2562 lines
124 KiB
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2562 lines
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<span>MMS Overview</span>
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</a>
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</li>
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<div class="desktop:grid-col-3">
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<span>Get Started with Quality Measures</span>
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</a>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<span>Roles in Measure Development</span>
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</a>
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</li>
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</ul>
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<a href="/about-quality/types/overview">
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<span>Overview</span>
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</a>
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</li>
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<span>Composite Measure</span>
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</button>
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<ul id="basic-nav-section-Composite-Measure" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Composite-Measure" >
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<a href="/about-quality/types/composite-measure/overview">
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<span>Overview</span>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<span>Component Measures</span>
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</a>
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</li>
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</ul>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/about-quality/types/population-health">
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<span>Population Health Measures</span>
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</a>
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</li>
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</ul>
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</div>
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<div class="desktop:grid-col-3">
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<div class="usa-nav__headermenu-item">
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<span><strong>Quality Measurement at CMS</strong></span>
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<ul id="basic-nav-section-Quality-Measurement-at-CMS" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Quality-Measurement-at-CMS" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/about-quality/quality-at-CMS/goals">
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<span>CMS Goals and Priorities</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/about-quality/quality-at-CMS/principles">
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<span>Measure Development Principles</span>
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</a>
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/about-quality/quality-at-CMS/quality">
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<span>Quality Across CMS</span>
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</a>
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||
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</li>
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</ul>
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</div>
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</div>
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</div>
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<span>Blueprint Measure Lifecycle</span>
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</button>
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<div class="desktop:grid-col-3">
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<div class="usa-nav__headermenu-item">
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<span><strong>Blueprint Measure Lifecycle</strong></span>
|
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</div>
|
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|
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<ul id="basic-nav-section-Blueprint-Measure-Lifecycle" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Blueprint-Measure-Lifecycle" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/blueprint-measure-lifecycle-overview">
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<span>Blueprint Measure Lifecycle Overview</span>
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</a>
|
||
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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|
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<a href="/about-quality/blueprint-measure-lifecycle/theory">
|
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<span>Measure Development Theory</span>
|
||
</a>
|
||
|
||
|
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</li>
|
||
|
||
|
||
</ul>
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</div>
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||
|
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<div class="desktop:grid-col-3">
|
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<div class="usa-nav__headermenu-item">
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<span><strong>Measure Conceptualization</strong></span>
|
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</div>
|
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|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Measure-Conceptualization" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Conceptualization" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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||
|
||
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<a href="/measure-lifecycle/measure-conceptualization/overview">
|
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<span>Overview</span>
|
||
</a>
|
||
|
||
|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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<button id="usa-accordion__button_second-2 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Conceptualization">
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<span>Information Gathering</span>
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</button>
|
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|
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|
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|
||
<ul id="basic-nav-section-Information-Gathering" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Information-Gathering" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/overview">
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<span>Overview</span>
|
||
</a>
|
||
|
||
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</li>
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||
|
||
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-conceptualization/information-gathering/conduct-environment-scan">
|
||
<span>Conduct an Environmental Scan</span>
|
||
</a>
|
||
|
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</li>
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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||
|
||
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|
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<a href="/measure-lifecycle/measure-conceptualization/information-gathering/analyze-data-gap-analysis">
|
||
<span>Analyze Data & Conduct Gap Analysis</span>
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</a>
|
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</li>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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|
||
<a href="/measure-lifecycle/measure-conceptualization/information-gathering/respecified-measures">
|
||
<span>Respecified Measures</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-conceptualization/information-gathering/justify-creation-new-measures">
|
||
<span>Justify the Creation of New Measures</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
|
||
|
||
|
||
|
||
<button id="usa-accordion__button_second-2 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Conceptualization">
|
||
<span>Business Case Development</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Business-Case-Development" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Business-Case-Development" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-conceptualization/business-case/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-conceptualization/business-case/outcomes">
|
||
<span>Documenting Outcomes, Benefits, & Costs</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-conceptualization/business-case/best-practices">
|
||
<span>Business Case Best Practices</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</div>
|
||
|
||
|
||
<div class="desktop:grid-col-3">
|
||
|
||
