Wsg 101 indicators 46 55 rebased

input/cql/HIVB2DTLogic.cql

@@ -2,87 +2,112 @@
 Library: HIV.B2.DT Logic
 
 @DecisionID: HIV.B2.DT
-@BusinessRule:
-@Trigger: 
-@Description: 
-
-Check for signs of serious illness
-Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach (2021) Chapter 5: Advanced HIV Disease. Figure 5.1: Algorithm for providing a package of care for people with advanced HIV disease.  
-Should this just be for anyone with HIV? 
-Wouldn't other  disease domains also code for general exam?
+@BusinessRule: Check for signs of serious illness
+@Trigger: HIV.B2 Check for signs of serious illness
+@Trigger: HIV.D3 Check for signs of serious illness
+@HitPolicy: Rule Order
+@Description: Check for serious illness
+
+Data Concepts:
+ * HIV.A.DE17: Age | Calculated age (number of years) of the client based on date of birth
+ * HIV.D.DE17: Signs of serious illness | Signs that may indicate the client has a serious illness and needs triage or an emergency referral
+ * HIV.D.DE9: Body temperature | Temperature of the client in Celsius
+
+Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach (2021) Chapter 5: Advanced HIV Disease. Figure 5.1: Algorithm for providing a package of care for people with advanced HIV disease.
 */
 
 library HIVB2DTLogic
 
- using FHIR version '4.0.1'
-
+using FHIR version '4.0.1'
 
- include HIVCommon version '0.0.1' called HIC
- include FHIRHelpers version '4.0.1'
- include WHOCommon called WCom
- include FHIRCommon called FC
+include HIVCommon version '0.0.1' called HIC
+include HIVConcepts called HCx
+include HIVEncounterElements called Elements
+include FHIRHelpers version '4.0.1'
 
- valueset "Tachycardia": ''
- valueset "Tachypnea": ''
- valueset "Unable to walk unaided": ''
- valueset "Body temperature = ≥ 39 °C": '' 
- valueset "Other sign of serious illness (specify)": ''
- valueset "Lethargy": ''
- valueset "Unconsciousness": ''
- valueset "Convulsions": ''
- valueset "Unable to breastfeed": ''
- valueset "Unable to drink": ''
- valueset "Repeated vomiting": ''
+include WHOCommon called WCom
 
- context Patient
+context Patient
 
  /*
-  * Age = ≥ 10 years
+  @input: "Age 10 or older"
+  @pseudocode: 'Age' >= 10 years
   */
-
-define "Age_10_or_more":
+define "Age 10 or older":
   AgeInYearsAt(Today()) >= 10
 
  /*
-  * Age < 10 years
+  @input: "Age under 10"
+  @pseudocode: 'Age' < 10 years
   */
-
-define "Age_less_than_10":
+define "Age under 10":
   AgeInYearsAt(Today()) < 10
 
