define "Initial Population":
  "Has Qualifying Encounter"
    and exists "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period"

define "Initial Population":
  "Has Qualifying Encounter"
    and exists "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period"

define "Denominator":
  "Initial Population"

define "Numerator":
  "Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT"

define "Denominator Exception":
  exists ( "No Bone Density Scan Ordered Due to Patient Refusal" )
    or exists ( "No Bone Density Scan Performed Due to Patient Refusal" )

define "SDE Sex":
  case
    when Patient.sex = '248153007' then "Male (finding)"
    when Patient.sex = '248152002' then "Female (finding)"
    else null
  end

define "SDE Payer":
  [Coverage: type in "Payer Type"] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }

define "SDE Ethnicity":
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }

define "SDE Race":
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }

/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):
  case
	  when choice is DateTime then
    	Interval[choice as DateTime, choice as DateTime]
		when choice is Interval<DateTime> then
  		choice as Interval<DateTime>
		when choice is Quantity then
		  Interval[Patient.birthDate + (choice as Quantity),
			  Patient.birthDate + (choice as Quantity) + 1 year)
		when choice is Interval<Quantity> then
		  Interval[Patient.birthDate + (choice.low as Quantity),
			  Patient.birthDate + (choice.high as Quantity) + 1 year)
		when choice is Timing then
      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>
		else
			null as Interval<DateTime>
	end

/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Choice<"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns">):
if condition.clinicalStatus ~ "active"
  or condition.clinicalStatus ~ "recurrence"
  or condition.clinicalStatus ~ "relapse" then
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
    (end of condition.abatementInterval()) abatementDate
    return if abatementDate is null then
      Interval[start of condition.onset.toInterval(), abatementDate)
    else
      Interval[start of condition.onset.toInterval(), abatementDate]

/*
@description: Returns an interval representing the normalized abatement of a given Condition.
@comment: If the abatement element of the Condition is represented as a DateTime, the result
is an interval beginning and ending on that DateTime.
If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The
result is an interval from the date the patient turned that age to immediately before one year later.
If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
before one year later than the date the patient turned the ending age of the quantity interval.
*/
define fluent function abatementInterval(condition Choice<"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns">):
	if condition.abatement is DateTime then
	  Interval[condition.abatement as DateTime, condition.abatement as DateTime]
	else if condition.abatement is Quantity then
		Interval[Patient.birthDate + (condition.abatement as Quantity),
			Patient.birthDate + (condition.abatement as Quantity) + 1 year)
	else if condition.abatement is Interval<Quantity> then
	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
	else if condition.abatement is Interval<DateTime> then
	  Interval[condition.abatement.low, condition.abatement.high)
	else null as Interval<DateTime>

define "SDE Sex":
  SDE."SDE Sex"

define "Androgen Deprivation Therapy for Urology Care Medication Active Start Dates":
  [MedicationRequest: "Androgen Deprivation Therapy for Urology Care"] ADTActive
    let firstMedicationPeriod: First((collapse(ADTActive.dosageInstruction.timing.repeat.bounds DoseTime
          return DoseTime.toInterval()
      )) DrugPeriods
        sort by start of $this
    ),

    //get the very first event as interval
    
    firstMedicationEvent: First((ADTActive.dosageInstruction.timing dosageTiming
        //returns first event for the specific dosageTiming
        
        return First(dosageTiming.event dosageTimingEvents
            sort ascending
        )) firstEvents
        sort ascending
    ),
    medicationDateTime: Min({ firstMedicationEvent, start of firstMedicationPeriod, 
      end of firstMedicationPeriod }
    )
    where ADTActive.status in { 'active', 'completed' }
      and ADTActive.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
    return medicationDateTime

define "Androgen Deprivation Therapy for Urology Care Medication Order Start Dates":
  [MedicationRequest: "Androgen Deprivation Therapy for Urology Care"] ADTOrder
    let firstMedicationPeriod: First((collapse(ADTOrder.dosageInstruction.timing.repeat.bounds DoseTime
          return DoseTime.toInterval()
      )) DrugPeriods
        sort by start of $this
    ),
    medicationDateTime: Min({ ADTOrder.authoredOn, start of firstMedicationPeriod, 
      end of firstMedicationPeriod }
    )
    where ADTOrder.status in { 'active', 'completed' }
      and ADTOrder.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
    return medicationDateTime

