- Initial Population =
- AND: Age>= 18 year(s) at: "Measurement Period"
- AND:
- OR: Count>= 2 : Union of:
- "Encounter, Performed: Care Services in Long-Term Residential Facility"
- "Encounter, Performed: Home Healthcare Services"
- "Encounter, Performed: Nursing Facility Visit"
- "Encounter, Performed: Office Visit"
- "Encounter, Performed: Outpatient Consultation"
- "Encounter, Performed: Patient Provider Interaction"
- during "Measurement Period"
- OR: "Encounter, Performed: Discharge Services - Hospital Inpatient" during "Measurement Period"
- AND: "Diagnosis: Heart Failure" overlaps Occurrence A of $HFEncounters144
- Denominator =
- AND: Union of:
- "Diagnostic Study, Performed: Ejection Fraction (result < 40 %)"
- "Diagnosis: Moderate or Severe LVSD"
- "Diagnosis: Left Ventricular Systolic Dysfunction (severity: Moderate or Severe)"
- starts before end of Occurrence A of $HFEncounters144
- Denominator Exclusions =
- Numerator =
- AND:
- OR: "Medication, Order: Beta Blocker Therapy for LVSD" during Occurrence A of $HFEncounters144
- OR: "Medication, Active: Beta Blocker Therapy for LVSD" overlaps Occurrence A of $HFEncounters144
- Numerator Exclusions =
- Denominator Exceptions =
- OR:
- AND: Most Recent: "Occurrence B of Physical Exam, Performed: Heart Rate" starts before start of "Occurrence A of Physical Exam, Performed: Heart Rate"
- AND: "Occurrence A of Physical Exam, Performed: Heart Rate (result < 50 bpm)" during Occurrence A of $HFEncounters144
- AND: "Occurrence B of Physical Exam, Performed: Heart Rate (result < 50 bpm)" during Occurrence A of $HFEncounters144
- OR: Union of:
- "Medication, Order not done: Medical Reason" for "Beta Blocker Therapy Ingredient"
- "Medication, Order not done: Patient Reason" for "Beta Blocker Therapy Ingredient"
- "Medication, Order not done: System Reason" for "Beta Blocker Therapy Ingredient"
- starts during Occurrence A of $HFEncounters144
- OR: Union of:
- "Diagnosis: Arrhythmia"
- "Diagnosis: Hypotension"
- "Diagnosis: Asthma"
- "Diagnosis: Allergy to Beta Blocker Therapy"
- "Medication, Intolerance: Beta Blocker Therapy"
- "Diagnosis: Intolerance to Beta Blocker Therapy"
- "Diagnosis: Bradycardia"
- "Medication, Allergy: Beta Blocker Therapy Ingredient"
- overlaps Occurrence A of $HFEncounters144
- OR:
- AND: "Diagnosis: Atrioventricular Block" overlaps Occurrence A of $HFEncounters144
- AND NOT: "Diagnosis: Cardiac Pacer in Situ" starts before end of Occurrence A of $HFEncounters144
- AND NOT: "Device, Applied: Cardiac Pacer" starts before end of Occurrence A of $HFEncounters144
- Stratification =
- $HFEncounters144 =
- Union of:
- "Encounter, Performed: Care Services in Long-Term Residential Facility"
- "Encounter, Performed: Home Healthcare Services"
- "Encounter, Performed: Nursing Facility Visit"
- "Encounter, Performed: Office Visit"
- "Encounter, Performed: Outpatient Consultation"
- "Encounter, Performed: Face-to-Face Interaction"
- "Encounter, Performed: Discharge Services - Hospital Inpatient"
- during "Measurement Period"
- "Device, Applied: Cardiac Pacer" using "Cardiac Pacer Grouping Value Set (2.16.840.1.113883.3.526.3.1193)"
- "Diagnosis: Allergy to Beta Blocker Therapy" using "Allergy to Beta Blocker Therapy Grouping Value Set (2.16.840.1.113883.3.526.3.1177)"
- "Diagnosis: Arrhythmia" using "Arrhythmia Grouping Value Set (2.16.840.1.113883.3.526.3.366)"
- "Diagnosis: Asthma" using "Asthma Grouping Value Set (2.16.840.1.113883.3.526.3.362)"
- "Diagnosis: Atrioventricular Block" using "Atrioventricular Block Grouping Value Set (2.16.840.1.113883.3.526.3.367)"
- "Diagnosis: Bradycardia" using "Bradycardia Grouping Value Set (2.16.840.1.113883.3.526.3.412)"
