================================================================================================= USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsPatientFacing Change Log ================================================================================================= The following CQL downloads are currently available on CDS Connect. - USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsPatientFacingFHIRv102_v2.2.0_CQL.zip - USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsPatientFacingFHIRv401_v2.2.0_CQL.zip ================================================================================================= USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_PatientFacing_FHIRv102 (FHIR DSTU2) ================================================================================================= ------------------------------------------------------------------------------------------------- VERSION 1.0.0 ------------------------------------------------------------------------------------------------- Initial FHIR DSTU2 version. ================================================================================================= USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsPatientFacingFHIRv102 (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_PatientFacing_FHIRv102 to USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsPatientFacingFHIRv102 - 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 - Update notification and recommendation text 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) NOTE: This version has not been piloted in a clinical setting, but has undergone logic testing and review. ------------------------------------------------------------------------------------------------- VERSION 2.2.0 ------------------------------------------------------------------------------------------------- Version 2.2.0 makes only minor changes to version 2.1.0, including: - Update USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsSharedLogicFHIRv102 to version 2.2.0 - Update CDSConnectCommonsForFHIRv102 to version 2.1.1 - Replace "LDL-c" (2.16.840.1.113883.3.117.1.7.1.215) value set with "LDL Cholesterol" (2.16.840.1.113883.3.526.3.1573) - Replace "Familial Hypercholesterolemia" (2.16.840.1.113762.1.4.1032.15) value set with "Familial Hypercholesterolemia" (2.16.840.1.113762.1.4.1047.100) - Replace LOINC 79423-0 code with "Cardiovascular disease 10Y risk" (2.16.840.1.113762.1.4.1032.308) value set - Replace inactive SNOMED-CT 169750002 "Mother currently breast-feeding (finding)" code with SNOMED-CT 55561003 "Active (qualifier value)" as positive breastfeeding status observation value - Update "Rationale", "Errors", and "Information" messages to consistently use the term "10-year ASCVD risk score" 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_PatientFacing_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 USPSTF_Statin_Use_for_Primary_Prevention_of_CVD_in_Adults_PatientFacing_FHIRv102 version 1.0.0. 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_PatientFacing_FHIRv401 version 1.0.0 has not been piloted in a clinical setting, but has undergone logic testing and review. ================================================================================================= USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsPatientFacingFHIRv401 (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_PatientFacing_FHIRv401 to USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsPatientFacingFHIRv401 - 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 - Update notification and recommendation text 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) NOTE: This version has not been piloted in a clinical setting, but has undergone logic testing and review. ------------------------------------------------------------------------------------------------- VERSION 2.2.0 ------------------------------------------------------------------------------------------------- Version 2.2.0 makes only minor changes to version 2.1.0, including: - Update USPSTFStatinUseForPrimaryPreventionOfCVDInAdultsSharedLogicFHIRv401 to version 2.2.0 - Update CDSConnectCommonsForFHIRv401 to version 2.1.1 - Replace "LDL-c" (2.16.840.1.113883.3.117.1.7.1.215) value set with "LDL Cholesterol" (2.16.840.1.113883.3.526.3.1573) - Replace "Familial Hypercholesterolemia" (2.16.840.1.113762.1.4.1032.15) value set with "Familial Hypercholesterolemia" (2.16.840.1.113762.1.4.1047.100) - Replace LOINC 79423-0 code with "Cardiovascular disease 10Y risk" (2.16.840.1.113762.1.4.1032.308) value set - Replace inactive SNOMED-CT 169750002 "Mother currently breast-feeding (finding)" code with SNOMED-CT 55561003 "Active (qualifier value)" as positive breastfeeding status observation value - Update "Rationale", "Errors", and "Information" messages to consistently use the term "10-year ASCVD risk score" NOTE: This version has not been piloted in a clinical setting, but has undergone logic testing and review.