Updated measures to be continuous variable since the denominator isn'…

…t calculable. Only includes clients receiving the dose within the measurement period.
WorldHealthOrganization · Oct 6, 2023 · 3caffc8 · 3caffc8
1 parent 8755fbd
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diff --git a/input/cql/IMMZIND08.cql → input/cql/IMMZINDMeasles.cql b/input/cql/IMMZIND08.cql → input/cql/IMMZINDMeasles.cql
@@ -1,5 +1,5 @@
 /*
- * Library: IMMZ.IND.08
+ * Library: IMMZ.IND.Measles
  * Immunization coverage for Measles containing vaccine (Estimated Denominator) 
  * Compares the administered doses of measles containing vaccines (MCV) with the estimated number of surviving infants (if dose 1) or a country supplied denominator (if dose 2) expressed as a percentage. 
  * 
@@ -17,7 +17,7 @@
  * References: WHO Immunization Facility Analysis Guide (1), WHO / UNICEF Joint Reporting Form (3 - elements 4240 and 4260 )
  */
 
-library IMMZIND08
+library IMMZINDMeasles
 
 // Start Skeleton CQL
 using FHIR version '4.0.1'
@@ -28,41 +28,50 @@ include IMMZConfig called IMMZCon
 include IMMZIndicatorCommon called IMMZIndCom
 include IMMZVaccineLibrary called IMMZvl
 include FHIRCommon called FC
+include IMMZD2DTMeasles called Measles
 // End Skeleton CQL
 parameter "Measurement Period" Interval<Date>
 
 context Patient
 
 /*
- * Numerator: Number of administrations of vaccinations containing a Measles component during reporting period
- * Numerator Computation: COUNT immunization events WHERE administered product is a Measles vaccine (IMMZ.A1.DE9) during reporting period
- */
-define "measure-population":
-	exists(IMMZIndCom."MCV Doses Administered to Patient During Measurement Period")
+define "MCV Doses Administered to Patient During Measurement Period":
+    Measles."MCV Doses Administered to Patient" I 
+    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
+*/
+
+define function "Measure Observation" (Patient "Patient"):
+  1
 
 /*
- * Disaggregator: Dose Sequence (1, 2)
- */
-define "Dose Sequence  Stratifier":
-	IMMZIndCom."MCV Doses Administered to Patient During Measurement Period" I
-	return (singleton from I.protocolApplied).doseNumber
+ * Target population for first dose: Any one over 9 (in high transmission area) or 12 (in low transmission area) months old
+ */ 
+define "Initial Population 05":
+	Measles."First MCV Dose Administered to Patient" I where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
 
 /*
- * Disaggregator: Age Group (<24H of Birth, < 2 weeks)
+ * Numerator for first dose: Anyone having received the first dose
  */
-define "Age Group Stratifier":
-	IMMZIndCom."Infant By Age Stratifier"
+define "Measure Population 05":
+	"Initial Population 05"
 
 /*
- * Disaggregator: Geographic Region
+ * Target population for second dose: Any one over 15 months
+ */ 
+define "Initial Population 40":
+	Measles."Second MCV Dose Administered to Patient" I where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
+
+/*
+ * Numerator for second dose: Anyone having received the first dose
  */
-define "Geographic Region Stratifier":
-	IMMZIndCom."By Geographic Region Stratifier"
+define "Measure Population 40":
+	"Initial Population 40"
+
 
 /*
- * Disaggregator: Administrative Gender (or Biological Sex)
+ * Combined stratifiers
  */
-define "Administrative Gender Stratifier":
-	IMMZIndCom."By Administrative Gender Stratifier"
+define "Stratification":
+		IMMZIndCom."By Administrative Gender Stratifier".code + ':' + IMMZIndCom."Toddler By Age Stratifier".code + ':' + IMMZIndCom."By Geographic Region Stratifier"
+
 
-/* End of IMMZ.IND.08 */
diff --git a/input/cql/IMMZIndicatorCommon.cql b/input/cql/IMMZIndicatorCommon.cql
@@ -21,6 +21,7 @@ code "P1Y--P9999Y": 'P1Y--P9999Y' from "ISO-8601-Derived Periods" display '> 1 y
 
 // Age Groups for Vaccines for Toddlers
 code "P0Y--P2Y": 'P0Y--P2Y' from "ISO-8601-Derived Periods" display '< 2 years'
+code "P1Y--P2Y": 'P1Y--P2Y' from "ISO-8601-Derived Periods" display '1 year'
 code "P2Y--P9999Y": 'P2Y--P9999Y' from "ISO-8601-Derived Periods" display '> 2 years'
 
