WHO Immunization Implementation Guide
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WHO Immunization Implementation Guide, published by World Health Organization (WHO). This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/WorldHealthOrganization/smart-immunizations and changes regularly. See the Directory of published versions

: IMMZ.IND.50 Dropout Rate of DTP1 to DTP3 (Individuals) - XML Representation

Draft as of 2022-05-12

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<Measure xmlns="http://hl7.org/fhir">
  <id value="IMMZIND50"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Measure</b><a name="IMMZIND50"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Measure &quot;IMMZIND50&quot; </p><p style="margin-bottom: 0px">Profile: <code>http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm</code></p></div><p><b>url</b>: <code>http://fhir.org/guides/who/smart-immunization/Measure/IMMZIND50</code></p><p><b>version</b>: 0.1.0</p><p><b>name</b>: IMMZIND50</p><p><b>title</b>: IMMZ.IND.50 Dropout Rate of DTP1 to DTP3 (Individuals)</p><p><b>status</b>: draft</p><p><b>date</b>: 2022-05-12 15:36:35-0400</p><p><b>publisher</b>: World Health Organization (WHO)</p><p><b>description</b>: Indicates the number of individuals which have dropped out of the DTP containing vaccine protocol (i.e. children which have received DTP1 but not DTP3).

This indicator works by counting the number of individuals who have received the first dose of DTP (dose 1) containing vaccine but not the last dose of DTP (are past-due for dose 3) with the children who have completed the vaccination protocol.</p><p><b>jurisdiction</b>: Global (Whole world) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (m49.htm#001)</span></p><p><b>library</b>: <a href="Library-IMMZIND50.html">IMMZIND50</a></p><p><b>scoring</b>: Proportion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.0.0/CodeSystem-measure-scoring.html">MeasureScoring</a>#proportion)</span></p><p><b>type</b>: Process <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.0.0/CodeSystem-measure-type.html">MeasureType</a>#process)</span></p><p><b>improvementNotation</b>: Increased score indicates improvement <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.0.0/CodeSystem-measure-improvement-notation.html">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>IMMZIND50</blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>numerator</blockquote><p><b>code</b>: Numerator <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.0.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#numerator)</span></p><p><b>description</b>: Number of children who have received DTP1 (numerator) minus number of children who have not received DTP dose 3 and are past due (numerator exclusion)</p><h3>Criteria</h3><table class="grid"><tr><td>-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>text/cql</td><td>numerator</td></tr></table></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>denominator</blockquote><p><b>code</b>: Denominator <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.0.0/CodeSystem-measure-population.html">MeasurePopulationType</a>#denominator)</span></p><p><b>description</b>: Number of children who have received DTP containing vaccine dose 1</p><h3>Criteria</h3><table class="grid"><tr><td>-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>text/cql</td><td>denominator</td></tr></table></blockquote><blockquote><p><b>stratifier</b></p><blockquote><p><b>id</b></p>geographic-region-stratifier</blockquote><h3>Criteria</h3><table class="grid"><tr><td>-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>text/cql</td><td>Geographic Region Stratifier</td></tr></table></blockquote><blockquote><p><b>stratifier</b></p><blockquote><p><b>id</b></p>gender-stratifier</blockquote><h3>Criteria</h3><table class="grid"><tr><td>-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>text/cql</td><td>Gender Stratifier</td></tr></table></blockquote></blockquote></div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements"/>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="male"/>
          <display value="Males"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="female"/>
          <display value="Females"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode">
        <valueCoding>
          <system value="http://hl7.org/fhir/administrative-gender"/>
          <code value="other"/>
          <display value="Other/NA"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIndicatorCommon"/>
        </extension>
        <extension url="name">
          <valueString value="By Administrative Gender Stratifier"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/**
 * By Administrative Gender of Patient Stratifier
 */
define &quot;By Administrative Gender Stratifier&quot;:
    case 
        when Patient.gender = 'male' then &quot;Males&quot;
        when Patient.gender = 'female' then &quot;Females&quot;
        else &quot;Other&quot;
    end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND50"/>
        </extension>
        <extension url="name">
          <valueString value="Gender Stratifier"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
 * Disaggregator: Gender
 */
define &quot;Gender Stratifier&quot;:
	IMMZIndCom.&quot;By Administrative Gender Stratifier&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIndicatorCommon"/>
        </extension>
        <extension url="name">
          <valueString value="By Geographic Region Stratifier"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/**
 * By Administrative Gender of Patient Stratifier
 */
define &quot;By Geographic Region Stratifier&quot;:
    First(Patient.address A where A.use in { 'home' }).state"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND50"/>
        </extension>
        <extension url="name">
          <valueString value="Geographic Region Stratifier"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
 * Disaggregator: Geographic Region
 */
define &quot;Geographic Region Stratifier&quot;:
	IMMZIndCom.&quot;By Geographic Region Stratifier&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZCommon"/>
        </extension>
        <extension url="name">
          <valueString value="Doses Administered to Patient"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/**
 * @dataElement All Doses Administered to Patient to patient ordered newest to oldest
 */
define &quot;Doses Administered to Patient&quot;:
  [Immunization] I
    where I.status = 'completed'
