Functional Status Assessments for Heart Failure

from
  ["Assessment, Performed": "Quality of life score [KCCQ]"] KCCQLifeQuality,
  ["Assessment, Performed": "Symptom stability score [KCCQ]"] KCCQSymptomStability,
  ["Assessment, Performed": "Self-efficacy score [KCCQ]"] KCCQSelfEfficacy,
  ["Assessment, Performed": "Total symptom score [KCCQ]"] KCCQSymptoms,
  ["Assessment, Performed": "Physical limitation score [KCCQ]"] KCCQPhysicalLimits,
  ["Assessment, Performed": "Social limitation score [KCCQ]"] KCCQSocialLimits
  let KCCQLifeQualityDate: date from start of Global."NormalizeInterval" ( KCCQLifeQuality.relevantDatetime, KCCQLifeQuality.relevantPeriod ),
  KCCQSymptomStabilityDate: date from start of Global."NormalizeInterval" ( KCCQSymptomStability.relevantDatetime, KCCQSymptomStability.relevantPeriod ),
  KCCQSelfEfficacyDate: date from start of Global."NormalizeInterval" ( KCCQSelfEfficacy.relevantDatetime, KCCQSelfEfficacy.relevantPeriod ),
  KCCQSymptomsDate: date from start of Global."NormalizeInterval" ( KCCQSymptoms.relevantDatetime, KCCQSymptoms.relevantPeriod ),
  KCCQPhysicalLimitsDate: date from start of Global."NormalizeInterval" ( KCCQPhysicalLimits.relevantDatetime, KCCQPhysicalLimits.relevantPeriod ),
  KCCQSocialLimitsDate: date from start of Global."NormalizeInterval" ( KCCQSocialLimits.relevantDatetime, KCCQSocialLimits.relevantPeriod )
  where KCCQLifeQualityDate same day as KCCQSymptomStabilityDate
    and KCCQSymptomStability.result is not null
    and KCCQLifeQualityDate same day as KCCQSelfEfficacyDate
    and KCCQSelfEfficacy.result is not null
    and KCCQLifeQualityDate same day as KCCQSymptomsDate
    and KCCQSymptoms.result is not null
    and KCCQLifeQualityDate same day as KCCQPhysicalLimitsDate
    and KCCQPhysicalLimits.result is not null
    and KCCQLifeQualityDate same day as KCCQSocialLimitsDate
    and KCCQSocialLimits.result is not null
    and KCCQLifeQuality.result is not null
  return Max({ KCCQLifeQualityDate, KCCQSymptomStabilityDate, KCCQSelfEfficacyDate, KCCQSymptomsDate, KCCQPhysicalLimitsDate, KCCQSocialLimitsDate })

["Assessment, Performed": "Overall summary score [KCCQ]"] KCCQSummaryScore
  let KCCQSummaryScoreDate: date from start of Global."NormalizeInterval" ( KCCQSummaryScore.relevantDatetime, KCCQSummaryScore.relevantPeriod )
  where KCCQSummaryScore.result is not null
  return Max({ KCCQSummaryScoreDate })

from
  ["Assessment, Performed": "Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]"] KCCQ12Item,
  ["Assessment, Performed": "Overall summary score [KCCQ-12]"] KCCQ12Summary
  let KCCQ12ItemDate: date from start of Global."NormalizeInterval" ( KCCQ12Item.relevantDatetime, KCCQ12Item.relevantPeriod ),
  KCCQ12SummaryDate: date from start of Global."NormalizeInterval" ( KCCQ12Summary.relevantDatetime, KCCQ12Summary.relevantPeriod )
  where KCCQ12ItemDate same day as KCCQ12SummaryDate
    and KCCQ12Summary.result is not null
    and KCCQ12Item.result is not null
  return Max({ KCCQ12ItemDate, KCCQ12SummaryDate })

