Review Logic for K.1.4 - Heading 4 - Patients Under 25 with CIN2

[mickohanlon23]

RE: Test Patient 37

Current logic indicates that CIN2 diagnoses need to happen within 2 years of each other, rather than CIN2 needing to persist for two years.

[ssebast2]

Dr. Guido said that if 'CIN2 or unspecified HSIL' is present 2 years after an initial 'CIN2 or unspecified HSIL', then treatment is indicated (this is in Section K.1 Heading 4.5), so our existing logic is incorrect.

UPDATE: 6/7/23: I spoke to Ginny. We are going to constrain the logic to look at results that came back >=2 years and <3 years since the patient needs to get a colpo at 6 months, 12 months and 24 months after a 'CIN2 or unspecified HSIL' and needs a grace period to get all of these tests done.

Disregard the email to @mickohanlon23 and Ginny to 1) determine how to best express this logic change, and 2) whether it is worthwhile to align the approach with similar scenarios mentioned in the sections below. It seemed reasonable to provide a grace period for this scenario.

• K.1.3 (< 25) - this mentions that the result persists at the 2 year f/u visit (where we time constrain the results to 2-2.5 years later)
• K.3.3 (Mgmt of CIN2 preceded by ASC-H/HSIL cytology) - mentions labs that persist for 2 years (we constrain the time as > 18 month and < 3 years)
• I.4.5 - we contrain to >=2 years and < 3 years

[mickohanlon23]

Thanks @ssebast2. So if I am understanding correctly I should ignore the 3rd paragraph and bullet points. And the change is simply that the second histologic HSIL has to be >=2 years and <3 years apart from the first, rather than <= 2 years apart?

[ssebast2]

Correct!

[mickohanlon23]

This is resolved by pull request https://github.com/ccsm-cds-tools/ccsm-cds-with-tests/pull/82