SMART DAK Cervical Cancer Screening
0.0.1 - ci-build
SMART DAK Cervical Cancer Screening, published by Dan Heslinga (independent contributor). This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/dhes/smart-dak-cxca/ and changes regularly. See the Directory of published versions
| Draft as of 2026-05-14 |
<Measure xmlns="http://hl7.org/fhir">
<id value="CXCAIND02"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="narrative-table">
<tbody>
<tr>
<th colspan="2" scope="row" class="row-header">Knowledge Artifact Metadata</th>
</tr>
<tr>
<th scope="row" class="row-header">Name (machine-readable)</th>
<td class="content-container">CXCAIND02</td>
</tr>
<tr>
<th scope="row" class="row-header">Title (human-readable)</th>
<td class="content-container">CXCA.IND.02 — Cervical Cancer Screening Cascade Completion (NotDone-aware)</td>
</tr>
<tr>
<th scope="row" class="row-header">Status</th>
<td class="content-container">Draft</td>
</tr>
<tr>
<th scope="row" class="row-header">Experimental</th>
<td class="content-container">false</td>
</tr>
<tr>
<th scope="row" class="row-header">Description</th>
<td class="content-container"><div><p>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).</p>
</div></td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Steward</th>
<td class="content-container">Dan Heslinga (independent contributor)</td>
</tr>
<tr>
<th scope="row" class="row-header">Steward Contact Details</th>
<td class="content-container">Dan Heslinga (independent contributor): <a href="https://github.com/dhes">https://github.com/dhes</a></td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Metadata</th>
</tr>
<tr>
<th scope="row" class="row-header">Version Number</th>
<td class="content-container">0.0.1</td>
</tr>
<tr>
<th scope="row" class="row-header">Measure Scoring</th>
<td class="content-container"><span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-scoring proportion}">Proportion</span></td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Population Criteria</th>
</tr>
<tr>
<th scope="row" class="row-header">Initial Population</th>
<td class="content-container">
<em>Description</em>: No description provided
<em>Logic Definition</em>: <a href="#cxcaind02cascadecompletionlogic-initial-population">Initial Population</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator</th>
<td class="content-container">
<em>Description</em>: No description provided
<em>Logic Definition</em>: <a href="#cxcaind02cascadecompletionlogic-denominator">Denominator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Numerator</th>
<td class="content-container">
<em>Description</em>: No description provided
<em>Logic Definition</em>: <a href="#cxcaind02cascadecompletionlogic-numerator">Numerator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Numerator Exclusion</th>
<td class="content-container">
<em>Description</em>: No description provided
<em>Logic Definition</em>: <a href="#cxcaind02cascadecompletionlogic-numerator-exclusion">Numerator Exclusion</a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Logic</th>
</tr>
<tr>
<th scope="row" class="row-header">Primary Library</th>
<td class="content-container"><a href="Library-CXCAIND02CascadeCompletionLogic.html">CXCAIND02CascadeCompletionLogic</a></td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: FHIR model information
<br/>
<em>Resource</em>: <a href="http://fhir.org/guides/cqf/common/4.0.1/4.0.1/Library-FHIR-ModelInfo.html">http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1</a>
<br/>
<em>Canonical URL</em>: <tt>http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Parameter</th>
<td class="content-container">
<em>Name</em>: PatientHasHPVPositiveInPeriod
<br/>
<em>Use</em>: In
<br/>
<em>Min Cardinality</em>: 0
<br/>
<em>Max Cardinality</em>: 1
<br/>
<em>Type</em>: boolean
</td>
</tr>
<tr>
<th scope="row" class="row-header">Parameter</th>
<td class="content-container">
<em>Name</em>: PatientHasCytologyCompletedInPeriod
<br/>
<em>Use</em>: In
<br/>
<em>Min Cardinality</em>: 0
<br/>
<em>Max Cardinality</em>: 1
<br/>
<em>Type</em>: boolean
</td>
</tr>
<tr>
<th scope="row" class="row-header">Parameter</th>
<td class="content-container">
<em>Name</em>: PatientHasCytologyNotDoneRecordedInPeriod
<br/>
<em>Use</em>: In
<br/>
<em>Min Cardinality</em>: 0
<br/>
<em>Max Cardinality</em>: 1
<br/>
<em>Type</em>: boolean
</td>
</tr>
<tr>
<th scope="row" class="row-header">Parameter</th>
<td class="content-container">
<em>Name</em>: Numerator
<br/>
<em>Use</em>: Out
<br/>
<em>Min Cardinality</em>: 0
<br/>
<em>Max Cardinality</em>: 1
<br/>
<em>Type</em>: boolean
</td>
</tr>
<tr>
<th scope="row" class="row-header">Parameter</th>
<td class="content-container">
<em>Name</em>: Denominator
<br/>
<em>Use</em>: Out
<br/>
<em>Min Cardinality</em>: 0
<br/>
<em>Max Cardinality</em>: 1
<br/>
<em>Type</em>: boolean
</td>
</tr>
<tr>
<th scope="row" class="row-header">Parameter</th>