from
  ["Assessment, Performed": "Physical score [MLHFQ]"] MLHFQPhysical,
  ["Assessment, Performed": "Emotional score [MLHFQ]"] MLHFQEmotional
  let MLHFQPhysicalDate: date from start of Global."NormalizeInterval" ( MLHFQPhysical.relevantDatetime, MLHFQPhysical.relevantPeriod ),
  MLHFQEmotionalDate: date from start of Global."NormalizeInterval" ( MLHFQEmotional.relevantDatetime, MLHFQEmotional.relevantPeriod )
  where MLHFQPhysicalDate same day as MLHFQEmotionalDate
    and MLHFQEmotional.result is not null
    and MLHFQPhysical.result is not null
  return Max({ MLHFQPhysicalDate, MLHFQEmotionalDate })

from
  ["Assessment, Performed": "PROMIS-10 Global Mental Health (GMH) score T-score"] PROMIS10MentalScore,
  ["Assessment, Performed": "PROMIS-10 Global Physical Health (GPH) score T-score"] PROMIS10PhysicalScore
  let PROMIS10MentalScoreDate: date from start of Global."NormalizeInterval" ( PROMIS10MentalScore.relevantDatetime, PROMIS10MentalScore.relevantPeriod ),
  PROMIS10PhysicalScoreDate: date from start of Global."NormalizeInterval" ( PROMIS10PhysicalScore.relevantDatetime, PROMIS10PhysicalScore.relevantPeriod )
  where PROMIS10MentalScoreDate same day as PROMIS10PhysicalScoreDate
    and PROMIS10PhysicalScore.result is not null
    and PROMIS10MentalScore.result is not null
  return Max({ PROMIS10MentalScoreDate, PROMIS10PhysicalScoreDate })

from
  ["Assessment, Performed": "PROMIS-29 Sleep disturbance score T-score"] Promis29Sleep,
  ["Assessment, Performed": "PROMIS-29 Satisfaction with participation in social roles score T-score"] Promis29SocialRoles,
  ["Assessment, Performed": "PROMIS-29 Physical function score T-score"] Promis29Physical,
  ["Assessment, Performed": "PROMIS-29 Pain interference score T-score"] Promis29Pain,
  ["Assessment, Performed": "PROMIS-29 Fatigue score T-score"] Promis29Fatigue,
  ["Assessment, Performed": "PROMIS-29 Depression score T-score"] Promis29Depression,
  ["Assessment, Performed": "PROMIS-29 Anxiety score T-score"] Promis29Anxiety
  let Promis29SleepDate: date from start of Global."NormalizeInterval" ( Promis29Sleep.relevantDatetime, Promis29Sleep.relevantPeriod ),
  Promis29SocialRolesDate: date from start of Global."NormalizeInterval" ( Promis29SocialRoles.relevantDatetime, Promis29SocialRoles.relevantPeriod ),
  Promis29PhysicalDate: date from start of Global."NormalizeInterval" ( Promis29Physical.relevantDatetime, Promis29Physical.relevantPeriod ),
  Promis29PainDate: date from start of Global."NormalizeInterval" ( Promis29Pain.relevantDatetime, Promis29Pain.relevantPeriod ),
  Promis29FatigueDate: date from start of Global."NormalizeInterval" ( Promis29Fatigue.relevantDatetime, Promis29Fatigue.relevantPeriod ),
  Promis29DepressionDate: date from start of Global."NormalizeInterval" ( Promis29Depression.relevantDatetime, Promis29Depression.relevantPeriod ),
  Promis29AnxietyDate: date from start of Global."NormalizeInterval" ( Promis29Anxiety.relevantDatetime, Promis29Anxiety.relevantPeriod )
  where Promis29SleepDate same day as Promis29SocialRolesDate
    and Promis29SocialRoles.result is not null
    and Promis29SleepDate same day as Promis29PhysicalDate
    and Promis29Physical.result is not null
    and Promis29SleepDate same day as Promis29PainDate
    and Promis29Pain.result is not null
    and Promis29SleepDate same day as Promis29FatigueDate
    and Promis29Fatigue.result is not null
    and Promis29SleepDate same day as Promis29DepressionDate
    and Promis29Depression.result is not null
    and Promis29SleepDate same day as Promis29AnxietyDate
    and Promis29Anxiety.result is not null
    and Promis29Sleep.result is not null
  return Max({ Promis29SleepDate, Promis29SocialRolesDate, Promis29PhysicalDate, Promis29PainDate, Promis29FatigueDate, Promis29DepressionDate, Promis29AnxietyDate })

