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measure-EXM104-9.1.000.json
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{
"resourceType": "Measure",
"id": "measure-EXM104-9.1.000",
"meta": {
"lastUpdated": "2020-01-29T22:39:51.988-07:00",
"profile": [
"http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table style=\"width: 60%; border-bottom: none;\" class=\"header_table\"> <!-- <tr th:if=\"${resource.hasId()}\" style=\"vertical-align: top;\"><th style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Id: </span></th><td style=\"width:80%\" colspan=\"3\" th:narrative=\"${resource.id}\"></td></tr> --><tr style=\"vertical-align: top;\"><td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Measure Title</span></td><td colspan=\"1\" style=\"width:60%\"><h1 style=\"font-size:10px\">Discharged on Antithrombotic Therapy</h1></td><td scope=\"row\" style=\"background-color:#656565; width:10%\"><span class=\"td_label\">Measure ID</span></td><td colspan=\"1\" style=\"width:10%\"><h1 style=\"font-size:10px\">EXM104</h1></td></tr> <!-- <th:block th:each=\"ident, iter : ${resource.identifier}\"><tr th:if=\"${ident.type.coding[0].code == 'CMS'}\" style=\"vertical-align: top;\"><td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">eCQM Identifier (Measure Authoring Tool)</span></td><td style=\"width:30%\" th:text=\"${ident.value}\"></td><td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">eCQM Version number</span></td><td style=\"width:30%\" th:text=\"${resource.version}\"></td></tr></th:block><th:block th:each=\"ident, iter : ${resource.identifier}\"><tr th:if=\"${ident.type.coding[0].code == 'NQF'}\" style=\"vertical-align: top;\"><td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">NQF Number</span></td><td style=\"width:30%\" th:text=\"${ident.value}\"></td><td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">GUID</span></td><td style=\"width:30%\" th:text=\"${resource.url}\"></td></tr></th:block> --><tr style=\"vertical-align: top;\"><td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Description</span></td><td colspan=\"3\" style=\"width:80%\"><div style=\"width:660px;overflow-x:hidden;overflow-y:auto\"><pre><p>Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge</p>\n</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n <tr>\r\n <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Measurement Period</span></td>\r\n <td colspan=\"3\" style=\"width:80%\">January 1 - December 31</td>\r\n </tr>\r\n <!-- <tr>\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Steward</span></td>\r\n <td style=\"width:80%\" colspan=\"3\" th:text=\"${resource.publisher}\"></td>\r\n </tr>\r\n <tr>\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Developer</span></td>\r\n <td style=\"width:80%\" colspan=\"3\" th:text=\"${resource.publisher}\"></td>\r\n </tr> -->\r\n <!-- <tr th:if=\"${resource.hasDisclaimer()}\">\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Disclaimer</span></td>\r\n <td style=\"width:80%\" colspan=\"3\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre th:text=\"${resource.disclaimer}\"></pre>\r\n </div>\r\n </td>\r\n </tr> -->\r\n <tr>\r\n <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Copyright and Disclaimer Notice</span></td>\r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre>These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.</pre>\r\n <br/>\r\n <pre>Measure specifications are in the Public Domain. LOINC(R) is a registered trademark of the Regenstrief Institute. This material contains SNOMED Clinical Terms(R) (SNOMED CT(C)) copyright 2004-2017 International Health Terminology Standards Development Organization. All rights reserved.</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n <tr>\r\n <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Clinical Recommendation Statement</span></td>\r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\"><p>Clinical trial results suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist</p>\n</div>\r\n </td>\r\n </tr>\r\n \r\n <tr style=\"vertical-align: top;\">\r\n <td rowspan=\"8\" scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">References</span></td>\r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre>Adams HP, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks E. Guidelines for the Early Management of Adults with Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical CardiologyCouncil, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke. 2007;38:1655-1711.</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n \r\n \r\n <tr style=\"vertical-align: top;\">\r\n \r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre>Adams H, Adams R, Del Zoppo G, Goldstein LB. Guidelines for the Early Management of Patients With Ischemic Stroke: Guidelines Update A Scientific Statement From the Stroke Council of the American Heart Association/American Stroke Association. Stroke Vol. 36, 2005: 916:923.</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n \r\n \r\n <tr style=\"vertical-align: top;\">\r\n \r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre>Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and Thrombolytic Therapy for Ischemic Stroke. Chest Vol. 119, 2001: 300-320.</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n \r\n \r\n <tr style=\"vertical-align: top;\">\r\n \r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre>Brott TG, Clark WM, Grotta JC, et al. Stroke the first hours. Guidelines for acute treatment. Consensus Statement. National Stroke Association. 2000.</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n \r\n \r\n <tr style=\"vertical-align: top;\">\r\n \r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre>Chen ZM, Sandercock P, Pan HC, et al. Indications for early aspirin use in acute ischemic stroke: a combined analysis of 40,000 randomized patients from the Chinese acute stroke trial and the international stroke trial. On behalf of the CAST and IST collaborative groups, Stroke 2000;31:1240-1249.