WHO SMART Guidelines - HIV
0.4.4 - ci-build

WHO SMART Guidelines - HIV, published by WHO. This guide is not an authorized publication; it is the continuous build for version 0.4.4 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-hiv/tree/main and changes regularly. See the Directory of published versions

Measure: HIV.IND.50 TB testing among those symptom-screened positive (Experimental)

Official URL: http://smart.who.int/hiv/Measure/HIVIND50 Version: 0.4.4
Draft as of 2024-08-18 Computable Name: HIVIND50

% of people living with HIV newly initiated on ART and screened positive for TB symptoms who then are tested for TB

Knowledge Artifact Metadata
Name (machine-readable) HIVIND50
Title (human-readable) HIV.IND.50 TB testing among those symptom-screened positive
Status Draft
Experimental true
Description

% of people living with HIV newly initiated on ART and screened positive for TB symptoms who then are tested for TB

Measure Steward WHO
Steward Contact Details WHO: http://who.int
Measure Metadata
Version Number 0.4.4
Measure Scoring Proportion
Improvement Notation Increased score indicates improvement
Population Basis boolean
Measure Population Criteria
Initial Population ID: HIV.IND.50.IP
Description:

Initial Population

Logic Definition: Initial Population
Denominator ID: HIV.IND.50.DEN
Description:

Number of people living with HIV newly initiated on ART and screened positive for TB symptoms during the reporting period

Logic Definition: Denominator
Numerator ID: HIV.IND.50.NUM
Description:

Number of people living with HIV newly initiated on ART who are investigated for active TB disease with appropriate diagnostic testing

Logic Definition: Numerator
Stratifier ID: HIV.IND.50.S
Measure Logic
Primary Library HIV.IND.50 Logic
Dependency Description: FHIR model information
Resource: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
Canonical URL: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
Dependency Description: Library HIE
Resource: HIVIndicatorElements
Canonical URL: http://smart.who.int/hiv/Library/HIVIndicatorElements
Dependency Description: Library Elements
Resource: HIVElements
Canonical URL: http://smart.who.int/hiv/Library/HIVElements
Dependency Description: Library Concepts
Resource: http://smart.who.int/hiv/Library/HIVConcepts|0.0.2
Canonical URL: http://smart.who.int/hiv/Library/HIVConcepts|0.0.2
Dependency Description: Library FHIRHelpers
Resource: http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Canonical URL: http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Dependency Description: Library ConceptsCustom
Resource: http://smart.who.int/hiv/Library/HIVConceptsCustom|0.0.1
Canonical URL: http://smart.who.int/hiv/Library/HIVConceptsCustom|0.0.1
Dependency Description: Library WC
Resource: WHOCommon
Canonical URL: http://smart.who.int/hiv/Library/WHOCommon
Dependency Description: Code system HIVConcepts
Resource: WHO SMART HIV Concepts CodeSystem
Canonical URL: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Dependency Description: Code system ConditionClinicalStatusCodes
Resource: Condition Clinical Status Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-clinical
Dependency Description: Code system ConditionCategoryCodes
Resource: Condition Category Codes
Canonical URL: http://terminology.hl7.org/CodeSystem/condition-category
Direct Reference Code Display: HIV-positive
Code: HIV.B.DE116
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Code: active
System: http://terminology.hl7.org/CodeSystem/condition-clinical
Direct Reference Code Display: Encounter Diagnosis
Code: encounter-diagnosis
System: http://terminology.hl7.org/CodeSystem/condition-category
Direct Reference Code Display: HIV status
Code: HIV.B.DE115
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: On ART
Code: HIV.D.DE38
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: First-time user of ART
Code: HIV.D.DE44
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: TB diagnostic test category
Code: HIV.D.DE992
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: TB screening result
Code: HIV.D.DE986
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: Screen positive for TB
Code: HIV.D.DE987
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: Male
Code: HIV.A.DE20
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: Female
Code: HIV.A.DE19
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: Transgender female
Code: HIV.A.DE22
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: Transgender male
Code: HIV.A.DE21
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Direct Reference Code Display: Other
Code: HIV.A.DE23
System: http://smart.who.int/hiv/CodeSystem/HIVConcepts
Parameter Name: Measurement Period
Use: In
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: Numerator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Denominator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Initial Population
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Stratification
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: string
Measure Logic Data Requirements
Data Requirement Type: Condition
Profile(s): Condition
Must Support Elements: code, clinicalStatus, category, onset
Code Filter(s):
Path: code
Code:
Data Requirement Type: Observation
Profile(s): Observation
Must Support Elements: code, status, value, issued, effective
Code Filter(s):
Path: code
Code:
Data Requirement Type: Observation
Profile(s): Observation
Must Support Elements: code, status, value, effective
Code Filter(s):
Path: code
Code:
Data Requirement Type: MedicationStatement
Profile(s): MedicationStatement
Must Support Elements: reasonCode
Data Requirement Type: Procedure
Profile(s): Procedure
Must Support Elements: status, category, partOf, performed
Data Requirement Type: Patient
Profile(s): Patient
Must Support Elements: use
Measure Logic Definitions
Logic Definition Library Name: HIVElements
define "HIV Status Positive Condition":
  [Condition: Concepts."HIV-positive - HIV.B.DE116"] C
    where C.clinicalStatus ~ ConceptsCustom."active"
      and exists(C.category CC where CC ~ ConceptsCustom."encounter-diagnosis")
    sort by start of onset.toInterval()
Logic Definition Library Name: HIVIndicatorElements
define "HIV Status Positive Condition":
  Elements."HIV Status Positive Condition" C
  where C.onset before end of "Measurement Period"
Logic Definition Library Name: HIVElements
/* End of HIV-inconclusive */

