Candidate Measure Submission Form (CPCF)

CHIPRA Pediatric Quality Measures Program (PQMP)

The CHIPRA Pediatric Quality Measures Program (PQMP) Candidate Measure Submission Form (CPCF) was approved by the Office of Management and Budget (OMB) in accordance with the Paperwork Reduction Act.  The OMB Control Number is 0935-0205 and the Expiration Date is December 31, 2015.

Section V. Evidence or Other Justification for the Focus of the Measure

The evidence base for the focus of the measures will be made explicit and transparent as part of the public release of CHIPRA deliberations; thus, it is critical for submitters to specify the scientific evidence or other basis for the focus of the measure in the following sections.

V.A. Research Evidence

Research evidence should include a brief description of the evidence base for valid relationship(s) among the structure, process, and/or outcome of health care that is the focus of the measure.  For example, evidence exists for the relationship between immunizing a child or adolescent (process of care) and improved outcomes for the child and the public.  If sufficient evidence existed for the use of immunization registries in practice or at the State level and the provision of immunizations to children and adolescents, such evidence would support the focus of a measure on immunization registries (a structural measure).

Describe the nature of the evidence, including study design, and provide relevant citations for statements made. Evidence may include rigorous systematic reviews of research literature and high-quality research studies.

«Research_Evidence» Character limit: 7500

+ Opportunity to upload attachment.

V.B. Clinical or Other Rationale Supporting the Focus of the Measure (optional)

Provide documentation of the clinical or other rationale for the focus of this measure, including citations as appropriate and available.

«Clinical_Or_Other_Rationale» Character limit: 7500

+ Opportunity to upload attachment.

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Current as of December 2013
Internet Citation: Candidate Measure Submission Form (CPCF): CHIPRA Pediatric Quality Measures Program (PQMP). December 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/policymakers/chipra/cpcf-form5.html