Public Comment on Intraoperative Hypotension QCDR Measure

Cleveland Clinic Anesthesiology Institute is part of a team developing a clinical quality measure for use by anesthesiologists1. The measure aims to evaluate intraoperative hypotension (IOH) and is specified as a Qualified Clinical Data Registry (QCDR) measure.

We invite the public to comment on the draft IOH measure specification, with comments accepted through April 30, 2019. The measure is in the early stages of development and testing, and public comment will help inform the final measure specification.

Instructions

Those wishing to comment on the measure may send their comments to IOHMeasure@mathematica-mpr.com by April 30, 2019. Commenters should provide their name, title, and organizational affiliation, and note whether their comments represent their own views or those of their organization. In addition, please note whether you are interested in further measure progress. All comments are welcome, but we are particularly interested in feedback on the following topics:

  • A mean arterial pressure (MAP) threshold of 65 mmHg is proposed to identify IOH
  • The time that a patient’s MAP should be below 65 mmHg to qualify as having IOH
  • The requirement that blood pressure data be captured automatically from the patient monitor rather than reported manually
  • The denominator population
  • Patients who are excluded from the denominator
  • Using anesthesia start time and anesthesia end time as the measure start and end times, respectively
  • Stratifying measure results by duration of surgery
  • Risk-adjusting the measure by age, body mass index, American Society of Anesthesiologists physical status classification, and gender (note that the risk-adjustment model is currently under development and additional risk-adjustment variables could be considered)

1 Mathematica is the developer of this measure with funding support from Edwards Lifesciences.