Outcomes Framework - Inclusion Criteria

Inclusion Criteria represent the selection of Treatment Episodes that you would like to measure. These criteria are used in both metric types to determine whether a particular Treatment Episode should be considered Included. There can be many reasons to include or exclude different patients. For example, you may wish to only include results where the patient started at a certain score or severity, or only include results where the patient completed a baseline measure close to Treatment Episode start.

These Inclusion Criteria apply both for Effectiveness and Efficiency Metrics.

ALL Inclusion Criteria must be met for a patient to be considered included.


Changing Inclusion Criteria

When creating or editing a metric, some Inclusion Criteria are recommended and defaulted in the templates. These can be adjusted or deselected using the checkbox.

  • Shown above, selecting less than 30 days between Treatment Episode start and baseline limits the dataset such that only patients who took a baseline measurement near the start of Treatment Episode are Included. This measures more of the full effect of care and not patients who were measured for the first time months into care.
  • Selecting An initial severity of: Mild, Moderate, Severe excludes results without symptoms, because they are unlikely to see Treatment Episode Response if they are not symptomatic.

You can experiment with these criterion to see how it affects the Included number in the Statistics:

  • See what happens if you unselect the days between Treatment Episode start and baseline, or adjust the number up or down.
  • Compare Mild, Moderate, or Severe default selected in An initial severity of with only one of the severities selected.
  • If you previously selected Last Measurement in the Time Period, try using the days between Treatment Episode start and selected measurement to limit the analysis to include only patients who have been in care long enough to see results.

Whenever you change something, the Statistics will change immediately.

Criteria Defined

Each of the Inclusion Criteria are described in more detail below.

Days Between Treatment Episode Start and Selected Measurement

This criterion helps restrict analysis to measurements within a certain time period.

When selected, a Treatment Episode will be included only if the number of days between Treatment Episode start and the measurement selected for analysis meets the given criteria. For example:

  • Only include measurements that are > 60 days after the start of the Treatment Episode.
  • Only include measurements that are < 30 days after the start of the Treatment Episode.

Note that it measures from Treatment Episode start, not from when the baseline measurement was taken. This is intentional: it is assumed the Treatment Episode has been progressing whether or not measurement has taken place, so the Treatment Episode start date is the appropriate start point for the analysis.

It is most commonly used with Effectiveness Metrics for Last Measurement where you want to ensure that there has been a minimum time in Treatment Episode before results are evaluated.


Days Between Treatment Episode Start and Baseline

This criterion helps restrict analysis to measurements to ensure that a baseline measurement was taken close to the start of Treatment Episode. This is important because if you have a patient who only started filling out measurements three months into the Treatment Episode, their baseline will not be accurate.

When selected, a Treatment Episode will be included only if the number of days between Treatment Episode start and the baseline measurement matches the criteria given. For example:

  • Only include patients where there are < 30 days between treatment episode start and baseline measurement.

It is generally good practice to use this criterion, otherwise you are at risk for including results where the baseline is not adequately set. Mirah’s recommendation is to only keep results where the baseline was done within 30 days of Treatment Episode start.


Patient Gender

When selected, a Treatment Episode will be included only if the patient matches the gender(s) selected. For example:

  • Include patients whose gender is either male or female.
  • Include patients whose gender is not unknown.

Age at Treatment Episode start

When selected, a Treatment Episode will be included only if the patient was at a certain age at the start of Treatment Episode. For example:

  • Include patients who were > 18 years old at Treatment Episode start
  • Include patients who were < 18 years old at Treatment Episode start

This can be used to segment patients into e.g. child, adolescent and adult populations.

In general, this is not commonly used because it is more common to have specific scales for each age bracket that are tailored for that age group. For example the PHQ-9A for adolescents vs the PHQ-9 for adults.


Initial Severity

This criterion is only available for scales that support clinical severity categories.

Initial Severity helps restrict analysis to patients in a certain level of clinical severity. For example, you may wish to exclude patients who were already at remission for a particular symptom from the analysis, as they will be unable to see Treatment Episode response on that dimension.

When selected, a Treatment Episode will be included only if the initial severity of the patient on the scale in question is in the categories given. For example:

  • Only include patients where their baseline score was in ‘Mild’, ‘Moderate’, or ‘Severe’.
  • Only include patients where their baseline score was ‘Severe’.

It is common to use this criterion to exclude patients already in remission from the analysis. Most commonly, these are patients who were in Treatment Episodes for another condition where they may not show a result on this scale.


Patient Race

When selected, a tTreatment Episode will be included only if the patient matches the race(s) selected. For example:

  • A patient’s race is ONE OF: Apache, Chiricahua
  • A patient’s race is NOT ONE OF: Chinese, Japanese