eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide
2024.0.0 - CI Build
eCQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2024.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/ecqm-content-qicore-2024/ and changes regularly. See the Directory of published versions
| Draft as of 2024-12-18 |
{
"resourceType" : "Measure",
"id" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR",
"meta" : {
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🔗 "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"🔗 ,
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"
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"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic HyperplasiaFHIR</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">1.4.000</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-UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR.html\">Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic HyperplasiaFHIR</a></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n short-name identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>CMS771FHIR</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-independent identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:0748d873-8e20-441e-9bbf-c1eefe3ea054</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n version-specific identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>urn:uuid:43e6a3d8-3d0d-4d94-b4c2-bb0232d83fb2</span>\n </p>\n \n </td>\n </tr>\n \n <tr>\n <th scope=\"row\">\n <b>\n \n \n publisher (CMS) identifier:\n \n \n </b>\n </th>\n\n <td style=\"padding-left: 4px;\">\n \n <p style=\"margin-bottom: 5px;\">\n <span>771FHIR</span>\n </p>\n \n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Effective Period: </b></th>\n <td style=\"padding-left: 4px;\">2025-01-01..2025-12-31</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\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">Large Urology Group Practice Association (LUGPA)</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Author: </b></th>\n <td style=\"padding-left: 4px;\">Large Urology Group Practice Association (LUGPA)</td>\n </tr>\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 patients with an office visit within the measurement period and with a new diagnosis of clinically significant Benign Prostatic Hyperplasia who have International Prostate Symptoms Score (IPSS) or American Urological Association (AUA) Symptom Index (SI) documented at time of diagnosis and again 6-12 months later with an improvement of 3 points</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Purpose: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>UNKNOWN</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>Limited proprietary coding is contained in the measure specifications for user convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Large Urology Group Practice Association (LUGPA) and Oregon Urology Institute (OUI) disclaim all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2023. American Medical Association. LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 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. 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\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\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rationale: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting older men, with a prevalence of 50% by age 60 years and 90% by the ninth decade of life (Medina et al., 1999). The enlarged gland had been proposed to contribute to the overall lower urinary tract symptoms (LUTS) complex (McVary et al., 2014). Although LUTS secondary to BPH is not often a life-threatening condition, the impact of LUTS/BPH on quality of life can be significant (Wei et al., 2005). The American Urological Association Symptom Index (AUA-SI) and the International Prostate Symptom Score (IPSS) were developed to measure outcomes in studies of different treatments for BPH (Wuerstle et al., 2011). The IPSS uses the same questions as the AUA-SI, but also adds a disease-specific quality of life question (OLeary, 2005). The IPSS was adopted in 1993 by the World Health Organization. It is a reproducible, validated index designed to determine disease severity and response to therapy (D’Silva et al., 2014). It includes 3 storage symptom questions (frequency, nocturia, urgency) and four voiding symptoms (feeling of incomplete emptying, intermittency, straining, and a weak stream) as well as a Bother question: If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that? A three-point improvement in the score is considered meaningful (McVary et al., 2014).</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 symptoms of BPH are lower urinary tract symptoms (LUTS). There are other disorders with similar symptoms that need to be excluded. History, physical examination, and testing are required prior to a diagnosis of BPH. IPSS by itself is not a reliable diagnostic tool for LUTS suggestive of BPH but serves as a quantitative measure of LUTS after the diagnosis is established (D’Silva et al., 2014). Medical and surgical interventions for BPH recommend a follow up IPSS evaluation to determine effectiveness of treatment. IPSS should be evaluated at the time of diagnosis and after definitive treatment.</p>\n</div></td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Guidance (Usage): </b></th>\n <td style=\"padding-left: 4px;\">The IPSS is inclusive of the symptom index score and the quality of life score. The AUA-SI is the symptom index score alone and must be added to the QOL score. The AUA-SI with the QOL equals the IPSS. Both of these are the urinary symptom score. The patient must have a urinary symptom score (USS) within 1 month after initial diagnosis. If more than one USS in the initial one month, then the first USS counts. The patient must have a USS again at 6-12 months after the initial diagnosis and if more than one USS in this time frame, then the last USS counts. The result of the test is a numeric value that relates to a continuous numeric scale. Reported either as an integer, a ratio, a real number, or a range. The test result value may optionally contain a relational operator from the set {<=, <, >, >=}. Valid values for a quantitative test are of the form “7”, “-7”, “7.4”, “-7.4”, “7.8912”, “0.125”, “<10”, “<10.15”, “>12000”, 1-10, 1:256. Hospitalization within 30 days of Initial BPH Diagnosis refers to a 30-day period between the end of the hospitalization and the clinical office setting BPH diagnosis. This is due to aggravating factors from hospitalization, such as bed rest, medications, surgery, and altered body functions. This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth. This FHIR-based measure has been derived from the QDM-based measure: CMS771v6. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).</td>\n </tr>\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Population Criteria: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <table class=\"grid-dict\">\n \n <tr>\n <th><b>6643b8e4f4fc785d87117128</b></th>\n </tr>\n \n \n <tr>\n <td>Initial Population:</td>\n\n \n \n <td>Male patients with an initial diagnosis of benign prostatic hyperplasia 6 months prior to the measurement period, and a urinary symptom score assessment within 1 month of initial diagnosis and a follow-up urinary symptom score assessment within 6-12 months, who had a qualifying visit during the measurement period</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator:</td>\n\n \n \n <td>Equals Initial Population</td>\n \n \n\n </tr>\n \n <tr>\n <td>Denominator Exclusion:</td>\n\n \n \n <td>Patients with urinary retention that starts within 1 year of initial BPH diagnosis. Patients with an initial BPH diagnosis that starts during, or within 30 days after end of hospitalization. Patients with a diagnosis of morbid obesity, or with a BMI Exam >=40 before the follow up urinary symptom score.</td>\n \n \n\n </tr>\n \n <tr>\n <td>Numerator:</td>\n\n \n \n <td>Patients with a documented improvement of at least 3 points in their urinary symptom score during the measurement period</td>\n \n \n\n </tr>\n \n \n </table>\n \n </td>\n </tr>\n \n \n\n \n <tr>\n <th scope=\"row\"><b> Supplemental Data Elements: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p>SDE Ethnicity</p>\n \n \n \n \n \n <p>SDE Payer</p>\n \n \n \n \n \n <p>SDE Race</p>\n \n \n \n \n \n <p>SDE Sex</p>\n \n \n \n </td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\">\n <b> Supplemental Data Guidance\n : </b></th>\n <td style=\"padding-left: 4px;\"> For every patient evaluated by this measure also identify payer, race, ethnicity and sex </td>\n </tr>\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-UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR.html\">UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n\n \n \n <tr>\n <th scope=\"row\"><b>Terminology and Other Dependencies: </b></th>\n <td style=\"padding-left: 4px;\">\n \n <li><code>Library/SupplementalDataElements|3.5.000</code></li>\n \n <li><code>Library/FHIRHelpers|4.4.000</code></li>\n \n <li><code>Library/QICoreCommon|2.1.000</code></li>\n \n <li><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">AdministrativeGender</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-loinc.html\">Logical Observation Identifiers, Names and Codes (LOINC)</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-icd10CM.html\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">Condition Clinical Status Codes</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a></li>\n \n <li><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1164.52/expansion\">Urinary retention</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1151.59/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1151.59</a></li>\n \n <li><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1164.67/expansion\">Morbid Obesity</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>SDE Sex</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Coding</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>SDE Payer</td>\n <td>Out</td>\n <td>0</td>\n <td>*</td>\n <td>Resource</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 <tr>\n <td>SDE Ethnicity</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</td>\n </tr>\n \n <tr>\n <td>Denominator Exclusions</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>boolean</td>\n </tr>\n \n <tr>\n <td>SDE Race</td>\n <td>Out</td>\n <td>0</td>\n <td>1</td>\n <td>Resource</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>Resource Type</b></th>\n <th><b>Resource Elements</b></th>\n <th><b>Valueset Name</b></th>\n <th><b>Valueset</b></th>\n </tr>\n \n <tr>\n <td>Patient(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-patient.html\">QICorePatient</a>)</td>\n <td>\n \n ethnicity\n \n race\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n effective\n \n status\n \n status.value\n \n value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n effective\n \n status\n \n status.value\n \n value\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-observation.html\">QICoreObservation</a>)</td>\n <td>\n \n code\n \n status\n \n status.value\n \n value\n \n effective\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Urinary retention\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1164.52/expansion\">Urinary retention</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n \n Morbid Obesity\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1164.67/expansion\">Morbid Obesity</a></td>\n </tr>\n \n <tr>\n <td>Condition(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-condition.html\">QICoreCondition</a>)</td>\n <td>\n \n code\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n class\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Office Visit\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a></td>\n </tr>\n \n <tr>\n <td>Encounter(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-encounter.html\">QICoreEncounter</a>)</td>\n <td>\n \n type\n \n period\n \n status\n \n status.value\n \n </td>\n <td>\n \n \n Hospital Services for Urology\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1151.59/expansion\">http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1151.59</a></td>\n </tr>\n \n <tr>\n <td>Coverage(<a href=\"http://hl7.org/fhir/us/qicore/STU4.1.1/StructureDefinition-qicore-coverage.html\">QICoreCoverage</a>)</td>\n <td>\n \n type\n \n period\n \n </td>\n <td>\n \n \n Payer Type\n \n \n </td>\n <td><a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer</a></td>\n </tr>\n \n <tr>\n <td>Observation(<a href=\"http://hl7.org/fhir/R4/bmi.html\">Observation Body Mass Index Profile</a>)</td>\n <td>\n \n value\n \n status\n \n status.value\n \n effective\n \n </td>\n <td>\n \n </td>\n <td/>\n </tr>\n \n </table>\n </td>\n </tr>\n\n \n <tr>\n <th scope=\"row\"><b>Direct Reference Codes:</b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr>\n <th><b>display</b></th>\n <th><b>code</b></th>\n <th><b>system</b></th>\n </tr>\n \n <tr>\n <td>Male</td>\n <td>M</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>Female</td>\n <td>F</td>\n <td><a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">http://hl7.org/fhir/administrative-gender</a></td>\n </tr>\n \n <tr>\n <td>International Prostate Symptom Score [IPSS]</td>\n <td>80976-4</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>American Urological Association Symptom Index [AUASI]</td>\n <td>80883-2</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]</td>\n <td>81090-3</td>\n <td><a href=\"https://loinc.org/\">http://loinc.org</a></td>\n </tr>\n \n <tr>\n <td>Benign prostatic hyperplasia with lower urinary tract symptoms</td>\n <td>N40.1</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-icd10CM.html\">http://hl7.org/fhir/sid/icd-10-cm</a></td>\n </tr>\n \n <tr>\n <td>Active</td>\n <td>active</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Recurrence</td>\n <td>recurrence</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Relapse</td>\n <td>relapse</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-clinical.html\">http://terminology.hl7.org/CodeSystem/condition-clinical</a></td>\n </tr>\n \n <tr>\n <td>Confirmed</td>\n <td>confirmed</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-condition-ver-status.html\">http://terminology.hl7.org/CodeSystem/condition-ver-status</a></td>\n </tr>\n \n <tr>\n <td>virtual</td>\n <td>VR</td>\n <td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">http://terminology.hl7.org/CodeSystem/v3-ActCode</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\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> 6643b8e4f4fc785d87117128 </td>\n <td colspan=\"3\" style=\"padding-left: 4px;\">\n \n <b>Group scoring:</b>\n \n <span> proportion </span>\n \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 <tr>\n \n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <span>Outcome </span>\n </p>\n \n \n \n </td>\n \n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Rate Aggregation: </b></th>\n <td colspan=\"3\" style=\"padding-left: 4px;\">None</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 \n <p style=\"margin-bottom: 5px;\">\n <span>Increased score indicates improvement </span>\n </p>\n \n \n \n \n </td>\n </tr>\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\">define "Initial Population":\n ( "Patient is Male" )\n and "Has Qualifying Encounter"\n and "Has Qualifying BPH Diagnosis"\n and "Urinary Symptom Score Within 1 Month after Initial BPH Diagnosis" is not null\n and "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" is not null</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>Denominator Exclusion</td>\n <td>\n \n <pre><code class=\"language-cql\">define "Denominator Exclusions":\n exists ( "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis" )\n or ( "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization" is not null )\n or ( "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment" )</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 "Urinary Symptom Score Improvement Greater Than or Equal To 3"</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>SupplementalDataElements</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n case\n when Patient.gender = 'male' then "M"\n when Patient.gender = 'female' then "F"\n else null\n end</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>SDE Sex</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Sex":\n SDE."SDE Sex"</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Documented IPSS Assessment Result</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Documented IPSS Assessment Result":\n [Observation: "International Prostate Symptom Score [IPSS]"] IPSSAssessment\n where IPSSAssessment.status in { 'final', 'amended', 'corrected' }\n and IPSSAssessment.value is not null\n return {\n effectiveDatetime: IPSSAssessment.effective.earliest ( ),\n valueInteger: IPSSAssessment.value as Integer\n }</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>AUA Symptom Index and Quality of Life Assessment Result</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "AUA Symptom Index and Quality of Life Assessment Result":\n [Observation: "American Urological Association Symptom Index [AUASI]"] AUASIAssessment\n let LastQOLOnDate: Last([Observation: "If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]"] QOLAssessment\n where QOLAssessment.effective.earliest() same day as AUASIAssessment.effective.earliest()\n and QOLAssessment.status in { 'final', 'amended', 'corrected' }\n and QOLAssessment.value is not null\n sort by effective.earliest()\n )\n where AUASIAssessment.status in { 'final', 'amended', 'corrected' }\n and AUASIAssessment.value is not null\n return {\n effectiveDatetime: AUASIAssessment.effective.earliest ( ),\n valueInteger: ( AUASIAssessment.value as Integer ) + ( LastQOLOnDate.value as Integer )\n }</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Urinary Symptom Score Assessment</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Urinary Symptom Score Assessment":\n "Documented IPSS Assessment Result"\n union "AUA Symptom Index and Quality of Life Assessment Result"</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period":\n First([Condition: "Benign prostatic hyperplasia with lower urinary tract symptoms"] NewBPHDiagnosis\n where NewBPHDiagnosis.prevalenceInterval() starts during Interval[start of "Measurement Period" - 6 months, start of "Measurement Period"]\n and NewBPHDiagnosis.isConfirmedActiveDiagnosis()\n sort by start of onset.toInterval()\n )</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Urinary Symptom Score Within 1 Month after Initial BPH Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Urinary Symptom Score Within 1 Month after Initial BPH Diagnosis":\n First("Urinary Symptom Score Assessment" USSAssessment\n with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis\n such that USSAssessment.effectiveDatetime 1 month or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval()\n sort by effectiveDatetime\n )</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis":\n Last("Urinary Symptom Score Assessment" USSAssessment\n with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis\n such that months between start of InitialBPHDiagnosis.prevalenceInterval() and USSAssessment.effectiveDatetime in Interval[6, 12]\n sort by effectiveDatetime\n )</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Urinary Symptom Score Change</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Urinary Symptom Score Change":\n from\n "Urinary Symptom Score Within 1 Month after Initial BPH Diagnosis" FirstUSSAssessment,\n "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment\n let USSChange: ( FirstUSSAssessment.valueInteger ) - ( FollowUpUSSAssessment.valueInteger )\n return USSChange</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Urinary Symptom Score Improvement Greater Than or Equal To 3</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Urinary Symptom Score Improvement Greater Than or Equal To 3":\n ( "Urinary Symptom Score Change" USSImprovement\n where USSImprovement >= 3\n ) 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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</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 "Urinary Symptom Score Improvement Greater Than or Equal To 3"</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Patient is Male</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Patient is Male":\n Patient.gender = 'male'</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Has Qualifying Encounter</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Qualifying Encounter":\n exists ( [Encounter: "Office Visit"] ValidEncounter\n where ValidEncounter.period during day of "Measurement Period"\n and ValidEncounter.class !~ "virtual"\n and ValidEncounter.status = 'finished'\n )</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Has Qualifying BPH Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Qualifying BPH Diagnosis":\n "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" 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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</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\">define "Initial Population":\n ( "Patient is Male" )\n and "Has Qualifying Encounter"\n and "Has Qualifying BPH Diagnosis"\n and "Urinary Symptom Score Within 1 Month after Initial BPH Diagnosis" is not null\n and "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" 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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</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 <tr>\n <th><b>Library Name</b></th>\n <th><b>Name</b></th>\n </tr>\n <tr>\n \n <td>SupplementalDataElements</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n [Coverage: type in "Payer Type"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>SDE Payer</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Payer":\n SDE."SDE Payer"</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>SupplementalDataElements</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>SDE Ethnicity</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Ethnicity":\n SDE."SDE Ethnicity"</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis":\n [Condition: "Urinary retention"] UrinaryRetention\n with "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis\n such that UrinaryRetention.prevalenceInterval ( ) starts 1 year or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval ( )\n where UrinaryRetention.isConfirmedActiveDiagnosis ( )</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization":\n "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period" InitialBPHDiagnosis\n with [Encounter: "Hospital Services for Urology"] InHospitalServices\n such that InitialBPHDiagnosis.prevalenceInterval ( ) starts during Interval[start of InHospitalServices.period, end of InHospitalServices.period + 31 days]\n and InHospitalServices.status = 'finished'</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Morbid Obesity Diagnosis On or Before Follow Up USS Assessment</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Morbid Obesity Diagnosis On or Before Follow Up USS Assessment":\n [Condition: "Morbid Obesity"] MorbidObesity\n with "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment\n such that MorbidObesity.prevalenceInterval ( ) overlaps "Measurement Period"\n and MorbidObesity.prevalenceInterval ( ) starts on or before FollowUpUSSAssessment.effectiveDatetime\n where MorbidObesity.isConfirmedActiveDiagnosis ( )</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n* @code: Body mass index (BMI) [Ratio] - 39156-5\n* @profile: http://hl7.org/fhir/StructureDefinition/bmi\n*/\n\n\ndefine "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment":\n exists ( ["observation-bmi"] BMIExam\n with "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis" FollowUpUSSAssessment\n such that BMIExam.value >= 40 'kg/m2'\n and BMIExam.status in { 'final', 'amended', 'corrected' }\n and BMIExam.effective.earliest ( ) during day of "Measurement Period"\n and BMIExam.effective.earliest ( ) on or before FollowUpUSSAssessment.effectiveDatetime\n return BMIExam.effective.earliest ( )\n )</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment":\n exists "Morbid Obesity Diagnosis On or Before Follow Up USS Assessment"\n or "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment"</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>Denominator Exclusions</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "Denominator Exclusions":\n exists ( "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis" )\n or ( "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization" is