define "Prostate Cancer Diagnosis":
  ( [ConditionProblemsHealthConcerns: "Prostate Cancer"]
    union [ConditionEncounterDiagnosis: "Prostate Cancer"] ) ProstateCancer
    where ProstateCancer.prevalenceInterval ( ) overlaps day of "Measurement Period"
      and ProstateCancer.isVerified ( )

define "First ADT in 3 Months Before to 9 Months After Start of Measurement Period":
  First(("Androgen Deprivation Therapy for Urology Care Medication Active Start Dates"
      union "Androgen Deprivation Therapy for Urology Care Medication Order Start Dates") ADTDateTime
      with "Prostate Cancer Diagnosis" ProstateCancer
        such that ADTDateTime during day of ProstateCancer.prevalenceInterval()
          and ADTDateTime during day of Interval[start of "Measurement Period" - 3 months, start of "Measurement Period" + 9 months]
      sort ascending
  )

define "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period":
  [ServiceRequest: "Injection of leuprolide acetate for twelve month period (regime/therapy)"] OrderTwelveMonthADT
    with "First ADT in 3 Months Before to 9 Months After Start of Measurement Period" FirstADTMP
      such that OrderTwelveMonthADT.authoredOn on or after day of FirstADTMP
        and OrderTwelveMonthADT.authoredOn during day of Interval[start of "Measurement Period" - 3 months, start of "Measurement Period" + 9 months]
        and OrderTwelveMonthADT.status in { 'active', 'completed' }
        and OrderTwelveMonthADT.intent = 'order'

define "Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT":
  exists ( ( [ServiceRequest: "DEXA Bone Density for Urology Care"] DEXAOrdered
        with "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period" OrderTwelveMonthsADT
          such that DEXAOrdered.authoredOn 3 months or less on or after day of OrderTwelveMonthsADT.authoredOn
            or DEXAOrdered.authoredOn 2 years or less before day of OrderTwelveMonthsADT.authoredOn
        where DEXAOrdered.status in { 'active', 'completed' }
          and DEXAOrdered.intent = 'order'
    )
      union ( [ObservationClinicalResult: "DEXA Bone Density for Urology Care"] DEXAPerformed
          with "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period" OrderTwelveMonthsADT
            such that DEXAPerformed.effective.toInterval ( ) 3 months or less on or after day of OrderTwelveMonthsADT.authoredOn
              or DEXAPerformed.effective.toInterval ( ) 2 years or less before day of OrderTwelveMonthsADT.authoredOn
          where DEXAPerformed.status in { 'final', 'amended', 'corrected' }
      )
  )

define "Numerator":
  "Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT"

define "No Bone Density Scan Ordered Due to Patient Refusal":
  [ServiceNotRequested: "DEXA Bone Density for Urology Care"] DEXANotOrdered
    with "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period" OrderTwelveMonthsADT
      such that DEXANotOrdered.authoredOn 3 months or less on or after day of OrderTwelveMonthsADT.authoredOn
        and DEXANotOrdered.reasonRefused in "Patient Declined"

define "No Bone Density Scan Performed Due to Patient Refusal":
  [ObservationCancelled: "DEXA Bone Density for Urology Care"] DEXANotPerformed
    with "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period" OrderTwelveMonthsADT
      such that DEXANotPerformed.issued 3 months or less on or after day of OrderTwelveMonthsADT.authoredOn
        and DEXANotPerformed.notDoneReason in "Patient Declined"

define "Denominator Exception":
  exists ( "No Bone Density Scan Ordered Due to Patient Refusal" )
    or exists ( "No Bone Density Scan Performed Due to Patient Refusal" )

define "Has Qualifying Encounter":
  exists ( ["Encounter": "Office Visit"] OfficeVisit
      where OfficeVisit.period during day of "Measurement Period"
        and OfficeVisit.status = 'finished'
  )

define "Initial Population":
  "Has Qualifying Encounter"
    and exists "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period"

define "Denominator":
  "Initial Population"

define "SDE Payer":
  SDE."SDE Payer"

define "Initial Population":
  "Has Qualifying Encounter"
    and exists "Order for 12 Months of ADT in 3 Months Before to 9 Months After Start of Measurement Period"

define "SDE Ethnicity":
  SDE."SDE Ethnicity"

define "SDE Race":
  SDE."SDE Race"

/*      
@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential
*/


define fluent function isVerified(condition Choice<ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns>):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon."confirmed"
      or condition.verificationStatus ~ QICoreCommon."unconfirmed"
      or condition.verificationStatus ~ QICoreCommon."provisional"
      or condition.verificationStatus ~ QICoreCommon."differential"
  )

define function ToString(value uri): value.value

/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]

/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }