define "Initial Population":
  "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed
    where AgeInYearsAt(date from start of "Measurement Period") >= 18

define "Denominator":
  "Initial Population"

define "Denominator Exclusions":
  "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed
    with ( [Condition: "Acute and Subacute Iridocyclitis"]
      union [Condition: "Amblyopia"]
      union [Condition: "Burn Confined to Eye and Adnexa"]
      union [Condition: "Cataract Secondary to Ocular Disorders"]
      union [Condition: "Cataract Congenital"]
      union [Condition: "Cataract Mature or Hypermature"]
      union [Condition: "Cataract Posterior Polar"]
      union [Condition: "Central Corneal Ulcer"]
      union [Condition: "Certain Types of Iridocyclitis"]
      union [Condition: "Choroidal Degenerations"]
      union [Condition: "Choroidal Detachment"]
      union [Condition: "Choroidal Hemorrhage and Rupture"]
      union [Condition: "Chronic Iridocyclitis"]
      union [Condition: "Cloudy Cornea"]
      union [Condition: "Corneal Edema"]
      union [Condition: "Disorders of Cornea Including Corneal Opacity"]
      union [Condition: "Degeneration of Macula and Posterior Pole"]
      union [Condition: "Degenerative Disorders of Globe"]
      union [Condition: "Diabetic Macular Edema"]
      union [Condition: "Diabetic Retinopathy"]
      union [Condition: "Disorders of Optic Chiasm"]
      union [Condition: "Disorders of Visual Cortex"]
      union [Condition: "Disseminated Chorioretinitis and Disseminated Retinochoroiditis"]
      union [Condition: "Focal Chorioretinitis and Focal Retinochoroiditis"]
      union [Condition: "Glaucoma"]
      union [Condition: "Glaucoma Associated with Congenital Anomalies and Dystrophies and Systemic Syndromes"]
      union [Condition: "Hereditary Choroidal Dystrophies"]
      union [Condition: "Hereditary Corneal Dystrophies"]
      union [Condition: "Hereditary Retinal Dystrophies"]
      union [Condition: "Hypotony of Eye"]
      union [Condition: "Injury to Optic Nerve and Pathways"]
      union [Condition: "Macular Scar of Posterior Polar"]
      union [Condition: "Morgagnian Cataract"]
      union [Condition: "Nystagmus and Other Irregular Eye Movements"]
      union [Condition: "Open Wound of Eyeball"]
      union [Condition: "Optic Atrophy"]
      union [Condition: "Optic Neuritis"]
      union [Condition: "Other and Unspecified Forms of Chorioretinitis and Retinochoroiditis"]
      union [Condition: "Other Background Retinopathy and Retinal Vascular Changes"]
      union [Condition: "Other Disorders of Optic Nerve"]
      union [Condition: "Other Endophthalmitis"]
      union [Condition: "Other Proliferative Retinopathy"]
      union [Condition: "Pathologic Myopia"]
      union [Condition: "Posterior Lenticonus"]
      union [Condition: "Prior Penetrating Keratoplasty"]
      union [Condition: "Purulent Endophthalmitis"]
      union [Condition: "Retinal Detachment with Retinal Defect"]
      union [Condition: "Retinal Vascular Occlusion"]
      union [Condition: "Retrolental Fibroplasias"]
      union [Condition: "Scleritis"]
      union [Condition: "Separation of Retinal Layers"]
      union [Condition: "Traumatic Cataract"]
      union [Condition: "Uveitis"]
      union [Condition: "Vascular Disorders of Iris and Ciliary Body"]
      union [Condition: "Visual Field Defects"] ) ComorbidDiagnosis
      such that ComorbidDiagnosis.prevalenceInterval ( ) overlaps before CataractSurgeryPerformed.performed.toInterval ( )
        and ComorbidDiagnosis.isActive ( )

define "Numerator":
  "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed
    with ( [Observation: "Best corrected visual acuity (observable entity)"]
      union [Observation: "Best Corrected Visual Acuity Exam Using Snellen Chart"] ) VisualAcuityExamPerformed
      such that VisualAcuityExamPerformed.effective.toInterval ( ) 90 days or less after day of end of CataractSurgeryPerformed.performed.toInterval ( )
        and VisualAcuityExamPerformed.status in { 'final', 'amended', 'corrected', 'preliminary' }
        and VisualAcuityExamPerformed.value as Concept in "Visual Acuity 20/40 or Better"

define "SDE Sex":
  case
      when Patient.gender = 'male' then "M"
      when Patient.gender = 'female' then "F"
      else null
    end