-define "Take action or refer client showing signs of a serious illness":
-  exists(([Observation: "Tachycardia"]
-  union [Observation: "Tachypnea"]
-  union [Observation: "Unable to walk unaided"]) O
-  where Age_10_or_more
-  and O.status in { 'final', 'amended' })
-  or exists(([Observation: "Lethargy"]
-  union [Observation: "Unconsciousness"]
-  union [Observation: "Convulsions"]
-  union [Observation: "Unable to breastfeed"]
-  union [Observation: "Unable to drink"]
-  union [Observation: "Unconsciousness"]
-  union [Observation: "Repeated vomiting"]) O
-  where Age_less_than_10
-  and O.status in { 'final', 'amended' }
-  )
-
-//plan definition Immediately take action or refer for care if a client is having this issue.
-
+/*
+ @output: "Immediately take action or refer for care if a client is having this issue"
+ */
+define "Immediately take action or refer for care if a client is having this issue":
+  exists(Elements."Signs of serious illness" O
+    where "Age 10 or older" 
+      and O.value ~ HCx."Tachycardia")
+
+/*
+ @output "Immediately take action or refer for care if client is showing this sign of a serious illness."
+ */
+define "Immediately take action or refer for care if client is showing this sign of a serious illness":
+  "Signs of serious illness age 10 or older" or "Signs of serious illness age under 10"
+
+/*
+ @output "Use clinical judgement and consider local epidemiology to determine if symptoms suggest client is seriously ill"
+ */
 define "Use clinical judgement and consider local epidemiology to determine if symptoms suggest client is seriously ill":
-  exists (([Observation: "Body temperature = ≥ 39 °C"]
-  union [Observation: "Other sign of serious illness (specify)"]) O
-  where Age_10_or_more
-  and O.status in { 'final', 'amended' })
-  // Please this condition needs to be fixed
-  // or exists((([Observation: "Body temperature = ≥ 39 °C"]
-  // intersect [Observation: "Tachycardia"])
-  // or ([Observation: "Body temperature = ≥ 39 °C"]
-  // intersect [Observation: "Tachypnea"])
-  // or [Observation: "Other sign of serious illness (specify)"]) O
-  // where Age_less_than_10
-  // and O.status in { 'final', 'amended' })
-  // )
-
-
-//plan definition  Use clinical judgement and consider local epidemiology to determine if symptoms suggest client is seriously ill. 
+  "Signs of serious illness requiring clinical judgement age 10 or older" or "Signs of serious illness requiring clinical judgement age under 10"
+
+/*
+ @dynamicValue: Guidance
+ */
+define "Guidance":
+  case 
+  when "Immediately take action or refer for care if a client is having this issue" 
+    then "Immediately take action or refer for care if a client is having this issue."
+  when "Immediately take action or refer for care if client is showing this sign of a serious illness" and "Age 10 or older"
+    then "Immediately take action or refer for care if client is showing this sign of a serious illness."
+  when "Immediately take action or refer for care if client is showing this sign of a serious illness" and "Age under 10"
+    then """This is a sign and/or symptom of a serious health condition.
+
+Immediately take action or refer for care if client is showing this sign of a serious illness."""
+  else null
+  end
+
+/*
+ Supporting Logic
+*/
+define "Signs of serious illness age 10 or older":
+  "Age 10 or older" and Elements."Signs of serious illness" O
+    where
+      O.value ~ HCx."Tachypnea" or
+      O.value ~ HCx."Unable to walk unaided"
+
+define "Signs of serious illness age under 10":
+  "Age under 10" and Elements."Signs of serious illness" O
+    where 
+      O.value in {
+        HCx."Lethargy - HIV.D.DE22",
+        HCx."Unconsciousness",
+        HCx."Convulsions",
+        HCx."Unable to breastfeed",
+        HCx."Unable to drink",
+        HCx."Repeated vomiting"
+      } 
+
+define "Signs of serious illness requiring clinical judgement age 10 or older":
+  "Age 10 or older" and Elements."Signs of serious illness" O
+    where
+      O.value ~ HCx."Fever of 39 C or greater" or
+      O.value ~ HCx."Other sign of serious illness"
+
+define "Signs of serious illness requiring clinical judgement age under 10":
+  "Age under 10" and Elements."Signs of serious illness" O
+    where 
+      O.value ~ HCx."Fever of 39 C or greater" or
+      O.value ~ HCx."Other sign of serious illness"

input/cql/HIVB7DTLogic.cql

@@ -32,7 +32,7 @@ valueset "Non-reactive": 'http://fhir.org/guides/who/hiv-dak/ValueSet/hiv-b-de10
 
 include FHIRHelpers version '4.0.1'
 include WHOCommon called WCom
-include FHIRCommon called FC
+
 
 //code "Assay 1 Reactive": 'HIV.B.DE95' from "TestresultofHIVassay1Codes" display 'Assay 1 reactive'
 //code "Reactive": 'HIV.B.DE103' from "HIV_DAK_Codes" display 'Reactive'