While aligning the CQL implementations of quality indicators for the benchmarking use case, we had a closer look at the Central venous catheter (291) concept set in the context of the Infection Rate quality indicator. A clinician from our team noted that the semantics of the concept set are unclear since it mixes devices and procedures and within procedures insertions, removals and replacements.
In our use case, the goal is to determine the presence of a CVT for certain time periods which is rather complicated and ambiguous to do with the current concepts. For this reason, we suggest representing the presence of a CVT via the Device domain rather than tracking CVT insertion, removal and replacement procedures. Concretely, we suggest removing the following concepts:
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Central venous cannula insertion via antecubital fossa vein (4051309)
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Central venous cannula insertion via axillary vein (4050424)
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Central venous cannula insertion via external jugular vein (4052414)
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Central venous cannula insertion via jugular vein (4116186)
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Central venous cannula insertion via long saphenous vein (4052528)
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Central venous cannula insertion via umbilical vein (4051310)
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Insertion of catheter for central venous pressure monitoring (4322479)
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Insertion of subclavian feeding line (4022465)
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Fluoroscopy guided removal of transhepatic central venous catheter with contrast (37111536)
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Fluoroscopy guided removal of tunneled central venous catheter with contrast (4330629)
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Fluoroscopy guided removal of tunneled central venous catheter with subcutaneous port with contrast (42535571)
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Removal of central venous catheter using fluoroscopic guidance with contrast (4328021)
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Removal of peripherally inserted central catheter (4313470)
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Removal of peripherally inserted central catheter using fluoroscopic guidance with contrast (4206836)
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Removal of tunneled central venous catheter (42873079)
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Fluoroscopy guided replacement of central venous catheter with contrast (4328008)
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Fluoroscopy guided replacement of peripherally inserted central catheter with contrast (4230578)
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Replacement of nontunneled centrally inserted central venous catheter (4259685)
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Replacement of peripherally inserted central venous catheter (4234472)
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Replacement of tunneled central venous catheter using fluoroscopic guidance with contrast (4329512)
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Replacement of tunneled centrally inserted central venous catheter (4234457)
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Replacement of tunneled centrally inserted central venous catheter with subcutaneous pump (4259686)
Finally, our colleague remarked that Umbilical venous catheter (37167492) could potentially be removed since INDICATE is only concerned with adult patients.
While aligning the CQL implementations of quality indicators for the benchmarking use case, we had a closer look at the Central venous catheter (291) concept set in the context of the Infection Rate quality indicator. A clinician from our team noted that the semantics of the concept set are unclear since it mixes devices and procedures and within procedures insertions, removals and replacements.
In our use case, the goal is to determine the presence of a CVT for certain time periods which is rather complicated and ambiguous to do with the current concepts. For this reason, we suggest representing the presence of a CVT via the Device domain rather than tracking CVT insertion, removal and replacement procedures. Concretely, we suggest removing the following concepts:
Central venous cannula insertion via antecubital fossa vein (4051309)
Central venous cannula insertion via axillary vein (4050424)
Central venous cannula insertion via external jugular vein (4052414)
Central venous cannula insertion via jugular vein (4116186)
Central venous cannula insertion via long saphenous vein (4052528)
Central venous cannula insertion via umbilical vein (4051310)
Insertion of catheter for central venous pressure monitoring (4322479)
Insertion of subclavian feeding line (4022465)
Fluoroscopy guided removal of transhepatic central venous catheter with contrast (37111536)
Fluoroscopy guided removal of tunneled central venous catheter with contrast (4330629)
Fluoroscopy guided removal of tunneled central venous catheter with subcutaneous port with contrast (42535571)
Removal of central venous catheter using fluoroscopic guidance with contrast (4328021)
Removal of peripherally inserted central catheter (4313470)
Removal of peripherally inserted central catheter using fluoroscopic guidance with contrast (4206836)
Removal of tunneled central venous catheter (42873079)
Fluoroscopy guided replacement of central venous catheter with contrast (4328008)
Fluoroscopy guided replacement of peripherally inserted central catheter with contrast (4230578)
Replacement of nontunneled centrally inserted central venous catheter (4259685)
Replacement of peripherally inserted central venous catheter (4234472)
Replacement of tunneled central venous catheter using fluoroscopic guidance with contrast (4329512)
Replacement of tunneled centrally inserted central venous catheter (4234457)
Replacement of tunneled centrally inserted central venous catheter with subcutaneous pump (4259686)
Finally, our colleague remarked that Umbilical venous catheter (37167492) could potentially be removed since INDICATE is only concerned with adult patients.