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

define "Cataract Surgery Between January and September of Measurement Period":
  [Procedure: "Cataract Surgery"] CataractSurgery
    where CataractSurgery.performed.toInterval ( ) during "Measurement Period"
      and CataractSurgery.performed.toInterval ( ) starts 92 days or more before end of "Measurement Period"
      and CataractSurgery.status = 'completed'

define "Numerator":
  "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed
    with ( [Observation: "Best corrected visual acuity (observable entity)"]
      union [Observation: "Best Corrected Visual Acuity Exam Using Snellen Chart"] ) VisualAcuityExamPerformed
      such that VisualAcuityExamPerformed.effective.toInterval ( ) 90 days or less after day of end of CataractSurgeryPerformed.performed.toInterval ( )
        and VisualAcuityExamPerformed.status in { 'final', 'amended', 'corrected', 'preliminary' }
        and VisualAcuityExamPerformed.value as Concept in "Visual Acuity 20/40 or Better"

define "Initial Population":
  "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed
    where AgeInYearsAt(date from start of "Measurement Period") >= 18

define "Denominator":
  "Initial Population"

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

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

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

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

define "Denominator Exclusions":
  "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed
    with ( [Condition: "Acute and Subacute Iridocyclitis"]
      union [Condition: "Amblyopia"]
      union [Condition: "Burn Confined to Eye and Adnexa"]
      union [Condition: "Cataract Secondary to Ocular Disorders"]
      union [Condition: "Cataract Congenital"]
      union [Condition: "Cataract Mature or Hypermature"]
      union [Condition: "Cataract Posterior Polar"]
      union [Condition: "Central Corneal Ulcer"]
      union [Condition: "Certain Types of Iridocyclitis"]
      union [Condition: "Choroidal Degenerations"]
      union [Condition: "Choroidal Detachment"]
      union [Condition: "Choroidal Hemorrhage and Rupture"]
      union [Condition: "Chronic Iridocyclitis"]
      union [Condition: "Cloudy Cornea"]
      union [Condition: "Corneal Edema"]
      union [Condition: "Disorders of Cornea Including Corneal Opacity"]
      union [Condition: "Degeneration of Macula and Posterior Pole"]
      union [Condition: "Degenerative Disorders of Globe"]
      union [Condition: "Diabetic Macular Edema"]
      union [Condition: "Diabetic Retinopathy"]
      union [Condition: "Disorders of Optic Chiasm"]
      union [Condition: "Disorders of Visual Cortex"]
      union [Condition: "Disseminated Chorioretinitis and Disseminated Retinochoroiditis"]
      union [Condition: "Focal Chorioretinitis and Focal Retinochoroiditis"]
      union [Condition: "Glaucoma"]
      union [Condition: "Glaucoma Associated with Congenital Anomalies and Dystrophies and Systemic Syndromes"]
      union [Condition: "Hereditary Choroidal Dystrophies"]
      union [Condition: "Hereditary Corneal Dystrophies"]
      union [Condition: "Hereditary Retinal Dystrophies"]
      union [Condition: "Hypotony of Eye"]
      union [Condition: "Injury to Optic Nerve and Pathways"]
      union [Condition: "Macular Scar of Posterior Polar"]
      union [Condition: "Morgagnian Cataract"]
      union [Condition: "Nystagmus and Other Irregular Eye Movements"]
      union [Condition: "Open Wound of Eyeball"]
      union [Condition: "Optic Atrophy"]
      union [Condition: "Optic Neuritis"]
      union [Condition: "Other and Unspecified Forms of Chorioretinitis and Retinochoroiditis"]
      union [Condition: "Other Background Retinopathy and Retinal Vascular Changes"]
      union [Condition: "Other Disorders of Optic Nerve"]
      union [Condition: "Other Endophthalmitis"]
      union [Condition: "Other Proliferative Retinopathy"]
      union [Condition: "Pathologic Myopia"]
      union [Condition: "Posterior Lenticonus"]
      union [Condition: "Prior Penetrating Keratoplasty"]
      union [Condition: "Purulent Endophthalmitis"]
      union [Condition: "Retinal Detachment with Retinal Defect"]
      union [Condition: "Retinal Vascular Occlusion"]
      union [Condition: "Retrolental Fibroplasias"]
      union [Condition: "Scleritis"]
      union [Condition: "Separation of Retinal Layers"]
      union [Condition: "Traumatic Cataract"]
      union [Condition: "Uveitis"]
      union [Condition: "Vascular Disorders of Iris and Ciliary Body"]
      union [Condition: "Visual Field Defects"] ) ComorbidDiagnosis
      such that ComorbidDiagnosis.prevalenceInterval ( ) overlaps before CataractSurgeryPerformed.performed.toInterval ( )
        and ComorbidDiagnosis.isActive ( )

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

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

/*
@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.
Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>>):
  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)
		else
			null as Interval<DateTime>
	end

define function ToString(value uri): value.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
        }

/*
@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, the resulting interval will have
a closed ending boundary. If the condition is not active, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Condition):
if condition.clinicalStatus ~ "active"
  or condition.clinicalStatus ~ "recurrence"
  or condition.clinicalStatus ~ "relapse" then
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval())

/* Candidates for FHIRCommon */

/*
@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse
*/
define fluent function isActive(condition Condition):
  condition.clinicalStatus ~ "active"
    or condition.clinicalStatus ~ "recurrence"
    or condition.clinicalStatus ~ "relapse"