</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n \r\n \r\n <tr style=\"vertical-align: top;\">\r\n \r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre>Coull BM, Williams LS, Goldstein LB, et al. Anticoagulants and Antiplatelet Agents in Acute Ischemic Stroke. Report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a Division of the American Heart Association) Stroke. 2002;33:1934 - 1942.</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n \r\n \r\n <tr style=\"vertical-align: top;\">\r\n \r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre>Guideline on the Use of Aspirin as Secondary Prophylaxis for Vascular Disease in Primary Care, Centre for Health Services Research University of Newcastle upon Tyne, & Centre for Health Economics of York, 1998.</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n \r\n \r\n <tr style=\"vertical-align: top;\">\r\n \r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre>Kernan, W.N., B. Ovbiagele, H. R. Black, D. M. Bravata, M. I. Chimowitz, M. D. Ezekowitz, M. C. Fang, M. Fisher, K. L. Furie, D. V. Heck, S. C. Johnston, S. E. Kasner, S. J. Kittner, P. H. Mitchell, M. W. Rich, D. Richardson, L. H. Schwamm, J. A. Wilson. "Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association." [in eng.] Stroke 45, no. 7 (May 2014): 2160-223.</pre>\r\n </div>\r\n </td>\r\n </tr>\r\n \r\n <tr>\r\n <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\"><span class=\"td_label\">Characteristics</span></td>\r\n </tr>\r\n <tr>\r\n <td scope=\"row\" style=\"width:20%\"><span>Scoring</span></td>\r\n <td colspan=\"3\" style=\"width:80%\">Proportion</td>\r\n </tr>\r\n <!-- <tr th:if=\"${resource.hasCompositeScoring()}\">\r\n <td style=\"width:20%\" scope=\"row\"><span class=\"td_label\">Composite Scoring</span></td>\r\n <td style=\"width:80%\" colspan=\"3\" th:text=\"${resource.compositeScoring.getText().substring(0, 1).toUpperCase() + resource.compositeScoring.getText().substring(1)}\"></td>\r\n </tr> -->\r\n \r\n <tr style=\"vertical-align: top;\">\r\n <td rowspan=\"1\" scope=\"row\" style=\"width:20%\"><span>Type</span></td>\r\n <td colspan=\"3\" style=\"width:80%\">Process</td>\r\n </tr>\r\n \r\n <!-- <tr th:if=\"${resource.hasStatus()}\" style=\"vertical-align: top;\">\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Status</span></td>\r\n <td style=\"width:80%\" colspan=\"3\" th:text=\"${resource.status.toString().substring(0, 1).toUpperCase() + resource.status.toString().substring(1).toLowerCase()}\"></td>\r\n </tr>\r\n <tr th:if=\"${resource.hasPurpose()}\" style=\"vertical-align: top;\">\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Purpose</span></td>\r\n <td style=\"width:80%\" colspan=\"3\" th:text=\"${resource.purpose}\"></td>\r\n </tr>\r\n <tr th:if=\"${resource.hasUsage()}\" style=\"vertical-align: top;\" >\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Usage</span></td>\r\n <td style=\"width:80%\" colspan=\"3\" th:text=\"${resource.usage}\"></td>\r\n </tr>\r\n <th:block th:each=\"context, iter : ${resource.useContext}\" >\r\n <tr style=\"vertical-align: top;\">\r\n <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Use Context</span></td>\r\n <td style=\"width:80%\" colspan=\"3\" th:text=\"${context}\"></td>\r\n </tr>\r\n </th:block>\r\n <th:block th:each=\"topics, iter : ${resource.topic}\" >\r\n <tr style=\"vertical-align: top;\">\r\n <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Topic</span></td>\r\n <td style=\"width:80%\" colspan=\"3\" th:text=\"${topics}\"></td>\r\n </tr>\r\n </th:block>\r\n <th:block th:each=\"cont, iter : ${resource.contributor}\" >\r\n <tr style=\"vertical-align: top;\">\r\n <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Contributor</span></td>\r\n <td style=\"width:80%\" colspan=\"3\">\r\n <b><span th:narrative=\"${cont.type.toCode()}\"></span>: </b><span th:text=\"${cont.name}\"></span>\r\n </td>\r\n </tr>\r\n </th:block> -->\r\n <!-- <th:block th:each=\"lib, iter : ${resource.library}\" >\r\n <tr style=\"vertical-align: top;\">\r\n <td th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Library</span></td>\r\n <td style=\"width:80%\" colspan=\"3\">\r\n <p th:if=\"${lib.hasIdentifier()}\"><b>identifier: </b><span th:narrative=\"${lib.identifier}\"></span></p>\r\n <p th:if=\"${lib.hasReference()}\"><b>reference: </b><span th:narrative=\"${lib.reference}\"></span></p>\r\n <p th:if=\"${lib.hasDisplay()}\"><b>display: </b><span th:text=\"${lib.display}\"></span></p>\r\n </td>\r\n </tr>\r\n </th:block> -->\r\n \r\n <!-- <tr th:if=\"${resource.hasRateAggregation()}\" >\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Rate Aggregation</span></td>\r\n <td style=\"width:80%\" colspan=\"3\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre th:text=\"${resource.rateAggregation}\"></pre>\r\n </div>\r\n </td>\r\n </tr>\r\n <tr th:if=\"${resource.hasRationale()}\">\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Rationale</span></td>\r\n <td style=\"width:80%\" colspan=\"3\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre th:text=\"${resource.rationale}\"></pre>\r\n </div>\r\n </td>\r\n </tr> -->\r\n <tr>\r\n <td scope=\"row\" style=\"width:20%\"><span>Improvement Notation</span></td>\r\n <td colspan=\"3\" style=\"width:80%\">A higher rate indicates better performance.</td>\r\n \r\n </tr>\r\n <tr>\r\n <td scope=\"row\" style=\"width:20%\"><span>Guidance</span></td>\r\n <td colspan=\"3\" style=\"width:80%\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\"><p>The "Non-elective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Inpatient encounter" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.</p>\n<p>The "Medication, Discharge" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.</p>\n</div>\r\n </td>\r\n </tr>\r\n <tr>\r\n <td colspan=\"4\" scope=\"row\" style=\"background-color:#656565; width:100%\"><span class=\"td_label\">Definitions</span></td>\r\n </tr>\r\n \r\n \r\n <!-- <th:block th:each=\"groups, iter : ${resource.uniquePopulationGroup}\" >\r\n <tr style=\"vertical-align: top;\">\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\" th:text=\"${groups.identifier.value}\"></span></td>\r\n <td style=\"width:80%\" colspan=\"3\">\r\n <div style=\"width:660px;overflow-x:hidden;overflow-y:auto\">\r\n <pre th:text=\"${pops.description}\"></pre>\r\n </div>\r\n </td>\r\n </tr>\r\n </th:block> -->\r\n </table>\r\n <table style=\"width: 60%; border-top: none; border-bottom: none\" class=\"header_table\">\r\n \r\n </table>\r\n <table style=\"width: 60%; border-top: none;\" class=\"header_table\">\r\n <!