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  • Measure Summary
  • NQMC:010346
  • Jun 2015
  • NQF-Endorsed Measure

Osteoporosis: percentage of women 65 to 85 years of age who have documentation in their medical record of having received a central dual-energy X-ray absorptiometry (DXA) test of their hip or spine.

National Committee for Quality Assurance (NCQA). Osteoporosis: screening for osteoporosis for women 65 to 85 years of age. Washington (DC): National Committee for Quality Assurance (NCQA); 2015 Jun 5. 2 p.

This is the current release of the measure.

This measure updates a previous version: American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American Association of Clinical Endocrinologists, American College of Rheumatology, The Endocrine Society, Physician Consortium for Performance Improvement®, National Committee for Quality Assurance. Osteoporosis physician performance measurement set. Chicago (IL): American Medical Association (AMA); 2009 Nov. 18 p.

Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of women 65 to 85 years of age who have documentation in their medical record of having received a central dual-energy X-ray absorptiometry (DXA) test of their hip or spine.

Rationale

Patients with elevated risk for osteoporosis should have the diagnosis of osteoporosis excluded or be on treatment of osteoporosis.

The following clinical recommendation statements are quoted verbatim from the referenced clinical guidelines and represent the evidence base for the measure:

The U.S. Preventive Services Task Force (USPSTF) (2011) recommends screening for osteoporosis in women aged 65 years and older and in younger women whose fracture risk is equal to or greater than that of a 65-year old white woman who has no additional risk factors.

"Based on the U.S. FRAX tool, a 65-year-old white woman with no other risk factors has a 9.3% 10-year risk for any osteoporotic fracture. White women between the ages of 50 and 64 years with equivalent or greater 10-year fracture risks based on specific risk factors include but are not limited to the following persons: 1) a 50-year-old current smoker with a body mass index (BMI) less than 21 kg/m2, daily alcohol use, and parental fracture history; 2) a 55-year-old woman with a parental fracture history; 3) a 60-year-old woman with a body mass index (BMI) less than 21 kg/m2 and daily alcohol use; and 4) a 60-year-old current smoker with daily alcohol use. The FRAX tool also predicts 10-year fracture risks for black, Asian, and Hispanic women in the United States. In general, estimated fracture risks in nonwhite women are lower than those for white women of the same age" (USPSTF, 2011).

Current diagnostic and treatment criteria for osteoporosis rely on dual-energy X-ray absorptiometry (DXA) measurements only. The USPSTF (2011) did not define a specific upper age limit for screening in women; however they noted that clinicians should take into account the patient's remaining lifespan when deciding whether to screen patients with significant illness; the benefit of treatment emerged 18 to 24 months after initiation of treatment.

Evidence for Rationale

National Committee for Quality Assurance (NCQA). Osteoporosis: screening for osteoporosis for women 65 to 85 years of age. Washington (DC): National Committee for Quality Assurance (NCQA); 2015 Jun 5. 2 p.

U.S. Preventive Services Task Force (USPSTF). Final update summary: osteoporosis: screening. [internet]. Rockville (MD): U.S. Preventive Services Task Force (USPSTF); 2011 Jan [accessed 2015 Jul 01].

Primary Health Components

Osteoporosis; screening; dual-energy x-ray absorptiometry (DXA); elderly

Denominator Description

Women 65 to 85 years of age (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

The number of women who have documentation in their medical record of having received a central dual-energy X-ray absorptiometry (DXA) test of their hip or spine (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Internal quality improvement

Pay-for-reporting

Public reporting

Measurement Setting

Ambulatory/Office-based Care

Ambulatory Procedure/Imaging Center

Hospital Outpatient

Professionals Involved in Delivery of Health Services

Physicians

Least Aggregated Level of Services Delivery Addressed

Individual Clinicians or Public Health Professionals

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Age 65 to 85 years

Target Population Gender

Female (only)

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Health and Well-being of Communities
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Staying Healthy

IOM Domain

Effectiveness

Case Finding Period

The reporting period

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Encounter

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Women 65 to 85 years of age

Note: Refer to the original measure documentation for administrative codes.

