Outcome

increase

define "Initial Population":
  "Qualified Scan without Inpatient Encounter"

define "Denominator":
  "Qualified Scan with Values"

define "Denominator Exclusion":
  "Qualified Scan with Values" CTScan
    where ( CTScan.value as Concept ).codes contains "Full Body"

define "Numerator":
  "Qualified Scan with Values" CTScan
    where AlaraCommon."CT Scan Qualifies" ( CTScan )

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 "Qualified Scan":
  [Observation: "CT dose and image quality category"] CTScan
    where QICoreCommon.ToInterval ( CTScan.effective ) ends during day of "Measurement Period"
      and AgeInYearsAt(date from start of "Measurement Period") >= 18

define "Qualified Scan without Inpatient Encounter":
  "Qualified Scan" QualifiedCTScan
    without [Encounter: "Encounter Inpatient"] InpatientEncounter
      such that QICoreCommon.ToInterval ( QualifiedCTScan.effective ) starts during QICoreCommon.ToInterval ( InpatientEncounter.period )

define "Qualified Scan with Values":
  "Qualified Scan without Inpatient Encounter" CTScan
    where AlaraCommon."Global Noise Value" ( CTScan ) is not null
      and AlaraCommon."Size Adjusted Value" ( CTScan ) is not null
      and CTScan.value is not null

define "Numerator":
  "Qualified Scan with Values" CTScan
    where AlaraCommon."CT Scan Qualifies" ( CTScan )

define "Denominator":
  "Qualified Scan with Values"

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

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

define "Initial Population":
  "Qualified Scan without Inpatient Encounter"

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 Exclusion":
  "Qualified Scan with Values" CTScan
    where ( CTScan.value as Concept ).codes contains "Full Body"

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.
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
@deprecated: This function is deprecated. Use the fluent function `toInterval()` instead
*/
define 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 "Global Noise Value"(Obs Observation ):
  singleton from ( Obs.component C
      where C.code ~ "Calculated CT global noise"
        and ( C.value as Quantity ).unit = '[hnsf\'U]'
      return (C.value as Quantity).value
  )

define function "Size Adjusted Value"(Obs Observation ):
  singleton from ( Obs.component C
      where C.code ~ "Calculated CT size-adjusted dose"
        and ( C.value as Quantity ).unit = 'mGy.cm'
      return (C.value as Quantity).value
  )

define function "CT Scan Qualifies"(Obs Observation ):
  "Qualifies"(Obs, "Abdomen and Pelvis Low Dose", 64, 598)
    or "Qualifies"(Obs, "Abdomen and Pelvis Routine Dose", 29, 644)
    or "Qualifies"(Obs, "Abdomen and Pelvis High Dose", 29, 1260)
    or "Qualifies"(Obs, "Cardiac Low Dose", 55, 93)
    or "Qualifies"(Obs, "Cardiac Routine Dose", 32, 576)
    or "Qualifies"(Obs, "Chest Low Dose", 55, 377)
    or "Qualifies"(Obs, "Chest Routine Dose", 49, 377)
    or "Qualifies"(Obs, "Cardiac High Dose or Chest High Dose", 49, 1282)
    or "Qualifies"(Obs, "Head Low Dose", 115, 582)
    or "Qualifies"(Obs, "Head Routine Dose", 115, 1025)
    or "Qualifies"(Obs, "Head High Dose", 115, 1832)
    or "Qualifies"(Obs, "Extremity", 73, 320)
    or "Qualifies"(Obs, "Neck or Cervical Spine", 25, 1260)
    or "Qualifies"(Obs, "Thoracic or Lumbar Spine", 25, 1260)
    or "Qualifies"(Obs, "Simultaneous Chest and Abdomen and Pelvis", 29, 1637)
    or "Qualifies"(Obs, "Simultaneous Thoracic and Lumbar Spine", 25, 2520)
    or "Qualifies"(Obs, "Simultaneous Head and Neck Routine Dose", 25, 2285)
    or "Qualifies"(Obs, "Simultaneous Head and Neck High Dose", 25, 3092)

define function "Qualifies"(Obs Observation, code System.Code, noiseThreshold Decimal, sizeDoseThreshold Decimal ):
  (Obs.value as Concept).codes contains code
    and ( "Global Noise Value"(Obs)>= noiseThreshold
        or "Size Adjusted Value"(Obs)>= sizeDoseThreshold
    )

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
        }