Longitudinal Maternal & Infant Health Information for Research
1.0.0 - STU 1.0.0

Longitudinal Maternal & Infant Health Information for Research, published by HL7 Public Health Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/fhir-mmm-ig/ and changes regularly. See the Directory of published versions

## Library: Library for Pregnancy Associated Maternal Deaths

Official URL: http://fhir.org/guides/cqf/Library/PAMDeaths | Version: 1.0.0
Draft as of 2023-03-29 | Computable Name: PAMDeaths

## Related Artifacts

depends-on | Code system Observation Category | Observation Category Codes
depends-on | Value set Delivery Live Births | Delivery Live Births
depends-on | Value set Delivery Procedure | Delivery - Procedure
depends-on | Value set Pregnancy Procedure Delivery CPT | `http://www.hl7.org/fhir/us/mihr/ValueSet/PregnancyProcedureDelivery-CPT`
depends-on | Value set Procedures During Pregnancy Valueset Group | Procedures During Pregnancy
depends-on | Value set Pregnancy | Pregnancy
depends-on | Value set Complications of Pregnancy, Childbirth and the Puerperium (ICD 9) | Complications of Pregnancy, Childbirth and the Puerperium
depends-on | Value set Complications of Pregnancy, Childbirth and the Puerperium | Complications of Pregnancy, Childbirth and the Puerperium
depends-on | Value set Delivery Diagnosis | Delivery - Diagnosis
depends-on | Value set Non Live Birth CPT Procedures | Non Live Birth CPT Procedures
depends-on | Value set Non Live Birth Diagnoses | Non Live Birth Diagnoses
depends-on | Code system SNOMEDCT | SNOMED CT (all versions)
depends-on | Code system LOINC | Logical Observation Identifiers, Names and Codes (LOINC)
depends-on | FHIR model information | `http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1`
depends-on | Library FHIRHelpers | `http://fhir.org/guides/cqf/Library/FHIRHelpers|4.0.1`
depends-on | Library Global | `http://fhir.org/guides/cqf/Library/MATGlobalCommonFunctionsFHIR4|6.1.000`

## Parameters

Measurement Period | in | 0 | 1 | Period
Patient | out | 0 | 1 | Patient
Delivery Procedure Group | out | 0 | * | Procedure
Pregnancy Group | out | 0 | * | Condition
Non-Live Birth Group | out | 0 | * | Condition
Pregnancy Test Confirms Pregnant | out | 0 | * | Observation
Delivery Diagnosis Group | out | 0 | * | Condition
Procedures During Pregnancy Group | out | 0 | * | Procedure
History of Pregnancy | out | 0 | * | Resource
Patient Deceased within a Year of Pregnancy | out | 0 | 1 | boolean
Initial Population | out | 0 | 1 | boolean
SDE Allergy Intolerance | out | 0 | * | AllergyIntolerance
SDE BMI | out | 0 | * | Observation
SDE Blood Pressure | out | 0 | * | Observation
SDE Height | out | 0 | * | Observation
SDE Body Temperature | out | 0 | * | Observation
SDE Body Weight | out | 0 | * | Observation
SDE Care Plan | out | 0 | * | CarePlan
SDE Care Team | out | 0 | * | CareTeam
SDE Conditions | out | 0 | * | Condition
SDE Compositions | out | 0 | * | Composition
SDE Insurance | out | 0 | * | Coverage
SDE Diagnostic Report | out | 0 | * | DiagnosticReport
SDE Document Reference | out | 0 | * | DocumentReference
SDE Device | out | 0 | * | Device
SDE Encounters | out | 0 | * | Encounter
SDE FamilyMemberHistory | out | 0 | * | FamilyMemberHistory
SDE Goal | out | 0 | * | Goal
SDE Head Circumference | out | 0 | * | Observation
SDE Heart Rate | out | 0 | * | Observation
SDE Immunization | out | 0 | * | Immunization
SDE Lab Observation | out | 0 | * | Observation
SDE Location | out | 0 | * | Location
SDE Medication | out | 0 | * | Medication
SDE Medication Request | out | 0 | * | MedicationRequest
SDE Organization | out | 0 | * | Organization
SDE Patient | out | 0 | * | Patient
SDE Pediatric BMI | out | 0 | * | Observation
SDE Occipital Frontal Head Circumference | out | 0 | * | Observation
SDE Pediatric Weight for Height | out | 0 | * | Observation
SDE Practitioner | out | 0 | * | Practitioner
SDE Practitioner Role | out | 0 | * | PractitionerRole
SDE Procedure | out | 0 | * | Procedure
SDE Provenance | out | 0 | * | Provenance
SDE Oximetry | out | 0 | * | Observation
SDE Related Person | out | 0 | * | RelatedPerson
SDE Respiratory Rate | out | 0 | * | Observation
SDE Smoking Status | out | 0 | * | Observation
SDE Vital Signs | out | 0 | * | Observation