Exclusions
Unspecified

Exceptions
Clinician documented that patient was not an eligible candidate for screening

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
The number of women who have documentation in their medical record of having received a central dual-energy X-ray absorptiometry (DXA) test of their hip or spine

Note: Refer to the original measure documentation for administrative codes.

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Administrative clinical data

Electronic health/medical record

Paper medical record

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Original Title

Measure #39: screening for osteoporosis for women 65 to 85 years of age.

Measure Collection Name

Osteoporosis

Submitter

National Committee for Quality Assurance - Health Care Accreditation Organization

Developer

National Committee for Quality Assurance - Health Care Accreditation Organization

Funding Source(s)

Unspecified

Composition of the Group that Developed the Measure

Osteoporosis Work Group: Steven Petak, MD, JD, FACE (Co-chair); Kenneth Saag, MD, MSc (Co-chair); Robert Adler, MD; C. Conrad Johnston, Jr., MD; H. Chris Alexander, III, MD, FACP; Joseph Lane, MD; Donald Bachman, MD, FACR; Leon Lenchik, MD; Joel Brill, MD; Bonnie McCafferty, MD, MSPH; Jan Busby-Whitehead, MD; Michael Maricic, MD; Thomas Dent, MD; Michael L. O'Dell, MD, MSHA, FAAFP; Nancy Dolan, MD; Sam J. W. Romeo, MD, MBA; Leonie Gordon, MB, ChB; Frank Salvi, MD, MS; Tomas Griebling, MD; Joseph Shaker, MD; Richard Hellman, MD, FACP, FACE; Madhavi Vemireddy, MD; Marc C. Hochberg, MD, MPH; David Wong, MD, MSc, FRS(C)

American Academy of Family Physicians: Bruce Bagley, MD; Janet Leiker, RN, MPH, CPHQ

American Academy of Orthopaedic Surgeons: Bob Haralson, MD, MBA; Jill Hughes

American Association of Clinical Endocrinologists: Tammy L. Chaney

American College of Rheumatology: Amy Miller

The Endocrine Society: Janet Kreizman

Facilitators: Timothy F. Kresowik, MD; Rebecca A. Kresowik

American Medical Association: Karen S. Kmetik, PhD; Heidi Bossley, MSN, MBA

National Osteoporosis Foundation: Roberta Biegel

National Committee for Quality Assurance: Sarah Sampsel, MPH

The Joint Commission: Ann Watt, RN

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Endorser

National Quality Forum

NQF Number

0046

Date of Endorsement

2014 Dec 30

Measure Initiative(s)

Physician Quality Reporting System

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2015 Jun

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

This measure updates a previous version: American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American Association of Clinical Endocrinologists, American College of Rheumatology, The Endocrine Society, Physician Consortium for Performance Improvement®, National Committee for Quality Assurance. Osteoporosis physician performance measurement set. Chicago (IL): American Medical Association (AMA); 2009 Nov. 18 p.

Source(s)

National Committee for Quality Assurance (NCQA). Osteoporosis: screening for osteoporosis for women 65 to 85 years of age. Washington (DC): National Committee for Quality Assurance (NCQA); 2015 Jun 5. 2 p.

Measure Availability

Source not available electronically.

For more information, contact the National Committee for Quality Assurance (NCQA) at 1100 13th Street, NW, Suite 1000, Washington, DC 20005; Phone: 202-955-3500; Fax: 202-955-3599; Web site: www.ncqa.org External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on October 12, 2007. The information was verified by the measure developer on November 21, 2007.

This NQMC summary was retrofitted into the new template on June 8, 2011.

This NQMC summary was edited by ECRI Institute on April 27, 2012.

Stewardship for this measure was transferred from the PCPI to the NCQA. NCQA informed NQMC that this measure was updated. This NQMC summary was updated by ECRI Institute on September 21, 2015. The information was verified by the measure developer on November 3, 2015.

Copyright Statement

This NQMC summary is based on the original measure, which is subject to the measure developer's copyright restrictions.

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