-- <th:block th:each=\"supples, iter : ${resource.supplementalData}\">\r\n <tr>\r\n <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\"><b>Supplemental Data:</b></th>\r\n <td style=\"width:80%\" colspan=\"3\" >\r\n <p style=\"margin-bottom: 5px;\" th:narrative=\"${supples.identifier}\"></p>\r\n <p style=\"margin-bottom: 5px;\" th:each=\"uses : ${supples.usage}\">\r\n <b>usage: </b>\r\n <span th:narrative=\"${uses}\"></span>\r\n </p>\r\n <p style=\"margin-bottom: 5px;\" th:if=\"${supples.hasCriteria()}\">\r\n <b>criteria: </b>\r\n <span th:narrative=\"${supples.criteria}\"></span>\r\n </p>\r\n <p style=\"margin-bottom: 5px;\" th:if=\"${supples.hasPath()}\">\r\n <b>path: </b>\r\n <span th:narrative=\"${supples.path}\"></span>\r\n </p>\r\n </td>\r\n </tr>\r\n </th:block> -->\r\n <!-- <th:block th:each=\"param, iter : ${resource.parameter}\">\r\n <tr style=\"vertical-align: top;\">\r\n <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\"><b>Parameter: </b></th>\r\n <td style=\"width:80%\" colspan=\"3\" >\r\n <span th:if=\"${param.hasName()}\">\r\n <b>name: </b>\r\n <span th:narrative=\"${param.name}\"></span>\r\n <br/>\r\n </span>\r\n <b>use: </b>\r\n <span th:narrative=\"${param.use.toCode()}\"></span>\r\n <br/>\r\n <span th:if=\"${param.hasMin()}\">\r\n <b>minimum cardinality: </b>\r\n <span th:narrative=\"${param.min}\"></span>\r\n <br/>\r\n </span>\r\n <span th:if=\"${param.hasMax()}\">\r\n <b>maximum cardinality: </b>\r\n <span th:narrative=\"${param.max}\"></span>\r\n <br/>\r\n </span>\r\n <b>type: </b>\r\n <span th:narrative=\"${param.type}\"></span>\r\n <br/>\r\n <span th:if=\"${param.hasDocumentation()}\">\r\n <b>documentation: </b>\r\n <span th:narrative=\"${param.documentation}\"></span>\r\n <br/>\r\n </span>\r\n <span th:if=\"${param.hasProfile()}\">\r\n <b>profile: </b>\r\n <span th:narrative=\"${param.profile}\"></span>\r\n <br/>\r\n </span>\r\n <p style=\"margin-bottom: 5px;\"></p>\r\n </td>\r\n </tr>\r\n </th:block> -->\r\n <!-- <th:block th:each=\"dataReq, iter : ${resource.dataRequirement}\">\r\n <tr style=\"vertical-align: top;\">\r\n <th th:if=\"${iter.index == 0}\" th:rowspan=\"${iter.size}\" scope=\"row\" ><b>Data Requirements: </b></th>\r\n <td style=\"width:80%\" colspan=\"3\" th:narrative=\"${dataReq}\"></td>\r\n </tr>\r\n </th:block> -->\r\n </table>\r\n <h2><a name=\"toc\">Table of Contents</a></h2>\r\n <ul style=\"padding-left: 50px;\">\r\n <li><a href=\"#d1e405\">Population Criteria</a></li>\r\n <li><a href=\"#d1e649\">Definitions</a></li>\r\n <li><a href=\"#d1e650\">Functions</a></li>\r\n <li><a href=\"#d1e555\">Terminology</a></li>\r\n <li><a href=\"#d1e647\">Data Criteria (QDM Data Elements)</a></li>\r\n <li><a href=\"#d1e767\">Supplemental Data Elements</a></li>\r\n <li><a href=\"#d1e879\">Risk Adjustment Variables</a></li>\r\n </ul>\r\n <div style=\"float:left; background:teal; height:3px; width:80%\"/>\r\n \r\n <pre><br/></pre>\r\n <h3><a name=\"d1e405\" href=\"#toc\">Population Criteria</a></h3>\r\n <div>\r\n <ul style=\"list-style:none;padding-left:10px;\">\r\n <li style=\"list-style:none;padding-left:0px;\" class=\"list-unstyled\">\r\n \r\n <div class=\"treeview hover p-l-10\">\r\n <ul class=\"list-unstyled\">\r\n <li class=\"list-unstyled\"><input id=\"Initial Population\" type=\"checkbox\"/><label for=\"Initial Population\" class=\"list-header\"><strong>Initial Population</strong></label>\r\n <ul class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <ul>\r\n <li style=\"padding-left: 0px;\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tTJC."Encounter with Principal Diagnosis and Age"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul></li>\r\n </ul>\r\n </div>\r\n \r\n \r\n <div class=\"treeview hover p-l-10\">\r\n <ul class=\"list-unstyled\">\r\n <li class=\"list-unstyled\"><input id=\"Numerator\" type=\"checkbox\"/><label for=\"Numerator\" class=\"list-header\"><strong>Numerator</strong></label>\r\n <ul class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <ul>\r\n <li style=\"padding-left: 0px;\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tTJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\r\n\t\twith "Antithrombotic Therapy at Discharge" DischargeAntithrombotic\r\n\t\t\tsuch that DischargeAntithrombotic.authoredOn during Global."Normalize Interval"(IschemicStrokeEncounter.period)</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul></li>\r\n </ul>\r\n </div>\r\n \r\n \r\n <div class=\"treeview hover p-l-10\">\r\n <ul class=\"list-unstyled\">\r\n <li class=\"list-unstyled\"><input id=\"Denominator\" type=\"checkbox\"/><label for=\"Denominator\" class=\"list-header\"><strong>Denominator</strong></label>\r\n <ul class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <ul>\r\n <li style=\"padding-left: 0px;\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tTJC."Ischemic Stroke Encounter"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul></li>\r\n </ul>\r\n </div>\r\n \r\n \r\n <div class=\"treeview hover p-l-10\">\r\n <ul class=\"list-unstyled\">\r\n <li class=\"list-unstyled\"><input id=\"Denominator Exclusion\" type=\"checkbox\"/><label for=\"Denominator Exclusion\" class=\"list-header\"><strong>Denominator Exclusion</strong></label>\r\n <ul class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <ul>\r\n <li style=\"padding-left: 0px;\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tTJC."Ischemic Stroke Encounters with Discharge Disposition"\r\n\t\tunion TJC."Comfort Measures during Hospitalization"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul></li>\r\n </ul>\r\n </div>\r\n \r\n \r\n </li>\r\n </ul>\r\n </div>\r\n\r\n <h3><a name=\"d1e649\" href=\"#toc\">Definitions</a></h3>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Antithrombotic Not Given at Discharge\" type=\"checkbox\"/>\r\n <label for=\"Antithrombotic Not Given at Discharge\" class=\"list-header\"><strong>Antithrombotic Not Given at Discharge</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\t["MedicationRequest": medication in "Antithrombotic Therapy"] NoAntithromboticDischarge\r\n where NoAntithromboticDischarge.doNotPerform is true\r\n\t\t\tand (NoAntithromboticDischarge.reasonCode in "Medical Reason"\r\n\t\t\t\tor NoAntithromboticDischarge.reasonCode in "Patient Refusal")\r\n //Note: expressed as an or with equivalence semantics pending resolution of potential CQL issue.