<div class="usa-nav__headermenu-item">
|
||
<span><strong>Measure Specification</strong></span>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Measure-Specification" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Specification" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/specifications-measure-category">
|
||
<span>Specifications by Measure Category</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/define-data-sources">
|
||
<span>Define Data Sources</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
|
||
|
||
|
||
|
||
<button id="usa-accordion__button_second-3 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Specification">
|
||
<span>Develop Specifications</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Develop-Specifications" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Develop-Specifications" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/develop-specification/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/develop-specification/target-initial-population">
|
||
<span>Define the Target/Initial Population</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/develop-specification/denominator">
|
||
<span>Define the Denominator</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/develop-specification/numerator">
|
||
<span>Define the Numerator and Exclusions</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/develop-specification/stratification">
|
||
<span>Define Stratification Scheme</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/develop-specification/respecifying-registry-measures">
|
||
<span>Respecifying Registry Measures to Electronic Clinical Quality Measures (eCQMs)</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
|
||
|
||
|
||
|
||
<button id="usa-accordion__button_second-3 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Specification">
|
||
<span>Specify the Code</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Specify-the-Code" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Specify-the-Code" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/specify-code/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/specify-code/code-systems-vocabularies-terminologies">
|
||
<span>Code Systems, Vocabularies, and Terminologies</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/specify-code/encode-clinical-information">
|
||
<span>Encoding Clinical Information</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/specify-code/data-standards">
|
||
<span>Data Standards</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
|
||
|
||
|
||
|
||
<button id="usa-accordion__button_second-3 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Specification">
|
||
<span>Construct Data Protocol</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Construct-Data-Protocol" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Construct-Data-Protocol" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/data-protocol/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/data-protocol/key-terms">
|
||
<span>Define Key Terms, Data Elements, Codes, and Code Systems</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/data-protocol/level-measurement-analysis">
|
||
<span>Describe Level of Measurement & Sampling</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/data-protocol/risk-adjustment">
|
||
<span>Determine Risk Adjustment</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/data-protocol/time-interval">
|
||
<span>Define Any Time Intervals</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/data-protocol/scoring">
|
||
<span>Describe Scoring & Calculation Algorithm</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/document-measure">
|
||
<span>Document the Measures</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
|
||
|
||
|
||
|
||
<button id="usa-accordion__button_second-3 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Specification">
|
||
<span>Measure Harmonization</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Measure-Harmonization" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Harmonization" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/measure-harmonization/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/measure-harmonization/alignment">
|
||
<span>Measure Harmonization and Alignment</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-specification/measure-harmonization/when-to-consider">
|
||
<span>When to Consider Measure Harmonization</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</div>
|
||
|
||
|
||
<div class="desktop:grid-col-3">
|
||
|
||
<div class="usa-nav__headermenu-item">
|
||
<span><strong>Measure Testing</strong></span>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Measure-Testing" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Testing" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
|
||
|
||
|
||
|
||
<button id="usa-accordion__button_second-4 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Testing">
|
||
<span>Measure Testing Process</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Measure-Testing-Process" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Testing-Process" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/process/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/process/develop-workplan">
|
||
<span>Develop The Testing Work Plan</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/process/perform-sampl">
|
||
<span>Perform Sampling</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/process/implement-and-analyze">
|
||
<span>Implement, Analyze, Refine & Retest</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/process/summary">
|
||
<span>Measure Testing Summary</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/process/testing-respecified-measures">
|
||
<span>Testing Respecified Measures</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
|
||
|
||
|
||
|
||
<button id="usa-accordion__button_second-4 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link usa-currentis_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Testing">
|
||
<span>Measure Evaluation Criteria</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Measure-Evaluation-Criteria" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Evaluation-Criteria" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/evaluation-criteria/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/evaluation-criteria/importance">
|
||
<span>Importance</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/evaluation-criteria/scientific-acceptability">
|
||
<span>Scientific Acceptability</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/evaluation-criteria/feasibility">
|
||
<span>Feasibility</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-testing/evaluation-criteria/usability">
|
||
<span>Usability & Use</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
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</div>
|
||
|
||
|
||
<div class="desktop:grid-col-3">
|
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|
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<div class="usa-nav__headermenu-item">
|
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<span><strong>Measure Implementation</strong></span>
|
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<ul id="basic-nav-section-Measure-Implementation" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Implementation" >
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<a href="/measure-lifecycle/measure-implementation/overview">
|
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<span>Overview</span>
|
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</a>
|
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|
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|
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</li>
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|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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|
||
|
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<a href="/measure-lifecycle/measure-implementation/selection">
|
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<span>Measure Selection</span>
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</a>
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</li>
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<span>Pre-Rulemaking</span>
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<ul id="basic-nav-section-Pre-Rulemaking" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Pre-Rulemaking" >
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<span>Overview</span>
|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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|
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|
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<a href="/measure-lifecycle/measure-implementation/pre-rulemaking/guidance-measure-submitters">
|
||
<span>Guidance for Measure Submitters</span>
|
||
</a>
|
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|
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|
