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  1. FHIR Specification Feedback
  2. FHIR-39376

Clarify Ratio Measures using Measure Observations

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Quality Measures (FHIR)
    • 3.0.0
    • Clinical Quality Information
    • STU
    • CQFM Ratio Measure
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      Agree with recommendation.  Will remove statement 'rate-based' from first sentence:

      Current text:

      The ratio diagrams depict the rate-based ratio measure. Ratio measures may also include continuous variable calculations for the numerator and denominator (continuous variable ratio measures) but the diagrams do not depict the continuous variable ratio measures.

      Recommended text:

      The ratio diagrams depict a ratio measure. Ratio measures may also include continuous variable calculations for the numerator and denominator (continuous variable ratio measures) but the diagrams do not depict the continuous variable ratio measures.

       
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      Agree with recommendation.  Will remove statement 'rate-based' from first sentence: Current text: The ratio diagrams depict the rate-based ratio measure. Ratio measures may also include continuous variable calculations for the numerator and denominator (continuous variable ratio measures) but the diagrams do not depict the continuous variable ratio measures. Recommended text: The ratio diagrams depict a ratio measure. Ratio measures may also include continuous variable calculations for the numerator and denominator (continuous variable ratio measures) but the diagrams do not depict the continuous variable ratio measures.  
    • Juliet Rubini / Stan Rankins : 15-0-0
    • Clarification
    • Non-substantive

    Description

      The text below Figure 3-4 and above Table 3-4 needs clarification.

      Current text:

      The ratio diagrams depict the rate-based ratio measure. Ratio measures may also include continuous variable calculations for the numerator and denominator (continuous variable ratio measures) but the diagrams do not depict the continuous variable ratio measures.

      What is a "rate-based" ratio measure?

      Should we mention that the diagrams do not depict  non-patient-based populations (i.e., populationBasis other than boolean), which could also be rate based?

      For CV, are two measure-observation populations required (one where the criteriaReference points to the denominator, and another where criteriaReference points to the numerator, or would the absence of a criteriaReference mean that the same measure observation function is to be used for both denominator and numerator calculations? Clarify that we cannot mix CV and rate-based with the numerator and denominator; i.e., a single Measure,group.population for a measure-observation associated with the numerator, but none for the denominator.

      The diagrams depict patients, so some explanation that a populationBasis other than boolean (patient-based) does not necessarily imply a CV measure or that a measure-observation population (function) is needed.  A populationBasis of Encounter, for example, could still be "rate-based".

      With multiple Measure.groups where one is ratio and another is proportion, how should Measure.meta.profile be handled? (or one cohort and another proportion, not necessarily a ratio measure issue).

      See https://github.com/projecttacoma/fqm-execution/issues/149 for related discussion

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            bryn.rhodes Bryn Rhodes
            mitrep9g Paul Denning
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              Updated:
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