\r\n and exists (NoAntithromboticDischarge.category C where FHIRHelpers.ToConcept(C) ~ Global."Community" or FHIRHelpers.ToConcept(C) ~ Global."Discharge")\r\n and NoAntithromboticDischarge.status = 'completed'\r\n and NoAntithromboticDischarge.intent = 'order'</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Antithrombotic Therapy at Discharge\" type=\"checkbox\"/>\r\n <label for=\"Antithrombotic Therapy at Discharge\" class=\"list-header\"><strong>Antithrombotic Therapy at Discharge</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\t["MedicationRequest": medication in "Antithrombotic Therapy"] Antithrombotic\r\n //Note: expressed as an or with equivalence semantics pending resolution of potential CQL issue.\r\n\t where exists (Antithrombotic.category C where FHIRHelpers.ToConcept(C) ~ Global."Community" or FHIRHelpers.ToConcept(C) ~ Global."Discharge")\r\n and Antithrombotic.status in { 'active', 'completed' }\r\n\t and Antithrombotic.intent.value = 'order'</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Denominator\" type=\"checkbox\"/>\r\n <label for=\"Denominator\" class=\"list-header\"><strong>Denominator</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tTJC."Ischemic Stroke Encounter"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Denominator Exception\" type=\"checkbox\"/>\r\n <label for=\"Denominator Exception\" class=\"list-header\"><strong>Denominator Exception</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\t"Encounter With No Antithrombotic At Discharge"\r\n\t\tunion "Encounter With Ticagrelor at Discharge"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Denominator Exclusion\" type=\"checkbox\"/>\r\n <label for=\"Denominator Exclusion\" class=\"list-header\"><strong>Denominator Exclusion</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tTJC."Ischemic Stroke Encounters with Discharge Disposition"\r\n\t\tunion TJC."Comfort Measures during Hospitalization"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Encounter With No Antithrombotic At Discharge\" type=\"checkbox\"/>\r\n <label for=\"Encounter With No Antithrombotic At Discharge\" class=\"list-header\"><strong>Encounter With No Antithrombotic At Discharge</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tTJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\r\n\t\twith "Antithrombotic Not Given at Discharge" NoDischargeAntithrombotic\r\n\t\t\tsuch that NoDischargeAntithrombotic.authoredOn during IschemicStrokeEncounter.period</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Encounter With Ticagrelor at Discharge\" type=\"checkbox\"/>\r\n <label for=\"Encounter With Ticagrelor at Discharge\" class=\"list-header\"><strong>Encounter With Ticagrelor at Discharge</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\"> TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\r\n with "Ticagrelor Therapy at Discharge" DischargeTicagrelor\r\n such that DischargeTicagrelor.authoredOn during IschemicStrokeEncounter.period</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Initial Population\" type=\"checkbox\"/>\r\n <label for=\"Initial Population\" class=\"list-header\"><strong>Initial Population</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tTJC."Encounter with Principal Diagnosis and Age"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Numerator\" type=\"checkbox\"/>\r\n <label for=\"Numerator\" class=\"list-header\"><strong>Numerator</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tTJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\r\n\t\twith "Antithrombotic Therapy at Discharge" DischargeAntithrombotic\r\n\t\t\tsuch that DischargeAntithrombotic.authoredOn during Global."Normalize Interval"(IschemicStrokeEncounter.period)</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"SDE Ethnicity\" type=\"checkbox\"/>\r\n <label for=\"SDE Ethnicity\" class=\"list-header\"><strong>SDE Ethnicity</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\"> SDE."SDE Ethnicity"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"SDE Payer\" type=\"checkbox\"/>\r\n <label for=\"SDE Payer\" class=\"list-header\"><strong>SDE Payer</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tSDE."SDE Payer"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"SDE Race\" type=\"checkbox\"/>\r\n <label for=\"SDE Race\" class=\"list-header\"><strong>SDE Race</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\"> SDE."SDE Race"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"SDE Sex\" type=\"checkbox\"/>\r\n <label for=\"SDE Sex\" class=\"list-header\"><strong>SDE Sex</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tSDE."SDE Sex"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 10px;\">\r\n <li style=\"list-style:none;\" class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"list-style:none;padding-left:0;\" class=\"list-unstyled\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"Ticagrelor Therapy at Discharge\" type=\"checkbox\"/>\r\n <label for=\"Ticagrelor Therapy at Discharge\" class=\"list-header\"><strong>Ticagrelor Therapy at Discharge</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\"> ["MedicationRequest": medication in TJC."Ticagrelor Therapy"] Ticagrelor\r\n //Note: expressed as an or with equivalence semantics pending resolution of potential CQL issue.