==================================================================================== USPSTFStatinUseForPrimaryPreventionOfCVDInAdults Change Log ==================================================================================== The following CQL downloads are currently available on CDS Connect. Older versions may be available by request. - USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsFHIRv102_v2.1.0_CQL.zip - USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsFHIRv401_v2.1.0_CQL.zip ==================================================================================== USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_FHIRv102 (FHIR DSTU2) ==================================================================================== ------------------------------------------------------------------------------------ VERSION 1.0.0 ------------------------------------------------------------------------------------ Initial FHIR DSTU2 version that was piloted in 2017. ------------------------------------------------------------------------------------ VERSION 1.0.1 ------------------------------------------------------------------------------------ Version 1.0.1 included the following minor changes: - Added a direct reference to the FHIRHelpers library to address a limitation in the CQL-to-ELM compiler. - Updated "IsSmoker" to return null when no smoking status is found USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults version 1.0.1 has not been piloted in a clinical setting, but has undergone logic testing and review. ------------------------------------------------------------------------------------ VERSION 1.1.0 ------------------------------------------------------------------------------------ Version 1.1.0 has been refactored to segment out logic which is shared with the patient-facing version of this artifact. The shared logic can now be found in an included library called USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_Shared_Logic_FHIRv102, and it implements the following updates to the inclusion and exclusion logic: - Changes ICD-10 code system identifier from urn:oid:2.16.840.1.113883.6.90 to http://hl7.org/fhir/sid/icd-10-cm - Replaces "High Density Lipoprotein (HDL)" (2.16.840.1.113883.3.600.875) value set with High Density Lipoprotein (HDL) LOINC (2.16.840.1.113883.3.600.873) value set - Replaces "Breastfeeding" (2.16.840.1.113762.1.4.1047.73) value set with "Breastfeeding ICD10" (2.16.840.1.113762.1.4.1047.67) value set - Replaces "Is Breastfeeding" (LOINC 63895-7) code and "yes" (LOINC LA33-6) value with "Breastfeeding status" (LOINC 63895-7) code and "Currently breastfeeding" (SNOMED-CT 169750002) value - Replaces "Coronary artery bypass graft" (2.16.840.1.113883.3.464.1003.104.12.1002) value set with "Coronary Artery Bypass Graft" (2.16.840.1.113883.3.464.1003.104.11.1004) value set - Replaces "PCI ICD10CM SNOMEDCT" (2.16.840.1.113762.1.4.1045.67) value set with "Percutaneous Coronary Intervention ICD10" (2.16.840.1.113883.3.3157.2000.1) value set - Replaces "PCI ICD9CM" (2.16.840.1.113762.1.4.1045.86) value set with "Percutaneous Coronary Intervention SNOMEDCT" (2.16.840.1.113883.3.3157.2000.2) value set - Replaces "ESRD monthly outpatient services" (2.16.840.1.113883.3.464.1003.109.12.1014) procedure search with "ESRD Monthly Outpatient Services" (2.16.840.1.113883.3.464.1003.109.11.1029) encounter search - Removes "Vascular access for dialysis" (2.16.840.1.113883.3.464.1003.109.12.1011) value set from procedure search - Additionally searches for LDL results using "LDL-c" (2.16.840.1.113883.3.117.1.7.1.215) value set - Additionally searches for pregancy conditions using "Pregnancy (New ICD10 codes published in 2018 and 2019)" (2.16.840.1.113762.1.4.1032.80) value set - Additionally searches for "Dependence on dialysis" (2.16.840.1.113762.1.4.1032.96) and "Dependence on renal dialysis" (ICD-10 Z99.2) conditions to determine if patient is on dialysis - Additionally searches for "Rhabdomyolysis" (2.16.840.1.113762.1.4.1032.97 and ICD-10 M62.82) conditions - Additionally searches for statin MedicationDispense records USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults version 1.1.0 has not been piloted in a clinical setting, but has undergone logic testing and review. ==================================================================================== USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsFHIRv102 (FHIR DSTU2) ==================================================================================== ------------------------------------------------------------------------------------ VERSION 2.0.0 ------------------------------------------------------------------------------------ Version 2.0.0 implements several best practices prescribed by FHIR Clinical Guidelines, including: - Rename library from USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_FHIRv102 to USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsFHIRv102 - Update shared library to USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsSharedLogicFHIRv102 version 2.0.0 - Update CDS Connect Commons library to CDSConnectCommonsForFHIRv102 version 2.0.0 - Update CDS Connect Conversions library to CDSConnectConversions version 2.0.0 - Surround all library-level identifiers and datatypes in quotes - Use descriptive names (no abbreviations) for query aliases and function arguments - Fix non-standard use of Exists(...) as a function Version 2.0.0 also introduces the following changes from the previous version: - Replace "Pregnancy" 2.16.840.1.113883.3.526.3.378 and "Pregnancy (New ICD10 codes published in 2018 and 2019)" 2.16.840.1.113762.1.4.1032.80 value sets with grouping value set "CDS Pregnancy" 2.16.840.1.113762.1.4.1032.264 - Replace "Breastfeeding ICD10" 2.16.840.1.113762.1.4.1047.67 with "Breastfeeding" 2.16.840.1.113762.1.4.1047.73 - Replace "Rhabdomyolysis" 2.16.840.1.113762.1.4.1032.97 and "Rhabdomyolysis code" M62.82 with grouping value set "CDS Rhabdomyolysis" 2.16.840.1.113762.1.4.1032.267 - Remove "Familial hypercholesterolemia code" E78.01 since