not null )\n or ( "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment" )</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>SupplementalDataElements</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n Patient.race R\n return Tuple {\n codes: R.ombCategory union R.detailed,\n display: R.text\n }</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>SDE Race</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define "SDE Race":\n SDE."SDE Race"</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>QICoreCommon</td>\n \n \n <td>earliest</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Given an interval, return the starting point if the interval has a starting boundary specified,\notherwise, return the ending point\n*/\ndefine fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):\n (choice.toInterval()) period\n return\n if (period."hasStart"()) then start of period\n else end of 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>QICoreCommon</td>\n \n \n <td>prevalenceInterval</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ "active"\n or condition.clinicalStatus ~ "recurrence"\n or condition.clinicalStatus ~ "relapse" then\n Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n (end of condition.abatementInterval()) abatementDate\n return if abatementDate is null then\n Interval[start of condition.onset.toInterval(), abatementDate)\n else\n Interval[start of condition.onset.toInterval(), abatementDate]</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>UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR</td>\n \n \n <td>isConfirmedActiveDiagnosis</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define fluent function isConfirmedActiveDiagnosis(condition Condition):\n condition.isActive ( )\n and condition.verificationStatus ~ QICoreCommon."confirmed"</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>QICoreCommon</td>\n \n \n <td>isActive</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/* Candidates for FHIRCommon */\n\n/*\n@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse\n*/\ndefine fluent function isActive(condition Condition):\n condition.clinicalStatus ~ "active"\n or condition.clinicalStatus ~ "recurrence"\n or condition.clinicalStatus ~ "relapse"</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>FHIRHelpers</td>\n \n \n <td>ToString</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</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>FHIRHelpers</td>\n \n \n <td>ToCode</td>\n \n </tr>\n <tr>\n \n <td/>\n <td>\n <pre class=\"highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n if coding is null then\n null\n else\n System.Code {\n code: coding.code.value,\n system: coding.system.value,\n version: coding.version.value,\n display: coding.display.value\n }</code></pre>\n </td>\n \n </tr>\n \n </table>\n </td>\n </tr>\n \n \n \n\n </table>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "M",
"display" : "Male"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/administrative-gender",
"code" : "F",
"display" : "Female"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "80976-4",
"display" : "International Prostate Symptom Score [IPSS]"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "80883-2",
"display" : "American Urological Association Symptom Index [AUASI]"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://loinc.org",
"code" : "81090-3",
"display" : "If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://hl7.org/fhir/sid/icd-10-cm",
"code" : "N40.1",
"display" : "Benign prostatic hyperplasia with lower urinary tract symptoms"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "active",
"display" : "Active"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "recurrence",
"display" : "Recurrence"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
"code" : "relapse",
"display" : "Relapse"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
"code" : "confirmed",
"display" : "Confirmed"
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
"valueCoding" : {
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "VR",
"display" : "virtual"
}
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n case\n when Patient.gender = 'male' then \"M\"\n when Patient.gender = 'female' then \"F\"\n else null\n end"
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "SDE Sex"
},
{
"url" : "statement",
"valueString" : "define \"SDE Sex\":\n SDE.\"SDE Sex\""
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Documented IPSS Assessment Result"
},
{
"url" : "statement",
"valueString" : "define \"Documented IPSS Assessment Result\":\n [Observation: \"International Prostate Symptom Score [IPSS]\"] IPSSAssessment\n where IPSSAssessment.status in { 'final', 'amended', 'corrected' }\n and IPSSAssessment.value is not null\n return {\n effectiveDatetime: IPSSAssessment.effective.earliest ( ),\n valueInteger: IPSSAssessment.value as Integer\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "AUA Symptom Index and Quality of Life Assessment Result"
},
{
"url" : "statement",
"valueString" : "define \"AUA Symptom Index and Quality of Life Assessment Result\":\n [Observation: \"American Urological Association Symptom Index [AUASI]\"] AUASIAssessment\n let LastQOLOnDate: Last([Observation: \"If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that [IPSS]\"] QOLAssessment\n where QOLAssessment.effective.earliest() same day as AUASIAssessment.effective.earliest()\n and QOLAssessment.status in { 'final', 'amended', 'corrected' }\n and QOLAssessment.value is not null\n sort by effective.earliest()\n )\n where AUASIAssessment.status in { 'final', 'amended', 'corrected' }\n and AUASIAssessment.value is not null\n return {\n effectiveDatetime: AUASIAssessment.effective.earliest ( ),\n valueInteger: ( AUASIAssessment.value as Integer ) + ( LastQOLOnDate.value as Integer )\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Urinary Symptom Score Assessment"
},
{
"url" : "statement",
"valueString" : "define \"Urinary Symptom Score Assessment\":\n \"Documented IPSS Assessment Result\"\n union \"AUA Symptom Index and Quality of Life Assessment Result\""
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period"