\r\n where exists (Ticagrelor.category C where FHIRHelpers.ToConcept(C) ~ Global."Community" or FHIRHelpers.ToConcept(C) ~ Global."Discharge")\r\n and Ticagrelor.status in { 'active', 'completed' }\r\n and Ticagrelor.intent = 'order'</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <h3><a name=\"d1e650\" href=\"#toc\">Functions</a></h3>\r\n \r\n <h3><a name=\"d1e555\" href=\"#toc\">Terminology</a></h3>\r\n <div>\r\n <ul style=\"padding-left: 50px;\">\r\n <li style=\"width:80%\">codesystem "Diagnosis Role" : 'http://terminology.hl7.org/CodeSystem/diagnosis-role'</li>\r\n <li style=\"width:80%\">codesystem "LOINC" : 'http://loinc.org'</li>\r\n <li style=\"width:80%\">codesystem "RequestIntent" : 'http://terminology.hl7.org/CodeSystem/request-intent'</li>\r\n <li style=\"width:80%\">codesystem "SNOMEDCT" : 'http://snomed.info/sct/731000124108'</li>\r\n <li style=\"width:80%\">code "Birth date" : '21112-8' from "LOINC" display 'Birth date'</li>\r\n <li style=\"width:80%\">code "Order" : 'order' from "RequestIntent" display 'Order'</li>\r\n <li style=\"width:80%\">valueset "Antithrombotic Therapy" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.201'</li>\r\n <li style=\"width:80%\">valueset "Comfort Measures" : 'http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45'</li>\r\n <li style=\"width:80%\">valueset "Discharge To Acute Care Facility" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87'</li>\r\n <li style=\"width:80%\">valueset "Discharged to Health Care Facility for Hospice Care" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207'</li>\r\n <li style=\"width:80%\">valueset "Discharged to Home for Hospice Care" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209'</li>\r\n <li style=\"width:80%\">valueset "Emergency Department Visit" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'</li>\r\n <li style=\"width:80%\">valueset "Ethnicity" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'</li>\r\n <li style=\"width:80%\">valueset "Hemorrhagic Stroke" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.212'</li>\r\n <li style=\"width:80%\">valueset "Ischemic Stroke" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247'</li>\r\n <li style=\"width:80%\">valueset "Left Against Medical Advice" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308'</li>\r\n <li style=\"width:80%\">valueset "Medical Reason" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473'</li>\r\n <li style=\"width:80%\">valueset "Non-Elective Inpatient Encounter" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424'</li>\r\n <li style=\"width:80%\">valueset "Observation Services" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143'</li>\r\n <li style=\"width:80%\">valueset "ONC Administrative Sex" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'</li>\r\n <li style=\"width:80%\">valueset "Patient Expired" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309'</li>\r\n <li style=\"width:80%\">valueset "Patient Refusal" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93'</li>\r\n <li style=\"width:80%\">valueset "Payer" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'</li>\r\n <li style=\"width:80%\">valueset "Race" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'</li>\r\n <li style=\"width:80%\">valueset "Ticagrelor Therapy" : 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.39'</li>\r\n </ul>\r\n </div>\r\n <h3><a name=\"d1e647\" href=\"#toc\">Data Criteria (QDM Data Elements)</a></h3>\r\n <div>\r\n <ul style=\"padding-left: 50px;\">\r\n <li style=\"width:80%\">"MedicationRequest: Antithrombotic Therapy" using "Antithrombotic Therapy (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.201)</li>\r\n <li style=\"width:80%\">"MedicationRequest: Ticagrelor Therapy" using "Ticagrelor Therapy (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.39)</li>\r\n </ul>\r\n </div>\r\n <h3><a name=\"d1e767\" href=\"#toc\">Supplemental Data Elements</a></h3>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 25px;\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"SDE Ethnicity\" type=\"checkbox\"/>\r\n <label for=\"SDE Ethnicity\" class=\"list-header\"><strong>SDE Ethnicity</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\"> SDE."SDE Ethnicity"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 25px;\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"SDE Payer\" type=\"checkbox\"/>\r\n <label for=\"SDE Payer\" class=\"list-header\"><strong>SDE Payer</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tSDE."SDE Payer"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 25px;\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"SDE Race\" type=\"checkbox\"/>\r\n <label for=\"SDE Race\" class=\"list-header\"><strong>SDE Race</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\"> SDE."SDE Race"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 25px;\">\r\n <li class=\"list-unstyled\">\r\n <div class=\"treeview hover p-l-10\">\r\n <input id=\"SDE Sex\" type=\"checkbox\"/>\r\n <label for=\"SDE Sex\" class=\"list-header\"><strong>SDE Sex</strong></label>\r\n <ul style=\"margin-right: 20%; opacity: 1;\" class=\"code\">\r\n <li class=\"list-unstyled\">\r\n <div>\r\n <ul style=\"padding-left: 0px;\">\r\n <li style=\"padding-left: 0px;\" class=\"list-unstyled\">\r\n <div>\r\n <pre class=\"cql-definition-body\">\tSDE."SDE Sex"</pre>\r\n </div></li>\r\n </ul> \r\n </div></li>\r\n </ul>\r\n </div></li>\r\n </ul>\r\n </div>\r\n \r\n <h3><a name=\"d1e879\" href=\"#toc\">Risk Adjustment Variables</a></h3>\r\n <div>\r\n <ul style=\"list-style:none;padding-left: 25px;\">\r\n <li>None</li>\r\n </ul>\r\n </div>\r\n <div style=\"float:left; background:teal; height:3px; width:80%\"/>\r\n <table>\r\n <!-- <tr th:if=\"${resource.hasSet()}\" >\r\n <td style=\"background-color:#656565; width:20%\" scope=\"row\"><span class=\"td_label\">Measure Set</span></td>\r\n <td style=\"width:80%\" th:text=\"${resource.set}\"></td>\r\n </tr> -->\r\n \r\n \r\n \r\n \r\n \r\n <tr style=\"vertical-align: top;\">\r\n <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Content</span></td>\r\n <td style=\"width:80%\"><b>type: </b><span>text/cql</span></td>\r\n </tr>\r\n <tr>\r\n <td colspan=\"2\" style=\"width:100%\">\r\n \r\n <pre><code class=\"language-cql\">library EXM104 version '8.1.000'\n// for 2020 Reporting Year\n//STK 2\n/*\nBased on CMS104 - Discharged on Antithrombotic Therapy\nAuthor: TJC\n*/\n\nusing FHIR version '4.0.0'\n\ninclude FHIRHelpers version '4.0.1'\ninclude MATGlobalCommonFunctions version '5.0.000' called Global\ninclude SupplementalDataElements version '2.0.0' called SDE\ninclude TJCOverall version '5.0.000' called TJC\n\ncodesystem "LOINC": 'http://loinc.org'\ncodesystem "SNOMEDCT": 'http://snomed.info/sct/731000124108'\n// NOTE: R4 code system URLs changed to be based on terminology.hl7.org...