## Data Requirements

Type: Patient (Patient)

Type: Procedure (Procedure)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1015

Type: Procedure (Procedure)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1078.5

Type: Procedure (Procedure)
Filter | Value
code | In ValueSet http://www.hl7.org/fhir/us/mihr/ValueSet/PregnancyProcedureDelivery-CPT

Type: Procedure (Procedure)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1009

Type: Procedure (Procedure)

Type: Condition (Condition)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378

Type: Condition (Condition)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1012

Type: Condition (Condition)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.11.1021

Type: Condition (Condition)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1166.127

Type: Condition (Condition)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1166.137

Type: Condition (Condition)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.278

Type: Condition (Condition)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1015

Type: Condition (Condition)
Filter | Value
code | In ValueSet http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1078.5

Type: Condition (Condition)
Filter | Value
code | In ValueSet http://www.hl7.org/fhir/us/mihr/ValueSet/PregnancyProcedureDelivery-CPT

Type: Condition (Condition)

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 82810-3: Pregnancy Status

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 11449-6: Pregnancy status - Reported

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 39156-5: Body mass index (BMI) [Ratio]

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 85354-9: Blood pressure panel with all children optional

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 8302-2: Body height

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 8310-5: Body temperature

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 29463-7: Body weight

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 9843-4: Head Occipital-frontal circumference

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 8867-4: Heart rate

Type: Observation (Observation)
Filter | Value
code | One of these codes: Observation Category Codes laboratory: Laboratory

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 59576-9: Body mass index (BMI) [Percentile] Per age and sex

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 8289-1: Head Occipital-frontal circumference Percentile

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 77606-2: Weight-for-length Per age and sex

Type: Observation (Observation)
Filter | Value
code | One of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 9279-1: Respiratory rate

Type: Observation (Observation)

Type: AllergyIntolerance (AllergyIntolerance)

Type: CarePlan (CarePlan)

Type: CareTeam (CareTeam)

Type: Composition (Composition)

Type: Coverage (Coverage)

Type: DiagnosticReport (DiagnosticReport)

Type: DocumentReference (DocumentReference)

Type: Device (Device)

Type: Encounter (Encounter)

Type: FamilyMemberHistory (FamilyMemberHistory)

Type: Goal (Goal)

Type: Immunization (Immunization)

Type: Location (Location)

Type: Medication (Medication)

Type: MedicationRequest (MedicationRequest)

Type: Organization (Organization)

Type: Practitioner (Practitioner)

Type: PractitionerRole (PractitionerRole)

Type: Provenance (Provenance)

Type: RelatedPerson (RelatedPerson)

## Contents

`text/cql`

    library PAMDeaths version '0.0.01'

    using FHIR version '4.0.1'

    include FHIRHelpers version '4.0.1' called FHIRHelpers
    include MATGlobalCommonFunctionsFHIR4 version '6.1.000' called Global

    codesystem "SNOMEDCT": 'http://snomed.info/sct'
    codesystem "LOINC": 'http://loinc.org'
    codesystem "Observation Category": 'http://terminology.hl7.org/CodeSystem/observation-category'

    //Delivery Procedure Group
    valueset "Delivery Live Births": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1015'
    valueset "Delivery Procedure": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1078.5'
    valueset "Pregnancy Procedure Delivery CPT": 'http://www.hl7.org/fhir/us/mihr/ValueSet/PregnancyProcedureDelivery-CPT'

