Metadata Title 大腸直腸癌__Trifluridine/tipiracil給付規定 Version 1.0.0 Status Draft Description 此 Library 為轉移性大腸或直腸癌病人申請使用 Trifluridine/tipiracil 之給付檢核條件。 Type logic-library from http://terminology.hl7.org/CodeSystem/library-type Parameters Parameter None Library Content CQL Content //大腸直腸_CRCTrifluridineTipiracil給付規定 library CRCTrifluridineTipiracilRule1 version '1.0.0' using FHIR version '4.0.1' include FHIRHelpers version '4.0.1' called FHIRHelpers include CRCCodeConcept version '1.0.0' called CodeConcept include Reusable version '1.0.0' called Reusable context Patient //============================================ // 申請類型判斷 //============================================ define "初次申請": "申請類型" = '初次使用' define "續用申請": "申請類型" = '續用' define "申請類型未知": "申請類型" = '無法判斷申請類型' define "申請類型": case when Reusable."續用註記為1" then '初次使用' when Reusable."續用註記為2" then '續用' else '無法判斷申請類型' end //============================================ // 主要規定一：初次使用條件 //============================================ /*規則1*/ //條件1-1 //Reusable."ICD-10使用C18、C19、C20、C21" define "ICD代碼檢核_布林值": Reusable."ICD-10使用C18、C19、C20、C21" //條件1-2 define "規則1-1-2=三個月內有影像檢查報告": exists ( [DiagnosticReport] O where exists ( O.code.coding Cdg where ( Cdg in CodeConcept.ICD10PCS2023Image or Cdg in CodeConcept.ICD10PCS2014Image ) and Cdg.code in CodeConcept.ImageReportTumorCode ) and O.effective is not null and FHIRHelpers.ToDateTime(O.effective) >= Today() - 90 days and FHIRHelpers.ToDateTime(O.effective) <= Today() ) //條件1-3 define "規則1-1-3=癌症分期分數或結果為M≠0": Count( [Observation] O where exists ( O.code.coding Cdg where Cdg.code = '399390009' and Cdg in CodeConcept.SNOMED ) and O.value is not null and O.value is FHIR.string and Matches((O.value as FHIR.string).value, '.*M[1-9].*') ) > 0 //條件1-4 define "規則1-1-4=三個月內有檢查報告": exists ( [DiagnosticReport] O2 where exists ( O2.code.coding Cdg where Cdg in CodeConcept.LOINC and Cdg.code = '65755-1' ) and O2.effective is not null and FHIRHelpers.ToDateTime(O2.effective) >= Today() - 90 days and FHIRHelpers.ToDateTime(O2.effective) <= Today() ) //條件1 define "規則1-1=轉移性大腸直腸癌": Reusable."ICD-10使用C18、C19、C20、C21" and "規則1-1-3=癌症分期分數或結果為M≠0" and ("規則1-1-2=三個月內有影像檢查報告" or "規則1-1-4=三個月內有檢查報告") //條件2 define "規則1-2=成人": exists ( [Claim] C where C.created is not null and AgeInDaysAt(C.created) > 18 ) //條件3-1 define "規則1-3-1=曾接受fluoropyrimidine為基礎的化療": ( exists ( [MedicationRequest] MROrder2 where MROrder2.intent = 'order' and exists ( MROrder2.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and (Cdg.code in CodeConcept.L01BC02 or Cdg.code in CodeConcept.L01BC03 or Cdg.code in CodeConcept.L01BC06 or Cdg.code in CodeConcept.L01BC53 or Cdg.code in CodeConcept.L01BC59) ) and Reusable."HasValidTiming"(MROrder2) and Reusable."GetEndTime"(MROrder2) < Today() ) ) //條件3-2 define "規則1-3-2=曾接受oxaliplatin為基礎的化療": ( exists ( [MedicationRequest] MROrder3 where MROrder3.intent = 'order' and exists ( MROrder3.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and Cdg.code in CodeConcept.L01XA03 ) and Reusable."HasValidTiming"(MROrder3) and Reusable."GetEndTime"(MROrder3) < Today() ) ) //條件3-3 define "規則1-3-3=曾接受irinotecan為基礎的化療": ( exists ( [MedicationRequest] MROrder4 where MROrder4.intent = 'order' and exists ( MROrder4.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and Cdg.code in CodeConcept.L01CE02 ) and Reusable."HasValidTiming"(MROrder4) and Reusable."GetEndTime"(MROrder4) < Today() ) ) //條件3-4 define "規則1-3-4=曾接受抗血管內皮生長因子(anti-VEGF)": ( exists ( [MedicationRequest] MROrder1 where MROrder1.intent = 'order' and exists ( MROrder1.