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 Surgeries in Patients with Significant Ocular Conditions Impacting the Visual Outcome of Surgery"

define "Numerator":
  "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed
    with ( [ObservationClinicalResult: "Best corrected visual acuity (observable entity)"]
      union [ObservationClinicalResult: "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' }
        and VisualAcuityExamPerformed.value as Concept in "Visual Acuity 20/40 or Better"

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
    }

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 day of "Measurement Period"
      and CataractSurgery.performed.toInterval ( ) starts 92 days or more before day of end of "Measurement Period"
      and CataractSurgery.status = 'completed'

define "Numerator":
  "Cataract Surgery Between January and September of Measurement Period" CataractSurgeryPerformed
    with ( [ObservationClinicalResult: "Best corrected visual acuity (observable entity)"]
      union [ObservationClinicalResult: "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' }
        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":
  SDE."SDE Payer"

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

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

define "Denominator Exclusions":
  "Cataract Surgeries in Patients with Significant Ocular Conditions Impacting the Visual Outcome of Surgery"

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.
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 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
        }