    //Procedures During Pregnancy Group
    valueset "Procedures During Pregnancy Valueset Group": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1009'

    //Pregnancy Group
    valueset "Pregnancy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378'
    valueset "Complications of Pregnancy, Childbirth and the Puerperium (ICD 9)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.11.1021'
    valueset "Complications of Pregnancy, Childbirth and the Puerperium": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.12.1012'

    //Pregnancy Delivery Diagnosis
    valueset "Delivery Diagnosis": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.278'

    //Non-Live Birth (Fetal Death/Abortion)
    valueset "Non Live Birth CPT Procedures": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1166.127'
    valueset "Non Live Birth Diagnoses": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1166.137'

    code "Pregnant (finding)": '77386006' from "SNOMEDCT" display 'Pregnant (finding)'
    code "Pregnancy Status":  '82810-3' from "LOINC" display 'Pregnancy Status'
    code "Pregnancy Status Reported": '11449-6' from "LOINC" display 'Pregnancy status - Reported'

    //Supplemental Data Element Codes
    code "BMI": '39156-5' from "LOINC"
    code "Blood Pressure": '85354-9' from "LOINC"
    code "Height": '8302-2' from "LOINC"
    code "Body Temperature": '8310-5' from "LOINC"
    code "Weight": '29463-7' from "LOINC"
    code "Head Circumference": '9843-4' from "LOINC"
    code "Heart Rate": '8867-4' from "LOINC"
    code "Laboratory": 'laboratory' from "Observation Category"
    code "Pediatric BMI": '59576-9' from "LOINC"
    code "Frontal Head Circumference": '8289-1' from "LOINC"
    code "Pediatric Weight": '77606-2' from "LOINC"
    code "Pulse Oximetry": '2708-6' from "LOINC"
    code "Oxygen Saturation": '59408-5' from "LOINC"
    code "Respiratory Rate": '9279-1' from "LOINC"
    code "Social History": 'social-history' from "Observation Category"
    code "Vital Signs": 'vital-signs' from "Observation Category"

    parameter "Measurement Period" Interval<DateTime>

    context Patient

    define "Initial Population":
    	"Patient Deceased within a Year of Pregnancy"

    define "History of Pregnancy":
    	"Delivery Procedure Group"
    	union "Pregnancy Group"
    	union "Non-Live Birth Group"
    	union "Pregnancy Test Confirms Pregnant"
    	union "Delivery Diagnosis Group"
    	union "Procedures During Pregnancy Group"

    define "Patient Deceased within a Year of Pregnancy":
    	exists("History of Pregnancy" Pregnancy)
        and (exists ("Pregnancy Group" PregnancyDx
                where Patient.deceased as FHIR.dateTime occurs 645 days or less after start of Global."Normalize Interval"(PregnancyDx.onset))
    		or exists(("Delivery Diagnosis Group"
    			union "Non-Live Birth Group" ) DeliveryCondition
    			where Patient.deceased as FHIR.dateTime occurs 365 days or less after end of Global."Normalize Interval"(DeliveryCondition.onset))
    		or exists("Pregnancy Test Confirms Pregnant" PregnancyConfirmedTest
    			where Patient.deceased as FHIR.dateTime occurs 645 days or less on or after start of Global."Normalize Interval"(PregnancyConfirmedTest.effective))
    		or exists(("Delivery Procedure Group"
    			union "Procedures During Pregnancy Group") DeliveryProcedure
    			where (Patient.deceased) as FHIR.dateTime occurs 365 days or less after end of Global."Normalize Interval"(DeliveryProcedure.performed))
    	)

    define "Delivery Procedure Group":
    	[Procedure: "Delivery Live Births"]
    	union [Procedure: "Delivery Procedure"]
    	union [Procedure: "Pregnancy Procedure Delivery CPT"]

    define "Procedures During Pregnancy Group":
    	[Procedure: "Procedures During Pregnancy Valueset Group"]

    define "Pregnancy Group":
    	[Condition: "Pregnancy"]
    	union [Condition: "Complications of Pregnancy, Childbirth and the Puerperium"]
    	union [Condition: "Complications of Pregnancy, Childbirth and the Puerperium (ICD 9)"]

