@prefix fhir: . @prefix owl: . @prefix rdf: . @prefix rdfs: . @prefix xsd: . # - resource ------------------------------------------------------------------- a fhir:PlanDefinition ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "CXCAD2DTHPVResultRouting"] ; # fhir:meta [ fhir:profile ( [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"^^xsd:anyURI ; fhir:l ] ) ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div [ fhir:v "
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Id: CXCAD2DTHPVResultRouting
Url: CXCA.D2.DT — HPV Result Routing
Version: 0.0.1
Title: CXCA.D2.DT — HPV Result Routing
Status: draft
Type: \n \n \n \n

\n system: http://terminology.hl7.org/CodeSystem/plan-definition-type\n

\n \n \n

\n code: eca-rule\n

\n \n \n \n \n \n
Date: 2026-05-14 00:50:23+0000
Publisher: Dan Heslinga (independent contributor)
Description:

Decision support recommendation for routing after an HPV high-risk DNA test result returns. Implements the three-outcome decision tree from Mongolia MOH Order A/641 (2020) Fig 2.4: HPV negative → routine; HPV+ with negative cytology re-read → repeat HPV in 12 months; HPV+ with cytology ≥ ASC-US → refer to colposcopy.

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Libraries: \n \n \n \n \n \n \n
CXCAD2DTHPVResultRoutingLogic
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Actions: \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n
\n \n HPV negative — return to routine screening: HPV high-risk DNA test result is negative. No further investigation indicated. Return the patient to the routine screening cycle per the binding pathway (HPV at next target age, or cytology at next 3-yearly visit).\n \n
\n \n \n If:\n \n Applicability:\n \n (Route — HPV negative, return to routine)\n
\n \n \n \n \n \n
\n \n HPV positive, cytology re-read negative — repeat HPV in 12 months: HPV high-risk DNA test result is positive but the cytology re-read of the saved slide shows no significant abnormality (NILM). Per A/641 Fig 2.4, do not refer to colposcopy at this time. Repeat the HPV test in 12 months. If still positive at the 12-month recheck, the next evaluation will route to colposcopy. (Recall scheduling — Phase 5 chunk 7 deferred.)\n \n
\n \n \n If:\n \n Applicability:\n \n (Route — HPV+, cytology negative, repeat HPV in 12 months)\n
\n \n \n \n \n \n
\n \n HPV positive, cytology ≥ ASC-US — refer to colposcopy: HPV high-risk DNA test result is positive and the cytology re-read shows ≥ ASC-US (any of ASC-US, ASC-H, LSIL, HSIL per Bethesda 2014). Per A/641 Fig 2.4, refer the patient to colposcopy without delay. Create a proposed ServiceRequest for colposcopy.\n \n
\n \n \n If:\n \n Applicability:\n \n (Route — HPV+, cytology ≥ ASC-US, refer to colposcopy)\n
\n \n \n \n \n Then: Definition: CXCAD2 — Colposcopy Service Request
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"^^rdf:XMLLiteral ] ] ; # fhir:contained ( [ a fhir:Library ; fhir:id [ fhir:v "effective-data-requirements" ] ; fhir:extension ( [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAD2DTHPVResultRoutingLogic" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Route — HPV+, cytology negative, repeat HPV in 12 months" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "/*\n * @output: CXCA.D#DE35 \"Route: repeat HPV test in 12 months\"\n * @bindingness: legal\n * HPV result is positive but the cytology re-read shows no significant\n * cellular abnormality (NILM / less than ASC-US). Per Fig 2.4, do not refer\n * to colposcopy yet — recheck HPV in 12 months. If still positive at recheck,\n * the next evaluation will route to colposcopy.\n */\ndefine \"Route — HPV+, cytology negative, repeat HPV in 12 months\":\n \"HPVResultPositive\"\n and not \"CytologyResultASCUSorWorse\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 0 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAD2DTHPVResultRoutingLogic" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Route — HPV negative, return to routine" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "// =============================================================================\n// Routing rules — three mutually-exclusive outcomes per A/641 Fig 2.4\n// =============================================================================\n\n/*\n * @output: CXCA.D#DE34 \"Route: return to routine screening\"\n * @bindingness: legal\n * HPV result is negative — no further investigation indicated.\n */\ndefine \"Route — HPV negative, return to routine\":\n not \"HPVResultPositive\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 1 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "libraryName"^^xsd:anyURI ; fhir:l fhir:libraryName ] ; fhir:value [ a fhir:String ; fhir:v "CXCAD2DTHPVResultRoutingLogic" ] ] [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:String ; fhir:v "Route — HPV+, cytology ≥ ASC-US, refer to colposcopy" ] ] [ fhir:url [ fhir:v "statement"^^xsd:anyURI ; fhir:l fhir:statement ] ; fhir:value [ a fhir:String ; fhir:v "/*\n * @output: CXCA.D#DE36 \"Route: refer to colposcopy\"\n * @bindingness: legal\n * HPV result is positive and cytology re-read shows ≥ ASC-US (any of\n * ASC-US, ASC-H, LSIL, HSIL per Bethesda 2014). Refer to colposcopy\n * directly per A/641 Fig 2.4 (Op.Inst. 5.6 covers the colposcopy procedure).