from
  ["Assessment, Performed": "VR-12 Mental component summary (MCS) score - oblique method T-score"] VR12MentalAssessment,
  ["Assessment, Performed": "VR-12 Physical component summary (PCS) score - oblique method T-score"] VR12PhysicalAssessment
  let VR12MentalAssessmentDate: date from start of Global."NormalizeInterval" ( VR12MentalAssessment.relevantDatetime, VR12MentalAssessment.relevantPeriod ),
  VR12PhysicalAssessmentDate: date from start of Global."NormalizeInterval" ( VR12PhysicalAssessment.relevantDatetime, VR12PhysicalAssessment.relevantPeriod )
  where VR12MentalAssessmentDate same day as VR12PhysicalAssessmentDate
    and VR12MentalAssessment.result is not null
    and VR12PhysicalAssessment.result is not null
  return Max({ VR12MentalAssessmentDate, VR12PhysicalAssessmentDate })

from
  ["Assessment, Performed": "VR-12 Mental component summary (MCS) score - orthogonal method T-score"] VR12MentalAssessment,
  ["Assessment, Performed": "VR-12 Physical component summary (PCS) score - orthogonal method T-score"] VR12PhysicalAssessment
  let VR12MentalAssessmentDate: date from start of Global."NormalizeInterval" ( VR12MentalAssessment.relevantDatetime, VR12MentalAssessment.relevantPeriod ),
  VR12PhysicalAssessmentDate: date from start of Global."NormalizeInterval" ( VR12PhysicalAssessment.relevantDatetime, VR12PhysicalAssessment.relevantPeriod )
  where VR12MentalAssessmentDate same day as VR12PhysicalAssessmentDate
    and VR12MentalAssessment.result is not null
    and VR12PhysicalAssessment.result is not null
  return Max({ VR12MentalAssessmentDate, VR12PhysicalAssessmentDate })

from
  ["Assessment, Performed": "VR-36 Mental component summary (MCS) score - oblique method T-score"] VR36MentalAssessment,
  ["Assessment, Performed": "VR-36 Physical component summary (PCS) score - oblique method T-score"] VR36PhysicalAssessment
  let VR36MentalAssessmentDate: date from start of Global."NormalizeInterval" ( VR36MentalAssessment.relevantDatetime, VR36MentalAssessment.relevantPeriod ),
  VR36PhysicalAssessmentDate: date from start of Global."NormalizeInterval" ( VR36PhysicalAssessment.relevantDatetime, VR36PhysicalAssessment.relevantPeriod )
  where VR36MentalAssessmentDate same day as VR36PhysicalAssessmentDate
    and VR36MentalAssessment.result is not null
    and VR36PhysicalAssessment.result is not null
  return Max({ VR36MentalAssessmentDate, VR36PhysicalAssessmentDate })

from
  ["Assessment, Performed": "VR-36 Mental component summary (MCS) score - orthogonal method T-score"] VR36MentalAssessment,
  ["Assessment, Performed": "VR-36 Physical component summary (PCS) score - orthogonal method T-score"] VR36PhysicalAssessment
  let VR36MentalAssessmentDate: date from start of Global."NormalizeInterval" ( VR36MentalAssessment.relevantDatetime, VR36MentalAssessment.relevantPeriod ),
  VR36PhysicalAssessmentDate: date from start of Global."NormalizeInterval" ( VR36PhysicalAssessment.relevantDatetime, VR36PhysicalAssessment.relevantPeriod )
  where VR36MentalAssessmentDate same day as VR36PhysicalAssessmentDate
    and VR36MentalAssessment.result is not null
    and VR36PhysicalAssessment.result is not null
  return Max({ VR36MentalAssessmentDate, VR36PhysicalAssessmentDate })