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|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
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|
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|
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<a href="/measure-lifecycle/measure-implementation/pre-rulemaking/measure-priorities">
|
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<span>Measure Priorities</span>
|
||
</a>
|
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|
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|
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</li>
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|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-implementation/pre-rulemaking/lists-and-reports">
|
||
<span>MUC Lists and Recommendation Reports</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
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|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-implementation/rollout">
|
||
<span>Measure Rollout</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
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|
||
<span>CMS Consensus-Based Entity (CBE) Endorsement and Maintenance</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-CMS-Consensus-Based-Entity-(CBE)-Endorsement-and-Maintenance" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-CMS-Consensus-Based-Entity-(CBE)-Endorsement-and-Maintenance" >
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-implementation/CMS-CBE-EM/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-implementation/CMS-CBE-EM/Measure-Submission-to-the-CMS-CBE">
|
||
<span>Measure Submission to the CMS CBE</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-implementation/CMS-CBE-EM/Endorsement-Process">
|
||
<span>The CMS CBE Endorsement Process</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</div>
|
||
|
||
|
||
<div class="desktop:grid-col-3">
|
||
|
||
<div class="usa-nav__headermenu-item">
|
||
<span><strong>Measure Use, Continuing Evaluation & Maintenance</strong></span>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Measure-Use,-Continuing-Evaluation-&-Maintenance" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Use,-Continuing-Evaluation-&-Maintenance" >
|
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|
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|
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|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-use/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-use/production-and-monitoring">
|
||
<span>Measure Production & Monitoring</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-use/evaluation">
|
||
<span>Continuing Evaluation</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
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<li class="usa-nav__submenu-item menu_level_2 is_expanded">
|
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|
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|
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<button id="usa-accordion__button_second-6 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Measure-Use,-Continuing-Evaluation-&-Maintenance">
|
||
<span>Measure Maintenance Reviews</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Measure-Maintenance-Reviews" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Measure-Maintenance-Reviews" >
|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
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<a href="/measure-lifecycle/measure-use/maintenance/overview">
|
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<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-use/maintenance/annual-update">
|
||
<span>Annual Update</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-use/maintenance/comprehensive-reevaluation">
|
||
<span>Comprehensive Reevaluation</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-use/maintenance/early-maintenance-review">
|
||
<span>Early Maintenance Review</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/measure-use/maintenance/harmonization-during-maintenance">
|
||
<span>Harmonization during Measure Maintenance</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</div>
|
||
|
||
|
||
<div class="desktop:grid-col-3">
|
||
|
||
<div class="usa-nav__headermenu-item">
|
||
<span><strong>Interested Party Engagement</strong></span>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Interested-Party-Engagement" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Interested-Party-Engagement" >
|
||
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/stakeholder-engagement/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/stakeholder-engagement/lifecycle">
|
||
<span>Interested Party Engagement in the Measure Lifecycle</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/stakeholder-engagement/roles">
|
||
<span>Roles in Engagement</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/measure-lifecycle/stakeholder-engagement/types">
|
||
<span>Types of Interested Party Engagement</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</div>
|
||
|
||
|
||
</div>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
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<li class="usa-nav__primary-item is_expanded">
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<button id="usa-accordion__button" class="usa-accordion__button usa-nav__link is_expanded " aria-expanded="false" aria-controls="extended-mega-nav-section-3">
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<span>Tools & Resources</span>
|
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</button>
|
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<div class="grid-row grid-gap-3 gridused">
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|
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<div class="desktop:grid-col-3">
|
||
|
||
<div class="usa-nav__headermenu-item">
|
||
<span><strong>MMS Tools & Resources</strong></span>
|
||
</div>
|
||
|
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|
||
|
||
|
||
<ul id="basic-nav-section-MMS-Tools-&-Resources" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-MMS-Tools-&-Resources" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/tools-and-resources/mms-supplemental-materials">
|
||
<span>Supplemental Materials</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
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<a href="/tools-and-resources/mms-templates">
|
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<span>Templates for Measure Development</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
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|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
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|
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<a href="/educational-resources">
|
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<span>Educational Resources</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/mms-tools">
|
||
<span>MMS Tools</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</div>
|
||
|
||
|
||
<div class="desktop:grid-col-3">
|
||
|
||
<div class="usa-nav__headermenu-item">
|
||
<span><strong>Additional Tools & Resources</strong></span>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Additional-Tools-&-Resources" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Additional-Tools-&-Resources" >
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/cms-tools">
|
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<span>CMS Tools</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/external-resources">
|
||
<span>External Resources</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="https://mmshub.cms.gov/glossary">
|
||
<span>Glossary</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</div>
|
||
|
||
|
||
<div class="desktop:grid-col-3">
|
||
|
||
<div class="usa-nav__headermenu-item">
|
||
<span><strong>Pre-Rulemaking Resources</strong></span>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Pre-Rulemaking-Resources" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Pre-Rulemaking-Resources" >
|
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|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/Pre-Rulemaking-Resources">
|
||
<span>Pre-Rulemaking Resources</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
</ul>
|
||
|
||
|
||
|
||
|
||
</div>
|
||
|
||
|
||
</div>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__primary-item is_expanded">
|
||
|
||
<button id="usa-accordion__button" class="usa-accordion__button usa-nav__link is_expanded " aria-expanded="false" aria-controls="extended-mega-nav-section-4">
|
||
<span>Get Involved</span>
|
||
</button>
|
||
|
||
|
||
|
||
<div id="extended-mega-nav-section-4" class="usa-nav__submenu usa-megamenu" hidden="">
|
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|
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|
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<div class="grid-row grid-gap-3 gridused">
|
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|
||
|
||
<div class="desktop:grid-col-3">
|
||
|
||