\n */\ndefine \"Route — HPV+, cytology ≥ ASC-US, refer to colposcopy\":\n \"HPVResultPositive\"\n and \"CytologyResultASCUSorWorse\"" ] ] [ fhir:url [ fhir:v "displaySequence"^^xsd:anyURI ; fhir:l fhir:displaySequence ] ; fhir:value [ a fhir:Integer ; fhir:v 2 ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"^^xsd:anyURI ; fhir:l ] ] ) ; fhir:name [ fhir:v "EffectiveDataRequirements" ] ; fhir:status [ fhir:v "active" ] ; fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/library-type"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "module-definition" ] ] ) ] ; fhir:relatedArtifact ( [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "FHIR model information" ] ; fhir:resource [ fhir:v "http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1"^^xsd:anyURI ; fhir:l ] ] ) ; fhir:parameter ( [ fhir:name [ fhir:v "HPVResultPositive" ] ; fhir:use [ fhir:v "in" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:name [ fhir:v "CytologyResultASCUSorWorse" ] ; fhir:use [ fhir:v "in" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:name [ fhir:v "Route — HPV+, cytology negative, repeat HPV in 12 months" ] ; fhir:use [ fhir:v "out" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:name [ fhir:v "Route — HPV negative, return to routine" ] ; fhir:use [ fhir:v "out" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:name [ fhir:v "Route — HPV+, cytology ≥ ASC-US, refer to colposcopy" ] ; fhir:use [ fhir:v "out" ] ; fhir:min [ fhir:v 0 ] ; fhir:max [ fhir:v "1" ] ; fhir:type [ fhir:v "boolean" ] ] ) ] ) ; # fhir:extension ( [ fhir:url [ fhir:v "http://smart.who.int/cxca/StructureDefinition/cxca-bindingness"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://smart.who.int/cxca/CodeSystem/CXCA.Bindingness"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "legal" ] ; fhir:display [ fhir:v "Legal — binding regulatory instrument" ] ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Canonical ; fhir:v "#effective-data-requirements"^^xsd:anyURI ; fhir:l <#effective-data-requirements> ] ] ) ; # fhir:url [ fhir:v "http://smart.who.int/cxca/PlanDefinition/CXCAD2DTHPVResultRouting"^^xsd:anyURI ; fhir:l ] ; # fhir:version [ fhir:v "0.0.1"] ; # fhir:name [ fhir:v "CXCAD2DTHPVResultRouting"] ; # fhir:title [ fhir:v "CXCA.D2.DT — HPV Result Routing"] ; # fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/plan-definition-type"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "eca-rule" ] ] ) ] ; # fhir:status [ fhir:v "draft"] ; # fhir:experimental [ fhir:v false] ; # fhir:date [ fhir:v "2026-05-14T00:50:23+00:00"^^xsd:dateTime] ; # fhir:publisher [ fhir:v "Dan Heslinga (independent contributor)"] ; # fhir:contact ( [ fhir:name [ fhir:v "Dan Heslinga (independent contributor)" ] ; fhir:telecom ( [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "https://github.com/dhes" ] ] ) ] ) ; # fhir:description [ fhir:v "Decision support recommendation for routing after an HPV high-risk DNA test result returns. Implements the three-outcome decision tree from Mongolia MOH Order A/641 (2020) Fig 2.4: HPV negative → routine; HPV+ with negative cytology re-read → repeat HPV in 12 months; HPV+ with cytology ≥ ASC-US → refer to colposcopy."] ; # fhir:library ( [ fhir:v "http://smart.who.int/cxca/Library/CXCAD2DTHPVResultRoutingLogic"^^xsd:anyURI ; fhir:l ] ) ; # fhir:action ( [ fhir:title [ fhir:v "HPV negative — return to routine screening" ] ; fhir:description [ fhir:v "HPV high-risk DNA test result is negative. No further investigation indicated. Return the patient to the routine screening cycle per the binding pathway (HPV at next target age, or cytology at next 3-yearly visit)." ] ; fhir:condition ( [ fhir:kind [ fhir:v "applicability" ] ; fhir:expression [ fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Route — HPV negative, return to routine" ] ] ] ) ] [ fhir:title [ fhir:v "HPV positive, cytology re-read negative — repeat HPV in 12 months" ] ; fhir:description [ fhir:v "HPV high-risk DNA test result is positive but the cytology re-read of the saved slide shows no significant abnormality (NILM). Per A/641 Fig 2.4, do not refer to colposcopy at this time. Repeat the HPV test in 12 months. If still positive at the 12-month recheck, the next evaluation will route to colposcopy. (Recall scheduling — Phase 5 chunk 7 deferred.)" ] ; fhir:condition ( [ fhir:kind [ fhir:v "applicability" ] ; fhir:expression [ fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Route — HPV+, cytology negative, repeat HPV in 12 months" ] ] ] ) ] [ fhir:title [ fhir:v "HPV positive, cytology ≥ ASC-US — refer to colposcopy" ] ; fhir:description [ fhir:v "HPV high-risk DNA test result is positive and the cytology re-read shows ≥ ASC-US (any of ASC-US, ASC-H, LSIL, HSIL per Bethesda 2014). Per A/641 Fig 2.4, refer the patient to colposcopy without delay. Create a proposed ServiceRequest for colposcopy." ] ; fhir:condition ( [ fhir:kind [ fhir:v "applicability" ] ; fhir:expression [ fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Route — HPV+, cytology ≥ ASC-US, refer to colposcopy" ] ] ] ) ; fhir:definition [ a fhir:Canonical ; fhir:v "http://smart.who.int/cxca/ActivityDefinition/CXCAD2ColposcopyServiceRequest"^^xsd:anyURI ; fhir:l ] ] ) . # # -------------------------------------------------------------------------------------