"Initial Population"

Hospice."Has Hospice Services"
  or exists ( ["Diagnosis": "Severe cognitive impairment (finding)"] SevereCognitiveImpairment
      where SevereCognitiveImpairment.prevalencePeriod overlaps "Measurement Period"
  )

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date KCCQ Domain Assessment Completed" InitialKCCQAssessmentDate,
    "Date KCCQ Domain Assessment Completed" FollowUpKCCQAssessmentDate
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialKCCQAssessmentDate 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpKCCQAssessmentDate during day of Interval[date from InitialKCCQAssessmentDate + 30 days, date from InitialKCCQAssessmentDate + 180 days]
    return ValidEncounters
)

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date KCCQ Total Assessment Completed" InitialKCCQTotalScore,
    "Date KCCQ Total Assessment Completed" FollowUpKCCQTotalScore
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialKCCQTotalScore 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpKCCQTotalScore during day of Interval[date from InitialKCCQTotalScore + 30 days, date from InitialKCCQTotalScore + 180 days]
    return ValidEncounters
)

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date KCCQ12 Total Assessment Completed" InitialKCCQ12Date,
    "Date KCCQ12 Total Assessment Completed" FollowUpKCCQ12Date
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialKCCQ12Date 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpKCCQ12Date during day of Interval[date from InitialKCCQ12Date + 30 days, date from InitialKCCQ12Date + 180 days]
    return ValidEncounters
)

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date MLHFQ Total Assessment Completed" InitialMLHFQDate,
    "Date MLHFQ Total Assessment Completed" FollowUpMLHFQDate
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialMLHFQDate 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpMLHFQDate during day of Interval[date from InitialMLHFQDate + 30 days, date from InitialMLHFQDate + 180 days]
    return ValidEncounters
)

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date PROMIS10 Total Assessment Completed" InitialPROMIS10Date,
    "Date PROMIS10 Total Assessment Completed" FollowUpPROMIS10Date
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialPROMIS10Date 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpPROMIS10Date during day of Interval[date from InitialPROMIS10Date + 30 days, date from InitialPROMIS10Date + 180 days]
    return ValidEncounters
)

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date PROMIS29 Total Assessment Completed" InitialPROMIS29Date,
    "Date PROMIS29 Total Assessment Completed" FollowUpPROMIS29Date
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialPROMIS29Date 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpPROMIS29Date during day of Interval[date from InitialPROMIS29Date + 30 days, date from InitialPROMIS29Date + 180 days]
    return ValidEncounters
)

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date VR12 Oblique Total Assessment Completed" InitialVR12ObliqueDate,
    "Date VR12 Oblique Total Assessment Completed" FollowUpVR12ObliqueDate
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialVR12ObliqueDate 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpVR12ObliqueDate during day of Interval[date from InitialVR12ObliqueDate + 30 days, date from InitialVR12ObliqueDate + 180 days]
    return ValidEncounters
)

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date VR12 Orthogonal Total Assessment Completed" InitialVR12OrthogonalDate,
    "Date VR12 Orthogonal Total Assessment Completed" FollowUpVR12OrthogonalDate
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialVR12OrthogonalDate 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpVR12OrthogonalDate during day of Interval[date from InitialVR12OrthogonalDate + 30 days, date from InitialVR12OrthogonalDate + 180 days]
    return ValidEncounters
)