<div class="usa-nav__headermenu-item">
|
||
<span><strong>Get Involved</strong></span>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Get-Involved" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Get-Involved" >
|
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|
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|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/get-involved/how-to">
|
||
<span>How to Get Involved</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
|
||
<li class="usa-nav__submenu-item menu_level_2 is_expanded">
|
||
|
||
|
||
|
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<button id="usa-accordion__button_second-1 usa-nav__submenu-list-2" class="usa-accordion__button_second usa-nav__link is_expanded closed" aria-expanded="false" aria-controls="basic-nav-section-Get-Involved">
|
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<span>Technical Expert Panels</span>
|
||
</button>
|
||
|
||
|
||
|
||
<ul id="basic-nav-section-Technical-Expert-Panels" class="usa-nav__submenu-list-2 is_collapsed " aria-controls="extended-mmega-nav-section-Technical-Expert-Panels" >
|
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|
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|
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|
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<li class="usa-nav__submenu-item menu_level_2 is_collapsed ">
|
||
|
||
|
||
|
||
<a href="/get-involved/technical-expert-panel/overview">
|
||
<span>Overview</span>
|
||
</a>
|
||
|
||
|
||
</li>
|
||
|
||
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<div class="views-row"><div class="views-field views-field-field-parent-title"><h1 class="field-content"><span class="glossify-exclude"><abbr tabindex="0" title="<p><span class="glossify-exclude">Measure testing</span> is the empirical analysis to demonstrate the reliability and validity of the measure as specified, including analysis of issues posing threats to the validity of conclusions about quality of care such as exclusions, risk adjustment/stratification for outcome and resource use measures, methods to identify differences in performance, and comparability of data sources/methods.</p> " class="glossify-tooltip-tip" lang="en">Measure Testing</abbr></span></h1></div></div>
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<div property="schema:text" class="field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>The <a href="https://www.iso.org/standard/72117.html">International Organization for Standardization (ISO) (2019)</a> notes a metric is reliable inasmuch as it constantly provides the same result when applied to the same phenomena. For the <abbr tabindex="0" title="<p>The <span class="glossify-exclude">measure score</span> is the numeric result computed by applying the measure specifications and scoring algorithm. The computed <span class="glossify-exclude">measure score</span> represents an aggregation of all appropriate patient-level data (e.g., proportion of patients who died, average lab value attained) for the measured entity (e.g., hospital, health plan, home health agency, clinician). The measure specifications designate the measured entity and to whom the measure applies.</p> " class="glossify-tooltip-tip" lang="en">measure score</abbr>, the phenomena are the quality construct. For the <abbr tabindex="0" title="<p>A data element is a basic unit of information with a unique meaning and subcategories (data items) of distinct value. National Institute of Standards and Technology. (n.d.). <em>Data element</em>. Computer Security Resource Center. Retrieved November 1, 2023, from&nbsp;<a href="https://csrc.nist.gov/glossary/term/data_element">https://csrc.nist.gov/glossary/term/data_element</a></p> " class="glossify-tooltip-tip" lang="en">data element</abbr>, the phenomena are the demographic, health status, health care activity, or other patient, clinician, or <abbr tabindex="0" title="<p>An encounter, as defined by the ASTM International is “(1) an instance of direct provider/practitioner to patient interaction, regardless of the setting, between a patient and a practitioner vested with primary responsibility for diagnosing, evaluating or treating the patient’s condition, or both, or providing social worker services; and (2) a contact between a patient and a practitioner who has primary responsibility for assessing and treating the patient at a given contact, exercising independent judgment.” Encounter serves as a focal point linking clinical, administrative, and financial information. Encounters occur in many settings—ambulatory care, inpatient care, emergency care, home health care, field and virtual (telemedicine).</p> " class="glossify-tooltip-tip" lang="en">encounter</abbr> attributes. For an instrument, the phenomena may be some construct such as ‘satisfaction’ or ‘functional status.’</p><h3>Accountable Entity Level (Measure Score) Reliability</h3><p>Measure developers should conduct accountable entity-level <abbr tabindex="0" title="<p><span class="glossify-exclude">Reliability</span> reflects the measure is well defined and precisely specified so measured entities can implement consistently within and across organizations and that it distinguishes differences in performance.</p> " class="glossify-tooltip-tip" lang="en">reliability</abbr> testing with computed measure scores for each <abbr tabindex="0" title="<p><span class="glossify-exclude">Measured entities</span> are the front-line clinicians and their organizations, including health information technology, collecting quality measurement data. <span class="glossify-exclude">Measured entities</span> are the implementers of quality measures. The effect of quality measure data collection on clinician workflow can be negative. There may be effects on their payments, positive and negative, with respect to reporting and actual performance on quality measures. Because of these potential effects, <span class="glossify-exclude">measured entities</span> should be involved in all aspects of the Measure Lifecycle.</p> " class="glossify-tooltip-tip" lang="en">measured entity</abbr>. <a href="https://www.rand.org/pubs/technical_reports/TR653.html">Adams, 2009</a> defines measure score reliability conceptually as the <abbr tabindex="0" title="<p>A <span class="glossify-exclude">ratio</span> is a score derived by dividing a count of one type of data by a count of another type of data (e.g., number of patients with central lines who develop infection divided by the number of central line days). The key to the definition of a <span class="glossify-exclude">ratio</span> is that the numerator is not in the denominator.</p> " class="glossify-tooltip-tip" lang="en">ratio</abbr> of signal to noise, where the signal is the <abbr tabindex="0" title="<p>A <span class="glossify-exclude">proportion</span> is a score derived by dividing the number of cases meeting a criterion for quality (i.e., the numerator) by the number of eligible cases within a given time frame (i.e., the denominator) where the numerator cases are a subset of the denominator cases (e.g., percentage of eligible women with a mammogram performed in the last year).</p> " class="glossify-tooltip-tip" lang="en">proportion</abbr> of the variability in measured performance explained by real differences in performance (differences in the quality construct). Measure score reliability matters because the metric is related to the ability to distinguish differences between measured entities due to true differences in performance rather than to chance (and therefore to reduce the probability of misclassification in comparative performance). The measure developer should always assess the measure score under development for reliability using data derived from testing.</p><p>The measure developer may assess accountable entity level reliability using an accepted method. See the table for examples.</p><table><thead><tr><th>Measure of Reliability</th><th>Description</th><th>Recommended Uses</th><th>Measure Reliability Tests</th></tr></thead><tbody><tr><th>Signal-to-noise</th><td>Estimates the proportion of overall variability explained by the differences between entities</td><td>Entity-level scores aggregated from dichotomous data at the patient level</td><td><strong>Beta-binomial model</strong> (<a href="https://www.rand.org/pubs/technical_reports/TR653.html">Adams, 2009</a> ) </td></tr><tr><th>Temporal correlation</th><td>Similar to random split-half correlation, assesses the correlation of data from adjacent time periods for each entity</td><td>To compare to a dataset from the same source separated by a minimal time period</td><td><p><strong><abbr tabindex="0" title="<p><span class="glossify-exclude">Intra-class correlation</span> refers to correlations within a class of data (for example correlations within repeated measurements of weight), rather than to correlations between two different classes of data (for example the correlation between weight and length). Liljequist, D., Elfving, B., &amp; Skavberg Roaldsen, K. (2019). Intraclass correlation - A discussion and demonstration of basic features. <em>PoS ONE 14</em>(7), e0219854.