Expand on text for post-hysterectomy language

[mickohanlon23]

We have discussed adding a caveat to all recommendations that account for a hysterectomy. This would expand upon the text to include language stating that you should stop screening only if you have not had a diagnosis of CIN2 or greater in the past 25 years, since this information may not be accessible to the CDS.

Something like:

“This patient has documentation of a hysterectomy. If hysterectomy was performed for treatment, patients should have 3 consecutive annual HPV-based tests before entering long term surveillance. Long term surveillance involves HPV based testing at 3-year intervals for 25 years.

Screening is generally not recommended after hysterectomy if no previous diagnosis of CIN2 or greater in the preceding 25 years and the cervix was removed at the time of hysterectomy.”

[mickohanlon23]

UPDATE: We will also add logic to recognize if a hysterectomy exists in the patient record without a date, and if so, to give the same general post-hysterectomy recommendation similar to the one described above.

[mickohanlon23]

This was resolved in Pull Request https://github.com/ccsm-cds-tools/ccsm-cds-with-tests/pull/79