},
{
"url" : "statement",
"valueString" : "define \"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period\":\n First([Condition: \"Benign prostatic hyperplasia with lower urinary tract symptoms\"] NewBPHDiagnosis\n where NewBPHDiagnosis.prevalenceInterval() starts during Interval[start of \"Measurement Period\" - 6 months, start of \"Measurement Period\"]\n and NewBPHDiagnosis.isConfirmedActiveDiagnosis()\n sort by start of onset.toInterval()\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Urinary Symptom Score Within 1 Month after Initial BPH Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Urinary Symptom Score Within 1 Month after Initial BPH Diagnosis\":\n First(\"Urinary Symptom Score Assessment\" USSAssessment\n with \"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period\" InitialBPHDiagnosis\n such that USSAssessment.effectiveDatetime 1 month or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval()\n sort by effectiveDatetime\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis\":\n Last(\"Urinary Symptom Score Assessment\" USSAssessment\n with \"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period\" InitialBPHDiagnosis\n such that months between start of InitialBPHDiagnosis.prevalenceInterval() and USSAssessment.effectiveDatetime in Interval[6, 12]\n sort by effectiveDatetime\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 7
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Urinary Symptom Score Change"
},
{
"url" : "statement",
"valueString" : "define \"Urinary Symptom Score Change\":\n from\n \"Urinary Symptom Score Within 1 Month after Initial BPH Diagnosis\" FirstUSSAssessment,\n \"Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis\" FollowUpUSSAssessment\n let USSChange: ( FirstUSSAssessment.valueInteger ) - ( FollowUpUSSAssessment.valueInteger )\n return USSChange"
},
{
"url" : "displaySequence",
"valueInteger" : 8
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Urinary Symptom Score Improvement Greater Than or Equal To 3"
},
{
"url" : "statement",
"valueString" : "define \"Urinary Symptom Score Improvement Greater Than or Equal To 3\":\n ( \"Urinary Symptom Score Change\" USSImprovement\n where USSImprovement >= 3\n ) is not null"
},
{
"url" : "displaySequence",
"valueInteger" : 9
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Numerator"
},
{
"url" : "statement",
"valueString" : "define \"Numerator\":\n \"Urinary Symptom Score Improvement Greater Than or Equal To 3\""
},
{
"url" : "displaySequence",
"valueInteger" : 10
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Patient is Male"
},
{
"url" : "statement",
"valueString" : "define \"Patient is Male\":\n Patient.gender = 'male'"
},
{
"url" : "displaySequence",
"valueInteger" : 11
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Has Qualifying Encounter"
},
{
"url" : "statement",
"valueString" : "define \"Has Qualifying Encounter\":\n exists ( [Encounter: \"Office Visit\"] ValidEncounter\n where ValidEncounter.period during day of \"Measurement Period\"\n and ValidEncounter.class !~ \"virtual\"\n and ValidEncounter.status = 'finished'\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 12
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Has Qualifying BPH Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Has Qualifying BPH Diagnosis\":\n \"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period\" is not null"
},
{
"url" : "displaySequence",
"valueInteger" : 13
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Initial Population"
},
{
"url" : "statement",
"valueString" : "define \"Initial Population\":\n ( \"Patient is Male\" )\n and \"Has Qualifying Encounter\"\n and \"Has Qualifying BPH Diagnosis\"\n and \"Urinary Symptom Score Within 1 Month after Initial BPH Diagnosis\" is not null\n and \"Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis\" is not null"
},
{
"url" : "displaySequence",
"valueInteger" : 14
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Denominator"
},
{
"url" : "statement",
"valueString" : "define \"Denominator\":\n \"Initial Population\""
},
{
"url" : "displaySequence",
"valueInteger" : 15
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n [Coverage: type in \"Payer Type\"] Payer\n return {\n code: Payer.type,\n period: Payer.period\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 16
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "SDE Payer"
},
{
"url" : "statement",
"valueString" : "define \"SDE Payer\":\n SDE.\"SDE Payer\""
},
{
"url" : "displaySequence",
"valueInteger" : 17
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "SupplementalDataElements"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n Patient.ethnicity E\n return Tuple {\n codes: { E.ombCategory } union E.detailed,\n display: E.text\n }"
},
{
"url" : "displaySequence",
"valueInteger" : 18
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "SDE Ethnicity"
},
{
"url" : "statement",
"valueString" : "define \"SDE Ethnicity\":\n SDE.\"SDE Ethnicity\""
},
{
"url" : "displaySequence",
"valueInteger" : 19
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis"
},
{
"url" : "statement",
"valueString" : "define \"Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis\":\n [Condition: \"Urinary retention\"] UrinaryRetention\n with \"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period\" InitialBPHDiagnosis\n such that UrinaryRetention.prevalenceInterval ( ) starts 1 year or less on or after day of start of InitialBPHDiagnosis.prevalenceInterval ( )\n where UrinaryRetention.isConfirmedActiveDiagnosis ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 20
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization"
},
{
"url" : "statement",
"valueString" : "define \"Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization\":\n \"Initial BPH Diagnosis Starts Within 6 Months Before the Measurement Period\" InitialBPHDiagnosis\n with [Encounter: \"Hospital Services for Urology\"] InHospitalServices\n such that InitialBPHDiagnosis.prevalenceInterval ( ) starts during Interval[start of InHospitalServices.period, end of InHospitalServices.period + 31 days]\n and InHospitalServices.status = 'finished'"
},
{
"url" : "displaySequence",
