WSG-99 Indicators HIV.IND.37-HIV.IND.45 and Refactoring of Indicator Logic #43
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pmanko
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| and C.code ~ Concepts."HIV-positive - HIV.B.DE116" | ||
| sort by start of onset.toInterval() | ||
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| define "First HIV Treatment": |
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What's the difference between "First HIV Treatment" and "First On ART"?
| code "HIV-positive": 'HIV.B.DE34' from "HIVConcepts" display 'HIV-positive' | ||
| code "HIV-negative": 'HIV.B.DE35' from "HIVConcepts" display 'HIV-negative' |
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Didn't we have two HIV-positive, i.e., one in HIV.B and one in HIV.D?
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Hmmm... looking at it (and this may be hard to do in a principled way) HIV.B.DE33 (the question to which these are the implied answers) concerns partner HIV status whereas HIV.B.DE115 concerns the client's HIV status. Of the two, it's probably less confusing if HIV.B.DE116 and HIV.B.DE117 are the plain "HIV-positive" and "HIV-negative" concepts.
input/cql/HIVElements.cql
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| parameter "Measurement Period" Interval<Date> default Interval[@2020-01-01, @2020-12-31] | ||
| // parameter "Measurement Period" Interval<Date> default Interval[@2020-01-01, @2020-12-31] | ||
| parameter "Measurement Date" Date default @2020-01-01 | ||
| parameter "Testing Interval" System.Quantity default 3 months |
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This parameter is a little weird. I think 3 month re-testing is standard for clients on PrEP, but, e.g., for clients on ART who aren't experiencing treatment failure, its generally annual testing and the WHO recommendations are basically annual retests for people at high risk with 3-6 month re-tests "based on individual risk factors".
Maybe it could be renamed?
input/cql/HIVElements.cql
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| define "HIV test result DiagnosticReport": | ||
| [DiagnosticReport: Concepts."HIV test type - HIV.B.DE81 Choices"] DR | ||
| with "HIV test" SR | ||
| such that DR.basedOn.references(SR) | ||
| where DR.status in { 'final', 'amended', 'corrected' } |
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Do we really want to make this dependent on a DiagnosticReport? In this case, it's not clear to me what value the DR adds over the Observation for our purposes (i.e., the Observation still has the basedOn stuff, we're only really checking a single observation, etc.
input/cql/HIVElements.cql
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| define "HIV test": | ||
| [ServiceRequest: Concepts."HIV test type - HIV.B.DE81 Choices"] SR | ||
| where SR.status in { 'active', 'completed' } |
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I'm a bit curious about this mapping:
- The service request is, as the name implies, a request and not an actual record of a test performed. Unless we're specifically trying to calculate how many tests were ordered its not clear to me that this is semantically the correct resource to use.
- It makes the "Non-Self HIV test" look (to me) like we're creating a resource that's just their to structurally allow the ServiceRequest to function. HIV self-tests are available on a non-prescription basis, which means that in the normal course of things, you'd only ever have orders for a small sub-set of HIV tests.
The testing algorithm in B7.DT does create ServiceRequests, but the actual record of the test being done, etc. but the final result is always recorded as an algorithm.
input/cql/HIVElements.cql
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| define "HIV test result DiagnosticReport Value": | ||
| "HIV test result DiagnosticReport Observation" O | ||
| return O.value |
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It might be worth considering using interpretation vs value here, but I don't feel very strongly about that.
pmanko
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