會研究這個題目主要是因為臺灣重大傷病實作指引,如同其他IG一樣,這個IG也定義了一個主要的Bundle和構成這個Bundle所需要的profile。然而,除了構成Bundle所需的profile之外,同時也定義了Questionnaire這個profile。有別於其他profile,Questionnaire並非為資料集,而比較像是蒐集資料的工具。
官網的說明如下:
A Questionnaire is an organized collection of questions intended to solicit information from patients, providers or other individuals involved in the healthcare domain.
LHC FHIR Tool
透過Google搜尋,找到一個資源相當完整的網站:LHC FHIR Tool在這個網站提供一個Questionnaire Viewer顯示如下:
Questionnaire-1
在Local端以Docker方式建置FHIR Server,並匯入[臺灣重大傷病實作指引]與[臺灣核心實作指引]所對應之Package後,下載臺灣重大傷病實作指引所提供的範例(Questionnaire),就可以和LHC Questionnaire Viewer結合,產生畫面如下:
Questionnaire-2
背景
llustration of FHIR- and CQL-based knowledge artifacts that provide quality measurement and decision support implementations of the US Preventive Services Task Force Recommendation on Colorectal Cancer Screening.
The artifacts are built using the approach and methodology of the FHIR Clinical Guidelines IG (CPG).
The U.S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force, 2016).
https://github.com/cqframework/cqf-ccc/tree/master
程式架構
計算範例CDS(ColorectalCancerScreeningCDS)
CQM(ColorectalCancerScreeningCQM)
Clinical Quality Language(CQL)概述
官方說明:
Clinical Quality Language (CQL) is a high-level, domain-specific language focused on clinical quality and targeted at measure and decision support artifact authors.
In addition, this specification describes a machine-readable canonical representation called Expression Logical Model (ELM) targeted at implementations and designed to enable sharing of clinical knowledge.
https://build.fhir.org/ig/HL7/cql/
簡單的說,CQL為領域專家撰寫的語言,人可以看得懂;ELM則是機器看得懂的語言,專注在系統開發與整合使用。下圖說明了彼此的關係,透過工具,可以將CQL與ELM互相轉換,應用於分析與需求確認。實際系統開發則是從ELM出發,透過程式語言,將複雜的邏輯轉換為可執行程式。
程式來源
https://github.com/cqframework/cqf-exercises/blob/master/input/cql/Exercises10Key.cql
Recommendation Statement
The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery
USPSTF 建議對55至80歲,曾經有每年抽30包之吸菸史,目前吸菸或在過去15年內戒菸的成年人每年進行一次低劑量電腦斷層掃描(LDCT)肺癌篩檢。一旦一個人15年不吸煙或出現嚴重限制預期壽命或進行治療性肺部手術的能力或意願的健康問題,就應停止篩檢。
程式說明
Libbrary名稱
https://github.com/cqframework/cql-translation-service
簡介
官網的說明:A microservice wrapper for the CQL to ELM conversion library and CQL formatter. 其實還蠻直覺的,就是一個CQL轉ELM的微服務。
安裝步驟
git clone
goit clone https://github.com/cqframework/cql-translation-service
Build Package