"valueInteger" : 21
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Morbid Obesity Diagnosis On or Before Follow Up USS Assessment"
},
{
"url" : "statement",
"valueString" : "define \"Morbid Obesity Diagnosis On or Before Follow Up USS Assessment\":\n [Condition: \"Morbid Obesity\"] MorbidObesity\n with \"Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis\" FollowUpUSSAssessment\n such that MorbidObesity.prevalenceInterval ( ) overlaps \"Measurement Period\"\n and MorbidObesity.prevalenceInterval ( ) starts on or before FollowUpUSSAssessment.effectiveDatetime\n where MorbidObesity.isConfirmedActiveDiagnosis ( )"
},
{
"url" : "displaySequence",
"valueInteger" : 22
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment"
},
{
"url" : "statement",
"valueString" : "/*\n* @code: Body mass index (BMI) [Ratio] - 39156-5\n* @profile: http://hl7.org/fhir/StructureDefinition/bmi\n*/\n\n\ndefine \"BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment\":\n exists ( [\"observation-bmi\"] BMIExam\n with \"Urinary Symptom Score 6 to 12 Months After Initial BPH Diagnosis\" FollowUpUSSAssessment\n such that BMIExam.value >= 40 'kg/m2'\n and BMIExam.status in { 'final', 'amended', 'corrected' }\n and BMIExam.effective.earliest ( ) during day of \"Measurement Period\"\n and BMIExam.effective.earliest ( ) on or before FollowUpUSSAssessment.effectiveDatetime\n return BMIExam.effective.earliest ( )\n )"
},
{
"url" : "displaySequence",
"valueInteger" : 23
}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
},
{
"url" : "name",
"valueString" : "Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment"
},
{
"url" : "statement",
"valueString" : "define \"Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment\":\n exists \"Morbid Obesity Diagnosis On or Before Follow Up USS Assessment\"\n or \"BMI Exam Result Greater Than or Equal To 40 During Measurement Period and On or Before Follow Up USS Assessment\""
},
{
"url" : "displaySequence",
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},
{
"extension" : [
{
"url" : "libraryName",
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},
{
"url" : "name",
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},
{
"url" : "statement",
"valueString" : "define \"Denominator Exclusions\":\n exists ( \"Urinary Retention Diagnosis Starts Within 1 Year After Initial BPH Diagnosis\" )\n or ( \"Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization\" is not null )\n or ( \"Morbid Obesity Diagnosis or BMI Exam Result Greater Than or Equal to 40 Starts On or Before Follow Up USS Assessment\" )"
},
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}
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},
{
"url" : "displaySequence",
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}
],
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
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],
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"extension" : [
{
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"valueString" : "QICoreCommon"
},
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},
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},
{
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},
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{
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},
{
"type" : "depends-on",
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"parameter" : [
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}
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},
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],
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],
"version" : "1.4.000",
"name" : "UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR",
"title" : "Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic HyperplasiaFHIR",
"status" : "draft",
"experimental" : false,
"date" : "2024-12-18T21:25:47+00:00",
"publisher" : "Large Urology Group Practice Association (LUGPA)",
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],
"description" : "Percentage of patients with an office visit within the measurement period and with a new diagnosis of clinically significant Benign Prostatic Hyperplasia who have International Prostate Symptoms Score (IPSS) or American Urological Association (AUA) Symptom Index (SI) documented at time of diagnosis and again 6-12 months later with an improvement of 3 points",
"purpose" : "UNKNOWN",
"usage" : "The IPSS is inclusive of the symptom index score and the quality of life score. The AUA-SI is the symptom index score alone and must be added to the QOL score. The AUA-SI with the QOL equals the IPSS. Both of these are the urinary symptom score. The patient must have a urinary symptom score (USS) within 1 month after initial diagnosis. If more than one USS in the initial one month, then the first USS counts. The patient must have a USS again at 6-12 months after the initial diagnosis and if more than one USS in this time frame, then the last USS counts. The result of the test is a numeric value that relates to a continuous numeric scale. Reported either as an integer, a ratio, a real number, or a range. The test result value may optionally contain a relational operator from the set {<=, <, >, >=}. Valid values for a quantitative test are of the form “7”, “-7”, “7.4”, “-7.4”, “7.8912”, “0.125”, “<10”, “<10.15”, “>12000”, 1-10, 1:256. Hospitalization within 30 days of Initial BPH Diagnosis refers to a 30-day period between the end of the hospitalization and the clinical office setting BPH diagnosis. This is due to aggravating factors from hospitalization, such as bed rest, medications, surgery, and altered body functions. This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth. This FHIR-based measure has been derived from the QDM-based measure: CMS771v6. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU4.1.1/) for more information on QI-Core and mapping recommendations from QDM to QI-Core 4.1.1 (https://hl7.org/fhir/us/qicore/STU4.1.1/qdm-to-qicore.html).",