\ncodesystem "Diagnosis Role": 'http://terminology.hl7.org/CodeSystem/diagnosis-role'\n//codesystem "Diagnosis Role": 'http://hl7.org/fhir/diagnosis-role'\ncodesystem "RequestIntent": 'http://terminology.hl7.org/CodeSystem/request-intent'\n//codesystem "RequestIntent": 'http://hl7.org/fhir/request-intent'\n\n\nvalueset "Antithrombotic Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.201'\nvalueset "Comfort Measures": 'http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45'\nvalueset "Discharge To Acute Care Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87'\nvalueset "Discharged to Health Care Facility for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207'\nvalueset "Discharged to Home for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209'\nvalueset "Emergency Department Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'\nvalueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'\nvalueset "Hemorrhagic Stroke": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.212'\nvalueset "Ischemic Stroke": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247'\nvalueset "Left Against Medical Advice": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308'\nvalueset "Medical Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473'\nvalueset "Non-Elective Inpatient Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424'\nvalueset "Observation Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143'\nvalueset "ONC Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'\nvalueset "Patient Expired": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309'\nvalueset "Patient Refusal": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93'\nvalueset "Payer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'\nvalueset "Race": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'\nvalueset "Ticagrelor Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.39'\n\ncode "Birth date": '21112-8' from "LOINC" display 'Birth date'\ncode "Order": 'order' from "RequestIntent" display 'Order'\n\nparameter "Measurement Period" Interval<DateTime>\n default Interval[@2019-01-01T00:00:00.0, @2020-01-01T00:00:00.0)\n\n\ncontext Patient\n\ndefine "SDE Ethnicity":\n SDE."SDE Ethnicity"\n\ndefine "SDE Payer":\n\tSDE."SDE Payer"\n\ndefine "SDE Race":\n SDE."SDE Race"\n\ndefine "SDE Sex":\n\tSDE."SDE Sex"\n\ndefine "Initial Population":\n\tTJC."Encounter with Principal Diagnosis and Age"\n\ndefine "Denominator":\n\tTJC."Ischemic Stroke Encounter"\n\ndefine "Denominator Exclusion":\n\tTJC."Ischemic Stroke Encounters with Discharge Disposition"\n\t\tunion TJC."Comfort Measures during Hospitalization"\n\ndefine "Numerator":\n\tTJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\n\t\twith "Antithrombotic Therapy at Discharge" DischargeAntithrombotic\n\t\t\tsuch that DischargeAntithrombotic.authoredOn during Global."Normalize Interval"(IschemicStrokeEncounter.period)\n\ndefine "Antithrombotic Therapy at Discharge":\n\t["MedicationRequest": medication in "Antithrombotic Therapy"] Antithrombotic\n //Note: expressed as an or with equivalence semantics pending resolution of potential CQL issue.\n\t where exists (Antithrombotic.category C where FHIRHelpers.ToConcept(C) ~ Global."Community" or FHIRHelpers.ToConcept(C) ~ Global."Discharge")\n and Antithrombotic.status in { 'active', 'completed' }\n\t and Antithrombotic.intent.value = 'order'\n\ndefine "Denominator Exception":\n\t"Encounter With No Antithrombotic At Discharge"\n\t\tunion "Encounter With Ticagrelor at Discharge"\n\ndefine "Encounter With No Antithrombotic At Discharge":\n\tTJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\n\t\twith "Antithrombotic Not Given at Discharge" NoDischargeAntithrombotic\n\t\t\tsuch that NoDischargeAntithrombotic.authoredOn during IschemicStrokeEncounter.period\n\ndefine "Antithrombotic Not Given at Discharge":\n\t["MedicationRequest": medication in "Antithrombotic Therapy"] NoAntithromboticDischarge\n where NoAntithromboticDischarge.doNotPerform is true\n\t\t\tand (NoAntithromboticDischarge.reasonCode in "Medical Reason"\n\t\t\t\tor NoAntithromboticDischarge.reasonCode in "Patient Refusal")\n //Note: expressed as an or with equivalence semantics pending resolution of potential CQL issue.\n and exists (NoAntithromboticDischarge.category C where FHIRHelpers.ToConcept(C) ~ Global."Community" or FHIRHelpers.ToConcept(C) ~ Global."Discharge")\n and NoAntithromboticDischarge.status = 'completed'\n and NoAntithromboticDischarge.intent = 'order'\n\ndefine "Encounter With Ticagrelor at Discharge":\n TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\n with "Ticagrelor Therapy at Discharge" DischargeTicagrelor\n such that DischargeTicagrelor.authoredOn during IschemicStrokeEncounter.period\n\ndefine "Ticagrelor Therapy at Discharge":\n ["MedicationRequest": medication in TJC."Ticagrelor Therapy"] Ticagrelor\n //Note: expressed as an or with equivalence semantics pending resolution of potential CQL issue.\n where exists (Ticagrelor.category C where FHIRHelpers.ToConcept(C) ~ Global."Community" or FHIRHelpers.ToConcept(C) ~ Global."Discharge")\n and Ticagrelor.status in { 'active', 'completed' }\n and Ticagrelor.intent = 'order'\n</code></pre>\r\n \r\n \r\n </td>\r\n </tr>\r\n \r\n \r\n \r\n \r\n \r\n \r\n <tr style=\"vertical-align: top;\">\r\n <td scope=\"row\" style=\"background-color:#656565; width:20%\"><span class=\"td_label\">Content</span></td>\r\n <td style=\"width:80%\"><b>type: </b><span>text/cql</span></td>\r\n </tr>\r\n <tr>\r\n <td colspan=\"2\" style=\"width:100%\">\r\n \r\n <pre><code class=\"language-cql\">library EXM104 version '8.1.000'\n// for 2020 Reporting Year\n//STK 2\n/*\nBased on CMS104 - Discharged on Antithrombotic Therapy\nAuthor: TJC\n*/\n\nusing FHIR version '4.0.0'\n\ninclude FHIRHelpers version '4.0.1'\ninclude MATGlobalCommonFunctions version '5.0.000' called Global\ninclude SupplementalDataElements version '2.0.0' called SDE\ninclude TJCOverall version '5.0.000' called TJC\n\ncodesystem "LOINC": 'http://loinc.org'\ncodesystem "SNOMEDCT": 'http://snomed.info/sct/731000124108'\n// NOTE: R4 code system URLs changed to be based on terminology.hl7.org...