"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerElements"
},
{
"url" : "name",
"valueString" : "Fecal Immunochemical Test DNA Result"
},
{
"url" : "statement",
"valueString" : "define \"Fecal Immunochemical Test DNA Result\":\n [Observation: Cx.\"FIT DNA\"] FitDNA\n\t\twhere FitDNA.status in {'final', 'amended', 'corrected', 'preliminary'}\n\t\t\tand FitDNA.value is not null"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerElements"
},
{
"url" : "name",
"valueString" : "Fecal Immunochemical Test DNA Result Within 3 Years"
},
{
"url" : "statement",
"valueString" : "define \"Fecal Immunochemical Test DNA Result Within 3 Years\":\n \"Fecal Immunochemical Test DNA Result\" R\n where R.issued 3 years or less on or before AsOf"
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerElements"
},
{
"url" : "name",
"valueString" : "CT Colonography Performed"
},
{
"url" : "statement",
"valueString" : "define \"CT Colonography Performed\":\n [Procedure: Cx.\"CT Colonography\"] Colonography\n where Colonography.status = 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerElements"
},
{
"url" : "name",
"valueString" : "CT Colonography Performed Within 5 Years"
},
{
"url" : "statement",
"valueString" : "define \"CT Colonography Performed Within 5 Years\":\n \"CT Colonography Performed\" P\n where FC.ToInterval(P.performed) ends 5 years or less on or before AsOf"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerElements"
},
{
"url" : "name",
"valueString" : "Flexible Sigmoidoscopy Performed"
},
{
"url" : "statement",
"valueString" : "/*\n@description: Completed Flexible Sigmoidoscopy Procedures\n*/\ndefine \"Flexible Sigmoidoscopy Performed\":\n [Procedure: Cx.\"Flexible Sigmoidoscopy\"] FlexibleSigmoidoscopy\n\t\twhere FlexibleSigmoidoscopy.status = 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerElements"
},
{
"url" : "name",
"valueString" : "Flexible Sigmoidoscopy Performed Within 5 Years"
},
{
"url" : "statement",
"valueString" : "define \"Flexible Sigmoidoscopy Performed Within 5 Years\":\n \"Flexible Sigmoidoscopy Performed\" P\n where FC.ToInterval(P.performed) ends 5 years or less on or before AsOf"
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerElements"
},
{
"url" : "name",
"valueString" : "Colonoscopy Performed"
},
{
"url" : "statement",
"valueString" : "define \"Colonoscopy Performed\":\n [Procedure: Cx.\"Colonoscopy\"] Colonoscopy\n\t\twhere Colonoscopy.status = 'completed'"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerElements"
},
{
"url" : "name",
"valueString" : "Colonoscopy Performed Within 10 Years"
},
{
"url" : "statement",
"valueString" : "define \"Colonoscopy Performed Within 10 Years\":\n \"Colonoscopy Performed\" P\n where FC.ToInterval(P.performed) ends 10 years or less on or before AsOf"
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerElements"
},
{
"url" : "name",
"valueString" : "Has Appropriate Colorectal Cancer Screening"
},
{
"url" : "statement",
"valueString" : "/*\n FOBT within 1 year\n or FIT DNA within 3 years\n or CT Colonography within 5 years\n or Flexible Sigmoidoscopy within 5 years\n or Colonoscopy within 10 years\n*/\ndefine \"Has Appropriate Colorectal Cancer Screening\":\n exists \"Fecal Occult Blood Test Result Within 1 Year\"\n or exists \"Fecal Immunochemical Test DNA Result Within 3 Years\"\n or exists \"CT Colonography Performed Within 5 Years\"\n or exists \"Flexible Sigmoidoscopy Performed Within 5 Years\"\n or exists \"Colonoscopy Performed Within 10 Years\""
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerScreeningCQM"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n CCE.\"Has Appropriate Colorectal Cancer Screening\""
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerScreeningCQM"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "/*\nNOTE: Removed qualifying encounters criteria to simplify for demonstration purposes\n*/\ndefine \"Initial Population\":\n AgeInYearsAt(start of \"Measurement Period\") in Interval[50, 75]"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "ColorectalCancerScreeningCQM"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Initial Population\""
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "Library CCE",
"resource" : "http://fhir.org/guides/cqf/ccc/Library/ColorectalCancerElements"
},
{
"type" : "depends-on",
"display" : "Library Cx",
"resource" : "http://fhir.org/guides/cqf/ccc/Library/ColorectalCancerConcepts"
},
{
"type" : "depends-on",
"display" : "Library FHIRHelpers",
"resource" : "http://fhir.org/guides/cqf/ccc/Library/FHIRHelpers|4.0.1"
},
{
"type" : "depends-on",
"display" : "Library FC",
"resource" : "http://fhir.org/guides/cqf/ccc/Library/FHIRCommon|4.0.1"
},
{
"type" : "depends-on",
"display" : "Value set Fecal Occult Blood Test (FOBT)",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"
},
{
"type" : "depends-on",
"display" : "Value set FIT DNA",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"
},
{
"type" : "depends-on",
"display" : "Value set CT Colonography",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038"
},
{
"type" : "depends-on",
"display" : "Value set Flexible Sigmoidoscopy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010"
},
{
"type" : "depends-on",