&nbsp;<a href="https://doi.org/10.1371/journal.pone.0219854">https://doi.org/10.1371/journal.pone.0219854</a></p> " class="glossify-tooltip-tip" lang="en">ICC</abbr></strong> (intraclass correlation coefficient)</p><p><strong><abbr tabindex="0" title="<p>The correlation coefficient is a test for quantifying the relationship between two variables.<br /> +1 indicates a strong positive relationship.<br /> -1 indicates a strong negative relationship.<br /> A result of zero indicates no relationship at all.<br /> Pearson product moment correlation coefficient is one of the most common correlation coefficient formulas.</p> " class="glossify-tooltip-tip" lang="en">Pearson's correlation coefficient</abbr></strong></p><p><strong><abbr tabindex="0" title="<p>Spearman's ρ is a nonparametric measure of rank correlation. It assesses how well the relationship between two variables can be described using a monotonic function. Spearman's coefficient is appropriate for both continuous and discrete ordinal variables.</p> " class="glossify-tooltip-tip" lang="en">Spearman's</abbr> p - </strong>a <abbr tabindex="0" title="<p>Non-parametric methods are a type of statistical test not involving the estimation of parameters of a statistical function. Merriam-Webster Dictionary. (n.d.). <em>Nonparametric</em>.&nbsp; Retrieved November 1, 2023, from https://www.merriam-webster.com/dictionary/nonparametric</p> " class="glossify-tooltip-tip" lang="en">non-parametric</abbr> correlation of ranked data</p><p><strong><abbr tabindex="0" title="<p>Kendall’s Tau is a statistic used to measure the ordinal association between two measured quantities. It is a measure of rank correlation: the similarity of the orderings of the data when ranked by each of the quantities.<br /> Comprehensive R Archive Network. (n.d.). Kendall's Ƭa. Tools for Descriptive Statistics. Retrieved November 13, 2023, from<br /> <a href="https://search.r-project.org/CRAN/refmans/DescTools/html/KendallTauA.html">https://search.r-project.org/CRAN/refmans/DescTools/html/KendallTauA.html</a></p> " class="glossify-tooltip-tip" lang="en">Kendall's Tau</abbr> -</strong> a non-parametric correlation of ranked data that is less sensitive to small <abbr tabindex="0" title="<p>A <span class="glossify-exclude">sample</span> is a subset of a population. The subset should be chosen in such a way that it accurately represents the whole population with respect to some characteristic of interest. A sampling frame lists all eligible cases in the population of interest (i.e., denominator) and how they are selected.</p> " class="glossify-tooltip-tip" lang="en">sample</abbr> sizes</p></td></tr><tr><th>Random split-half correlation</th><td>Randomly splits data from each entity in half and estimates the correlation of the two halves across all entities</td><td>When an independent dataset or data from an adjacent time period are not available</td><td><p><strong>ICC</strong> </p><p><strong>Pearson's correlation coefficient</strong></p><p><strong>Spearman's p - </strong>a non-parametric correlation of ranked data</p><p><strong>Kendall's Tau -</strong> a non-parametric correlation of ranked data that is less sensitive to small sample sizes</p></td></tr></tbody></table><p>The measure developer should also determine if the reliability extends to the repeatability of significant differences between group means and/or the stability of rankings within groups. In other words, does the measure reliably detect differences in scores between groups expected to be different or does the measure allocate the same proportion of participants into ranks on different administrations? The measure developer can accomplish this in part by measuring the significance of differences between groups in measure scores. The measure developer needs to carefully select the tests to account for data distribution and whether the scores are from the same respondents (dependent or paired samples) or different respondents (independent or unpaired samples). With respect to the data distributions, use <abbr tabindex="0" title="<p><span class="glossify-exclude">Parametric methods</span> make certain assumptions about a data set; namely, that the data are drawn from a population with a normal distribution. <span class="glossify-exclude">Parametric methods</span> generally have high statistical power. Tyler, J. (2017). <em>What are parametric and nonparametric tests?</em> Retrieved November 1, 2023, from https://sciencing.com/parametric-nonparametric-tests-8574813.html</p> " class="glossify-tooltip-tip" lang="en">parametric</abbr> tests if data are normally distributed (e.g., the mean best represents the center, data are ratio or interval). Use non-parametric tests if data are not normally distributed (e.g., the median better represents the center and the data are categorical or ordinal) or if the sample size is small (<a href="https://www.researchgate.net/profile/William-Trochim/publication/243783609_The_Research_Methods_Knowledge_Base/links/55db837008aed6a199ac6246/The-Research-Methods-Knowledge-Base.pdf">Trochim, 2002</a>; <a href="https://sphweb.bumc.bu.edu/otlt/MPH-Modules/BS/BS704_Nonparametric/BS704_Nonparametric_print.html">Sullivan, n.d.</a>). For example, measure developers often report medians for reliability scores because they do not tend to be normally distributed. Use a special case for non-parametric testing for dichotomous categorical data (e.g., Yes/No; see the Tests of Measure Score Differences table).</p><h4>Tests of Measure Score Differences (<a href="https://www.researchgate.net/profile/William-Trochim/publication/243783609_The_Research_Methods_Knowledge_Base/links/55db837008aed6a199ac6246/The-Research-Methods-Knowledge-Base.pdf">Trochim, 2002</a>)</h4><table><thead><tr><th>Comparisons</th><th>Parametric</th><th>Non-Parametric</th><th>Non-Parametric</th></tr></thead><tbody><tr><th> </th><td><em>Ratio or Interval Data</em></td><td><em>Ordinal, Nominal</em></td><td><em>Dichotomous</em></td></tr><tr><th>One group score to reference value</th><td>1 sample <abbr tabindex="0" title="<p>A t-test is a type of statistical analysis used to compare the averages of two groups and determine whether the differences between them are more likely to arise from random chance. The two groups may be independent; that is, a control group and experimental group, or they can be dependent, wherein a single group yields pretreatment and posttreatment scores.</p> " class="glossify-tooltip-tip" lang="en">t-test</abbr></td><td>Wilcoxon test</td><td><abbr tabindex="0" title="<p>Chi-square test measures the statistical significance of a difference in proportions. It is a statistical test commonly used to compare observed data with data one would expect to obtain according to a specific hypothesis.<br /> Pelletier, L. R., &amp; Beaudin, C. L. (Eds.). (2012). <em>Q solutions: Essential resources for the healthcare quality professional </em>(3rd ed.). National Association for Healthcare Quality.</p> " class="glossify-tooltip-tip" lang="en">Chi-square</abbr></td></tr><tr><th>Two scores from two groups</th><td><abbr tabindex="0" title="<p>An unpaired t-test is a statistical test comparing the averages/means of two independent or unrelated groups to determine if there is a significant difference between the two.&nbsp;Gleichmann, N. (2023, October 14). Paired vs unpaired T-test: Differences, assumptions and hypotheses.&nbsp;<em>Technology Networks Informatics.</em>&nbsp;Retrieved November 16, 2023, from&nbsp;<a href="https://www.technologynetworks.com/informatics/articles/paired-vs-unpaired-t-test-differences-assumptions-and-hypotheses-330826">https://www.technologynetworks.com/informatics/articles/paired-vs-unpaired-t-test-differences-assumptions-and-hypotheses-330826</a></p> " class="glossify-tooltip-tip" lang="en">Unpaired t-test</abbr></td><td><abbr tabindex="0" title="<p>A Mann-Whitney U test is used to compare the differences between two independent samples when the sample distributions are not normally distributed and the sample sizes are small (n &lt;30). Zach. (2018, December 22). Mann-Whitney U Test. <em>Statology</em>. Retrieved November 16, 2023, from <a href="https://www.statology.org/mann-whitney-u-test/">https://www.statology.org/mann-whitney-u-test/</a><br /> &nbsp;</p> " class="glossify-tooltip-tip" lang="en">Mann-Whitney</abbr></td><td>Fischer’s test</td></tr><tr><th>Two scores from the same group</th><td>Paired t-test</td><td>Wilcoxon test</td><td><abbr tabindex="0" title="<p>The McNemar test is a non-parametric test used to analyze paired nominal data. The minimal sample size required for the McNemar test is at least ten discordant pairs.&nbsp;&nbsp;Sundjaja, J.H., Shrestha, R., &amp; Krishan, K. (2021).&nbsp;<em>McNemar and Mann-Whitney U Tests.</em>&nbsp;StatPearls Publishing.