    sort by date from (occurrence as FHIR.dateTime) desc"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZCommon"/>
        </extension>
        <extension url="name">
          <valueString value="DTP Doses Administered to Patient"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/**
 * @dataElement DTP containing Doses Administered to Patient
 */
define &quot;DTP Doses Administered to Patient&quot;:
  &quot;Doses Administered to Patient&quot; I
  where
    I.vaccineCode in IMMZc.&quot;DTP Vaccine&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND50"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Patient Should Complete DTP Series During Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/**
 * Patient should be completing DTP during measurement period
 */
define &quot;Patient Should Complete DTP Series During Measurement Period&quot;:
	exists(
		IMMZCom.&quot;DTP Doses Administered to Patient&quot; I 
		where 
			(singleton from I.protocolApplied).doseNumber = 1
	)
	and 
	exists(
		[ImmunizationRecommendation] IR 
		where 
			exists(
				IR.recommendation RC where
				exists(RC.dateCriterion DC where date from DC.value during &quot;Measurement Period&quot;)
				and RC.doseNumber = 3
				and RC.vaccineCode in IMMZc.&quot;DTP Vaccine&quot;
		)
	)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIndicatorCommon"/>
        </extension>
        <extension url="name">
          <valueString
                       value="DTP Doses Administered to Patient During Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
 * DTP Doses administered to the patient during the measurement period
 */
define &quot;DTP Doses Administered to Patient During Measurement Period&quot;:
    IMMZCom.&quot;DTP Doses Administered to Patient&quot; I
		where IMMZCom.ToDate(I.occurrence) during &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND50"/>
        </extension>
        <extension url="name">
          <valueString value="numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
 * Numerator: Number of administrations of DTP1 administered during reporting period minus the number of administrations of DTP3 administered during report period
 * Numerator Computation: COUNT immunization events WHERE administered product is DTP (IMMZ.A1.DE24) AND dose sequence is 1  during reporting period
SUBTRACT
COUNT immunization events WHERE administered product is DTP (IMMZ.A1.DE24) AND dose sequence is 3  during reporting period
 */
define &quot;numerator&quot;:
	&quot;Patient Should Complete DTP Series During Measurement Period&quot;
	and not exists(IMMZIndCom.&quot;DTP Doses Administered to Patient During Measurement Period&quot; I where (singleton from I.protocolApplied).doseNumber = 3)"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
        <extension url="libraryName">
          <valueString value="IMMZIND50"/>
        </extension>
        <extension url="name">
          <valueString value="denominator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
 * Denominator: Number of doses of DTP1 administered
 * Denominator Computation: COUNT immunization events WHERE administered product is DTP (IMMZ.A1.DE24) AND dose sequence is 1 before reporting period 
 */
define &quot;denominator&quot;:
	&quot;Patient Should Complete DTP Series During Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="9"/>
        </extension>
      </extension>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="module-definition"/>
        </coding>
      </type>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library IMMZIndCom"/>
        <resource
                  value="http://fhir.org/guides/who/smart-immunization/Library/IMMZIndicatorCommon"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource
                  value="http://fhir.org/guides/who/smart-immunization/Library/FHIRHelpers|4.0.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library IMMZCom"/>
        <resource
                  value="http://fhir.org/guides/who/smart-immunization/Library/IMMZCommon"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library IMMZc"/>
        <resource
                  value="http://fhir.org/guides/who/smart-immunization/Library/IMMZConcepts"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system Administrative Gender Codes"/>
        <resource value="http://hl7.org/fhir/administrative-gender"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set DTP Vaccine"/>
        <resource
                  value="http://fhir.org/guides/who/smart-immunization/ValueSet/IMMZ.A1.DE24"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="Gender Stratifier"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Coding"/>
      </parameter>
      <parameter>
        <name value="Geographic Region Stratifier"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="string"/>
      </parameter>
      <parameter>
        <name value="numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <dataRequirement>
        <type value="Patient"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
        <mustSupport value="use"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Immunization"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/Immunization"/>
        <mustSupport value="status"/>
        <mustSupport value="vaccineCode"/>
        <mustSupport value="protocolApplied"/>
        <mustSupport value="protocolApplied.doseNumber"/>
        <mustSupport value="occurrence"/>
      </dataRequirement>
      <dataRequirement>
        <type value="ImmunizationRecommendation"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation"/>
        <mustSupport value="recommendation"/>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem">
    <valueReference>
      <reference value="Device/cqf-tooling"/>
    </valueReference>
  </extension>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements" id="effective-data-requirements">
    <valueReference>
      <reference value="#effective-data-requirements"/>
    </valueReference>
  </extension>
  <url
       value="http://fhir.org/guides/who/smart-immunization/Measure/IMMZIND50"/>
  <version value="0.1.0"/>
  <name value="IMMZIND50"/>
  <title value="IMMZ.IND.50 Dropout Rate of DTP1 to DTP3 (Individuals)"/>
  <status value="draft"/>
  <date value="2022-05-12T15:36:35.078-04:00"/>
  <publisher value="World Health Organization (WHO)"/>
  <description
               value="Indicates the number of individuals which have dropped out of the DTP containing vaccine protocol (i.e. children which have received DTP1 but not DTP3).

