Chlamydia Screening for Women (NQF 0033)
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1 Chlamydia Screening fr Wmen (NQF 0033) EMeasure Name Chlamydia Screening fr Wmen EMeasure Id Pending Versin Number 1 Set Id Pending Available Date N infrmatin Measurement Perid January 1, 20xx thrugh December 31, 20xx Measure Steward Natinal Cmmittee fr Quality Assurance Endrsed by Natinal Quality Frum Descriptin The percentage f wmen years f age wh were identified as sexually active and wh had at least ne test fr chlamydia during the measurement year. Measure scring Prprtin Measure type Prcess Ratinale This measure assesses apprpriate screening fr chlamydia amng wmen in a specific age demgraphic. Chlamydia is ne f the mst frequently ccurring sexually transmitted diseases in the United States, resulting in ver 2.8 millin new cases each year. Wmen are particularly susceptible and accunt fr ver 80% f new cases, accrding t the U.S. Natinal Health and Nutritin Examinatin Survey. Additinally, heath care csts attributable t chlamydia and its cmplicatins exceed $3.5 billin per year in the U.S.. Early detectin and treatment have prven t be effective in preventing and managing chlamydia. Several studies have shwn that screening reduces verall disease prevalence by 4.2% and is strngly crrelated with a reduced incidence f pelvic inflammatry disease (PID). This measure facilitates effrts tward early screening and treatment t imprve health utcmes fr infected wmen and prevent the spread f disease. Clinical Recmmendatin Statement The U.S. Preventive Services Task Frce (USPSTF) strngly recmmends that clinicians rutinely screen all sexually active wmen aged 25 years and yunger, and ther asymptmatic wmen at increased risk fr infectin, fr chlamydial infectin. Rating: A recmmendatin ( The American Academy f Family Physicians (AAFP, 2005)) strngly recmmends screening all sexually active females age 25 years r yunger and ther wmen at increased risk fr chlamydia. American Cllege f Preventive Medicine: Sexually active wmen with risk factrs shuld be screened annually by any well validated, labratry based amplificatin r antigen methd, using cervical r urine specimens. Risk factrs include age <25 years, a new male sex partner r tw r mre partners during the preceding year, incnsistent use f barrier cntraceptin, histry f a prir sexually transmitted disease (STD), African American race, and cervical ectpy. All partners f wmen with psitive tests shuld be tested fr Chlamydia trachmatis. Wmen with mucpurulent discharge, suggestive f cervicitis, shuld be tested immediately. The American Cllege f Obstetricians and Gyneclgists recmmends rutine
2 References screening fr chlamydial infectin fr all sexually active adlescents and ther asymptmatic wmen at high risk fr infectin. American Cllege f Obstetricians and Gyneclgists, ACOG Cmmittee n Primary Care. Cmmittee Opinin N Washingtn DC: ACOG, 1999 Hllblad Fadiman K, Gldman SM. American Cllege f Preventive Medicine Practice Plicy Statement: Screening fr Chlamydia trachmatis. American Jurnal f Preventive Medicine 2003; 24(3) Definitins U.S. Preventive Services Task Frce. Screening fr chlamydial infectin including cular prphylaxis in newbrns. In: Guide t clinical preventive services. 2nd ed. Baltimre (MD): Williams & Wilkins; Table f Cntents Ppulatin criteria 1 Ppulatin criteria 2 Ppulatin criteria 3 Data criteria (QDS Data Elements) Summary calculatin Please refer t the spreadsheet fr this measure fr detail regarding data criteria and cde lists. Ppulatin criteria 1 Initial Patient Ppulatin = AND: Patient characteristic: birth date (age) >=15 and <= 23 years t expect screening fr patients within ne year after reaching 15 years until 24 years; Denminatr = AND: All patients in the initial patient ppulatin; AND: Encunter: encunter utpatient ; AND: OR: Prcedure perfrmed: prcedures indicative f sexually active wmen ; OR: Labratry test result: OR: Labratry test perfrmed: OR: Device applied: IUD use ; OR: Device allergy: IUD use ; OR: Cmmunicatin t patient: cntraceptive use educatin ; OR: Medicatin active: cntraceptives ; OR: Medicatin rder: cntraceptives ; OR: Medicatin dispensed: cntraceptives ;
