define "Initial Population":
  "Patients Aged 35 to 70 with an Office Visit During the Measurement Period"
    and ( "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian"
        or "Most Recent BMI Equal to or Greater Than 23 and Is Asian"
    )

define "Denominator":
  "Initial Population"

define "Denominator Exclusions":
  "Has Pregnancy Observation During Measurement Period"
    or exists "Has Pregnancy Diagnosis During Measurement Period"
    or exists "Has Advanced Illness or Limited Life Expectancy"
    or exists "Diabetes Diagnosis Overlaps 2 Year Look Back Period"
    or exists "Prediabetes Diagnosis Overlaps 2 Year Look Back Period"
    or "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period"

define "Numerator":
  exists "Glycemic Laboratory Test Performed During Measurement Period"

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

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

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 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
        }

/*
@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

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

define "Glycemic Laboratory Test Performed During Measurement Period":
  [LaboratoryResultObservation: "Glycemic Screening Tests"] LabTestPerformed
    where QICoreCommon.ToInterval ( LabTestPerformed.effective ) during day of "Measurement Period"
      and LabTestPerformed.status in { 'final', 'amended', 'corrected' }

define "Numerator":
  exists "Glycemic Laboratory Test Performed During Measurement Period"

define "Preventive Care Outpatient Visits During Measurement Period":
  [Encounter: "Preventative Clinical Encounters"] PreventiveCare
    where PreventiveCare.period ends during day of "Measurement Period"
      and PreventiveCare.status = 'finished'

define "Office Visit During the Measurement Period":
  [Encounter: "Outpatient Clinical Encounters"] OfficeVisit
    where OfficeVisit.period during day of "Measurement Period"
      and OfficeVisit.status = 'finished'

define "Aged 35 to 70 at Start of Measurement Period":
  "AgeInYearsAt"(date from start of "Measurement Period") between 35 and 70

define "Patients Aged 35 to 70 with an Office Visit During the Measurement Period":
  ( exists ( "Preventive Care Outpatient Visits During Measurement Period" )
      or Count("Office Visit During the Measurement Period") >= 2
  )
    and "Aged 35 to 70 at Start of Measurement Period" is true

define "Most Recent BMI":
  First([USCoreBMIProfile] BMI
      where BMI.status in { 'final', 'amended', 'corrected' }
      sort by start of effective.toInterval() desc
  )

define "Patient is Asian":
  exists ( SDE."SDE Race".codes C
      where C ~ "Asian"
  )

define "Patient is not Asian":
  not ( "Patient is Asian" )

define "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian":
  "Most Recent BMI".value >= 25 'kg/m2'
    and "Patient is not Asian"

define "Most Recent BMI Equal to or Greater Than 23 and Is Asian":
  "Most Recent BMI".value >= 23 'kg/m2'
    and "Patient is Asian"

define "Initial Population":
  "Patients Aged 35 to 70 with an Office Visit During the Measurement Period"
    and ( "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian"
        or "Most Recent BMI Equal to or Greater Than 23 and Is Asian"
    )

define "Denominator":
  "Initial Population"

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

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

define "Has Pregnancy Observation During Measurement Period":
  exists ( [USCoreObservationPregnancyStatusProfile] PregnantObservation
      where PregnantObservation.value in "Pregnancy"
        and PregnantObservation.effective.toInterval ( ) overlaps day of "Measurement Period"
  )

define "Has Pregnancy Diagnosis During Measurement Period":
  ( ( [ConditionProblemsHealthConcerns: "Pregnancy"]
      union [ConditionEncounterDiagnosis: "Pregnancy"]
  ).verified ( ) ) PregnancyDx
    where PregnancyDx.prevalenceInterval ( ) overlaps day of "Measurement Period"

define "Has Advanced Illness or Limited Life Expectancy":
  ( ( ["ConditionProblemsHealthConcerns": "Advanced Illness"]
      union ["ConditionEncounterDiagnosis": "Advanced Illness"]
      union ["ConditionProblemsHealthConcerns": "Limited Life Expectancy"]
      union ["ConditionEncounterDiagnosis": "Limited Life Expectancy"]
  ).verified ( ) ) AdvancedIllness
    where "AdvancedIllness".onset before day of end of "Measurement Period"

define "Look Back Period":
  Interval[start of "Measurement Period" - 2 years, start of "Measurement Period" )

define "Diabetes Diagnosis Overlaps 2 Year Look Back Period":
  ( ( ["ConditionProblemsHealthConcerns": "Diabetes"]
      union [ConditionEncounterDiagnosis: "Diabetes"]
  ).verified ( ) ) PriorDiabetes
    where "PriorDiabetes".prevalenceInterval ( ) overlaps day of "Look Back Period"

define "Prediabetes Diagnosis Overlaps 2 Year Look Back Period":
  ( ( ["ConditionProblemsHealthConcerns": "Prediabetes (Borderline Diabetes)"]
      union [ConditionEncounterDiagnosis: "Prediabetes (Borderline Diabetes)"]
  ).verified ( ) ) PriorPrediabetes
    where "PriorPrediabetes".prevalenceInterval ( ) overlaps day of "Look Back Period"

define "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period":
  exists ( [LaboratoryResultObservation: "Glycemic Screening Tests"] LabTestPerformed
      where QICoreCommon.ToInterval ( LabTestPerformed.effective ) during day of "Look Back Period"
        and LabTestPerformed.status in { 'final', 'amended', 'corrected' }
  )

define "Denominator Exclusions":
  "Has Pregnancy Observation During Measurement Period"
    or exists "Has Pregnancy Diagnosis During Measurement Period"
    or exists "Has Advanced Illness or Limited Life Expectancy"
    or exists "Diabetes Diagnosis Overlaps 2 Year Look Back Period"
    or exists "Prediabetes Diagnosis Overlaps 2 Year Look Back Period"
    or "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period"

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

define fluent function verified(conditions List<Choice<ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis>>):
  conditions C
    where C.verificationStatus is not null implies ( C.verificationStatus ~ "confirmed"
        or C.verificationStatus ~ "unconfirmed"
        or C.verificationStatus ~ "provisional"
        or C.verificationStatus ~ "differential"
    )