"display" : "Value set Colonoscopy",
"resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020"
}
],
"parameter" : [
{
"name" : "Measurement Period",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "Period"
},
{
"name" : "Numerator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Denominator",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Initial Population",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
}
],
"dataRequirement" : [
{
"type" : "Observation",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Observation"
],
"mustSupport" : [
"code",
"status",
"value",
"issued"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1011"
}
]
},
{
"type" : "Observation",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Observation"
],
"mustSupport" : [
"code",
"status",
"value",
"issued"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1039"
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"status",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1038"
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"status",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1010"
}
]
},
{
"type" : "Procedure",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
],
"mustSupport" : [
"code",
"status",
"performed"
],
"codeFilter" : [
{
"path" : "code",
"valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1020"
}
]
},
{
"type" : "Patient",
"profile" : [
🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
]
}
]
}
],
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
"valueReference" : {
🔗 "reference" : "Device/cqf-tooling"
}
},
{
"id" : "effective-data-requirements",
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
"valueReference" : {
"reference" : "#effective-data-requirements"
}
}
],
"url" : "http://fhir.org/guides/cqf/ccc/Measure/ColorectalCancerScreeningCQM",
"version" : "0.1.0",
"name" : "ColorectalCancerScreeningCQM",
"title" : "Colorectal Cancer Screening CQM",
"status" : "draft",
"experimental" : true,
"date" : "2024-05-14T12:25:12-06:00",
"publisher" : "Clinical Quality Framework",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://github.com/cqframework"
}
]
}
],
"description" : "Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer",
"jurisdiction" : [
{
"coding" : [
{
"system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code" : "001"
}
]
}
],
"purpose" : "Illustration",
"copyright" : "This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2020 National Committee for Quality Assurance. All Rights Reserved. \n\nLimited 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 third party codes contained in the specifications.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2020 American Medical Association. LOINC(R) copyright 2004-2020 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2020 International Health Terminology Standards Development Organisation. ICD-10 copyright 2020 World Health Organization. All Rights Reserved.",
"effectivePeriod" : {
"start" : "2022-01-01",
"end" : "2022-12-31"
},
"library" : [
🔗 "http://fhir.org/guides/cqf/ccc/Library/ColorectalCancerScreeningCQM"
],
"disclaimer" : "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.\n \nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
"scoring" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
},
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "process"
}
]
}
],
"rationale" : "Colorectal cancer represents eight percent of all new cancer cases in the United States. In 2020, there were an estimated 147,950 new cases of colorectal cancer and an estimated 53,200 deaths attributed to it. According to the National Cancer Institute, about 4.2 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (National Cancer Institute, 2020).\n\nScreening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society, 2020).",
"clinicalRecommendationStatement" : "The U.S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force, 2016). \nAppropriate screenings are defined by any one of the following:\n-Colonoscopy (every 10 years)\n-Flexible sigmoidoscopy (every 5 years)\n-Fecal occult blood test (annually)\n-FIT-DNA (every 3 years)\n-Computed tomographic colonography (every 5 years)",
"improvementNotation" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "increase"
}
]
},
"guidance" : "Patient self-report for procedures as well as diagnostic studies should be recorded in \"Procedure, Performed\" template or \"Diagnostic Study, Performed\" template in QRDA-1. \n\nDo not count digital rectal exams (DRE), fecal occult blood tests (FOBTs) performed in an office setting or performed on a sample collected via DRE.\n\nThis eCQM is a patient-based measure.\n\nThis version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.",
"group" : [
{
"population" : [
{
"id" : "B225F36D-A1FE-4840-A685-4B48964C6890",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "19E7BDDF-1A30-4179-A186-402D43D29D90",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "C071B00B-A126-47F0-85CC-4DD7B76BD15D",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
}
]
}
]
}
IG © 2019+ Clinical Quality Framework. Package fhir.cqf.ccc#0.1.0 based on FHIR 4.0.1. Generated 2024-08-29
Links: Table of Contents |
QA Report
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