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ccsm-cds-tools / ccsm-cds-with-tests

This repository contains clinical decision support (CDS) which provides recommendations for cervical cancer screening and management (CCSM).
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Update Observation Logic Section K.1 Heading 3 #132

Open mrnosal opened 7 months ago

mrnosal commented 7 months ago

This addresses the latest L2 observation logic for Section K.1 Heading 3 - Management of Histology of Less than CIN2 Preceded by Cytology ASC-H and HSIL in Patients Younger than 25 Year

The logic was updated to check for cytology or histology after 'CIN1 or less preceded by ASC-H/HSIL' by looking for a count of < 2. This means there are two possible cases: the cytology or histology result is present or there are zero results present. Adding a COUNT clause to the CQL logic complicates looking for the original CIN1 or less result. Therefore, to simplify the logic, these checks were added as individual cases (look for zero results after the CIN1 or less, look for one result after the CIN1 or less). This adds some redundancy to the code, but makes inspection of the code easier.

The time range for the "persists for 2 years" is specified as ">2 years" so test results which were exactly two years apart in the test cases need to be adjusted.

Additional logic diagrams have been linked to the JIRA ticket CCSMCDS-45 for this PR.

mrnosal commented 3 months ago

Refactored section K.1 Heading 3 code. Parts 1 and 2 were refactored to use PrecedingCytologyIsAscH and PrecedingCytologyIsHSIL instead of relying on SecondMostRecentCytology. K.1 Heading 3 part 3 was significantly refactored to use approach discussed. (Option B: Looking for “Most Recent” CytologyInterpretedAsAscH and checking that the patient hasn’t gotten a treatment for it yet.) Added extra test case for patient receiving normal followup at 1 year, but still ASC-H/HSIL persists at 2 year followup.