![](media/image1.png){width="5.972916666666666in"
height="0.4791666666666667in"}

Top of Form

## Complete Summary

#### TITLE

Venous thromboembolism (VTE): percentage of adult patients who have a
high clinical pretest probability for pulmonary embolism (PE) who
received low molecular weight heparin (LMWH) during evaluation.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Venous
thromboembolism. Bloomington (MN): Institute for Clinical Systems
Improvement (ICSI); 2007 Jun. 91 p. \[212 references\]

### 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 adult patients who have
a high clinical pretest probability for pulmonary embolism (PE) who
received low molecular weight heparin (LMWH) during evaluation.

#### RATIONALE

The priority aim addressed by this measure is to prevent progression or
recurrence of thromboembolic disease.

#### PRIMARY CLINICAL COMPONENT

Venous thromboembolism (VTE); pulmonary embolism (PE); high clinical
pretest probability; low molecular weight heparin (LMWH)

#### DENOMINATOR DESCRIPTION

Total number of adult patients with a documented high clinical pretest
probability of pulmonary embolism (PE) (see the related \"Denominator
Inclusions/Exclusions\" field in the Complete Summary)

#### NUMERATOR DESCRIPTION

Total number of adult patients with a documented high clinical pretest
probability of pulmonary embolism (PE) receiving low molecular weight
heparin (LMWH) during the evaluation for PE

### 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

-   [Venous
    thromboembolism.](http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=11284)

### 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

Hospitals\
Physician Group Practices/Clinics

#### PROFESSIONALS RESPONSIBLE FOR HEALTH CARE

Physicians

#### LOWEST LEVEL OF HEALTH CARE DELIVERY ADDRESSED

Group Clinical Practices

#### TARGET POPULATION AGE

Age greater than or equal to 18 years

#### TARGET POPULATION GENDER

Either male or female

#### STRATIFICATION BY VULNERABLE POPULATIONS

Unspecified

### Characteristics of the Primary Clinical Component

#### INCIDENCE/PREVALENCE

Unspecified

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

Unspecified

#### UTILIZATION

Unspecified

#### COSTS

Unspecified

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Getting Better

#### IOM DOMAIN

Effectiveness

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

Adults 18 years and older suspected of having a pulmonary embolism (PE)

A list of all adult patients with a documented high clinical pretest
probability of PE during the previous target period. The medical records
can be reviewed to determine if low molecular weight heparin (LMWH) was
used during evaluation.

Data may be collected semiannually.

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Total number of adult patients with a documented high clinical pretest
probability of pulmonary embolism (PE)\*

\*Model for Predicting Clinical Pretest Probability for PE:

-   Clinical signs and symptoms of deep vein thrombosis (DVT) (minimum
    of leg swelling and pain with palpation of the deep veins) \-- 3
    points

-   Alternative diagnosis is less likely \-- 3 points

-   Heart rate greater than 100 \-- 1.5 points

-   Immobilization or surgery in previous 4 weeks \-- 1.5 points

-   Previous DVT/PE \-- 1.5 points

-   Hemoptysis \-- 1 point

-   Malignancy (active or treated in the last 6 months or palliative)
    \-- 1 point

Score less than 2 = low clinical pretest probability

Score 2-6 = moderate clinical pretest probability

Score more than 6 = high clinical pretest probability

**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

#### DENOMINATOR TIME WINDOW

Time window brackets index event

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Total number of adult patients with a documented high clinical pretest
probability of pulmonary embolism (PE) receiving low molecular weight
heparin (LMWH) during the evaluation for PE

**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

Percentage of adult patients who have a high clinical pretest
probability for PE who received low molecular weight heparin (LMWH)
during evaluation.

#### MEASURE COLLECTION

[Venous Thromboembolism
Measures](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=26&doc=4509)

#### DEVELOPER

Institute for Clinical Systems Improvement

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

2006 Feb

#### REVISION DATE

2007 Jun

#### MEASURE STATUS

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems
Improvement (ICSI). Venous thromboembolism. Bloomington (MN): Institute
for Clinical Systems Improvement (ICSI); 2006 Feb. 91 p.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Venous
thromboembolism. Bloomington (MN): Institute for Clinical Systems
Improvement (ICSI); 2007 Jun. 91 p. \[212 references\]

#### MEASURE AVAILABILITY

The individual measure, \"Percentage of adult patients who have a high
clinical pretest probability for PE who received low molecular weight
heparin (LMWH) during evaluation,\" is published in \"Health Care
Guideline: Venous Thromboembolism.\" 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 May 1, 2006. This NQMC
summary was updated by ECRI Institute on October 8, 2007.

#### COPYRIGHT STATEMENT

This NQMC summary (abstracted Institute for Clinical Systems Improvement
\[ICSI\] Measure) is based on the original measure, which is subject to
the measure developer\'s copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be
downloaded by any individual or organization. If the abstracted ICSI
Measures are downloaded by an individual, the individual may not
distribute copies to third parties.

If the abstracted ICSI Measures are downloaded by an organization,
copies may be distributed to the organization\'s employees but may not
be distributed outside of the organization without the prior written
consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved
by the Institute for Clinical Systems Improvement, Inc. The Institute
for Clinical Systems Improvement, Inc. assumes no liability for any
adaptations or revisions or modifications made to the abstracts of the
ICSI Measures.

### Disclaimer

#### NQMC DISCLAIMER

The National Quality Measures Clearinghouse™ (NQMC) does not develop,
produce, approve, or endorse the measures represented on this site.

All measures summarized by NQMC and hosted on our site are produced
under the auspices of medical specialty societies, relevant professional
associations, public and private organizations, other government
agencies, health care organizations or plans, individuals, and similar
entities.

Measures represented on the NQMC Web site are submitted by measure
developers, and are screened solely to determine that they meet the NQMC
Inclusion Criteria which may be found at
<http://www.qualitymeasures.ahrq.gov/about/inclusion.aspx>.

NQMC, AHRQ, and its contractor ECRI Institute make no warranties
concerning the content or its reliability and/or validity of the quality
measures and related materials represented on this site. The inclusion
or hosting of measures in NQMC may not be used for advertising or
commercial endorsement purposes.

Readers with questions regarding measure content are directed to contact
the measure developer.

Bottom of Form

© 2008 National Quality Measures Clearinghouse

Date Modified: 11/10/2008