Performance Measurement Network

Question: Comprehensive Stroke (CSTK Sub-Populations)

Karen, would you please confirm the measures that apply to each sub-population? From my review it appears that the measures that correspond to the 3 sub-populations are as follows:

CSTK-1: The count of all patients in sub-population 1 – Ischemic Stroke

CSTK-2, CSTK-5 (5a/5b, CSTK-7, CSTK-8: The count of all patients in sub-population 2 - Ischemic Stroke with IV t-PA, IA t-PA or MER

CSTK-3,(3a/3b CSTK-4, CSTK-6: The count of all patients in sub-population 3 – Hemorrhagic Stroke

Appreciate your response.)

Answer:

The measures that the subpopulation applies to is under the quarterly and monthly descriptions on pages 9-11 of the implementation guide and is as follows:

Sub-population 1 - CSTK-01 Measure

Sub-Population 2 - Measures CSTK-01, CSTK-02, CSTK-05, CSTK-07, CSTK-08

Sub-population 3 - Measures CSTK-03, CSTK-04, and CSTK-06

CSTK-01 NIHSS Score Performed for Ischemic Stroke Patients requires a sample from BOTH CSTK-01 sub-population1 and CSTK sub-population 2 (i.e., two individual sample selections to meet the minimum sample requirement for this measure because ischemic stroke w/o procedures is the 60-70% of all cases. The other approx. 25%-30% have a reperfusion procedure. We want to make sure that both sub-groups are adequately represented in the sample selection.

If you had 50 principal diagnoses of ischemic stroke for the month of June and 10 had a reperfusion therapy/procedure, your required sample for CSTK-01 is 10 for sub-population 2 PLUS 14 cases randomly selected from the remaining 40 cases that did not have a procedure (sub-population 1)for a total minimum sample requirement of 34 cases for CSTK-01. Using the same example of 50 principal diagnoses of ischemic stroke for the month of June and 10 ischemic cases with reperfusion procedures, your minimum required sample for CSTK-02, CSTK-05, CSTK-07, CSTK-08 is the 10 cases that had a procedure.

Sampling for CSTK will only benefit those HCOs with a large volume of hemorrhagic cases or large number of ischemic strokes who receive reperfusion therapies. Many HCOs may not meet the minimum required sample size for CSTK sub-population 2 and CSTK sub-population 3 and will need 100% review of cases in these two sub-groups. )

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: CSTK,

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