{ "resourceType" : "Measure", "id" : "CXCAIND02", "text" : { "status" : "extensions", "div" : "
\n \n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n\n\n\n\n \n \n \n \n \n \n \n \n \n\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n \n\n\n \n \n \n \n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n \n \n \n \n \n \n\n\n \n \n \n \n \n \n \n \n \n \n \n \n\n \n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n\n\n \n \n \n \n \n\n\n \n \n\n\n\n \n \n \n \n\n\n \n\n \n \n \n\n\n \n\n \n \n \n\n\n \n\n \n \n \n\n\n \n\n \n \n \n\n\n \n\n \n \n \n\n\n \n\n \n \n \n\n\n \n\n \n \n \n \n \n\n\n\n\n \n \n\n \n\n \n\n\n\n\n \n\n\n \n\n \n\n \n\n\n\n\n \n\n\n \n\n \n\n \n\n\n\n\n \n\n\n \n\n \n\n \n\n\n\n\n \n\n\n\n \n\n\n \n\n \n
Knowledge Artifact Metadata
Name (machine-readable)CXCAIND02
Title (human-readable)CXCA.IND.02 — Cervical Cancer Screening Cascade Completion (NotDone-aware)
StatusDraft
Experimentalfalse
Description

Proportion of HPV-positive women in the measurement period whose follow-up cascade reached resolution — either through completed cytology or through explicit documented non-occurrence using the CXCAServiceNotRequested profile. Patients with neither (absent records) are excluded from the numerator, surfacing visibility gaps rather than conflating them with documented LTFU. See input/cql/CXCAIND02CascadeCompletionLogic.cql for the methodology rationale and the Mongolia April 2026 Khan-Uul pilot numbers that motivate this measure (371 HPV+ women, 184 cytology, 187 LTFU).

\n
Measure StewardDan Heslinga (independent contributor)
Steward Contact DetailsDan Heslinga (independent contributor): https://github.com/dhes
Measure Metadata
Version Number0.0.1
Measure ScoringProportion
Measure Population Criteria
Initial Population\n \n \n Description: No description provided\n \n \n \n \n Logic Definition: Initial Population \n \n \n
Denominator\n \n \n Description: No description provided\n \n \n \n \n Logic Definition: Denominator \n \n \n
Numerator\n \n \n Description: No description provided\n \n \n \n \n Logic Definition: Numerator \n \n \n
Numerator Exclusion\n \n \n Description: No description provided\n \n \n \n \n Logic Definition: Numerator Exclusion \n \n \n
Measure Logic
Primary LibraryCXCAIND02CascadeCompletionLogic
Dependency\n \n Description: FHIR model information\n \n
\n \n \n \n \n \n \n Resource: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1\n
\n Canonical URL: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1\n \n
Parameter\n Name: PatientHasHPVPositiveInPeriod\n
\n Use: In\n
\n Min Cardinality: 0\n
\n Max Cardinality: 1\n
\n Type: boolean\n
Parameter\n Name: PatientHasCytologyCompletedInPeriod\n
\n Use: In\n
\n Min Cardinality: 0\n
\n Max Cardinality: 1\n
\n Type: boolean\n
Parameter\n Name: PatientHasCytologyNotDoneRecordedInPeriod\n
\n Use: In\n
\n Min Cardinality: 0\n
\n Max Cardinality: 1\n
\n Type: boolean\n
Parameter\n Name: Numerator\n
\n Use: Out\n
\n Min Cardinality: 0\n
\n Max Cardinality: 1\n
\n Type: boolean\n
Parameter\n Name: Denominator\n
\n Use: Out\n
\n Min Cardinality: 0\n
\n Max Cardinality: 1\n
\n Type: boolean\n
Parameter\n Name: Initial Population\n
\n Use: Out\n
\n Min Cardinality: 0\n
\n Max Cardinality: 1\n
\n Type: boolean\n
Parameter\n Name: Numerator Exclusion\n
\n Use: Out\n
\n Min Cardinality: 0\n
\n Max Cardinality: 1\n
\n Type: boolean\n
Measure Logic Definitions
\n \n \n \n \n Logic Definition\n Library Name: CXCAIND02CascadeCompletionLogic
\n 
/*\n * @numerator: HPV+ patients who reached cascade *resolution* — either by\n *   completing cytology OR by having a documented non-occurrence record.\n */\ndefine "Numerator":\n  "PatientHasHPVPositiveInPeriod"\n    and ("PatientHasCytologyCompletedInPeriod"\n      or "PatientHasCytologyNotDoneRecordedInPeriod")