/*
@dataElement: HIV.B.DE115 - HIV status
@activity: HIV.B7 Test for HIV using testing algorithm
@description: HIV status reported after applying the national HIV testing algorithm. No single HIV test can provide an HIV-positive diagnosis.
*/
define "HIV Status Observation":
  [Observation: Concepts."HIV status"] O
    where O.status in { 'final', 'amended', 'corrected' }
Logic Definition Library Name: HIVElements
define "HIV Status Positive Observation":
"HIV Status Observation" O
    where O.value ~ Concepts."HIV-positive - HIV.B.DE116"
      sort by start of effective.toInterval()
Logic Definition Library Name: HIVIndicatorElements
define "HIV Status Positive Observation":
  Elements."HIV Status Positive Observation" O
  where O.issued before end of "Measurement Period"
  or O.effective.toInterval() starts before end of "Measurement Period"
Logic Definition Library Name: HIVIndicatorElements
define "Has HIV-positive Status":
  exists "HIV Status Positive Condition"
  or exists "HIV Status Positive Observation"
Logic Definition Library Name: HIVElements
/* End of Established on ART */

/*
@dataElement: HIV.D.DE43 - ART start type
@activity: HIV.D8 Capture or update client history
@description: Whether the client is ART naive or is restarting ART
*/

define "ART start type":
  [MedicationStatement] MS
    where exists(MS.reasonCode C where C ~ Concepts."On ART - HIV.D.DE38")
    sort by start of effective.toInterval()
Logic Definition Library Name: HIVElements
/* End of ART start type */

/*
@dataElement: HIV.D.DE44 - First-time user of ART
@activity: HIV.D8 Capture or update client history
@description: Client is ART naive, having never taken ART to treat HIV before
*/

define "First-time user of ART":
  "ART start type" MS
      where exists(MS.reasonCode C where C ~ Concepts."First-time user of ART")
Logic Definition Library Name: HIVElements
/* End of TB screening date */

/*
@dataElement: HIV.D.DE992 - TB diagnostic test category
@activity: HIV.D4 Screen for TB
@description: The type of diagnostic test performed to detect tuberculosis (TB) disease
*/

define "TB diagnostic test category":
  [Procedure] P
  where P.status = 'completed'
  and P.category ~ Concepts."TB diagnostic test category"
Logic Definition Library Name: HIVElements
/* End of History of contact with a person with TB */

/*
@dataElement: HIV.D.DE986 - TB screening result
@activity: HIV.D4 Screen for TB
@description: Record the result of the tuberculosis (TB) screening
*/

define "TB screening result":
  [Observation: Concepts."TB screening result"] O
    where O.status in { 'final', 'amended', 'corrected' }
Logic Definition Library Name: HIVElements
/* End of TB screening result */

/*
@dataElement: HIV.D.DE987 - Screen positive for TB
@activity: HIV.D4 Screen for TB
@description: Screening result was positive for tuberculosis (TB)
*/

define "Screen positive for TB":
  "TB screening result" O
  where O.value ~ Concepts."Screen positive for TB"
Logic Definition Library Name: HIVIND50Logic
/**
 * Numerator
 * 
 * Definition: Number of people living with HIV newly initiated on ART who are investigated for active TB disease with appropriate diagnostic testing*
 * Calculation: COUNT of clients with "HIV status"='HIV-positive' AND with "ART start type"='First-time user of ART' AND with "ART start date" in the reporting period AND "TB screening date" in the reporting period AND "TB screening result"='Screen positive for TB' AND a "TB diagnostic test category" is NOT NULL AND with a "TB diagnostic test date" in the reporting period
 */

define "Numerator":
  HIE."Has HIV-positive Status"
  and (start of First(HE."First-time user of ART").effective.toInterval() during "Measurement Period")
  //related the two since we want a positive observation from a specific diagnostic test.
  and exists(
    HE."TB diagnostic test category" P
    with HE."Screen positive for TB" O
      such that P.partOf.references(O)
    where P.performed.toInterval() during "Measurement Period"
  )
Logic Definition Library Name: HIVIndicatorElements
/* End of TB screening result */

/*
@dataElement: HIV.D.DE987 - Screen positive for TB
@activity: HIV.D4 Screen for TB
@description: Screening result was positive for tuberculosis (TB)
*/

define "Screen positive for TB":
  exists Elements."Screen positive for TB" O
    where O.effective.toInterval() during "Measurement Period"
Logic Definition Library Name: HIVIND50Logic
/**
 * Denominator
 *
 * Definition: Number of people living with HIV newly initiated on ART and screened positive for TB symptoms during the reporting period
 * Calculation: COUNT of clients with "HIV status"='HIV-positive' AND with "ART start type"='First-time user of ART' AND with "ART start date" in the reporting period AND "TB screening date" in the reporting period AND "TB screening result"='Screen positive for TB'
 */

define "Denominator":
  HIE."Has HIV-positive Status"
  and (start of First(HE."First-time user of ART").effective.toInterval() during "Measurement Period")
  and HIE."Screen positive for TB"
Logic Definition Library Name: HIVIND50Logic
/* Populations */

/*
 *Initial Population
 */

define "Initial Population":
  true
Logic Definition Library Name: HIVIndicatorElements
/*
@dataElement: HIV.A.DE18 - Gender
@activity: HIV.A6.1 Review sociodemographic data with client | HIV.A5 Create new client record
@description: Gender of the client
*/

/*
 * By Administrative Gender of Patient Stratifier
 * Need to expand codes
 */

define "By Administrative Gender Stratifier":
  case 
      when Patient.gender = 'male' then Concepts."Male"
      when Patient.gender = 'female' then Concepts."Female"
      when Patient.gender = 'transgender female' then Concepts."Transgender female"
      when Patient.gender = 'transgender male' then Concepts."Transgender male"
      else Concepts."Other - HIV.A.DE23"
  end
Logic Definition Library Name: HIVIndicatorElements
/* End of Visit date A.DE3 */

/*
@dataElement: HIV.A.DE17 - Age
@activity: HIV.A6.1 Review sociodemographic data with client | HIV.A5 Create new client record
@description: Calculated age (number of years) of the client based on date of birth
*/
define "Age In Years":
  AgeInYearsAt(start of "Measurement Period")
Logic Definition Library Name: HIVIndicatorElements
/*
 * By Age Stratifiers
 * Age (0–4, 5–9, 10–14, 15–19, 20–24, 25–49, 50+ years)
 * 
 */
define "By Age Stratifier 2":
  case 
      when "Age In Years" <= 4 then '0-4'
      when "Age In Years" <= 9 then '5-9'
      when "Age In Years" <= 14 then '10–14'
      when "Age In Years" <= 19 then '15–19'
      when "Age In Years" <= 24 then '20–24'
      when "Age In Years" <= 49 then '25–49'
      when "Age In Years" >= 50 then '50+'
      else null
  end
Logic Definition Library Name: HIVIndicatorElements
// Geographic Region
define "By Geographic Region Stratifier":
    First(Patient.address A where A.use in { 'home' }).state
Logic Definition Library Name: HIVIND50Logic
define "Stratification":
 HIE."By Administrative Gender Stratifier".code 
  + ':' + HIE."By Age Stratifier 2"
+ ':' + HIE."By Geographic Region Stratifier"
Logic Definition Library Name: FHIRHelpers
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }
Logic Definition Library Name: FHIRHelpers
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }
Logic Definition Library Name: FHIRHelpers
define function ToDateTime(value dateTime): value.value
Logic Definition Library Name: FHIRHelpers
define function ToString(value ObservationStatus): value.value
Logic Definition Library Name: FHIRHelpers
define function ToDateTime(value instant): value.value
Logic Definition Library Name: FHIRHelpers
define function ToString(value ProcedureStatus): value.value
Logic Definition Library Name: WHOCommon
/*
@description: Returns true if any of the given references are to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(references List<FHIR.Reference>, resource FHIR.Resource):
  exists (references R where R.references(resource))
Logic Definition Library Name: WHOCommon
/*
@description: Returns true if the given reference is to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference FHIR.Reference, resource FHIR.Resource):
  resource.id = Last(Split(reference.reference, '/'))
Logic Definition Library Name: FHIRHelpers
define function ToString(value string): value.value
Logic Definition Library Name: FHIRHelpers
define function ToString(value AdministrativeGender): value.value
Logic Definition Library Name: FHIRHelpers
define function ToString(value AddressUse): value.value
Generated using version 0.4.6 of the sample-content-ig Liquid templates