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and (Cdg.code in CodeConcept.L01EK or Cdg.code in CodeConcept.L01FG) ) and Reusable."HasValidTiming"(MROrder1) and Reusable."GetEndTime"(MROrder1) < Today() ) ) //條件3 define "規則1-3=曾接受的基礎化學治療": "規則1-3-1=曾接受fluoropyrimidine為基礎的化療" and "規則1-3-2=曾接受oxaliplatin為基礎的化療" and "規則1-3-3=曾接受irinotecan為基礎的化療" and "規則1-3-4=曾接受抗血管內皮生長因子(anti-VEGF)" //條件4-1 define "規則1-4-1=檢核是否為RAS 原生型(wild type)(符合者需有條件4-2不符合者不用)": exists ( [Observation] RasObs where RasObs.status = 'final' and exists ( RasObs.code.coding Cdg where Cdg.code = '69548-6' and Cdg in CodeConcept.LOINC ) and exists ( RasObs.component C where exists ( C.code.coding Cdg where Cdg.code in CodeConcept.GeneTest ) ) and exists ( RasObs.interpretation.coding I where I.code = 'NEG' ) ) //條件4-2 define "規則1-4-2=接受過抗表皮生長因子受體（anti-EGFR）療法": ( exists ( [MedicationRequest] MROrder1 where MROrder1.intent = 'order' and exists ( MROrder1.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and Cdg.code in CodeConcept.L01EB or Cdg.code in CodeConcept.L01FE ) and Reusable."HasValidTiming"(MROrder1) and Reusable."GetEndTime"(MROrder1) < Today() ) ) //條件4 define "規則1-4=若K-ras為原生型(wild type)，需再加上接受過抗表皮生長因子受體（anti-EGFR）療法": if "規則1-4-1=檢核是否為RAS 原生型(wild type)(符合者需有條件4-2不符合者不用)" then "規則1-4-2=接受過抗表皮生長因子受體（anti-EGFR）療法" else true define "規則1": "規則1-1=轉移性大腸直腸癌" and "規則1-2=成人" and "規則1-3=曾接受的基礎化學治療" and "規則1-4=若K-ras為原生型(wild type)，需再加上接受過抗表皮生長因子受體（anti-EGFR）療法" /*規則2*/ define "規則2=需檢附All-RAS 基因突變分析檢測結果報告": exists ( [Observation] RasObservation where RasObservation.status = 'final' and exists ( RasObservation.code.coding ObsCodeCoding where ObsCodeCoding.code = '69548-6' and ObsCodeCoding in CodeConcept.LOINC ) and exists ( RasObservation.component ComponentRecord where exists ( ComponentRecord.code.coding ComponentCodeCoding where ComponentCodeCoding.code in CodeConcept.GeneTest ) ) and exists ( RasObservation.derivedFrom DerivedFromRef where DerivedFromRef.reference is not null ) and exists ( [DocumentReference] DocumentRef where exists ( RasObservation.derivedFrom DerivedFromRef where EndsWith(DerivedFromRef.reference, DocumentRef.id) ) and DocumentRef.status = 'current' and exists ( DocumentRef.content ContentRecord where ContentRecord.attachment.url is not null ) ) ) /*規則3*/ define "規則3=申請項目": exists ( [MedicationRequest] MRPlan where MRPlan.intent = 'plan' and exists ( MRPlan.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and Cdg.code in CodeConcept.L01BC59 ) ) define "主要規定一": "初次申請" and "規則1" and "規則2=需檢附All-RAS 基因突變分析檢測結果報告" and "規則3=申請項目" //============================================ // 主要規定二：續用條件－治療持續給付 //============================================ define "續用規則1=客觀證據（如：影像學）證實無惡化": exists ( [MedicationRequest] MRPlan where MRPlan.intent = 'plan' and exists ( MRPlan.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and Cdg.code in CodeConcept.L01BC59 ) and exists ( [DiagnosticReport] Report where exists ( Report.code.coding Cdg where Cdg.code in CodeConcept.ImageReportCode ) and Report.effective is not null and FHIRHelpers.ToDateTime(Report.effective) >= Today() - 90 days and FHIRHelpers.ToDateTime(Report.effective) <= Today() ) ) define "主要規定二": "續用申請" and "續用規則1=客觀證據（如：影像學）證實無惡化" //============================================ // 主要規定三：藥品使用規則 //============================================ /*規則1*/ define "規則1=不得與regorafenib併用": exists ( [MedicationRequest] MRmed where MRmed.intent = 'plan' and exists ( MRmed.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and Cdg.code in CodeConcept.L01BC59 ) and exists MRmed.dosageInstruction and MRmed.dosageInstruction[0].timing.repeat.bounds is Period and (start of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period)) is not null and (end of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period)) is not null and not exists ( [MedicationRequest] M where M.intent = 'plan' and exists ( M.