&nbsp;<a href="https://www.ncbi.nlm.nih.gov/books/NBK560699/">https://www.ncbi.nlm.nih.gov/books/NBK560699/</a></p> " class="glossify-tooltip-tip" lang="en">McNemar's test</abbr></td></tr><tr><th>More than two scores from two groups</th><td>Analysis of variance (ANOVA)</td><td>Kruskal-Wallis</td><td>Chi-square</td></tr><tr><th>More than two scores from the same group</th><td><p>Repeated measures</p><p>ANOVA</p></td><td><abbr tabindex="0" title="<p>The Friedman Test is a non-parametric test used to determine whether or not there is a statistically significant difference between the means of three or more groups in which the same subjects show up in each group. Zach. (2020, May 4). Friedman test: Definition, formula, and example.&nbsp;<em>Statology.</em>&nbsp;Retrieved November 27, 2023, from https://www.statology.org/friedman-test/</p> " class="glossify-tooltip-tip" lang="en">Friedman test</abbr></td><td>Cochrane’s Q</td></tr></tbody></table><h3>Patient/Encounter Level (Data Element) Reliability</h3><p>Measure developers conduct data element reliability testing with patient or encounter-level data elements (<abbr tabindex="0" title="<p>The <span class="glossify-exclude">numerator</span> is the upper portion of a fraction used to calculate a rate, proportion, or ratio. Also called the measure focus, it is the target process, condition, event, or outcome. <span class="glossify-exclude">Numerator</span> criteria are the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator. A <span class="glossify-exclude">numerator</span> statement describes the action satisfying the conditions of the performance measure.</p> " class="glossify-tooltip-tip" lang="en">numerator</abbr>, <abbr tabindex="0" title="<p>The <span class="glossify-exclude">denominator</span> is a statement describing the population evaluated by the performance measure and is the lower part of a fraction used to calculate a rate, proportion, or ratio. It can be the same as the target/initial population or a subset of the target/initial population to further constrain the population for the purpose of the measure. CV measures may refer to this as measure population.</p> " class="glossify-tooltip-tip" lang="en">denominator</abbr>, and exclusions, at a minimum). Patient/encounter level reliability refers to the repeatability of the testing findings—that is, whether the measure <abbr tabindex="0" title="<p><span class="glossify-exclude">Specifications</span> are measure instructions addressing data elements, data sources, point of data collection, timing and frequency of data collection and reporting, specific instruments used (if appropriate), and implementation strategies.</p> " class="glossify-tooltip-tip" lang="en">specifications</abbr> are able to extract the correct data elements consistently across measured entities. Per the <abbr tabindex="0" title="<p>The Medicare Improvements for Patients and Providers Act of 2008 requires the U.S. Department of Health and Human Services to contract with a consensus-based entity (CBE) regarding performance measurement. The CMS CBE endorses quality measures through a transparent, consensus-based process incorporating feedback from diverse groups of interested parties to foster health care quality improvement.</p> " class="glossify-tooltip-tip" lang="en">CMS consensus-based entity</abbr> (CBE), if the measure developer assesses patient/encounter level <abbr tabindex="0" title="<p><span class="glossify-exclude">Validity</span> includes measure <span class="glossify-exclude">validity</span> (when the measure accurately represents the evaluated concept and achieves the intended purpose, meaning to measure quality) and data element <span class="glossify-exclude">validity</span>, which is the extent to which the information represented by the data element or code used in the measure reflects the actual concept or event intended.</p> " class="glossify-tooltip-tip" lang="en">validity</abbr>, they do not need to test data element reliability. The CMS CBE does not require data element reliability from <abbr tabindex="0" title="<p>An electronic clinical quality measure (eCQM) is a measure specified in a standard electronic format that uses data electronically extracted from electronic health records and/or health information technology systems to measure the quality of health care provided. Electronic Clinical Quality Improvement Resource Center. (n.d.) <em>Glossary</em>. Retrieved May 22, 2024, from&nbsp;https://ecqi.healthit.gov/glossary</p>" class="glossify-tooltip-tip" lang="en">electronic clinical quality measures</abbr> (eCQMs) if based on data from structured fields. However, the CMS CBE requires demonstration of reliability at both the patient/encounter level and computed performance score for instrument-based measures, including <abbr tabindex="0" title="<p>A patient-reported outcome-based performance measure (PRO-PM) is a performance measure that is based on patient-reported outcome measure (PROM) data aggregated for an accountable health care entity. Measured entities collect the data directly from the patient using the PROM tool, which can be an instrument, scale, or single-item measure.</p> " class="glossify-tooltip-tip" lang="en">patient-reported outcome-based performance measures</abbr>. Measure developers may exclude from reliability testing data elements already established as reliable (e.g., age). Measure developers should critically review all data elements prior to deciding which to include in reliability testing.</p><p>Testing patient/encounter level reliability is less common with <a href="https://ecqi.healthit.gov/dqm">digital measures</a> than with manually abstracted measures because electronic systems are good at standardizing processes. However, when using natural language processing to extract data elements for digital measures, the measure developer should also conduct patient/encounter level reliability testing in addition to patient/encounter level validity testing.</p><h3>Types of Reliability</h3><p>Depending on the complexity of the measure specifications, the measure developer may assess one or more types of reliability. Some general types of reliability include</p><h4>Summary of Measure Data Element Reliability Types, Uses, and Tests (<a href="https://doi.org/10.1371/journal.pone.0215225">Soobiah et al., 2019</a>)</h4><table><thead><tr><th>Measure of Reliability</th><th>Description </th><th>Recommended Uses</th><th>Measure Reliability Tests</th></tr></thead><tbody><tr><th>Internal consistency</th><td>Internal consistency assesses the extent to which items (e.g., multiple item survey) designed to measure a given construct are inter-correlated, the extent to which data elements within a measure score are measuring the same construct.</td><td>Evaluating data elements or items for a single construct (i.e., questionnaire design)</td><td><p><strong><abbr tabindex="0" title="<p>Cronbach's alpha is a quantitative measure of internal consistency reliability. Cronbach's alpha ranges between 0 and 1, with higher values indicating more reliability.&nbsp;</p> " class="glossify-tooltip-tip" lang="en">Cronbach's alpha</abbr> (α) </strong>(<a href="https://doi.org/10.1007/bf02310555">Cronbach, 1951</a>) assesses how continuous data elements within a measure are correlated with each other</p><p><strong><abbr tabindex="0" title="<p>The Kuder-Richardson Formula 20 (KR-20) is a quantitative measure of internal consistency reliability for measurements with binary variables.&nbsp;</p> " class="glossify-tooltip-tip" lang="en">Kuder-Richardson Formula 20</abbr> (KR-20) </strong>assesses reliability of dichotomous data</p><p><strong><abbr tabindex="0" title="<p><span>McDonald's omega (ω) is a quantitative test of internal consistency reliability based on a one-factor model. McDonald's omega is a reliability coefficient similar to Cronbach's Alpha. Omega has the advantage of taking into account the strength of association between items and constructs and item-specific measurement errors.&nbsp;</span><span><span><span>ResearchGate. (2015). Re: What are the commonly used cut-off values for McDonald's Omega? Retrieved December 18, 2023 from:&nbsp;</span></span></span><a href="https://www.researchgate.net/post/What_are_the_commonly_used_cut-off_values_for_McDonalds_Omega/565e8eae6307d98cd88b4567/citation/download"><span>https://www.researchgate.net/post/What_are_the_commonly_used_cut-off_values_for_McDonalds_Omega/565e8eae6307d98cd88b4567/citation/download</span></a></p> " class="glossify-tooltip-tip" lang="en">McDonald's Omega</abbr></strong> <strong>(ω)</strong></p></td></tr><tr><th>Test-retest reliability (temporal reliability)</th><td>Test-retest reliability (temporal reliability) is the consistency of scores from the same respondent across two administrations of measurements (<abbr tabindex="0" title="<p><!--StartFragment -->Bland, M. (2000). An introduction to medical statistics (3rd ed.). Oxford Medical Publications.</p> <p><!--EndFragment --></p> " class="glossify-tooltip-tip" lang="en">Bland, 2000</abbr>). The measure developer should use the <abbr tabindex="0" title="<p>The coefficient of stability is an index of reliability determined via a test-retest method in which the same test is administered to the same respondents at two different points in time.