16, 2013 2013 ACCF/AHA Heart Failure Guidelines: Executive Summary October 15, 2013:1495 539 insuf ciency, diabetes mellitus, or chronic lung disease with the HF syndrome should logically require a modi cation of treatment, outcome assessment, or follow-up care. About 25% of Americans have multiple chronic conditions; this gure rises to 75% in those >65 years of age, including the diseases referred to above, as well as asthma, hypertension, cognitive disorders, or depression (347). Most randomized controlled trials in HF speci cally excluded patients with signi cant Table 26. ACCF/AHA/AMA-PCPI 2011 HF Measurement Set Measure Description* Care Setting Level of Measurement 1. LVEF assessment Percentage of patients aged 18 y with a diagnosis of HF for whom the quantitative or qualitative results of a recent or prior (any time in the past) LVEF assessment is documented within a 12-mo period Outpatient Individual practitioner 2. LVEF assessment Percentage of patients aged 18 y with a principal discharge diagnosis of HF with documentation in the hospital record of the results of an LVEF assessment performed either before arrival or during hospitalization, OR documentation in the hospital record that LVEF assessment is planned for after discharge Inpatient  Individual practitioner  Facility 3. Symptom and activity assessment Percentage of patient visits for patients aged 18 y with a diagnosis of HF with quantitative results of an evaluation of both current level of activity and clinical symptoms documented Outpatient Individual practitioner 4. 