Proportion

Process

increase

define "Initial Population":
  AgeInYearsAt(date from start of "Measurement Period") >= 13
    and "Has Qualifying Encounter During Measurement Period"
    and "Has HIV Diagnosis Before End of Measurement Period"

define "Denominator":
  "Initial Population"

define "Numerator":
  "Has Chlamydia Testing"
    and "Has Gonorrhea Testing"
    and "Has Syphilis Testing"

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 "Has Chlamydia Testing":
  exists ["Observation": "Chlamydia Screening"] ChlamydiaTest
    where ChlamydiaTest.value is not null
      and ChlamydiaTest.status in { 'final', 'amended', 'corrected' }
      and ChlamydiaTest.effective.latest ( ) during day of "Measurement Period"

define "Has Gonorrhea Testing":
  exists ["Observation": "Gonorrhea Screening"] GonorrheaTest
    where GonorrheaTest.value is not null
      and GonorrheaTest.status in { 'final', 'amended', 'corrected' }
      and GonorrheaTest.effective.latest ( ) during day of "Measurement Period"

define "Has Syphilis Testing":
  exists ["Observation": "Syphilis Tests"] SyphilisTest
    where SyphilisTest.value is not null
      and SyphilisTest.status in { 'final', 'amended', 'corrected' }
      and SyphilisTest.effective.latest ( ) during day of "Measurement Period"

define "Numerator":
  "Has Chlamydia Testing"
    and "Has Gonorrhea Testing"
    and "Has Syphilis Testing"

define "Has Qualifying Encounter During Measurement Period":
/*Note: applied workaround using value set 'Preventive Care Services Other', as a DRC cannot be used directly from an encounter retrieve; additional info can be found in CQLIT-368*/
  
  exists ( ( ["Encounter": "Office Visit"]
      union ["Encounter": "Outpatient Consultation"]
      union ["Encounter": "Annual Wellness Visit"]
      union ["Encounter": "Face-to-Face Interaction"]
      union ["Encounter": "Home Healthcare Services"]
      union ["Encounter": "Preventive Care Services Established Office Visit, 18 and Up"]
      union ["Encounter": "Preventive Care Services Initial Office Visit, 18 and Up"]
      union ["Encounter": "Preventive Care Services, Initial Office Visit, 0 to 17"]
      union ["Encounter": "Preventive Care, Established Office Visit, 0 to 17"]
      union ["Encounter": "Telephone Visits"]
      union ["Encounter": "Preventive Care Services Other"] ) QualifyingEncounter
      where QualifyingEncounter.period during day of "Measurement Period"
  )

define "Has HIV Diagnosis Before End of Measurement Period":
  exists ["Condition": "HIV"] HIVDx
    where HIVDx.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"

define "Initial Population":
  AgeInYearsAt(date from start of "Measurement Period") >= 13
    and "Has Qualifying Encounter During Measurement Period"
    and "Has HIV Diagnosis Before End of Measurement Period"

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

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

/*
@description: Given an interval, returns the ending point if the interval has an ending boundary specified,
otherwise, returns the starting point
*/
define fluent function latest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):
  (choice.toInterval()) period
    return
      if (period."hasEnd"()) then end of period
      else start of period

/*
@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, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, 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
    (end of condition.abatementInterval()) abatementDate
    return if abatementDate is null then
      Interval[start of condition.onset.toInterval(), abatementDate)
    else
      Interval[start of condition.onset.toInterval(), abatementDate]

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
        }