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date VR36 Oblique Total Assessment Completed" InitialVR36ObliqueDate,
    "Date VR36 Oblique Total Assessment Completed" FollowUpVR36ObliqueDate
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialVR36ObliqueDate 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpVR36ObliqueDate during day of Interval[date from InitialVR36ObliqueDate + 30 days, date from InitialVR36ObliqueDate + 180 days]
    return ValidEncounters
)

exists ( from
    "Qualifying Encounters" ValidEncounters,
    "Date VR36 Orthogonal Total Assessment Completed" InitialVR36OrthogonalDate,
    "Date VR36 Orthogonal Total Assessment Completed" FollowUpVR36OrthogonalDate
    where ValidEncounters.relevantPeriod ends 180 days or more before day of end of "Measurement Period"
      and InitialVR36OrthogonalDate 14 days or less on or before day of end of ValidEncounters.relevantPeriod
      and date from FollowUpVR36OrthogonalDate during day of Interval[date from InitialVR36OrthogonalDate + 30 days, date from InitialVR36OrthogonalDate + 180 days]
    return ValidEncounters
)

exists ( ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter
    where ( InpatientEncounter.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
        or InpatientEncounter.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
    )
      and InpatientEncounter.relevantPeriod ends during day of "Measurement Period"
)
  or exists ( ["Encounter, Performed": "Hospice Encounter"] HospiceEncounter
      where HospiceEncounter.relevantPeriod overlaps day of "Measurement Period"
  )
  or exists ( ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment
      where HospiceAssessment.result ~ "Yes (qualifier value)"
        and Global."NormalizeInterval" ( HospiceAssessment.relevantDatetime, HospiceAssessment.relevantPeriod ) overlaps day of "Measurement Period"
  )
  or exists ( ["Intervention, Order": "Hospice Care Ambulatory"] HospiceOrder
      where HospiceOrder.authorDatetime during day of "Measurement Period"
  )
  or exists ( ["Intervention, Performed": "Hospice Care Ambulatory"] HospicePerformed
      where Global."NormalizeInterval" ( HospicePerformed.relevantDatetime, HospicePerformed.relevantPeriod ) overlaps day of "Measurement Period"
  )
or exists ( ["Diagnosis": "Hospice Diagnosis"] HospiceCareDiagnosis
      where HospiceCareDiagnosis.prevalencePeriod overlaps day of "Measurement Period"
  )

AgeInYearsAt(date from start of "Measurement Period") >= 18
  and exists ( ["Diagnosis": "Heart Failure"] HeartFailure
      where HeartFailure.prevalencePeriod overlaps before "Measurement Period"
  )
  and exists ( "Two Outpatient Encounters during Measurement Period" )

( "Has Encounter with Initial and Follow Up PROMIS10 Assessments" )
  or ( "Has Encounter with Initial and Follow Up PROMIS29 Assessments" )
  or ( "Has Encounter with Initial and Follow Up VR12 Oblique Assessments" )
  or ( "Has Encounter with Initial and Follow Up VR12 Orthogonal Assessments" )
  or ( "Has Encounter with Initial and Follow Up VR36 Oblique Assessments" )
  or ( "Has Encounter with Initial and Follow Up VR36 Orthogonal Assessments" )
  or ( "Has Encounter with Initial and Follow Up MLHFQ Assessments" )
  or ( "Has Encounter with Initial and Follow Up KCCQ12 Assessments" )
  or ( "Has Encounter with Initial and Follow Up KCCQ Domain Score Assessments" )
  or ( "Has Encounter with Initial and Follow Up KCCQ Total Score Assessments" )

( ["Encounter, Performed": "Office Visit"]
  union ["Encounter, Performed": "Telephone Visits"]
  union ["Encounter, Performed": "Virtual Encounter"] ) ValidEncounters
  where ValidEncounters.relevantPeriod during day of "Measurement Period"

["Patient Characteristic Ethnicity": "Ethnicity"]

["Patient Characteristic Payer": "Payer Type"]

["Patient Characteristic Race": "Race"]

["Patient Characteristic Sex": "ONC Administrative Sex"]

from
  "Qualifying Encounters" OfficeVisit1,
  "Qualifying Encounters" OfficeVisit2
  where OfficeVisit2.relevantPeriod starts 1 day or more after day of end of OfficeVisit1.relevantPeriod
  return OfficeVisit1

if pointInTime is not null then Interval[pointInTime, pointInTime]
  else if period is not null then period 
  else null as Interval<DateTime>