"copyright" : "Limited proprietary coding is contained in the measure specifications for user convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Large Urology Group Practice Association (LUGPA) and Oregon Urology Institute (OUI) disclaim all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2023. American Medical Association. LOINC(R) copyright 2004-2023 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2023 World Health Organization. All Rights Reserved.",
"effectivePeriod" : {
"start" : "2025-01-01",
"end" : "2025-12-31"
},
"author" : [
{
"name" : "Large Urology Group Practice Association (LUGPA)",
"telecom" : [
{
"system" : "url",
"value" : "https://www.lugpa.org/"
}
]
}
],
"library" : [
🔗 "https://madie.cms.gov/Library/UrinarySymptomScoreChangeAfterBenignProstaticHyperplasiaFHIR"
],
"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. Due to technical limitations, registered trademarks are indicated by (R) or [R], and unregistered trademarks are indicated by (TM) or [TM].",
"scoring" : {
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"code" : "proportion",
"display" : "Proportion"
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},
"rationale" : "Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting older men, with a prevalence of 50% by age 60 years and 90% by the ninth decade of life (Medina et al., 1999). The enlarged gland had been proposed to contribute to the overall lower urinary tract symptoms (LUTS) complex (McVary et al., 2014). Although LUTS secondary to BPH is not often a life-threatening condition, the impact of LUTS/BPH on quality of life can be significant (Wei et al., 2005). The American Urological Association Symptom Index (AUA-SI) and the International Prostate Symptom Score (IPSS) were developed to measure outcomes in studies of different treatments for BPH (Wuerstle et al., 2011). The IPSS uses the same questions as the AUA-SI, but also adds a disease-specific quality of life question (OLeary, 2005). The IPSS was adopted in 1993 by the World Health Organization. It is a reproducible, validated index designed to determine disease severity and response to therapy (D’Silva et al., 2014). It includes 3 storage symptom questions (frequency, nocturia, urgency) and four voiding symptoms (feeling of incomplete emptying, intermittency, straining, and a weak stream) as well as a Bother question: If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that? A three-point improvement in the score is considered meaningful (McVary et al., 2014).",
"clinicalRecommendationStatement" : "The symptoms of BPH are lower urinary tract symptoms (LUTS). There are other disorders with similar symptoms that need to be excluded. History, physical examination, and testing are required prior to a diagnosis of BPH. IPSS by itself is not a reliable diagnostic tool for LUTS suggestive of BPH but serves as a quantitative measure of LUTS after the diagnosis is established (D’Silva et al., 2014). Medical and surgical interventions for BPH recommend a follow up IPSS evaluation to determine effectiveness of treatment. IPSS should be evaluated at the time of diagnosis and after definitive treatment.",
"group" : [
{
"id" : "6643b8e4f4fc785d87117128",
"extension" : [
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
"code" : "proportion",
"display" : "Proportion"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
"valueCode" : "boolean"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-type",
"code" : "outcome",
"display" : "Outcome"
}
]
}
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
"valueCode" : "None"
},
{
"url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
"code" : "increase",
"display" : "Increased score indicates improvement"
}
]
}
}
],
"population" : [
{
"id" : "DF446A75-F4AB-4A5D-B121-066198848C5A",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "initial-population",
"display" : "Initial Population"
}
]
},
"description" : "Male patients with an initial diagnosis of benign prostatic hyperplasia 6 months prior to the measurement period, and a urinary symptom score assessment within 1 month of initial diagnosis and a follow-up urinary symptom score assessment within 6-12 months, who had a qualifying visit during the measurement period",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Initial Population"
}
},
{
"id" : "180F8058-1D0B-4367-81C2-FA5736868C5F",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator",
"display" : "Denominator"
}
]
},
"description" : "Equals Initial Population",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator"
}
},
{
"id" : "71261DED-82AC-4F2E-AE2B-3E74CA3F8A42",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "denominator-exclusion",
"display" : "Denominator Exclusion"
}
]
},
"description" : "Patients with urinary retention that starts within 1 year of initial BPH diagnosis. Patients with an initial BPH diagnosis that starts during, or within 30 days after end of hospitalization. Patients with a diagnosis of morbid obesity, or with a BMI Exam >=40 before the follow up urinary symptom score.",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Denominator Exclusions"
}
},
{
"id" : "5CA575BA-5A1E-431E-903C-FAC40AA0CBE7",
"code" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-population",
"code" : "numerator",
"display" : "Numerator"
}
]
},
"description" : "Patients with a documented improvement of at least 3 points in their urinary symptom score during the measurement period",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "Numerator"
}
}
]
}
],
"supplementalData" : [
{
"id" : "sde-ethnicity",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Ethnicity",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Ethnicity"
}
},
{
"id" : "sde-payer",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Payer",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Payer"
}
},
{
"id" : "sde-race",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Race",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Race"
}
},
{
"id" : "sde-sex",
"usage" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
"code" : "supplemental-data"
}
]
}
],
"description" : "SDE Sex",
"criteria" : {
"language" : "text/cql-identifier",
"expression" : "SDE Sex"
}
}
]
}
IG © 2023+ cqframework. Package gov.healthit.ecqi.ecqms#2024.0.0 based on FHIR 4.0.1. Generated 2024-12-19
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