Proportion

Process

increase

define "Initial Population":
  AgeInYearsAt(date from start of "Measurement Period") >= 18
    and exists "Primary Open Angle Glaucoma Encounter"

define "Denominator":
  "Initial Population"

define "Numerator":
  exists "Cup to Disc Ratio Performed with Result"
    and exists "Optic Disc Exam Performed with Result"

define "Denominator Exceptions":
  exists "Medical Reason for Not Performing Cup to Disc Ratio"
    or exists "Medical Reason for Not Performing Optic Disc Exam"

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 "Qualifying Encounter During Measurement Period":
  ( ["Encounter": "Office Visit"]
    union ["Encounter": "Ophthalmological Services"]
    union ["Encounter": "Outpatient Consultation"]
    union ["Encounter": "Nursing Facility Visit"]
    union ["Encounter": "Care Services in Long-Term Residential Facility"] ) QualifyingEncounter
    where QualifyingEncounter.period during "Measurement Period"
      and QualifyingEncounter.status = 'finished'
      and QualifyingEncounter.class !~ "virtual"

define "Primary Open Angle Glaucoma Encounter":
  "Qualifying Encounter During Measurement Period" ValidQualifyingEncounter
    with ["Condition": "Primary Open-Angle Glaucoma"] PrimaryOpenAngleGlaucoma
      such that PrimaryOpenAngleGlaucoma.prevalenceInterval ( ) overlaps ValidQualifyingEncounter.period
        and PrimaryOpenAngleGlaucoma.isActive ( )
        and not ( PrimaryOpenAngleGlaucoma.verificationStatus ~ QICoreCommon."unconfirmed"
            or PrimaryOpenAngleGlaucoma.verificationStatus ~ QICoreCommon."refuted"
            or PrimaryOpenAngleGlaucoma.verificationStatus ~ QICoreCommon."entered-in-error"
        )

define "Cup to Disc Ratio Performed with Result":
  ["Observation": "Cup to Disc Ratio"] CupToDiscExamPerformed
    with "Primary Open Angle Glaucoma Encounter" EncounterWithPOAG
      such that CupToDiscExamPerformed.effective.toInterval ( ) during EncounterWithPOAG.period
    where CupToDiscExamPerformed.value is not null
      and CupToDiscExamPerformed.status in { 'final', 'amended', 'corrected' }

define "Optic Disc Exam Performed with Result":
  ["Observation": "Optic Disc Exam for Structural Abnormalities"] OpticDiscExamPerformed
    with "Primary Open Angle Glaucoma Encounter" EncounterWithPOAG
      such that OpticDiscExamPerformed.effective.toInterval ( ) during EncounterWithPOAG.period
    where OpticDiscExamPerformed.value is not null
      and OpticDiscExamPerformed.status in { 'final', 'amended', 'corrected' }

define "Numerator":
  exists "Cup to Disc Ratio Performed with Result"
    and exists "Optic Disc Exam Performed with Result"

define "Initial Population":
  AgeInYearsAt(date from start of "Measurement Period") >= 18
    and exists "Primary Open Angle Glaucoma Encounter"

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"

define "Medical Reason for Not Performing Cup to Disc Ratio":
  ["ObservationNotDone": "Cup to Disc Ratio"] CupToDiscExamNotPerformed
    with "Primary Open Angle Glaucoma Encounter" EncounterWithPOAG
      such that CupToDiscExamNotPerformed.issued during EncounterWithPOAG.period
    where CupToDiscExamNotPerformed.notDoneReason in "Medical Reason"

define "Medical Reason for Not Performing Optic Disc Exam":
  ["ObservationNotDone": "Optic Disc Exam for Structural Abnormalities"] OpticDiscExamNotPerformed
    with "Primary Open Angle Glaucoma Encounter" EncounterWithPOAG
      such that OpticDiscExamNotPerformed.issued during EncounterWithPOAG.period
    where OpticDiscExamNotPerformed.notDoneReason in "Medical Reason"

define "Denominator Exceptions":
  exists "Medical Reason for Not Performing Cup to Disc Ratio"
    or exists "Medical Reason for Not Performing Optic Disc Exam"

/*
@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]

/* Candidates for FHIRCommon */

/*
@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse
*/
define fluent function isActive(condition Condition):
  condition.clinicalStatus ~ "active"
    or condition.clinicalStatus ~ "recurrence"
    or condition.clinicalStatus ~ "relapse"

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
        }