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## Complete Summary

#### TITLE

Diagnosis and treatment of adult degenerative joint disease (DJD)/
Osteoarthritis (OA) of the knee: percentage of patients with DJD with
documented education in four comprehensive areas: protecting the joint,
exercise, pain relief, healthy living habits.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Diagnosis and
treatment of adult degenerative joint disease (DJD)/osteoarthritis (OA)
of the knee. Bloomington (MN): Institute for Clinical Systems
Improvement (ICSI); 2007 Mar. 41 p. \[54 references\]

### 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 patients with
degenerative joint disease (DJD) with documented education in four
comprehensive areas: protecting the joint, exercise, pain relief,
healthy living habits.

#### RATIONALE

The priority aim addressed by this measure is to increase patient
education for patients with degenerative joint disease (DJD).

#### PRIMARY CLINICAL COMPONENT

Degenerative joint disease (DJD); patient education (protecting the
joint, exercise, pain relief, healthy living habits)

#### DENOMINATOR DESCRIPTION

Total number of patients with degenerative joint disease (DJD) whose
medical records are reviewed\*

\*Patients with a diagnosis code of 715.96, 715.16, 715.26, 715.36 who
have not been seen in clinic with the same diagnosis code within the
previous 6 months.

#### NUMERATOR DESCRIPTION

Number of records with documentation\* of patient education about
degenerative joint disease (DJD)

\*Documented is defined as any evidence in the medical record that
patient education materials were provided related to caring for
degenerative joint disease as recommended in the guideline (refer to the
National Guideline Clearinghouse \[NGC\] summary of the Institute for
Clinical Systems Improvement \[ICSI\] guideline [Diagnosis and Treatment
of Adult Degenerative Joint Disease \[DJD\]/Osteoarthritis \[OA\] of the
Knee](http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=11081&string=5844)).

### 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

-   [Diagnosis and treatment of adult degenerative joint disease
    (DJD)/osteoarthritis (OA) of the
    knee.](http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=11081)

### 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

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

The American College of Rheumatology reports that more than 21 million
Americans are affected by osteoarthritis. It is the most common type of
arthritis, which is the leading cause of disability in the United
States. The Centers for Disease Control and Prevention (CDC) estimates
that by the year 2020, sixty million Americans, or almost 20% of the
population, will be affected by some form of arthritis, and nearly 12
million will experience activity limitation.

#### EVIDENCE FOR INCIDENCE/PREVALENCE

Institute for Clinical Systems Improvement (ICSI). Diagnosis and
treatment of adult degenerative joint disease (DJD)/osteoarthritis (OA)
of the knee. Bloomington (MN): Institute for Clinical Systems
Improvement (ICSI); 2007 Mar. 41 p. \[54 references\]

#### ASSOCIATION WITH VULNERABLE POPULATIONS

Unspecified

#### BURDEN OF ILLNESS

See the \"Incidence/Prevalence\" field.

#### UTILIZATION

Unspecified

#### COSTS

Total costs associated with arthritis are estimated by the Centers for
Disease Control and Prevention (CDC) to be almost \$65 billion annually.

#### EVIDENCE FOR COSTS

Institute for Clinical Systems Improvement (ICSI). Diagnosis and
treatment of adult degenerative joint disease (DJD)/osteoarthritis (OA)
of the knee. Bloomington (MN): Institute for Clinical Systems
Improvement (ICSI); 2007 Mar. 41 p. \[54 references\]

### Institute of Medicine National Healthcare Quality Report Categories

#### IOM CARE NEED

Living with Illness

#### IOM DOMAIN

Effectiveness\
Patient-centeredness

### Data Collection for the Measure

#### CASE FINDING

Users of care only

#### DESCRIPTION OF CASE FINDING

Patients 18 years of age and older diagnosed with degenerative joint
disease (DJD)

Data may be collected electronically using the claims/encounter database
or the enrollment database. Medical groups should identify patients with
degenerative joint disease seen at the clinic. Each medical group can
then generate a list of all eligible patients with degenerative joint
disease seen during the target month/quarter. The eligible patients are
those who are 18 years old and older who have been continuously enrolled
in the clinic for the past 6 months. A random sample of 20 charts can be
chosen from this list. The patient medical records will be reviewed for
any evidence that a clinician provided patient education.

A minimum of 20 charts per month can be reviewed.

#### DENOMINATOR SAMPLING FRAME

Patients associated with provider

#### DENOMINATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Total number of patients with degenerative joint disease (DJD) whose
medical records are reviewed\*

\*Patients with a diagnosis code of 715.96, 715.16, 715.26, 715.36 who
have not been seen in clinic with the same diagnosis code within the
previous 6 months.

**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\
Encounter

#### DENOMINATOR TIME WINDOW

Time window precedes index event

#### NUMERATOR INCLUSIONS/EXCLUSIONS

**Inclusions**\
Number of records with documentation\* of patient education about
degenerative joint disease (DJD)

\*Documented is defined as any evidence in the medical record that
patient education materials were provided related to caring for
degenerative joint disease as recommended in the guideline (refer to the
National Guideline Clearinghouse \[NGC\] summary of the Institute for
Clinical Systems Improvement \[ICSI\] guideline [Diagnosis and Treatment
of Adult Degenerative Joint Disease \[DJD\]/Osteoarthritis \[OA\] of the
Knee](http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=11081&string=5844)).

**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

Encounter or point in time

#### 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 patients with degenerative joint disease with documented
education in four comprehensive areas: protecting the joint, exercise,
pain relief, healthy living habits.

#### MEASURE COLLECTION

[Diagnosis and Treatment of Adult Degenerative Joint Disease (DJD) of
the Knee
Measures](http://www.qualitymeasures.ahrq.gov/Browse/DisplayOrganization.aspx?org_id=26&doc=4434)

#### DEVELOPER

Institute for Clinical Systems Improvement

#### ADAPTATION

Measure was not adapted from another source.

#### RELEASE DATE

2003 Nov

#### REVISION DATE

2007 Mar

#### MEASURE STATUS

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems
Improvement (ICSI). Diagnosis and treatment of adult degenerative joint
disease (DJD) of the knee. Bloomington (MN): Institute for Clinical
Systems Improvement (ICSI); 2004 Nov. 43 p.

#### SOURCE(S)

Institute for Clinical Systems Improvement (ICSI). Diagnosis and
treatment of adult degenerative joint disease (DJD)/osteoarthritis (OA)
of the knee. Bloomington (MN): Institute for Clinical Systems
Improvement (ICSI); 2007 Mar. 41 p. \[54 references\]

#### MEASURE AVAILABILITY

The individual measure, \"Percentage of patients with degenerative joint
disease with documented education in four comprehensive areas:
protecting the joint, exercise, pain relief, healthy living habits,\" is
published in \"Health Care Guideline: Diagnosis and Treatment of Adult
Degenerative Joint Disease (DJD)/Osteoarthritis (OA) of the Knee.\" 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 July 19, 2004. This summary
was updated by ECRI Institute on January 13, 2005 and again on September
25, 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
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All other copyright rights in the abstracted ICSI Measures are reserved
by the Institute for Clinical Systems Improvement, Inc. The Institute
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adaptations or revisions or modifications made to the abstracts of the
ICSI Measures.

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© 2008 National Quality Measures Clearinghouse

Date Modified: 11/3/2008