This indicator works by counting the number of individuals who have received the first dose of DTP (dose 1) containing vaccine but not the last dose of DTP (are past-due for dose 3) with the children who have completed the vaccination protocol."/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <library
           value="http://fhir.org/guides/who/smart-immunization/Library/IMMZIND50"/>
  <scoring>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
      <code value="proportion"/>
    </coding>
  </scoring>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
      <code value="process"/>
    </coding>
  </type>
  <improvementNotation>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
      <code value="increase"/>
    </coding>
  </improvementNotation>
  <group id="IMMZIND50">
    <population id="numerator">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
        </coding>
      </code>
      <description
                   value="Number of children who have received DTP1 (numerator) minus number of children who have not received DTP dose 3 and are past due (numerator exclusion)"/>
      <criteria>
        <language value="text/cql"/>
        <expression value="numerator"/>
      </criteria>
    </population>
    <population id="denominator">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
        </coding>
      </code>
      <description
                   value="Number of children who have received DTP containing vaccine dose 1"/>
      <criteria>
        <language value="text/cql"/>
        <expression value="denominator"/>
      </criteria>
    </population>
    <stratifier id="geographic-region-stratifier">
      <criteria>
        <language value="text/cql"/>
        <expression value="Geographic Region Stratifier"/>
      </criteria>
    </stratifier>
    <stratifier id="gender-stratifier">
      <criteria>
        <language value="text/cql"/>
        <expression value="Gender Stratifier"/>
      </criteria>
    </stratifier>
  </group>
</Measure>