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BreastCancerScreeningFHIR.cql
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BreastCancerScreeningFHIR.cql
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library BreastCancerScreeningFHIR version '2.0.003'
using FHIR version '4.0.1'
include FHIRHelpers version '4.0.001' called FHIRHelpers
include SupplementalDataElementsFHIR4 version '2.0.000' called SDE
include MATGlobalCommonFunctionsFHIR4 version '6.0.000' called Global
include AdultOutpatientEncountersFHIR4 version '2.0.000' called AdultOutpatientEncounters
include HospiceFHIR4 version '2.0.000' called Hospice
include AdvancedIllnessandFrailtyExclusionECQMFHIR4 version '5.12.000' called Frailty
codesystem "LOINC": 'http://loinc.org'
codesystem "SNOMEDCT": 'http://snomed.info/sct'
valueset "Bilateral Mastectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005'
valueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'
valueset "Female": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.560.100.2'
valueset "History of bilateral mastectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068'
valueset "Left": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1036'
valueset "Mammography": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018'
valueset "ONC Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1'
valueset "Payer": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'
valueset "Race": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'
valueset "Right": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1035'
valueset "Status Post Left Mastectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069'
valueset "Status Post Right Mastectomy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070'
valueset "Unilateral Mastectomy Left": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1133'
valueset "Unilateral Mastectomy Right": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1134'
valueset "Unilateral Mastectomy, Unspecified Laterality": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071'
code "Birth date": '21112-8' from "LOINC" display 'Birth date'
code "Left (qualifier value)": '7771000' from "SNOMEDCT" display 'Left (qualifier value)'
code "Right (qualifier value)": '24028007' from "SNOMEDCT" display 'Right (qualifier value)'
parameter "Measurement Period" Interval<DateTime>
default Interval[@2019-01-01T00:00:00.0, @2020-01-01T00:00:00.0)
context Patient
define "SDE Ethnicity":
SDE."SDE Ethnicity"
define "SDE Payer":
SDE."SDE Payer"
define "SDE Race":
SDE."SDE Race"
define "SDE Sex":
SDE."SDE Sex"
define "Initial Population":
Patient.gender = 'female'
and AgeInYearsAt(start of "Measurement Period") between 51 and 74
and exists AdultOutpatientEncounters."Qualifying Encounters"
define "Denominator":
"Initial Population"
define "Right Mastectomy Diagnosis":
(
( [Condition: "Status Post Right Mastectomy"]
//where C.clinicalStatus ~ ToConcept(Global."active") not nneeded for exclusion
)
union (
[Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis
where UnilateralMastectomyDiagnosis.bodySite in "Right"
// and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active") not needed for exclusion
)
) RightMastectomy
where Global."Normalize Interval"(RightMastectomy.onset) starts on or before end of "Measurement Period"
define "Right Mastectomy Procedure":
[Procedure: "Unilateral Mastectomy Right"] UnilateralMastectomyRightPerformed
where Global."Normalize Interval"(UnilateralMastectomyRightPerformed.performed) ends on or before end of "Measurement Period"
and UnilateralMastectomyRightPerformed.status = 'completed'
define "Left Mastectomy Procedure":
[Procedure: "Unilateral Mastectomy Left"] UnilateralMastectomyLeftPerformed
where Global."Normalize Interval"(UnilateralMastectomyLeftPerformed.performed) ends on or before end of "Measurement Period"
and UnilateralMastectomyLeftPerformed.status = 'completed'
define "Left Mastectomy":
(
( [Condition: "Status Post Left Mastectomy"]
// where C.clinicalStatus ~ ToConcept(Global."active") not needed for exclusion
)
union (
[Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis
where UnilateralMastectomyDiagnosis.bodySite in "Left"
// and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active") not needed for exclusion
)
) LeftMastectomy
where Global."Normalize Interval"(LeftMastectomy.onset) starts on or before end of "Measurement Period"
define "Bilateral Mastectomy Diagnosis":
[Condition: "History of bilateral mastectomy"] BilateralMastectomyHistory
where Global."Normalize Interval"(BilateralMastectomyHistory.onset) starts on or before end of "Measurement Period"
// and BilateralMastectomyHistory.clinicalStatus ~ ToConcept(Global."active") not needed because it is an exclusion
define "Bilateral Mastectomy Procedure":
[Procedure: "Bilateral Mastectomy"] BilateralMastectomyPerformed
where Global."Normalize Interval"(BilateralMastectomyPerformed.performed) ends on or before end of "Measurement Period"
and BilateralMastectomyPerformed.status = 'completed'
define "Numerator":
exists (
[DiagnosticReport: "Mammography"] Mammogram
where ( Global."Normalize Interval"(Mammogram.effective) ends 27 months or less on or before end of "Measurement Period" )
and Mammogram.status in { 'final', 'amended', 'corrected', 'appended' }
)
define "Denominator Exclusion":
Hospice."Has Hospice"
or (( exists "Right Mastectomy Diagnosis"
or exists "Right Mastectomy Procedure")
and (exists "Left Mastectomy" or exists "Left Mastectomy Procedure"))
or exists "Bilateral Mastectomy Diagnosis"
or exists "Bilateral Mastectomy Procedure"
or Frailty."Advanced Illness and Frailty Exclusion Not Including Over Age 80"
or (AgeInYearsAt(start of "Measurement Period") >= 65
and Frailty."Long Term Care Periods Longer Than 90 Consecutive Days")