it is now in the value set NOTE: This version has not been piloted in a clinical setting, but has undergone logic testing and review. ------------------------------------------------------------------------------------ VERSION 2.1.0 ------------------------------------------------------------------------------------ Version 2.1.0 makes only minor changes to version 2.0.0, including: - Update USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsSharedLogicFHIRv102 to version 2.1.0 - Update CDSConnectCommonsForFHIRv102 to version 2.1.0 - Replace extensional value set "Low intensity statin therapy" 2.16.840.1.113762.1.4.1047.107 with grouping value set "Low intensity statin therapy" 2.16.840.1.113883.3.526.3.1574 (currently expands to same codes) - Replace extensional value set "Moderate intensity statin therapy" 2.16.840.1.113762.1.4.1047.98 with grouping value set "Moderate intensity statin therapy" 2.16.840.1.113883.3.526.3.1575 (currently expands to same codes) - Replace extensional value set "High intensity statin therapy" 2.16.840.1.113762.1.4.1047.97 with grouping value set "High intensity statin therapy" 2.16.840.1.113883.3.526.3.1572 (currently expands to same codes) - Use canonical URL representation of value sets instead of bare OID representation - Remove use of CQL concept declarations, as they are no longer necessary (CQL code declarations are sufficient) - Update Recommendation text for improved readability NOTE: This version has not been piloted in a clinical setting, but has undergone logic testing and review. ==================================================================================== USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_FHIRv401 (FHIR R4) ==================================================================================== ------------------------------------------------------------------------------------ VERSION 1.0.0 ------------------------------------------------------------------------------------ The USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_PatientFacing_FHIRv401 version 1.0.0 library is a FHIR R4 port of the USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_PatientFacing_FHIRv102 version 1.0.0 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. NOTE: The following list encompasses changes in the primary CQL library as well as the USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_Shared_Logic_FHIRv401 library. - 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 - Encounter.reason is replaced by Encounter.reasonCode 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 v3.1.1 Smokingstatus profile and associated codes / value sets 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 and ConditionsByConcept were replaced by simpler retrieves USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_FHIRv401 version 1.0.0 has not been piloted in a clinical setting, but has undergone logic testing and review. ==================================================================================== USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsFHIRv401 (FHIR R4) ==================================================================================== ------------------------------------------------------------------------------------ VERSION 2.0.0 ------------------------------------------------------------------------------------ Version 2.0.0 implements several best practices prescribed by FHIR Clinical Guidelines, including: - Rename library from USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_FHIRv401 to USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsFHIRv401 - Update shared library to USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsSharedLogicFHIRv401 version 2.0.0 - Update CDS Connect Commons library to CDSConnectCommonsForFHIRv401 version 2.0.0 - Update CDS Connect Conversions library to CDSConnectConversions version 2.0.0 - Surround all library-level identifiers and datatypes in quotes - Use descriptive names (no abbreviations) for query aliases and function arguments - Fix non-standard use of Exists(...) as a function Version 2.0.0 also introduces the following changes from the previous version: - Replace "Pregnancy" 2.16.840.1.113883.3.526.3.378 and "Pregnancy (New ICD10 codes published in 2018 and 2019)" 2.16.840.1.113762.1.4.1032.80 value sets with grouping value set "CDS Pregnancy" 2.16.840.1.113762.1.4.1032.264 - Replace "Breastfeeding ICD10" 2.16.840.1.113762.1.4.1047.67 with "Breastfeeding" 2.16.840.1.113762.1.4.1047.73 - Replace "Rhabdomyolysis" 2.16.840.1.113762.1.4.1032.97 and "Rhabdomyolysis code" M62.82 with grouping value set "CDS Rhabdomyolysis" 2.16.840.1.113762.1.4.1032.267 - Remove "Familial hypercholesterolemia code" E78.01 since it is now in the value set NOTE: This version has not been piloted in a clinical setting, but has undergone logic testing and review. ------------------------------------------------------------------------------------ VERSION 2.1.0 ------------------------------------------------------------------------------------ Version 2.1.0 makes only minor changes to version 2.0.0, including: - Update USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsSharedLogicFHIRv401 to version 2.1.0 - Update CDSConnectCommonsForFHIRv401 to version 2.1.0 - Replace extensional value set "Low intensity statin therapy" 2.16.840.1.113762.1.4.1047.107 with grouping value set "Low intensity statin therapy" 2.16.840.1.113883.3.526.3.1574 (currently expands to same codes) - Replace extensional value set "Moderate intensity statin therapy" 2.16.840.1.113762.1.4.1047.98 with grouping value set "Moderate intensity statin therapy" 2.16.840.1.113883.3.526.3.1575 (currently expands to same codes) - Replace extensional value set "High intensity statin therapy" 2.16.840.1.113762.1.4.1047.97 with grouping value set "High intensity statin therapy" 2.16.840.1.113883.3.526.3.1572 (currently expands to same codes) - Update Recommendation text for improved readability NOTE: This version has not been piloted in a clinical setting, but has undergone logic testing and review.