Breast Cancer Screening

( ["Encounter, Performed": "Office Visit"]
	union ["Encounter, Performed": "Annual Wellness Visit"]
	union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"]
	union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"]
	union ["Encounter, Performed": "Home Healthcare Services"] ) ValidEncounter
	where ValidEncounter.relevantPeriod during "Measurement Period"

//If the measure does NOT include populations age 80 and older, then use this logic:
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
		where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 65
			and "Has Criteria Indicating Frailty"
			and ( Count("Outpatient Encounters with Advanced Illness")>= 2
					or exists ( "Inpatient Encounter with Advanced Illness" )
					or exists "Dementia Medications In Year Before or During Measurement Period"
			)
)

"CumulativeDays"("Long Term Care Periods During Measurement Period")

["Medication, Active": "Dementia Medications"] DementiaMed
	where DementiaMed.relevantPeriod overlaps Interval[( start of "Measurement Period" - 1 year ), 
	end of "Measurement Period"]

exists ( ["Device, Order": "Frailty Device"] FrailtyDeviceOrder
		where FrailtyDeviceOrder.authorDatetime during "Measurement Period"
)
	or exists ( ["Device, Applied": "Frailty Device"] FrailtyDeviceApplied
			where FrailtyDeviceApplied.relevantPeriod overlaps "Measurement Period"
	)
	or exists ( ["Diagnosis": "Frailty Diagnosis"] FrailtyDiagnosis
			where FrailtyDiagnosis.prevalencePeriod overlaps "Measurement Period"
	)
	or exists ( ["Encounter, Performed": "Frailty Encounter"] FrailtyEncounter
			where FrailtyEncounter.relevantPeriod overlaps "Measurement Period"
	)
	or exists ( ["Symptom": "Frailty Symptom"] FrailtySymptom
			where FrailtySymptom.prevalencePeriod overlaps "Measurement Period"
	)

"Days Spent in Long Term Care During Measurement Period" > 90

["Encounter, Performed": "Acute Inpatient"] InpatientEncounter
	where exists ( InpatientEncounter.diagnoses Diagnosis
			where Diagnosis in "Advanced Illness"
	)
		and InpatientEncounter.relevantPeriod starts 2 years or less before 
		end of "Measurement Period"

( ["Encounter, Performed": "Care Services in Long-Term Residential Facility"]
	union ["Encounter, Performed": "Nursing Facility Visit"] ) LongTermFacilityEncounter
	where LongTermFacilityEncounter.relevantPeriod overlaps "Measurement Period"
	return LongTermFacilityEncounter.relevantPeriod
		intersect "Measurement Period"

( ["Encounter, Performed": "Outpatient"]
	union ["Encounter, Performed": "Observation"]
	union ["Encounter, Performed": "ED"]
	union ["Encounter, Performed": "Nonacute Inpatient"] ) OutpatientEncounter
	where exists ( OutpatientEncounter.diagnoses Diagnosis
			where Diagnosis in "Advanced Illness"
	)
		and OutpatientEncounter.relevantPeriod starts 2 years or less before 
		end of "Measurement Period"

["Diagnosis": "History of bilateral mastectomy"] BilateralMastectomyHistory
	where BilateralMastectomyHistory.prevalencePeriod starts before 
	end of "Measurement Period"

["Procedure, Performed": "Bilateral Mastectomy"] BilateralMastectomyPerformed
	where BilateralMastectomyPerformed.relevantPeriod ends before end of "Measurement Period"

"Initial Population"

Hospice."Has Hospice"
	or ( Count("Unilateral Mastectomy Procedure")= 2 )
	or ( ( exists ( "Right Mastectomy Diagnosis" )
				or exists ( "Right Mastectomy Procedure" )
		)
			and ( exists ( "Left Mastectomy Diagnosis" )
					or exists ( "Left Mastectomy Procedure" )
			)
	)
	or exists "Bilateral Mastectomy Diagnosis"
	or exists "Bilateral Mastectomy Procedure"
	or FrailtyLTI."Advanced Illness and Frailty Exclusion Including Under Age 80"
	or ( exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
			where ( Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 65 )
				and FrailtyLTI."Has Spent More Than 90 Days in Long Term Care"
	)

exists ( ["Encounter, Performed": "Encounter Inpatient"] DischargeHospice
		where ( DischargeHospice.dischargeDisposition as Code ~ "Discharge to home for hospice care (procedure)"
				or DischargeHospice.dischargeDisposition as Code ~ "Discharge to healthcare facility for hospice care (procedure)"
		)
			and DischargeHospice.relevantPeriod ends during "Measurement Period"
)
	or exists ( ["Intervention, Order": "Hospice care ambulatory"] HospiceOrder
			where HospiceOrder.authorDatetime during "Measurement Period"
	)
	or exists ( ["Intervention, Performed": "Hospice care ambulatory"] HospicePerformed
			where HospicePerformed.relevantPeriod overlaps "Measurement Period"
	)

exists ( ["Patient Characteristic Sex": "Female"] )
	and exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate
		where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")in Interval[51, 74 )
			and exists AdultOutpatientEncounters."Qualifying Encounters"

( ["Diagnosis": "Status Post Left Mastectomy"]
	union ( ["Diagnosis": "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis
			where UnilateralMastectomyDiagnosis.anatomicalLocationSite in "Left"
	) ) LeftMastectomy
	where LeftMastectomy.prevalencePeriod starts before 
	end of "Measurement Period"

["Procedure, Performed": "Unilateral Mastectomy Left"] UnilateralMastectomyLeftPerformed
		where UnilateralMastectomyLeftPerformed.relevantPeriod ends before end of "Measurement Period"

exists ( ["Diagnostic Study, Performed": "Mammography"] Mammogram
		where ( Mammogram.relevantPeriod ends 27 months or less before day of end "Measurement Period" )
)

( ["Diagnosis": "Status Post Right Mastectomy"] RightMastectomyProcedure
	union ( ["Diagnosis": "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis
			where UnilateralMastectomyDiagnosis.anatomicalLocationSite in "Right"
	) ) RightMastectomy
	where RightMastectomy.prevalencePeriod starts before 
	end of "Measurement Period"

["Procedure, Performed": "Unilateral Mastectomy Right"] UnilateralMastectomyRightPerformed
		where UnilateralMastectomyRightPerformed.relevantPeriod ends before end of "Measurement Period"

["Patient Characteristic Ethnicity": "Ethnicity"]

["Patient Characteristic Payer": "Payer"]

["Patient Characteristic Race": "Race"]

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

["Procedure, Performed": "Unilateral Mastectomy"] UnilateralMastectomy
	where UnilateralMastectomy.relevantPeriod ends before 
	end of "Measurement Period"

Sum((collapse Intervals)CollapsedInterval
		return all duration in days of CollapsedInterval
)

years between ToDate(BirthDateTime)and ToDate(AsOf)

DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)