- "Diagnosis: Cardiac Pacer in Situ" using "Cardiac Pacer in Situ Grouping Value Set (2.16.840.1.113883.3.526.3.368)"
- "Diagnosis: Heart Failure" using "Heart Failure Grouping Value Set (2.16.840.1.113883.3.526.3.376)"
- "Diagnosis: Hypotension" using "Hypotension Grouping Value Set (2.16.840.1.113883.3.526.3.370)"
- "Diagnosis: Intolerance to Beta Blocker Therapy" using "Intolerance to Beta Blocker Therapy Grouping Value Set (2.16.840.1.113883.3.526.3.1178)"
- "Diagnosis: Left Ventricular Systolic Dysfunction" using "Left Ventricular Systolic Dysfunction Grouping Value Set (2.16.840.1.113883.3.526.3.1091)"
- "Diagnosis: Moderate or Severe LVSD" using "Moderate or Severe LVSD Grouping Value Set (2.16.840.1.113883.3.526.3.1090)"
- "Diagnostic Study, Performed: Ejection Fraction" using "Ejection Fraction Grouping Value Set (2.16.840.1.113883.3.526.3.1134)"
- "Encounter, Performed: Care Services in Long-Term Residential Facility" using "Care Services in Long-Term Residential Facility Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1014)"
- "Encounter, Performed: Discharge Services - Hospital Inpatient" using "Discharge Services - Hospital Inpatient Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1007)"
- "Encounter, Performed: Face-to-Face Interaction" using "Face-to-Face Interaction Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1048)"
- "Encounter, Performed: Home Healthcare Services" using "Home Healthcare Services Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1016)"
- "Encounter, Performed: Nursing Facility Visit" using "Nursing Facility Visit Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1012)"
- "Encounter, Performed: Office Visit" using "Office Visit Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1001)"
- "Encounter, Performed: Outpatient Consultation" using "Outpatient Consultation Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1008)"
- "Encounter, Performed: Patient Provider Interaction" using "Patient Provider Interaction Grouping Value Set (2.16.840.1.113883.3.526.3.1012)"
- "Medication, Active: Beta Blocker Therapy for LVSD" using "Beta Blocker Therapy for LVSD Grouping Value Set (2.16.840.1.113883.3.526.3.1184)"
- "Medication, Allergy: Beta Blocker Therapy Ingredient" using "Beta Blocker Therapy Ingredient Grouping Value Set (2.16.840.1.113883.3.526.3.1493)"
- "Medication, Intolerance: Beta Blocker Therapy" using "Beta Blocker Therapy Grouping Value Set (2.16.840.1.113883.3.526.3.1174)"
- "Medication, Order: Beta Blocker Therapy for LVSD" using "Beta Blocker Therapy for LVSD Grouping Value Set (2.16.840.1.113883.3.526.3.1184)"
- "Medication, Order: Beta Blocker Therapy Ingredient" using "Beta Blocker Therapy Ingredient Grouping Value Set (2.16.840.1.113883.3.526.3.1493)"
- "Medication, Order not done: Medical Reason" using "Medical Reason Grouping Value Set (2.16.840.1.113883.3.526.3.1007)"
- "Medication, Order not done: Patient Reason" using "Patient Reason Grouping Value Set (2.16.840.1.113883.3.526.3.1008)"
- "Medication, Order not done: System Reason" using "System Reason Grouping Value Set (2.16.840.1.113883.3.526.3.1009)"
- "Physical Exam, Performed: Heart Rate" using "Heart Rate Grouping Value Set (2.16.840.1.113883.3.526.3.1176)"
- Attribute: "Severity: Moderate or Severe" using "Moderate or Severe Grouping Value Set (2.16.840.1.113883.3.526.3.1092)"
- "Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity CDCREC Value Set (2.16.840.1.114222.4.11.837)"
- "Patient Characteristic Payer: Payer" using "Payer SOP Value Set (2.16.840.1.114222.4.11.3591)"
- "Patient Characteristic Race: Race" using "Race CDCREC Value Set (2.16.840.1.114222.4.11.836)"
- "Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex AdministrativeGender Value Set (2.16.840.1.113762.1.4.1)"