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## Complete Summary

#### TITLE

Menopause and hormone therapy (HT): collaborative decision-making and
management: the percentage of women in menopause who have had a bone
mineral density (BMD) measurement a year after cessation of HT.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Menopause and hormone
therapy (HT): collaborative decision-making and management. Bloomington
(MN): Institute for Clinical Systems Improvement (ICSI); 2006 Oct. 63 p.
\[195 references\]

### Measure Domain

#### PRIMARY MEASURE DOMAIN

Process

The validity of measures depends on how they are built. By examining the
key building blocks of a measure, you can assess its validity for your
purpose. For more information, visit the [Measure
Validity](http://www.qualitymeasures.ahrq.gov/resources/measure_domains.aspx)
page.

#### SECONDARY MEASURE DOMAIN

Does not apply to this measure

### Brief Abstract

#### DESCRIPTION

This measure is used to assess the percentage of women in menopause who
have had a bone mineral density (BMD) measurement a year after cessation
of hormone therapy (HT).

#### RATIONALE

The priority aim addressed by this measure is to increase the percentage
of women with appropriate follow-up to cessation of hormone therapy
(HT).

#### PRIMARY CLINICAL COMPONENT

Menopause; hormone therapy (HT); bone mineral density (BMD) measurement

#### DENOMINATOR DESCRIPTION

Total number of women in the medical group\'s practice in menopause who
have discontinued hormone therapy (HT) (see the related \"Denominator
Inclusions/Exclusions\" field in the Complete Summary)

#### NUMERATOR DESCRIPTION

Number of women in menopause receiving a bone mineral density (BMD)
measurement a year after cessation of hormone therapy (HT)

### Evidence Supporting the Measure

#### EVIDENCE SUPPORTING THE CRITERION OF QUALITY

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

#### NATIONAL GUIDELINE CLEARINGHOUSE LINK

-   [Menopause and hormone therapy (HT): collaborative decision-making
    and
    management.](http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10038)

### Evidence Supporting Need for the Measure

#### NEED FOR THE MEASURE

Unspecified

### State of Use of the Measure

#### STATE OF USE

Current routine use

#### CURRENT USE

Internal quality improvement

### Application of Measure in its Current Use

#### CARE SETTING

Physician Group Practices/Clinics

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Group Clinical Practices

#### TARGET POPULATION AGE

Unspecified

#### TARGET POPULATION GENDER

Female (only)

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

More women than ever before will be entering menopause as the \"baby
boomer\" generation ages. By the year 2020, the number of perimenopausal
women will almost double, to 40 million.

#### EVIDENCE FOR INCIDENCE/PREVALENCE

Institute for Clinical Systems Improvement (ICSI). Menopause and hormone
therapy (HT): collaborative decision-making and management. Bloomington
(MN): Institute for Clinical Systems Improvement (ICSI); 2006 Oct. 63 p.
\[195 references\]

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Living with Illness

#### IOM DOMAIN

Effectiveness

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

Women who are in menopause and have discontinued hormone therapy (HT).

Select a randomized sample of the eligible population for data
collection. The suggested sample size for each medical group is at least
10 charts each month.

The medical record of each woman is reviewed to determine if the woman
is in menopause and had discontinued HT.

The suggested time frame for data collection is a calendar month.

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Total number of women in the medical group\'s practice\* in
menopause\*\* who have discontinued hormone therapy (HT)

\*\"In the medical group practice\" is defined as a woman who has been
seen two or more times by the medical group (including office visits and
urgent care).

\*\*A woman is diagnosed as having menopause if 1) she has had complete
cessation of menses for one year, 2) premature menopause, or 3)
surgical-, chemotherapy-, or radiation-induced menopause, or 4) if
younger than average, or continuation of regular menses, and has a
positive follicle stimulating hormone (FSH) and/or estradiol lab test.
This would correspond to patients with diagnosis codes 627.x and 256.31
and Current Procedure Terminology (CPT) codes 80418, 80426, and/or
82670.

**Exclusions**\
Unspecified

#### RELATIONSHIP OF DENOMINATOR TO NUMERATOR

All cases in the denominator are equally eligible to appear in the
numerator

#### DENOMINATOR (INDEX) EVENT 

Clinical Condition\
Therapeutic Intervention

#### DENOMINATOR TIME WINDOW

Time window follows index event

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Number of women in menopause receiving a bone mineral density (BMD)
measurement a year after cessation of hormone therapy (HT)

**Exclusions**\
Unspecified

#### MEASURE RESULTS UNDER CONTROL OF HEALTH CARE PROFESSIONALS, ORGANIZATIONS AND/OR POLICYMAKERS

The measure results are somewhat or substantially under the control of
the health care professionals, organizations and/or policymakers to whom
the measure applies.

#### NUMERATOR TIME WINDOW

Episode of care

#### DATA SOURCE

Administrative data\
Medical record

#### LEVEL OF DETERMINATION OF QUALITY

Individual Case

#### PRE-EXISTING INSTRUMENT USED

Unspecified

### Computation of the Measure

#### SCORING

Rate

#### INTERPRETATION OF SCORE

Better quality is associated with a higher score

#### ALLOWANCE FOR PATIENT FACTORS

Unspecified

#### STANDARD OF COMPARISON

Internal time comparison

### Evaluation of Measure Properties

#### EXTENT OF MEASURE TESTING

Unspecified

### Identifying Information

#### ORIGINAL TITLE

The percentage of women in menopause who have had a bone mineral density
(BMD) measurement a year after cessation of HT.

#### MEASURE COLLECTION

[Menopause and Hormone Therapy (HT): Collaborative Decision-Making and
Management
Measures](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=26&doc=6153)

#### DEVELOPER

Institute for Clinical Systems Improvement

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

2004 Oct

#### REVISION DATE

2006 Oct

#### MEASURE STATUS

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems
Improvement (ICSI). Menopause and hormone therapy (HT): collaborative
decision-making and management. Bloomington (MN): Institute for Clinical
Systems Improvement (ICSI); 2005 Aug. 64 p.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Menopause and hormone
therapy (HT): collaborative decision-making and management. Bloomington
(MN): Institute for Clinical Systems Improvement (ICSI); 2006 Oct. 63 p.
\[195 references\]

#### MEASURE AVAILABILITY

The individual measure, \"The percentage of women in menopause who have
had a bone mineral density (BMD) measurement a year after cessation of
HT,\" is published in \"Health Care Guideline: Menopause and Hormone
Therapy (HT): Collaborative Decision-Making and Management.\" This
document is available from the [Institute for Clinical Systems
Improvement (ICSI) Web
site](http://www.icsi.org/guidelines_and_more/guidelines__order_sets___protocols/).

For more information, contact ICSI at, 8009 34th Avenue South, Suite
1200, Bloomington, MN 55425; phone: 952-814-7060; fax: 952-858-9675; Web
site: [www.icsi.org](http://www.icsi.org/); e-mail:
<icsi.info@icsi.org>.

#### NQMC STATUS

This NQMC summary was completed by ECRI on January 19, 2005. This NQMC
summary was updated by ECRI on October 25, 2005 and again on December
11, 2006.

#### COPYRIGHT STATEMENT

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\[ICSI\] Measure) is based on the original measure, which is subject to
the measure developer\'s copyright restrictions.

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/3/2008