================================================================================ Million_Hearts_Baseline_10_Year_ASCVD_Risk Change Log ================================================================================ The following CQL downloads are currently available on CDS Connect. Older versions may be available by request. - Million_Hearts_Baseline_10_Year_ASCVD_Risk_FHIRv102_v1.0.2_CQL.zip - Million_Hearts_Baseline_10_Year_ASCVD_Risk_FHIRv401_v1.0.0_CQL.zip ================================================================================ Million_Hearts_Baseline_10_Year_ASCVD_Risk_FHIRv102 (FHIR DSTU2) ================================================================================ -------------------------------------------------------------------------------- VERSION 1.0.0 -------------------------------------------------------------------------------- Initial FHIR DSTU2 version. This version was not piloted. -------------------------------------------------------------------------------- VERSION 1.0.1 -------------------------------------------------------------------------------- Version 1.0.1 added a direct reference to the FHIRHelpers library to address a limitation in the CQL-to-ELM compiler. This version was not piloted. -------------------------------------------------------------------------------- VERSION 1.0.2 -------------------------------------------------------------------------------- Version 1.0.2 included the following minor changes related to clarifications and corrections in the CQL specification: - Updated "IsSmoker" to return null when no smoking status is found - Updated "HasMissingOrOldData" to use the "AnyTrue" instead of "exists" Million_Hearts_Baseline_10_Year_ASCVD_Risk_FHIRv102 version 1.0.2 was used in a 2019 pilot to calculate the estimated 10-year CVD risk as input to the USPSTF_Diet_and_Activity_for_CVD_Prevention_in_Adults_FHIRv102 artifact. ================================================================================ Million_Hearts_Baseline_10_Year_ASCVD_Risk_FHIRv401 (FHIR R4) ================================================================================ -------------------------------------------------------------------------------- VERSION 1.0.0 -------------------------------------------------------------------------------- The Million_Hearts_Baseline_10_Year_ASCVD_Risk_FHIRv401 version 1.0.0 library is a FHIR R4 port of the Million_Hearts_Baseline_10_Year_ASCVD_Risk_FHIRv102 version 1.0.2 library. While the intent of the logic remains the same as the FHIR DSTU2-based version, changes in the FHIR specification (from DSTU2 to R4) require additional changes in the CQL logic. This R4 representation contains the following changes related to the movement from FHIR DSTU2 to FHIR R4. - FHIR data model is now version 4.0.1 - FHIRHelpers is now version 4.0.1 - CDS_Connect_Commons_for_FHIRv102 has been replaced by CDS_Connect_Commons_for_FHIRv401 version 1.0.0 - MedicationOrder is replaced by MedicationRequest In addition to porting the data model, it also leverages new IGs and profiles, resulting in the following additional changes from the DSTU2 version: - Uses US Core v4.0.0 Race extension and associated codes / value sets - Uses US Core v4.0.0 Smokingstatus profile and associated codes / value sets - Uses FHIR core Blood Pressure profile (of which Systolic is a component) - NOTE: it also retains support for standalone Systolic BP observation The following additional changes were made based on new capabilities in later versions of the CQL spec and tooling: - URL-based value set identifiers are used rather than plain OIDs - code/concept pairs are no longer needed; code definitions are sufficient, so concept definitions have been removed - CQL retrieves now support codes, so ObservationsByConcept was replaced by a simpler retrieve - FHIRHelpers ToQuantity now supports Quantity.code, so custom ToQuantity and QuantityValue functions have been removed - The FHIR modelinfo was updated to properly reflect extension URLs as FHIR.url types, so CQL was adjusted accordingly Million_Hearts_Baseline_10_Year_ASCVD_Risk_FHIRv401 version 1.0.0 has not been piloted in a clinical setting, but has undergone logic testing and review.