<br /> APA Dictionary of Psychology. (n.d.). <em>Stability coefficient</em>. Retrieved November 27, 2023, from&nbsp;<a href="https://dictionary.apa.org/stability-coefficient">https://dictionary.apa.org/stability-coefficient</a></p> " class="glossify-tooltip-tip" lang="en">coefficient of stability</abbr> to quantify the association for the two measurement occasions or when assessing information not expected to change over a short or medium interval of time. Test-retest reliability is not appropriate for repeated measurement of disease symptoms nor for measuring <abbr tabindex="0" title="<p>An intermediate outcome is a measure assessing the change produced by a health care intervention leading to a long-term outcome.</p> " class="glossify-tooltip-tip" lang="en">intermediate outcomes</abbr> that follow an expected trajectory for improvement or deterioration. The measure developer assesses test-retest reliability when there is a rationale for expecting stability—rather than change—over the time period.</td><td>Assessing whether participant performance on the same test is repeatable or assessing the consistency of scores across time. Used if the measure developer expects the measured construct to be stable over time and measured objectively.</td><td><p><strong>Correlation coefficient </strong>quantifies the association between continuous (Pearson or <em>r</em>p) or ordinal (Spearman or <em>r</em>s) scores</p><p><strong>ICC</strong> reflects both correlation and agreement between measurements of continuous data</p><p><strong>Kendall’s Tau correlation coefficient</strong>, τb, is a non-parametric test of association </p></td></tr><tr><th>Intra-rater/abstractor reliability</th><td>Intra-rater reliability is the consistency of scores assigned by one rater across two or more measurements (Bland, 2000).</td><td>Assessing consistency of assignment or abstraction by one rater (e.g., rater scores at two timepoints).</td><td><p><strong>ICC</strong></p><p><strong>Kendall’s Tau </strong></p><p><strong><abbr tabindex="0" title="<p>Gwet's AC1 is a quantitative measure of agreement of binary ratings between two raters (inter-rater reliability).</p> " class="glossify-tooltip-tip" lang="en">Gwet's AC1</abbr></strong></p><p><strong>Percent agreement </strong>is the number of ratings that agree divided by the total ratings</p><p><strong>Cohen’s Kappa </strong></p></td></tr><tr><th>Inter-rater (inter-abstractor) reliability</th><td>Inter-rater (inter-abstractor) reliability is the consistency of ratings from two or more observers (often using the same method or instrumentation) when rating the same information (Bland, 2000). It is frequently employed to assess reliability of data elements used in exclusion specifications, as well as the calculation of measure scores when the measure requires review or abstraction. Quantitatively summarize the extent of inter-rater/abstractor reliability and concordance rates with confidence intervals which are acceptable statistics to describe inter-rater/abstractor reliability. eCQMs implemented as direct queries to <abbr tabindex="0" title="<p>The <span class="glossify-exclude">electronic health record</span> is also known as the electronic patient record, electronic medical record, or computerized patient record. As defined by the International Social Security Association, an <span class="glossify-exclude">EHR</span> is a “longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, diagnoses and treatment, medications, allergies, immunizations as well as radiology images and laboratory results.” International Social Security Association. (n.d.). <em>Information and communication technology - Guideline 91. electronic health record system</em>. Retrieved November 1, 2023, from&nbsp;<a href="https://ww1.issa.int/guidelines/ict/180156">https://ww1.issa.int/guidelines/ict/180156</a></p> " class="glossify-tooltip-tip" lang="en">electronic health record</abbr> databases may not use abstraction. Therefore, there may be no need for inter-rater reliability for eCQMs.</td><td>Assessing consistency of assignment by multiple raters.</td><td><p><strong>ICC</strong></p><p><strong>Kendall’s Tau </strong></p><p><strong>Gwet's AC1</strong></p><p><strong>Percent agreement </strong></p><p><strong><abbr tabindex="0" title="<p>Cohen's kappa, or Cohen's Kappa coefficient, is a quantitative measure of agreement of categorical variables between two raters (inter-rater reliability) or one rater at two time periods (intra-rater reliability). A Cohen's kappa of 0 indicates agreement equivalent to chance. A Cohen's kappa of 1 indicates total agreement.</p> " class="glossify-tooltip-tip" lang="en">Cohen's Kappa</abbr></strong></p></td></tr></tbody></table><dl class="ckeditor-accordion"><dt>Intraclass Correlation Coefficient</dt><dd><p>ICC is one of the most commonly used metrics of test-retest, intra-rater, and inter-rater reliability index that reflects both degree of correlation and agreement between measurements of continuous data (Koo & Li, 2016). There are six different variations of ICC. The variation selected depends on the number of raters (model and form) and the type of reliability (agreement or consistency in ratings) used. The result is an expected value of the true ICC, estimated with a 95 percent <abbr tabindex="0" title="<p>A confidence interval (CI) provides a range of possible values around a sample estimate (a mean, proportion, or ratio) calculated from data. CIs are commonly used when comparing groups and reflect the always-present uncertainty when working with samples of subjects. Rosati, R. J., &amp; Quality, N. a. F. H. (2012). Q Soultions: Information Management.&nbsp;</p> " class="glossify-tooltip-tip" lang="en">confidence interval</abbr>. The measure developer may consider a test to have moderate reliability if the ICC is between 0.5 and 0.75 and excellent reliability if ICC > 0.75 (Gwet, 2008). See the Variations of Intraclass Correlation table.</p></dd></dl></div>
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<div class="field field--name-field-body-cont- field--type-text-long field--label-hidden field__item"><dl class="ckeditor-accordion"><dt>Variations of Intraclass Correlation</dt><dd><table><thead><tr><th>Model</th><th>Definition</th><th>Form</th><th>Definition</th></tr></thead><tbody><tr><td>1 way random</td><td>Assessment of each subject by a different set of randomly selected raters</td><td>1</td><td rowspan="2">Calculating <abbr tabindex="0" title="<p><span class="glossify-exclude">Reliability</span> reflects the measure is well defined and precisely specified so measured entities can implement consistently within and across organizations and that it distinguishes differences in performance.</p> " class="glossify-tooltip-tip" lang="en">reliability</abbr> from a single measurement</td></tr><tr><td rowspan="2">2 way random</td><td rowspan="2">Assessment of each subject by each rater and selection of raters is random</td><td>1 & K</td></tr><tr><td>1 & K</td><td rowspan="2">Calculating reliability by taking an average of the k raters’ measurements</td></tr><tr><td>2 way mixed</td><td>Assessment of each subject by each rater, but the raters are the only raters of interest</td><td>K</td></tr></tbody></table><p>With respect to other approaches to reliability across all types of reliability estimation, the shared objective is to ensure replication of measurements or decisions. In terms of comparisons of groups, where possible the measure developer should extend reliability to assess stability of the relative positions of different groups or determination of significant differences between groups. These types of assessments address the <abbr tabindex="0" title="<p>A <span class="glossify-exclude">proportion</span> is a score derived by dividing the number of cases meeting a criterion for quality (i.e., the numerator) by the number of eligible cases within a given time frame (i.e., the denominator) where the numerator cases are a subset of the denominator cases (e.g., percentage of eligible women with a mammogram performed in the last year).</p> " class="glossify-tooltip-tip" lang="en">proportion</abbr> of variation in the measure attributable to the group. The measure developer describes the proportion as true differences (signal) relative to variation in the measure due to other factors, including chance variation (noise). Measure developers may consider measures with a relatively high proportion of signal variance reliable because of their power for discriminating among <abbr tabindex="0" title="<p><span class="glossify-exclude">Measured entities</span> are the front-line clinicians and their organizations, including health information technology, collecting quality measurement data. <span class="glossify-exclude">Measured entities</span> are the implementers of quality measures. The effect of quality measure data collection on clinician workflow can be negative. There may be effects on their payments, positive and negative, with respect to reporting and actual performance on quality measures. Because of these potential effects, <span class="glossify-exclude">measured entities</span> should be involved in all aspects of the Measure Lifecycle.