 // Age groups for newborns
@@ -83,7 +84,8 @@ define "Infant By Age Stratifier":
  */
 define "Toddler By Age Stratifier":
     case 
-        when AgeInYearsAt(start of "Measurement Period") < 2 then "P0Y--P2Y"
+        when AgeInYearsAt(start of "Measurement Period") < 1 then "P0Y--P1Y"
+        when AgeInYearsAt(start of "Measurement Period") < 2 then "P1Y--P2Y"
         when AgeInYearsAt(start of "Measurement Period") >= 2 then "P2Y--P9999Y"
         else null
     end
@@ -137,228 +139,6 @@ define "Seasonal Influenza By Age Stratifier":
         when AgeInYearsAt(start of "Measurement Period") >= 60 then "P60Y--P9999Y"
         else null
     end
-/*
- * BCG Doses administered to the patient during the measurement period
- */
-define "BCG Doses Administered to Patient During Measurement Period":
-    IMMZCom."BCG Doses Administered to Patient" I
-		where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/*
- * DTP Doses administered to the patient during the measurement period
- */
-define "DTP Doses Administered to Patient During Measurement Period":
-    IMMZCom."DTP Doses Administered to Patient" I
-		where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/*
- * HepB Doses administered to the patient during the measurement period
- */
-define "HepB Birth Doses Administered to Patient During Measurement Period":
-    IMMZCom."HepB Doses Administered to Patient" I
-		where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-        and (singleton from I.protocolApplied).doseNumber = 0
-
-/**
- * Non-Birth HepB doses administered to patient
- */
-define "HepB Non-Birth Doses Administered to Patient During Measurement Period":
-    IMMZCom."HepB Doses Administered to Patient" I
-		where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-        and (singleton from I.protocolApplied).doseNumber > 0
-
-/**
- * IPV Doses Administered to Patient
- */
-define "IPV Doses Administered to Patient During Measurement Period":
-    IMMZCom."IPV Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-define "Seasonal Influenza Doses Administered to Patient During Reporting Period":
-    IMMZCom."Seasonal Influenza Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/**
- * OPV Birth Doses Administered to Patient
- */
-define "bOPV Birth Doses Administered to Patient During Measurement Period":
-    IMMZCom."bOPV Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-    and (singleton from I.protocolApplied).doseNumber = 0
-
-/**
- * OPV Non-Birth Doses Administered to Patient
- */
-define "bOPV Non-Birth Doses Administered to Patient During Measurement Period":
-    IMMZCom."bOPV Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-    and (singleton from I.protocolApplied).doseNumber > 0
-
-
-/**
- * MCV Doses Administered to Patient
- */
-define "MCV Doses Administered to Patient During Measurement Period":
-    IMMZCom."MCV Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/**
- * HPV Doses Administered to Patient
- */
-define "HPV Doses Administered to Patient During Measurement Period":
-    IMMZCom."HPV Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/**
- * Meningococcal Doses Administered to Patient
- */
-define "Meningococcal Doses Administered to Patient During Measurement Period":
-    IMMZCom."Meningococcal Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/**
- * Pneumococcal Doses Administered to Patient
- */
-define "Pneumococcal Doses Administered to Patient During Measurement Period":
-    IMMZCom."Pneumococcal Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/**
- * HIB Doses Administered to Patient
- */
-define "Hib Doses Administered to Patient During Measurement Period":
-    IMMZCom."Hib Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/**
- * Rotavirus Doses Administered to Patient
- */
-define "Rotavirus Doses Administered to Patient During Measurement Period":
-    IMMZCom."Rotavirus Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/**
- * RCV Doses Administered to Patient
- */
-define "Rubella Doses Administered to Patient During Measurement Period":
-    IMMZCom."Rubella Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/**
- * Varicella Doses Administered to Patient
- */
-define "Varicella Doses Administered to Patient During Measurement Period":
-    IMMZCom."Varicella Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-
-/**
- * Diptheria Doses Administered to Patient
- */
-define "Diphtheria Booster Doses Administered to Patient During Measurement Period":
-    IMMZCom."Diphtheria Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-        and (singleton from I.protocolApplied).doseNumber > 3
-
-/**
- * Pertussis Doses Administered to Patient
- */