<td class="content-container">
<em>Name</em>: Initial Population
<br/>
<em>Use</em>: Out
<br/>
<em>Min Cardinality</em>: 0
<br/>
<em>Max Cardinality</em>: 1
<br/>
<em>Type</em>: boolean
</td>
</tr>
<tr>
<th scope="row" class="row-header">Parameter</th>
<td class="content-container">
<em>Name</em>: Numerator Exclusion
<br/>
<em>Use</em>: Out
<br/>
<em>Min Cardinality</em>: 0
<br/>
<em>Max Cardinality</em>: 1
<br/>
<em>Type</em>: boolean
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Logic Definitions</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cxcaind02cascadecompletionlogic-numerator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CXCAIND02CascadeCompletionLogic</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
* @numerator: HPV+ patients who reached cascade *resolution* — either by
* completing cytology OR by having a documented non-occurrence record.
*/
define "Numerator":
"PatientHasHPVPositiveInPeriod"
and ("PatientHasCytologyCompletedInPeriod"
or "PatientHasCytologyNotDoneRecordedInPeriod")</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cxcaind02cascadecompletionlogic-denominator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CXCAIND02CascadeCompletionLogic</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
* @denominator: Patients with an HPV+ result during the measurement period.
* These are the patients whose cascade we want to track.
*/
define "Denominator":
"PatientHasHPVPositiveInPeriod"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cxcaind02cascadecompletionlogic-initial-population"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CXCAIND02CascadeCompletionLogic</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
* @initialPopulation: as defined by Member State (placeholder — true)
* Real implementation: women in target age range alive at start of period
* in the jurisdiction.
*/
define "Initial Population":
true</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cxcaind02cascadecompletionlogic-numerator-exclusion"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CXCAIND02CascadeCompletionLogic</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
* @numeratorExclusion: HPV+ patients whose resolution was via documented
* non-occurrence (LTFU) rather than actual cytology completion.
*
* FHIR Measure semantics: numerator-exclusion is subtracted from the
* numerator when computing the proportion. This lets a single Measure
* resource expose three computable views:
* - Cascade resolution rate: Numerator / Denominator
* - True follow-up rate: (Numerator − NumeratorExclusion) / Denominator
* - Documented LTFU rate: NumeratorExclusion / Denominator
* Together with (Denominator − Numerator) = the absent / unknown count,
* this gives programme managers a four-way partition of the HPV+ cohort.
*/
define "Numerator Exclusion":
"PatientHasHPVPositiveInPeriod"
and "PatientHasCytologyNotDoneRecordedInPeriod"
and not "PatientHasCytologyCompletedInPeriod"</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Generated using version 0.4.6 of the sample-content-ig Liquid templates</th>
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<valueString value="Numerator"/>
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<valueString
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* @numerator: HPV+ patients who reached cascade *resolution* — either by
* completing cytology OR by having a documented non-occurrence record.
*/
define "Numerator":
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*/
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*/
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* @numeratorExclusion: HPV+ patients whose resolution was via documented
* non-occurrence (LTFU) rather than actual cytology completion.
*
* FHIR Measure semantics: numerator-exclusion is subtracted from the
* numerator when computing the proportion. This lets a single Measure
* resource expose three computable views:
* - Cascade resolution rate: Numerator / Denominator
* - True follow-up rate: (Numerator − NumeratorExclusion) / Denominator
* - Documented LTFU rate: NumeratorExclusion / Denominator
* Together with (Denominator − Numerator) = the absent / unknown count,
* this gives programme managers a four-way partition of the HPV+ cohort.
*/
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<url value="http://smart.who.int/cxca/Measure/CXCAIND02"/>
<version value="0.0.1"/>
<name value="CXCAIND02"/>
<title
value="CXCA.IND.02 — Cervical Cancer Screening Cascade Completion (NotDone-aware)"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2026-05-14T00:50:23+00:00"/>
<publisher value="Dan Heslinga (independent contributor)"/>
<contact>
<name value="Dan Heslinga (independent contributor)"/>
<telecom>
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<description
value="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)."/>
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