</p> " class="glossify-tooltip-tip" lang="en">measured entities</abbr> and the repeatability of group-level differences across <abbr tabindex="0" title="<p>A <span class="glossify-exclude">sample</span> is a subset of a population. The subset should be chosen in such a way that it accurately represents the whole population with respect to some characteristic of interest. A sampling frame lists all eligible cases in the population of interest (i.e., denominator) and how they are selected.</p> " class="glossify-tooltip-tip" lang="en">samples</abbr>. However, not all reliable measures have a high proportion of signal variance, e.g., due to shrinkage. Provided the number of observations within groups is sufficiently large, measure developers can partially address these questions using methods such as ANOVA, estimation of variance components within a hierarchical mixed (i.e., random effects) model, or <abbr tabindex="0" title="<p><span class="glossify-exclude">Bootstrap analysis (bootstrapping)</span>, as used in risk adjustment models, generally refers to estimating properties of a model estimate or the stability of an estimate by sampling from an approximating distribution. The measure developer may accomplish this by constructing many resamples of equal size from the observed dataset (e.g., the development sample), when the resamples are smaller than the observed dataset. This technique allows estimation of the sample distribution of a statistic. Measure developers can also use it to construct hypothesis tests. In the case of a regression or logistic regression risk adjustment model, the measure developer can use it to provide additional guidance regarding the inclusion of risk factors in the model.</p> " class="glossify-tooltip-tip" lang="en">bootstrapping</abbr> simulations. Changes in group ranking across multiple measurements may also add to an understanding of the stability of group-level measurement (<a href="http://www.rand.org/pubs/technical_reports/TR653.html">Adams, 2009</a>).</p></dd></dl><dl class="ckeditor-accordion"><dt>Instrument Reliability</dt><dd><p>Measure developers must assess instrument-based measures (from a survey, test, questionnaire, or scale) at both the <abbr tabindex="0" title="<p>A data element is a basic unit of information with a unique meaning and subcategories (data items) of distinct value. National Institute of Standards and Technology. (n.d.). <em>Data element</em>. Computer Security Resource Center. Retrieved November 1, 2023, from&nbsp;<a href="https://csrc.nist.gov/glossary/term/data_element">https://csrc.nist.gov/glossary/term/data_element</a></p> " class="glossify-tooltip-tip" lang="en">data element</abbr> (or item) level and the <abbr tabindex="0" title="<p>The <span class="glossify-exclude">measure score</span> is the numeric result computed by applying the measure specifications and scoring algorithm. The computed <span class="glossify-exclude">measure score</span> represents an aggregation of all appropriate patient-level data (e.g., proportion of patients who died, average lab value attained) for the measured entity (e.g., hospital, health plan, home health agency, clinician). The measure specifications designate the measured entity and to whom the measure applies.</p> " class="glossify-tooltip-tip" lang="en">measure score</abbr> level. Measure developers may assess item reliability by evaluating test-retest reliability (see the Types of Reliability table), which evaluates the consistency of the item from one time to the next. The measure developer may estimate precision of the measure score, measure score reliability, using the methods outlined in the Measure Reliability Types, Uses, and Tests table.</p><p>Measure developers evaluating a statistic, such as <abbr tabindex="0" title="<p>Cronbach's alpha is a quantitative measure of internal consistency reliability. Cronbach's alpha ranges between 0 and 1, with higher values indicating more reliability.&nbsp;</p> " class="glossify-tooltip-tip" lang="en">Cronbach's alpha</abbr> or <abbr tabindex="0" title="<p><span>McDonald's omega (ω) is a quantitative test of internal consistency reliability based on a one-factor model. McDonald's omega is a reliability coefficient similar to Cronbach's Alpha. Omega has the advantage of taking into account the strength of association between items and constructs and item-specific measurement errors.&nbsp;</span><span><span><span>ResearchGate. (2015). Re: What are the commonly used cut-off values for McDonald's Omega? Retrieved December 18, 2023 from:&nbsp;</span></span></span><a href="https://www.researchgate.net/post/What_are_the_commonly_used_cut-off_values_for_McDonalds_Omega/565e8eae6307d98cd88b4567/citation/download"><span>https://www.researchgate.net/post/What_are_the_commonly_used_cut-off_values_for_McDonalds_Omega/565e8eae6307d98cd88b4567/citation/download</span></a></p> " class="glossify-tooltip-tip" lang="en">McDonald's Omega</abbr>, with all the items in the measure against the Cronbach's alpha excluding the item in question. If the alpha increases in the latter situation, the item is not strongly related to the other items in the scale (<a href="https://files.eric.ed.gov/fulltext/ED526237.pdf">Ritter, 2010</a>). Measure developers should critically review all items in a scale prior to deciding which to include in reliability testing. Items should always undergo reliability testing if they are new, gathered in a different mode (e.g., telephone vs. self-administered survey), used on a different <abbr tabindex="0" title="<p>The <span class="glossify-exclude">population</span> is the total group of people of interest for a quality measure, sometimes called the target/initial <span class="glossify-exclude">population</span>. The measure <span class="glossify-exclude">population</span> is a defined subset appropriate to the measure set not excluded from the individual measure.</p> " class="glossify-tooltip-tip" lang="en">population</abbr>, or included as part of a new scale.</p></dd><dt>Form Equivalence</dt><dd><p>If using multiple modes or data collections, the measure developer should document and quantify discrepancies between methods (i.e., mode effects). Form equivalence (parallel forms) reliability is the extent to which multiple formats or versions of a test yield the same results (<abbr tabindex="0" title="<p><!--StartFragment -->Bland, M. (2000). An introduction to medical statistics (3rd ed.). Oxford Medical Publications.</p> <p><!--EndFragment --></p> " class="glossify-tooltip-tip" lang="en">Bland, 2000</abbr>). Measure developers may use form equivalence reliability when testing comparability of results across more than one method of data collection, across automated data extraction from different <abbr tabindex="0" title="<p><span class="glossify-exclude">Data sources</span> are the primary source document(s) used for data collection (e.g., billing or administrative data, encounter form, enrollment form, patient medical record).</p> " class="glossify-tooltip-tip" lang="en">data sources</abbr>, or testing agreement between the known values from a simulated data set and the elements obtained when applying the <abbr tabindex="0" title="<p><span class="glossify-exclude">Specifications</span> are measure instructions addressing data elements, data sources, point of data collection, timing and frequency of data collection and reporting, specific instruments used (if appropriate), and implementation strategies.</p> " class="glossify-tooltip-tip" lang="en">specifications</abbr> to the data set. As part of the analysis, the measure developer should investigate and document the reasons for discrepancies between methods (i.e., mode effects –for example, when results from a telephone survey are different from results of the same survey when mailed). Measure developers may measure form equivalence with the same methods used to assess measure reliability according to the data type including <abbr tabindex="0" title="<p><span class="glossify-exclude">Intra-class correlation</span> refers to correlations within a class of data (for example correlations within repeated measurements of weight), rather than to correlations between two different classes of data (for example the correlation between weight and length). Liljequist, D., Elfving, B., &amp; Skavberg Roaldsen, K. (2019). Intraclass correlation - A discussion and demonstration of basic features. <em>PoS ONE 14</em>(7), e0219854.&nbsp;<a href="https://doi.org/10.1371/journal.pone.0219854">https://doi.org/10.1371/journal.pone.0219854</a></p> " class="glossify-tooltip-tip" lang="en">ICC</abbr>, Pearson's correlation, Spearman’s rho, or <abbr tabindex="0" title="<p>Kendall’s Tau is a statistic used to measure the ordinal association between two measured quantities. It is a measure of rank correlation: the similarity of the orderings of the data when ranked by each of the quantities.<br /> Comprehensive R Archive Network. (n.d.). Kendall's Ƭa. Tools for Descriptive Statistics. Retrieved November 13, 2023, from<br /> <a href="https://search.r-project.org/CRAN/refmans/DescTools/html/KendallTauA.html">https://search.r-project.org/CRAN/refmans/DescTools/html/KendallTauA.html</a></p> " class="glossify-tooltip-tip" lang="en">Kendall's Tau</abbr>.</p></dd></dl></div>
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