\ncodesystem "Diagnosis Role": 'http://terminology.hl7.org/CodeSystem/diagnosis-role'\n//codesystem "Diagnosis Role": 'http://hl7.org/fhir/diagnosis-role'\ncodesystem "RequestIntent": 'http://terminology.hl7.org/CodeSystem/request-intent'\n//codesystem "RequestIntent": 'http://hl7.org/fhir/request-intent'\n\n\nvalueset "Antithrombotic Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.201'\nvalueset "Comfort Measures": 'http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45'\nvalueset "Discharge To Acute Care Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87'\nvalueset "Discharged to Health Care Facility for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207'\nvalueset "Discharged to Home for Hospice Care": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209'\nvalueset "Emergency Department Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292'\nvalueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'\nvalueset "Hemorrhagic Stroke": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.212'\nvalueset "Ischemic Stroke": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247'\nvalueset "Left Against Medical Advice": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308'\nvalueset "Medical Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473'\nvalueset "Non-Elective Inpatient Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424'\nvalueset "Observation Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143'\nvalueset "ONC Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'\nvalueset "Patient Expired": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309'\nvalueset "Patient Refusal": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93'\nvalueset "Payer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'\nvalueset "Race": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'\nvalueset "Ticagrelor Therapy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.39'\n\ncode "Birth date": '21112-8' from "LOINC" display 'Birth date'\ncode "Order": 'order' from "RequestIntent" display 'Order'\n\nparameter "Measurement Period" Interval<DateTime>\n default Interval[@2019-01-01T00:00:00.0, @2020-01-01T00:00:00.0)\n\n\ncontext Patient\n\ndefine "SDE Ethnicity":\n SDE."SDE Ethnicity"\n\ndefine "SDE Payer":\n\tSDE."SDE Payer"\n\ndefine "SDE Race":\n SDE."SDE Race"\n\ndefine "SDE Sex":\n\tSDE."SDE Sex"\n\ndefine "Initial Population":\n\tTJC."Encounter with Principal Diagnosis and Age"\n\ndefine "Denominator":\n\tTJC."Ischemic Stroke Encounter"\n\ndefine "Denominator Exclusion":\n\tTJC."Ischemic Stroke Encounters with Discharge Disposition"\n\t\tunion TJC."Comfort Measures during Hospitalization"\n\ndefine "Numerator":\n\tTJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\n\t\twith "Antithrombotic Therapy at Discharge" DischargeAntithrombotic\n\t\t\tsuch that DischargeAntithrombotic.authoredOn during Global."Normalize Interval"(IschemicStrokeEncounter.period)\n\ndefine "Antithrombotic Therapy at Discharge":\n\t["MedicationRequest": medication in "Antithrombotic Therapy"] Antithrombotic\n //Note: expressed as an or with equivalence semantics pending resolution of potential CQL issue.\n\t where exists (Antithrombotic.category C where FHIRHelpers.ToConcept(C) ~ Global."Community" or FHIRHelpers.ToConcept(C) ~ Global."Discharge")\n and Antithrombotic.status in { 'active', 'completed' }\n\t and Antithrombotic.intent.value = 'order'\n\ndefine "Denominator Exception":\n\t"Encounter With No Antithrombotic At Discharge"\n\t\tunion "Encounter With Ticagrelor at Discharge"\n\ndefine "Encounter With No Antithrombotic At Discharge":\n\tTJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\n\t\twith "Antithrombotic Not Given at Discharge" NoDischargeAntithrombotic\n\t\t\tsuch that NoDischargeAntithrombotic.authoredOn during IschemicStrokeEncounter.period\n\ndefine "Antithrombotic Not Given at Discharge":\n\t["MedicationRequest": medication in "Antithrombotic Therapy"] NoAntithromboticDischarge\n where NoAntithromboticDischarge.doNotPerform is true\n\t\t\tand (NoAntithromboticDischarge.reasonCode in "Medical Reason"\n\t\t\t\tor NoAntithromboticDischarge.reasonCode in "Patient Refusal")\n //Note: expressed as an or with equivalence semantics pending resolution of potential CQL issue.\n and exists (NoAntithromboticDischarge.category C where FHIRHelpers.ToConcept(C) ~ Global."Community" or FHIRHelpers.ToConcept(C) ~ Global."Discharge")\n and NoAntithromboticDischarge.status = 'completed'\n and NoAntithromboticDischarge.intent = 'order'\n\ndefine "Encounter With Ticagrelor at Discharge":\n TJC."Ischemic Stroke Encounter" IschemicStrokeEncounter\n with "Ticagrelor Therapy at Discharge" DischargeTicagrelor\n such that DischargeTicagrelor.authoredOn during IschemicStrokeEncounter.period\n\ndefine "Ticagrelor Therapy at Discharge":\n ["MedicationRequest": medication in TJC."Ticagrelor Therapy"] Ticagrelor\n //Note: expressed as an or with equivalence semantics pending resolution of potential CQL issue.\n where exists (Ticagrelor.category C where FHIRHelpers.ToConcept(C) ~ Global."Community" or FHIRHelpers.ToConcept(C) ~ Global."Discharge")\n and Ticagrelor.status in { 'active', 'completed' }\n and Ticagrelor.intent = 'order'\n</code></pre>\r\n \r\n \r\n </td>\r\n </tr>\r\n \r\n </table>\r\n</div>"
},
"contained": [
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"value": "104"
}
],
"version": "9.1.000",
"name": "EXM104",
"title": "Discharged on Antithrombotic Therapy",
"status": "active",
"experimental": true,
"publisher": "The Joint Commission",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "https://www.jointcommission.org/en/"
}
]
}
],
"description": "Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge",
"useContext": [
{
"code": {
"code": "program"
},
"valueCodeableConcept": {
"text": "eligible-provider"
}
}
],
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "US"
}
]
}
],
"purpose": "Ischemic stroke patients prescribed or continuing to take antithrombotic therapy at hospital discharge",