\n
\n \n \n \n \n Logic Definition\n Library Name: CXCAIND02CascadeCompletionLogic
\n 
/*\n * @denominator: Patients with an HPV+ result during the measurement period.\n *   These are the patients whose cascade we want to track.\n */\ndefine "Denominator":\n  "PatientHasHPVPositiveInPeriod"
\n
\n \n \n \n \n Logic Definition\n Library Name: CXCAIND02CascadeCompletionLogic
\n 
/*\n * @initialPopulation: as defined by Member State (placeholder — true)\n *   Real implementation: women in target age range alive at start of period\n *   in the jurisdiction.\n */\ndefine "Initial Population":\n  true
\n
\n \n \n \n \n Logic Definition\n Library Name: CXCAIND02CascadeCompletionLogic
\n 
/*\n * @numeratorExclusion: HPV+ patients whose resolution was via documented\n *   non-occurrence (LTFU) rather than actual cytology completion.\n *\n *   FHIR Measure semantics: numerator-exclusion is subtracted from the\n *   numerator when computing the proportion. This lets a single Measure\n *   resource expose three computable views:\n *     - Cascade resolution rate: Numerator / Denominator\n *     - True follow-up rate:     (Numerator − NumeratorExclusion) / Denominator\n *     - Documented LTFU rate:    NumeratorExclusion / Denominator\n *   Together with (Denominator − Numerator) = the absent / unknown count,\n *   this gives programme managers a four-way partition of the HPV+ cohort.\n */\ndefine "Numerator Exclusion":\n  "PatientHasHPVPositiveInPeriod"\n    and "PatientHasCytologyNotDoneRecordedInPeriod"\n    and not "PatientHasCytologyCompletedInPeriod"
\n
Generated using version 0.4.6 of the sample-content-ig Liquid templates
\n
" }, "contained" : [{ "resourceType" : "Library", "id" : "effective-data-requirements", "extension" : [{ "extension" : [{ "url" : "libraryName", "valueString" : "CXCAIND02CascadeCompletionLogic" }, { "url" : "name", "valueString" : "Numerator" }, { "url" : "statement", "valueString" : "/*\n * @numerator: HPV+ patients who reached cascade *resolution* — either by\n * completing cytology OR by having a documented non-occurrence record.\n */\ndefine \"Numerator\":\n \"PatientHasHPVPositiveInPeriod\"\n and (\"PatientHasCytologyCompletedInPeriod\"\n or \"PatientHasCytologyNotDoneRecordedInPeriod\")" }, { "url" : "displaySequence", "valueInteger" : 0 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CXCAIND02CascadeCompletionLogic" }, { "url" : "name", "valueString" : "Denominator" }, { "url" : "statement", "valueString" : "/*\n * @denominator: Patients with an HPV+ result during the measurement period.\n * These are the patients whose cascade we want to track.\n */\ndefine \"Denominator\":\n \"PatientHasHPVPositiveInPeriod\"" }, { "url" : "displaySequence", "valueInteger" : 1 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CXCAIND02CascadeCompletionLogic" }, { "url" : "name", "valueString" : "Initial Population" }, { "url" : "statement", "valueString" : "/*\n * @initialPopulation: as defined by Member State (placeholder — true)\n * Real implementation: women in target age range alive at start of period\n * in the jurisdiction.\n */\ndefine \"Initial Population\":\n true" }, { "url" : "displaySequence", "valueInteger" : 2 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }, { "extension" : [{ "url" : "libraryName", "valueString" : "CXCAIND02CascadeCompletionLogic" }, { "url" : "name", "valueString" : "Numerator Exclusion" }, { "url" : "statement", "valueString" : "/*\n * @numeratorExclusion: HPV+ patients whose resolution was via documented\n * non-occurrence (LTFU) rather than actual cytology completion.