3 Numeratr = OR: Encunter: pregnancy ; OR: Labratry test perfrmed: lab tests indicative f sexually active wman ; OR: Diagnsis active: sexually active wman ; OR: Labratry test perfrmed: chlamydia screening ; OR: Labratry test result: chlamydia screening ; Exclusins = OR: OR: Labratry test result: OR: Labratry test perfrmed: AND: OR: Medicatin dispensed: retinid <=7 days after Labratry test perfrmed: OR: Medicatin dispensed: retinid <=7 days after Labratry test result: OR: Medicatin active: retinid <=7 days after Labratry test perfrmed: OR: Medicatin active: retinid <=7 days after Labratry test result: OR: Medicatin rder: retinid <=7 days after Labratry test perfrmed: OR: Medicatin rder: retinid <=7 days after Labratry test result: OR: Diagnstic study perfrmed: x ray study <= 7 days after Labratry test perfrmed: OR: Diagnstic study perfrmed: x ray study <= 7 days after Labratry test result: OR: Diagnstic study result: x ray study <=7 days after Labratry test perfrmed: pregnancy test ; OR: Diagnstic study perfrmed: x ray study <= 7 days after Labratry test result: Ppulatin criteria 2 Initial Patient Ppulatin = AND: Patient characteristic: birth date (age) >=14 and <= 19 years t capture all patients wh will reach the ages f 15 thrugh 20 years during the measurement perid; Denminatr = AND: All patients in the initial patient ppulatin; AND: Encunter: encunter utpatient ; AND:
4 Numeratr = OR: Prcedure perfrmed: prcedures indicative f sexually active wmen ; OR: Labratry test result: OR: Labratry test perfrmed: OR: Device applied: IUD use ; OR: Device allergy: IUD use ; OR: Cmmunicatin t patient: cntraceptive use educatin ; OR: Medicatin active: cntraceptives ; OR: Medicatin rder: cntraceptives ; OR: Medicatin dispensed: cntraceptives ; OR: Encunter: pregnancy ; OR: Labratry test perfrmed: lab tests indicative f sexually active wman ; OR: Diagnsis active: sexually active wman ; OR: Labratry test perfrmed: chlamydia screening ; OR: Labratry test result: chlamydia screening ; Exclusins = OR: OR: Labratry test result: OR: Labratry test perfrmed: AND: OR: Medicatin dispensed: retinid <=7 days after Labratry test perfrmed: OR: Medicatin dispensed: retinid <=7 days after Labratry test result: OR: Medicatin active: retinid <=7 days after Labratry test perfrmed: OR: Medicatin active: retinid <=7 days after Labratry test result: OR: Medicatin rder: retinid <=7 days after Labratry test perfrmed: OR: Medicatin rder: retinid <=7 days after Labratry test result: OR: Diagnstic study perfrmed: x ray study <= 7 days after Labratry test perfrmed: OR: Diagnstic study perfrmed: x ray study <= 7 days after Labratry test result: OR: Diagnstic study result: x ray study <=7 days after Labratry test perfrmed: pregnancy test ; OR: Diagnstic study perfrmed: x ray study <= 7 days after Labratry test result: Ppulatin criteria 3 Initial Patient Ppulatin =
5 AND: Patient characteristic: birth date (age) >=20 and <= 23 years t capture all patients wh will reach the ages f 21 thrugh 24 years during the measurement perid; Denminatr = Numeratr = AND: All patients in the initial patient ppulatin; AND: Encunter: encunter utpatient ; AND: OR: Prcedure perfrmed: prcedures indicative f sexually active wmen ; OR: Labratry test result: OR: Labratry test perfrmed: OR: Device applied: IUD use ; OR: Device allergy: IUD use ; OR: Cmmunicatin t patient: cntraceptive use educatin ; OR: Medicatin active: cntraceptives ; OR: Medicatin rder: cntraceptives ; OR: Medicatin dispensed: cntraceptives ; OR: Encunter: pregnancy ; OR: Labratry test perfrmed: lab tests indicative f sexually active wman ; OR: Diagnsis active: sexually active wman ; OR: Labratry test perfrmed: chlamydia screening ; OR: Labratry test result: chlamydia screening ; Exclusins = OR: OR: Labratry test result: OR: Labratry test perfrmed: AND: OR: Medicatin dispensed: retinid <=7 days after Labratry test perfrmed: OR: Medicatin dispensed: retinid <=7 days after Labratry test result: OR: Medicatin active: retinid <=7 days after Labratry test perfrmed: OR: Medicatin active: retinid <=7 days after Labratry test result: OR: Medicatin rder: retinid <=7 days after Labratry test perfrmed: OR: Medicatin rder: retinid <=7 days after Labratry test result: OR: Diagnstic study perfrmed: x ray study <= 7 days after Labratry test perfrmed: OR: Diagnstic study perfrmed: x ray study <= 7 days after Labratry test result:
6 Data criteria (QDS Data Elements) Initial Patient Ppulatin = OR: Diagnstic study result: x ray study <=7 days after Labratry test perfrmed: OR: Diagnstic study perfrmed: x ray study <= 7 days after Labratry test result: Patient characteristic: birth date using birth date cde list befre the beginning f the measurement perid ; Denminatr = All patients in the initial patient ppulatin; Encunter: encunter utpatient using encunter utpatient cde list gruping befre r simultaneusly t the measurement end date ; Prcedure perfrmed: prcedures indicative f sexually active wmen using cde list prcedures indicative f sexually active wman during the measurement perid ; Labratry test perfrmed: pregnancy test using pregnancy test cde list gruping during the measurement perid ; Labratry test result: pregnancy test using pregnancy test cde list gruping during the measurement perid ; Device applied: IUD use using IUD use cde list befre r simultaneusly t the measurement end date ; Device allergy: IUD use using IUD use cde list befre r simultaneusly t the measurement end date ; Cmmunicatin t patient: cntraceptive use educatin using cntraceptive use educatin cde list befre r simultaneusly t the measurement end date ; Medicatin active: cntraceptives using cntraceptives cde list befre r simultaneusly t the measurement end date ; Medicatin rder: cntraceptives using cntraceptives cde list befre r simultaneusly t the measurement end date ; Medicatin dispensed: cntraceptives using cntraceptives cde list befre r simultaneusly t the measurement end date ; Encunter: pregnancy using pregnancy cde list during the measurement perid ; Labratry test perfrmed: lab tests indicative f sexually active wman using cde list lab tests indicative f sexually active wman befre r simultaneusly t the measurement end date ; Diagnsis active: sexually active wman using cde list sexually active wman cde list gruping befre r simultaneusly t the measurement end date ; Numeratr = Labratry test perfrmed: chlamydia screening using chlamydia screening cde list [CPT] during the measurement perid ; Labratry test result: chlamydia screening using chlamydia screening cde list [LOINC] during the measurement perid ;
7 Exclusins = Labratry test result: pregnancy test using pregnancy test cde list gruping during the measurement perid ; Labratry test perfrmed: pregnancy test using pregnancy test cde list gruping during the measurement perid ; Medicatin dispensed: retinid using retinid cde list after Labratry test perfrmed: Medicatin active: retinid using retinid cde list after Labratry test perfrmed: Medicatin rder: retinid using retinid cde list after Labratry test perfrmed: Diagnstic study perfrmed: x ray study using x ray study cde list gruping after r Labratry test perfrmed: pregnancy test r Labratry test result: Diagnstic study result: x ray study using x ray study cde list gruping after r befre Labratry test perfrmed: pregnancy test r Labratry test result: Summary calculatin Calculatin is generic t all measures: Calculate the final denminatr by adding all that meet denminatr criteria. Subtract frm the final denminatr all that d nt meet numeratr criteria yet als meet exclusin criteria. Nte sme measures d nt have exclusin criteria. The perfrmance calculatin is the number meeting numeratr criteria divided by the final denminatr. Fr measures with multiple patient ppulatins, repeat this prcess fr each patient ppulatin and reprt each result separately. Fr measures with multiple numeratrs, calculate each numeratr separately within each ppulatin using the paired exclusin. Measure set CLINICAL QUALITY MEASURE SET
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