-define "Pertussis Booster Doses Administered to Patient During Measurement Period":
-    IMMZCom."Diphtheria Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-        and (singleton from I.protocolApplied).doseNumber > 3
-
-
-/**
- * Tetanus Doses Administered to Patient
- */
-define "Tetanus Booster Doses Administered to Patient During Measurement Period":
-    IMMZCom."Tetanus Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-        and (singleton from I.protocolApplied).doseNumber > 4
-
-
-/**
- * Yellow Fever Doses Administered to Patient
- */
-define "Yellow Fever Doses Administered to Patient During Measurement Period":
-    IMMZCom."Yellow Fever Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-
-/**
- * Japanese Encephalitis  Doses Administered to Patient
- */
-define "JE Doses Administered to Patient During Measurement Period":
-    IMMZCom."JE Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/**
- * Typhoid Encephalitis  Doses Administered to Patient
- */
-define "Typhoid Doses Administered to Patient During Measurement Period":
-    IMMZCom."Typhoid Doses Administered to Patient" I 
-    where IMMZCom.ToDate(I.occurrence) during "Measurement Period"
-
-/** 
- * HPV Doses recommended during reporting period - 
- *  This is used since the country should define the rules which recommend an HPV dose (age, sex, etc.)
- */
-define "HPV Doses Recommended During Reporting Period":
-    [ImmunizationRecommendation] IR
-    where exists(IR.recommendation RC where exists(RC.dateCriterion DC where date from DC.value during "Measurement Period")
-    and RC.vaccineCode in IMMZc."HPV Vaccine")
-
-
-/** 
- * Rubella Doses recommended during reporting period - 
- *  This is used since the country should define the rules which recommend an Rubella dose (configuration, age, sex, etc.)
- */
-define "Rubella Doses Recommended During Reporting Period":
-    [ImmunizationRecommendation] IR
-    where exists(IR.recommendation RC where exists(RC.dateCriterion DC where date from DC.value during "Measurement Period")
-    and RC.vaccineCode in IMMZc."Rubella Vaccine")
-
-/** 
- * Varicella Doses recommended during reporting period - 
- *  This is used since the country should define the rules which recommend an Varicella dose (configuration, age, sex, etc.)
- */
-define "Varicella Doses Recommended During Reporting Period":
-    [ImmunizationRecommendation] IR
-    where exists(IR.recommendation RC where exists(RC.dateCriterion DC where date from DC.value during "Measurement Period")
-    and RC.vaccineCode in IMMZc."Varicella Vaccine")
-
-/** 
- * Diphtheria Booster Doses recommended during reporting period - 
- *  This is used since the country should define the rules which recommend an Diphtheria booster dose (configuration, age, sex, etc.)
- */
-define "Diphtheria Booster Doses Recommended During Reporting Period":
-    [ImmunizationRecommendation] IR
-    where exists(IR.recommendation RC where exists(RC.dateCriterion DC where date from DC.value during "Measurement Period")
-    and RC.doseNumber > 3
-    and RC.vaccineCode in IMMZc."Diphtheria Vaccine")
-
-/** 
- * Pertussis Booster Doses recommended during reporting period - 
- *  This is used since the country should define the rules which recommend an Pertussis booster dose (configuration, age, sex, etc.)
- */
-define "Pertussis Booster Doses Recommended During Reporting Period":
-    [ImmunizationRecommendation] IR
-    where exists(IR.recommendation RC where exists(RC.dateCriterion DC where date from DC.value during "Measurement Period")
-    and RC.doseNumber > 3
-    and RC.vaccineCode in IMMZc."Pertussis Vaccine")
-
-
-/** 
- * Tetanus Booster Doses recommended during reporting period - 
- *  This is used since the country should define the rules which recommend an Tetanus booster dose (configuration, age, sex, etc.)
- */
-define "Tetanus Booster Doses Recommended During Reporting Period":
-    [ImmunizationRecommendation] IR
-    where exists(IR.recommendation RC where exists(RC.dateCriterion DC where date from DC.value during "Measurement Period")
-    and RC.doseNumber > 3
-    and RC.vaccineCode in IMMZc."Tetanus Vaccine")
-
 
 /**
  * By Administrative Gender of Patient Stratifier

diff --git a/input/fsh/Aliases.fsh b/input/fsh/Aliases.fsh
@@ -3,4 +3,7 @@ Alias: $LNC = http://loinc.org
 Alias: $ICD11 = http://hl7.org/fhir/sid/icd-11
 Alias: $ICD10 = http://hl7.org/fhir/sid/icd-10
 Alias: $CVX = http://hl7.org/fhir/sid/cvx 
-Alias: $GENDER = http://hl7.org/fhir/administrative-gender
+Alias: $GENDER = http://hl7.org/fhir/administrative-gender
+
+Alias: $measure-scoring = http://terminology.hl7.org/CodeSystem/measure-scoring
+Alias: $measure-population = http://terminology.hl7.org/CodeSystem/measure-population