    define "Delivery Diagnosis Group":
    	[Condition: "Delivery Diagnosis"]
    	union [Condition: "Delivery Live Births"]
    	union [Condition: "Delivery Procedure"]
    	union [Condition: "Pregnancy Procedure Delivery CPT"]

    define "Non-Live Birth Group":
    	[Condition: "Non Live Birth CPT Procedures"]
    	union [Condition: "Non Live Birth Diagnoses"]

    define "Pregnancy Test Confirms Pregnant":
        ([Observation: "Pregnancy Status"]
    	union [Observation: "Pregnancy Status Reported"]) PregnancyConfirmedTest
    		where PregnancyConfirmedTest.value ~ "Pregnant (finding)"

    //Supplemental Data Elements
    define "SDE Allergy Intolerance":
    	[AllergyIntolerance] Allergy

    define "SDE BMI":
    	[Observation: code ~ "BMI"] BMI

    define "SDE Blood Pressure":
    	[Observation: code ~ "Blood Pressure"] BP

    define "SDE Height":
    	[Observation: code ~ "Height"] Height

    define "SDE Body Temperature":
    	[Observation: code ~ "Body Temperature"] BodyTemperature

    define "SDE Body Weight":
    	[Observation: code ~ "Weight"] Weight

    define "SDE Care Plan":
    	[CarePlan] CarePlans

    define "SDE Care Team":
    	[CareTeam] CareTeams

    define "SDE Conditions":
    	[Condition] Conditions

    define "SDE Compositions":
    	[Composition] Compositions

    define "SDE Insurance":
    	[Coverage] Coverages

    define "SDE Diagnostic Report":
    	[DiagnosticReport] DiagnosticReports

    define "SDE Document Reference":
    	[DocumentReference] DocumentReference

    define "SDE Device":
    	[Device] Devices

    define "SDE Encounters":
    	[Encounter] Encounters

    define "SDE FamilyMemberHistory":
    	[FamilyMemberHistory] FamilyMemberHistory

    define "SDE Goal":
    	[Goal] Goals

    define "SDE Head Circumference":
    	[Observation: code ~ "Head Circumference"] HeadCircumference

    define "SDE Heart Rate":
    	[Observation: code ~ "Heart Rate"] HeartRate

    define "SDE Immunization":
    	[Immunization] Immunizations

    define "SDE Lab Observation":
    	[Observation: code ~ "Laboratory"] LabObservations

    define "SDE Location":
    	[Location] Locations

    define "SDE Medication":
    	[Medication] Medications

    define "SDE Medication Request":
    	[MedicationRequest] MedicationRequests

    define "SDE Organization":
    	[Organization] Organizations

    define "SDE Patient":
    	[Patient] Patients

    define "SDE Pediatric BMI":
    	[Observation: code ~ "Pediatric BMI"] PediatricBMI

    define "SDE Occipital Frontal Head Circumference":
    	[Observation: code ~ "Frontal Head Circumference"] FrontalHead

    define "SDE Pediatric Weight for Height":
    	[Observation: code ~ "Pediatric Weight"] PediatricWeight

    define "SDE Practitioner":
    	[Practitioner] Practitioners

    define "SDE Practitioner Role":
    	[PractitionerRole] PractitionerRoles

    define "SDE Procedure":
    	[Procedure] Procedures

    define "SDE Provenance":
    	[Provenance] Provenances

    define "SDE Oximetry":
    	[Observation] Oximetry
    	where (Oximetry.code ~ "Pulse Oximetry"
    	or Oximetry.code ~ "Oxygen Saturation")

    define "SDE Related Person":
    	[RelatedPerson] RelatedPersons

    define "SDE Respiratory Rate":
    	[Observation: code ~ "Respiratory Rate"] RespiratoryRate

    define "SDE Smoking Status":
        [Observation] SmokingStatus
    	with SmokingStatus.category category
    	such that category ~ "Social History"

    define "SDE Vital Signs":
    	[Observation] VitalSigns
    	with VitalSigns.category category
    	such that category ~ "Vital Signs"

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