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and Cdg.code in CodeConcept.L01EX05 ) and exists M.dosageInstruction and M.dosageInstruction[0].timing.repeat.bounds is Period and (start of (M.dosageInstruction[0].timing.repeat.bounds as Period)) is not null and (end of (M.dosageInstruction[0].timing.repeat.bounds as Period)) is not null and (start of (M.dosageInstruction[0].timing.repeat.bounds as Period)) <= (end of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period)) and (end of (M.dosageInstruction[0].timing.repeat.bounds as Period)) >= (start of (MRmed.dosageInstruction[0].timing.repeat.bounds as Period)) ) ) /*規則2*/ define "規則2=每次申請事前審查之療程以8週為限": exists [MedicationRequest] MRPlan where MRPlan.intent = 'plan' and exists ( MRPlan.medication.coding Cdg where Cdg in CodeConcept.NHIMedication and Cdg.code in CodeConcept.L01BC59 ) and days between start of (MRPlan.dosageInstruction[0].timing.repeat.bounds as Period) and end of (MRPlan.dosageInstruction[0].timing.repeat.bounds as Period) <= 56 define "主要規定三": "規則1=不得與regorafenib併用" and "規則2=每次申請事前審查之療程以8週為限" //============================================ // 審核結果 //============================================ define "MainRule1_Pass": if "初次申請" then "主要規定一" else null define "MainRule2_Pass": if "續用申請" then "主要規定二" else null define "MainRule3_Pass": "主要規定三" define "大腸直腸癌TrifluridineTipiracil申請結果_布林": case when "初次申請" then ("MainRule1_Pass" and "MainRule3_Pass") when "續用申請" then ("MainRule2_Pass" and "MainRule3_Pass") else false end define "大腸直腸癌TrifluridineTipiracil申請結果": case when "申請類型未知" then '申請未通過：無法判斷申請類型' when "初次申請" and "MainRule1_Pass" and "MainRule3_Pass" then '初次使用Trifluridine/Tipiracil用藥申請 - 通過' when "初次申請" then '初次使用Trifluridine/Tipiracil用藥申請 - 未通過' when "續用申請" and "MainRule2_Pass" and "MainRule3_Pass" then '續用Trifluridine/Tipiracil用藥申請 - 通過' when "續用申請" then '續用Trifluridine/Tipiracil用藥申請 - 未通過' else '申請未通過' end //============================================ // 申請審核報告（根據申請類型顯示相關檢核） //============================================ define "申請審核報告": '\n' + '\n=== Trifluridine/Tipiracil 申請審核報告 ===\n' + '\n【申請類型】' + "申請類型" + '\n' + case when "初次申請" then '\n【初次使用條件檢核】\n' + '主要規定一：' + case when "MainRule1_Pass" then '通過' else '未通過' end + '\n' + case when "規則1" then '● 符合：轉移性大腸直腸癌成人患者及治療史條件' else '▲ 不符合：轉移性大腸直腸癌成人患者及治療史條件' end + '\n' + case when "規則1-4-1=檢核是否為RAS 原生型(wild type)(符合者需有條件4-2不符合者不用)" and "規則1-4-2=接受過抗表皮生長因子受體（anti-EGFR）療法" then '● 符合：RAS為原生型且已接受anti-EGFR療法' when "規則1-4-1=檢核是否為RAS 原生型(wild type)(符合者需有條件4-2不符合者不用)" and not "規則1-4-2=接受過抗表皮生長因子受體（anti-EGFR）療法" then '▲ 不符合：RAS為原生型但未接受anti-EGFR療法' else '○ RAS非原生型，無需接受anti-EGFR療法' end + '\n' + case when "規則2=需檢附All-RAS 基因突變分析檢測結果報告" then '● 符合：檢附All-RAS基因突變分析檢測結果報告' else '▲ 不符合：檢附All-RAS基因突變分析檢測結果報告' end + '\n' + case when "規則3=申請項目" then '● 符合：申請項目為Trifluridine/Tipiracil' else '▲ 不符合：申請項目為Trifluridine/Tipiracil' end + '\n' when "續用申請" then '\n【續用條件檢核】\n' + '主要規定二：' + case when "MainRule2_Pass" then '通過' else '未通過' end + '\n' + case when "續用規則1=客觀證據（如：影像學）證實無惡化" then '● 符合：提出客觀證據（影像學）證實無惡化' else '▲ 不符合：提出客觀證據（影像學）證實無惡化' end + '\n' else '\n【錯誤】無法判斷申請類型\n' end + '\n【藥品使用規則檢核】\n' + '主要規定三：' + case when "MainRule3_Pass" then '通過' else '未通過' end + '\n' + case when "規則1=不得與regorafenib併用" then '● 符合：不得與regorafenib併用' else '▲ 不符合：與regorafenib併用' end + '\n' + case when "規則2=每次申請事前審查之療程以8週為限" then '● 符合：每次申請事前審查之療程≦8週' else '▲ 不符合：每次申請事前審查之療程超過8週' end + '\n' + '\n【申請結果】\n' + "大腸直腸癌TrifluridineTipiracil申請結果" + '\n' + '\n====================\n' ELM XML Content Encoded data ELM JSON Content Encoded data Generated using version 0.5.3-cibuild of the sample-content-ig Liquid templates
此 Library 為轉移性大腸或直腸癌病人申請使用 Trifluridine/tipiracil 之給付檢核條件。