text/cql
/*\n * Library: IMMZDT01 (IMMZ.DT.01.BCG)\n * Rule: If child or person has not been vaccinated, give BCG vaccine as soon as possible after birth \n * Trigger: Patient has never had BCG vaccination\n */\nlibrary IMMZDT01\n// Start Skeleton CQL\nusing FHIR version '4.0.1'\ninclude FHIRHelpers version '4.0.1'\ninclude IMMZCommon called IMMZCom\ninclude IMMZConcepts called IMMZc\ninclude IMMZVaccineLibrary called IMMZvl\ninclude IMMZConfig called IMMZConf\n// End Skeleton CQL\ncontext Patient\n\n/*\n * Determine if the patient has risk of occupational exposure in low and high TB incidence areas (e.g. health\n * workers, laboratory workers, medical students, prison workers, other individuals with occupational exposure).\n * \n * The logic for determine this still needs to be determined. Defaulting to true until this can be done.\n */\ndefine "Risk of occupational exposure in low and high TB areas": true\n\n\n/*\n * Rule: Should vaccinate patient for BCG\n * Annotations:\n * - Provide BCG immunizations – using the "BCG vaccine immunization – NO PREVIOUS" schedule (1 dose scheme)\n * - \n * - Provide BCG immunizations – using the "BCG vaccine immunization – NO PREVIOUS" schedule (1 dose scheme) if CD4% >25% for children aged <5 years or CD4 count ≥200 if aged >5 years\n * Outputs:\n * - Immunize Patient for BCG - TST-negative\n * - Immunize Patient for BCG - IGRA-negative\n * - Immunize Patient for BCG - No Doses\n * - Immunize Patient for BCG - History Unknown\n * - Immunize Patient for BCG - No Doses and HIV Status Positive and immunicologically stable\n * - \n * References:\n * - WHO recommendations for routine immunization - summary tables: https://www.who.int/teams/immunization-vaccines-and-biologicals/policies/who-recommendations-for-routine-immunization---summary-tables\n * - \n * Logic:\n * ((((((("TST Test Result" = "TST-negative") and ("High incidence of TB and/or high leprosy burden" = true)) or (("IGRA Test Result" = "IGRA-negative") and ("High incidence of TB and/or high leprosy burden" = true))) or (("BCG vaccine immunization history" = "No-doses") and ("High incidence of TB and/or high leprosy burden" = true))) or (("BCG vaccine immunization history" = "Unknown") and ("High incidence of TB and/or high leprosy burden" = true))) or ((((("BCG vaccine immunization history" = "No-doses" = true) and ("HIV Status" = "Positive" = true)) and ("CD4%" >"25%" = true)) and ("Current Patient Age in Years" < 5)) and ("High incidence of TB and/or high leprosy burden" = true))) or ((((("BCG vaccine immunization history" = "No-doses" = true) and ("HIV Status" = "Positive" = true)) and ("CD4 count" ≥ "200" = true)) and ("Current Patient Age in Years" > 5)) and ("High incidence of TB and/or high leprosy burden" = true)))\n * SHARING SCHEDULE LOGIC, KEEPING THIS FOR NOW IN CASE THAT DECISION CHANGES.\ndefine "Should vaccinate patient for BCG":\n IMMZConf."High incidence of TB and/or high leprosy burden" = true and (\n Coalesce((IMMZCom."Most Recent TST Test Result" in IMMZc."Negative Result"), false) or \n Coalesce((IMMZCom."Most Recent IGRA Test Result" in IMMZc."Negative Result"), false) or \n (IMMZCom."No BCG Doses Administered to Patient") or \n (\n (IMMZCom."No BCG Doses Administered to Patient" and IMMZCom."HIV Status" in IMMZc."HIV status - HIV positive Choices") and \n (\n Coalesce((IMMZCom."Most Recent CD4%" > 25'%' and IMMZCom."Current Patient Age In Years" < 5), false) or \n Coalesce((IMMZCom."Most Recent CD4 Count" >= 200 and IMMZCom."Current Patient Age In Years" >= 5), false)\n )\n )\n ) \n*/\n\n/*\n * Rule: Provision of the BCG dose\n * Create Condition:\n * - BCG dose should be provided if the patient has not received any BCG doses, and is in a High incidence of TB and/or high leprosy burden, and TST-negative and IGRA-negative\n * \n * Completion:\n * - "BCG Dose 1 provided" = TRUE\n *\n * References:\n * - WHO recommendations for routine immunization - summary tables: https://www.who.int/teams/immunization-vaccines-and-biologicals/policies/who-recommendations-for-routine-immunization---summary-tables\n * \n */\ndefine "Provision of the BCG dose":\n IMMZCom."No BCG Doses Administered to Patient" and\n if IMMZCom."HIV Status" in IMMZc."HIV status - HIV positive Choices" \n then \n (\n Coalesce((IMMZCom."Most Recent CD4%" > 25'%' and IMMZCom."Current Patient Age In Years" < 5), false) or \n Coalesce((IMMZCom."Most Recent CD4 Count" >= 200 and IMMZCom."Current Patient Age In Years" >= 5), false)\n )\n else \n (\n IMMZConf."High incidence of TB and/or high leprosy burden" = true or\n (\n "Risk of occupational exposure in low and high TB areas" and (\n Coalesce((IMMZCom."Most Recent TST Test Result" in IMMZc."Negative Result"), false) or \n Coalesce((IMMZCom."Most Recent IGRA Test Result" in IMMZc."Negative Result"), false)\n )\n )\n )\n\ndefine "Schedule Due Date for BCG dose":\n ToDateTime( Patient.birthDate )\n\ndefine "Should vaccinate patient for BCG":\n "Provision of the BCG dose" and ("Schedule Due Date for BCG dose" <= (Now()))\n \n