\n *\n * FHIR Measure semantics: numerator-exclusion is subtracted from the\n * numerator when computing the proportion. This lets a single Measure\n * resource expose three computable views:\n * - Cascade resolution rate: Numerator / Denominator\n * - True follow-up rate: (Numerator − NumeratorExclusion) / Denominator\n * - Documented LTFU rate: NumeratorExclusion / Denominator\n * Together with (Denominator − Numerator) = the absent / unknown count,\n * this gives programme managers a four-way partition of the HPV+ cohort.\n */\ndefine \"Numerator Exclusion\":\n \"PatientHasHPVPositiveInPeriod\"\n and \"PatientHasCytologyNotDoneRecordedInPeriod\"\n and not \"PatientHasCytologyCompletedInPeriod\"" }, { "url" : "displaySequence", "valueInteger" : 3 }], "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition" }], "name" : "EffectiveDataRequirements", "status" : "active", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/library-type", "code" : "module-definition" }] }, "relatedArtifact" : [{ "type" : "depends-on", "display" : "FHIR model information", "resource" : "http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1" }], "parameter" : [{ "name" : "PatientHasHPVPositiveInPeriod", "use" : "in", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "PatientHasCytologyCompletedInPeriod", "use" : "in", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "PatientHasCytologyNotDoneRecordedInPeriod", "use" : "in", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "Numerator", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "Denominator", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "Initial Population", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }, { "name" : "Numerator Exclusion", "use" : "out", "min" : 0, "max" : "1", "type" : "boolean" }] }], "extension" : [{ "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements", "valueCanonical" : "#effective-data-requirements" }], "url" : "http://smart.who.int/cxca/Measure/CXCAIND02", "version" : "0.0.1", "name" : "CXCAIND02", "title" : "CXCA.IND.02 — Cervical Cancer Screening Cascade Completion (NotDone-aware)", "status" : "draft", "experimental" : false, "date" : "2026-05-14T00:50:23+00:00", "publisher" : "Dan Heslinga (independent contributor)", "contact" : [{ "name" : "Dan Heslinga (independent contributor)", "telecom" : [{ "system" : "url", "value" : "https://github.com/dhes" }] }], "description" : "Proportion of HPV-positive women in the measurement period whose follow-up cascade reached resolution — either through completed cytology or through explicit documented non-occurrence using the CXCAServiceNotRequested profile. Patients with neither (absent records) are excluded from the numerator, surfacing visibility gaps rather than conflating them with documented LTFU. See input/cql/CXCAIND02CascadeCompletionLogic.cql for the methodology rationale and the Mongolia April 2026 Khan-Uul pilot numbers that motivate this measure (371 HPV+ women, 184 cytology, 187 LTFU).", "library" : ["http://smart.who.int/cxca/Library/CXCAIND02CascadeCompletionLogic"], "scoring" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring", "code" : "proportion" }] }, "group" : [{ "population" : [{ "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "initial-population" }] }, "criteria" : { "language" : "text/cql-identifier", "expression" : "Initial Population" } }, { "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "denominator" }] }, "criteria" : { "language" : "text/cql-identifier", "expression" : "Denominator" } }, { "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator" }] }, "criteria" : { "language" : "text/cql-identifier", "expression" : "Numerator" } }, { "code" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/measure-population", "code" : "numerator-exclusion" }] }, "criteria" : { "language" : "text/cql-identifier", "expression" : "Numerator Exclusion" } }] }] }