Id: CXCAD2DTHPVResultRouting
Url: CXCA.D2.DT — HPV Result Routing
Version: 0.0.1
Title: CXCA.D2.DT — HPV Result Routing
Status: draft
Type:

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

code: eca-rule

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.
Libraries:
CXCAD2DTHPVResultRoutingLogic
Actions:
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).
If: Applicability: (Route — HPV negative, return to routine)
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.)
If: Applicability: (Route — HPV+, cytology negative, repeat HPV in 12 months)
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.
If: Applicability: (Route — HPV+, cytology ≥ ASC-US, refer to colposcopy)
Then: Definition: CXCAD2 — Colposcopy Service Request
<type> <coding> <system value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/> <code value="eca-rule"/> </coding> </type> <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> <system value="url"/> <value value="https://github.com/dhes"/> </telecom> </contact> <description value="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."/> <library value="http://smart.who.int/cxca/Library/CXCAD2DTHPVResultRoutingLogic"/> <action> <title value="HPV negative — return to routine screening"/> <description value="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)."/> <condition> <kind value="applicability"/> <expression> <language value="text/cql-identifier"/> <expression value="Route — HPV negative, return to routine"/> </expression> </condition> </action> <action> <title value="HPV positive, cytology re-read negative — repeat HPV in 12 months"/> <description value="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.)"/> <condition> <kind value="applicability"/> <expression> <language value="text/cql-identifier"/> <expression value="Route — HPV+, cytology negative, repeat HPV in 12 months"/> </expression> </condition> </action> <action> <title value="HPV positive, cytology ≥ ASC-US — refer to colposcopy"/> <description value="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."/> <condition> <kind value="applicability"/> <expression> <language value="text/cql-identifier"/> <expression value="Route — HPV+, cytology ≥ ASC-US, refer to colposcopy"/> </expression> </condition> <definitionCanonical value="http://smart.who.int/cxca/ActivityDefinition/CXCAD2ColposcopyServiceRequest"/> </action> </PlanDefinition>