"copyright": "Measure specifications are in the Public Domain. LOINC(R) is a registered trademark of the Regenstrief Institute. This material contains SNOMED Clinical Terms(R) (SNOMED CT(C)) copyright 2004-2017 International Health Terminology Standards Development Organization. All rights reserved.",
"approvalDate": "2016-01-01",
"lastReviewDate": "2019-08-19",
"effectivePeriod": {
"start": "2019-01-01",
"end": "2019-12-31"
},
"topic": [
{
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"code": "57024-2",
"display": "Health Quality Measure Document"
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],
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{
"type": "citation",
"citation": "Adams HP, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks E. Guidelines for the Early Management of Adults with Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical CardiologyCouncil, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke. 2007;38:1655-1711."
},
{
"type": "citation",
"citation": "Adams H, Adams R, Del Zoppo G, Goldstein LB. Guidelines for the Early Management of Patients With Ischemic Stroke: Guidelines Update A Scientific Statement From the Stroke Council of the American Heart Association/American Stroke Association. Stroke Vol. 36, 2005: 916:923."
},
{
"type": "citation",
"citation": "Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P. Antithrombotic and Thrombolytic Therapy for Ischemic Stroke. Chest Vol. 119, 2001: 300-320."
},
{
"type": "citation",
"citation": "Brott TG, Clark WM, Grotta JC, et al. Stroke the first hours. Guidelines for acute treatment. Consensus Statement. National Stroke Association. 2000."
},
{
"type": "citation",
"citation": "Chen ZM, Sandercock P, Pan HC, et al. Indications for early aspirin use in acute ischemic stroke: a combined analysis of 40,000 randomized patients from the Chinese acute stroke trial and the international stroke trial. On behalf of the CAST and IST collaborative groups, Stroke 2000;31:1240-1249."
},
{
"type": "citation",
"citation": "Coull BM, Williams LS, Goldstein LB, et al. Anticoagulants and Antiplatelet Agents in Acute Ischemic Stroke. Report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a Division of the American Heart Association) Stroke. 2002;33:1934 - 1942."
},
{
"type": "citation",
"citation": "Guideline on the Use of Aspirin as Secondary Prophylaxis for Vascular Disease in Primary Care, Centre for Health Services Research University of Newcastle upon Tyne, & Centre for Health Economics of York, 1998."
},
{
"type": "citation",
"citation": "Kernan, W.N., B. Ovbiagele, H. R. Black, D. M. Bravata, M. I. Chimowitz, M. D. Ezekowitz, M. C. Fang, M. Fisher, K. L. Furie, D. V. Heck, S. C. Johnston, S. E. Kasner, S. J. Kittner, P. H. Mitchell, M. W. Rich, D. Richardson, L. H. Schwamm, J. A. Wilson. \"Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association.\" [in eng.] Stroke 45, no. 7 (May 2014): 2160-223. "
},
{
"type": "depends-on",
"resource": "Library/library-FHIRHelpers-4.0.1"
},
{
"type": "depends-on",
"resource": "Library/library-MATGlobalCommonFunctions-5.0.000"
},
{
"type": "depends-on",
"resource": "Library/library-SupplementalDataElements-2.0.0"
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"resource": "Library/library-TJCOverall-5.0.000"
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],
"library": [
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],
"disclaimer": "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.",
"scoring": {
"coding": [
{
"system": "http://hl7.org/fhir/measure-scoring",
"code": "proportion"
}
]
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"type": [
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"code": "process"
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]
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],
"rationale": "The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist.\n\nFor patients with a stroke due to a cardioembolic source (eg atrial fibrillation, mechanical heart valve), warfarin is recommended unless contraindicated. In recent years, novel oral anticoagulant agents (NOACs) have been developed and approved by the U.S. Food and Drug Administration (FDA) for stroke prevention, and may be considered as an alternative to warfarin for select patients. Anticoagulation therapy is not generally recommended for secondary stroke prevention in patients presumed to have a non-cardioembolic stroke.\nAnticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.",
"clinicalRecommendationStatement": "Clinical trial results suggest that antithrombotic therapy should be prescribed at discharge following acute ischemic stroke to reduce stroke mortality and morbidity as long as no contraindications exist",
"improvementNotation": {
"coding": [
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"code": "increase"
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},
"guidance": "The \"Non-elective Inpatient Encounter\" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the \"Inpatient encounter\" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.\n\nThe \"Medication, Discharge\" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.",
"group": [
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],
"supplementalData": [
{
"code": {
"text": "sde-ethnicity"
},
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"code": "supplemental-data"
}
]
}
],
"criteria": {
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"expression": "SDE Ethnicity"
}
},
{
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}
]
}
],
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"expression": "SDE Payer"
}
},
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"code": {
"text": "sde-race"
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"code": "supplemental-data"
}
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}
],
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"expression": "SDE Race"
}
},
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"code": {
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"code": "supplemental-data"
}
]
}
],
"criteria": {
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"expression": "SDE Sex"
}
}
]
}