Table : Additional Decisions Decision Category Concept Rationale Familial The USPSTF recommendation does not include individuals who have familial Verify completeness Hypercholesterolemia hypercholesterolemia, since they may be more likely to require statin use. added as an Exclusion LDL-C lab result > 190 The USPSTF recommendation does not apply to individuals with an LDL-C > 190 mg/dL, Verify completeness mg/dL as an since they may be more likely to require statin use. Exclusion Diagnosis of Active Statins are not indicated for pregnant women (per Cholesterol Management Work Group Verify completeness Pregnancy as an recommendation based on their medical expertise). Exclusion Statins are not indicated for pregnant women (per Cholesterol Management Work Group Pregnancy Observation recommendation based on their medical expertise). Since EHRs can capture pregnancy as Verify completeness as an Exclusion a diagnosis or an observation, this concept was added to exclusion logic during early pilot testing. Diagnosis: Statins are not indicated for women who are breastfeeding (per Cholesterol Management Verify completeness Breastfeeding added as Work Group recommendation based on their medical expertise) an Exclusion Diagnosis of End Stage Statins are not indicated for individuals who are diagnosed with ESRD (per Cholesterol Verify completeness Renal Disease (ESRD) Management Work Group recommendation based on their medical expertise). Aligns with added as an Exclusion ACC/AHA thoughts on contraindications for statin use. Statins are not indicated for individuals who are diagnosed with ESRD (per Cholesterol Actively undergoing Management Work Group recommendation based on their medical expertise), and active Verify completeness dialysis as an dialysis is an indication of ESRD. Active is evaluated by having a dialysis treatment within Exclusion the past 7 days. Statins are not indicated for individuals with severe liver disease represented by Diagnosis: Diagnosis of Active Active Cirrhosis (per Cholesterol Work Group recommendation based on their medical Verify completeness Cirrhosis as an expertise). Per the work group, not all liver conditions clearly exclude a recommendation for Exclusion statin therapy (e.g., Hepatitis B and C).
Table : Additional Decisions Decision Category Concept Rationale Verify completeness Familial Hypercholesterolemia added as an Exclusion The USPSTF recommendation does not include individuals who have familial hypercholesterolemia, since they may be more likely to require statin use. Verify completeness LDL-C lab result > 190 mg/dL as an Exclusion The USPSTF recommendation does not apply to individuals with an LDL-C > 190 mg/dL, since they may be more likely to require statin use. Verify completeness Diagnosis of Active Pregnancy as an Exclusion Statins are not indicated for pregnant women (per Cholesterol Management Work Group recommendation based on their medical expertise). Verify completeness Pregnancy Observation as an Exclusion Statins are not indicated for pregnant women (per Cholesterol Management Work Group recommendation based on their medical expertise). Since EHRs can capture pregnancy as a diagnosis or an observation, this concept was added to exclusion logic during early pilot testing. Verify completeness Diagnosis: Breastfeeding added as an Exclusion Statins are not indicated for women who are breastfeeding (per Cholesterol Management Work Group recommendation based on their medical expertise) Verify completeness Diagnosis of End Stage Renal Disease (ESRD) added as an Exclusion Statins are not indicated for individuals who are diagnosed with ESRD (per Cholesterol Management Work Group recommendation based on their medical expertise). Aligns with ACC/AHA thoughts on contraindications for statin use. Verify completeness Actively undergoing dialysis as an Exclusion Statins are not indicated for individuals who are diagnosed with ESRD (per Cholesterol Management Work Group recommendation based on their medical expertise), and active dialysis is an indication of ESRD. Active is evaluated by having a dialysis treatment within the past 7 days. Verify completeness Diagnosis of Active Cirrhosis as an Exclusion Statins are not indicated for individuals with severe liver disease represented by Diagnosis: Active Cirrhosis (per Cholesterol Work Group recommendation based on their medical expertise). Per the work group, not all liver conditions clearly exclude a recommendation for statin therapy (e.g., Hepatitis B and C).