Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide
1.0.0 - ci-build

Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Screening Eligible - TTL Representation

Draft as of 2024-10-22

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:PlanDefinition ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "flow-ScreeningEligible"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-computableplandefinition"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-computableplandefinition>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<div>\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">flow-ScreeningEligible</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\"><a href=\"PlanDefinition-flow-ScreeningEligible.html\">Screening Eligible</a></td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">1.0.0</td>\n        </tr>\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">Screening Eligible</td>\n        </tr>\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Status: </b></th>\n            <td style=\"padding-left: 4px;\">draft</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Experimental: </b></th>\n            <td style=\"padding-left: 4px;\">true</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Type: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-plan-definition-type.html\">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>eca-rule</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2024-10-22</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">MITRE</td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\"><div><p>Determines whether a patient is eligible for routine breast cancer screening. This includes absolute exclusion criteria for which routine screening is not indicated in all guidelines and pathways.</p>\n<p>Individuals who have certain signs or symptoms concerning for breast cancer or other breast diseases are excluded from routine screening pathways and should have diagnostic testing performed.</p>\n</div></td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Knowledge Capability: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                executable \n            </td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Knowledge Representation Level: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                structured\n            </td>\n        </tr>\n        \n\n        \n\n        \n\n        \n\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Copyright: </b></th>\n            <td style=\"padding-left: 4px;\"><div><p>(C) 2024 The MITRE Corporation. All Rights Reserved. Approved for Public Release: 24-2711. Distribution Unlimited. Unless otherwise noted, this work is available under an Apache 2.0 license. It was produced by the MITRE Corporation for the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention in accordance with the Statement of Work, contract number 75FCMC18D0047, task order number 75D30123F17931.</p>\n</div></td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Approval Date: </b></th>\n            <td style=\"padding-left: 4px;\">2024-10-22</td>\n        </tr>\n        \n\n        \n\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Libraries: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    \n                    <tr>\n                        <td><code>Library/ScreeningEligible|1.0.0</code></td>\n                    </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n\n        \n        <tr>\n            <th scope=\"row\"><b>Actions: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    \n                    <tr>\n                        <td>\n                            \n                            <b> Screening eligible:</b> Patient is eligible for screening\n                            \n                            <br/>\n                            \n                            \n                            <b>If:</b>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(CheckIsIncludedAndNotExcluded)</i>\n                            <br/>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(IsScreeningEligible)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                            <b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateEligible|1.0.0</code><br/>\n                            \n                            \n                            \n                        </td>\n                    </tr>\n                    \n                    <tr>\n                        <td>\n                            \n                            <b> Not eligible for screening:</b> This patient is not eligible for screening.\n\nReferenced guidelines apply to individuals assigned female at birth. Routine screening of cis-gender individuals assigned male at birth is not recommended. For transgender women, consider specialist referral.\n\nAdditional resources: ACR Appropriateness Criteria® Transgender Breast Cancer Screening; UCSF guidelines 'Screening for breast cancer in transgender women'\n                            \n                            <br/>\n                            \n                            \n                            <b>If:</b>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(CheckIsIncludedAndNotExcluded)</i>\n                            <br/>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(ExistsNotEligibleNotAssignedFemaleAtBirth)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                            <b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0</code><br/>\n                            \n                            <i>Dynamic Values:</i><br/>\n                            \n                            reasonCode[0].coding[0]: <i>(ScreeningEligibleReason)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                        </td>\n                    </tr>\n                    \n                    <tr>\n                        <td>\n                            \n                            <b> Refer to Oncologic care plan:</b> This patient is not eligible for routine screening and should be referred to a specialist for management.\n\nBreast cancer within 5 years may require enhanced surveillance including diagnostic mammogram. Refer to patient's Oncologic treatment team or Survivorship Care Plan for patient specific guidance.\n                            \n                            <br/>\n                            \n                            \n                            <b>If:</b>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(CheckIsIncludedAndNotExcluded)</i>\n                            <br/>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(ExistsNotEligibleCurrentBreastCancer)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                            <b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0</code><br/>\n                            \n                            <i>Dynamic Values:</i><br/>\n                            \n                            reasonCode[0].coding[0]: <i>(ScreeningEligibleReason)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                        </td>\n                    </tr>\n                    \n                    <tr>\n                        <td>\n                            \n                            <b> Not eligible for screening:</b> This patient is not eligible for screening.\n\nNew breast symptoms or exam findings, or chronic symptoms or findings which have progressively worsened, should undergo diagnostic testing rather than routine screening.\n                            \n                            <br/>\n                            \n                            \n                            <b>If:</b>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(CheckIsIncludedAndNotExcluded)</i>\n                            <br/>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(ExistsNotEligibleBreastSymptomsOrFindings)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                            <b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0</code><br/>\n                            \n                            <i>Dynamic Values:</i><br/>\n                            \n                            reasonCode[0].coding[0]: <i>(ScreeningEligibleReason)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                        </td>\n                    </tr>\n                    \n                    <tr>\n                        <td>\n                            \n                            <b> Not eligible for screening:</b> This patient is not eligible for screening.\n\nThis patient has had bilateral mastectomy and does not meet the eligibility requirements for routine breast cancer screening.\n                            \n                            <br/>\n                            \n                            \n                            <b>If:</b>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(CheckIsIncludedAndNotExcluded)</i>\n                            <br/>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(ExistsNotEligibleBilateralMastectomy)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                            <b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0</code><br/>\n                            \n                            <i>Dynamic Values:</i><br/>\n                            \n                            reasonCode[0].coding[0]: <i>(ScreeningEligibleReason)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                        </td>\n                    </tr>\n                    \n                    <tr>\n                        <td>\n                            \n                            <b> Screening Eligible Missing Data:</b> Error due to missing required data for inclusion and exclusion evaluation.\n                            \n                            <br/>\n                            \n                            \n                            <b>If:</b>\n                            \n                            <i>Applicability:</i>\n                            \n                            <i>(MissingAgeOrBirthdate)</i>\n                            <br/>\n                            \n                            \n                            \n                            \n                            <b>Then:</b> <i>Definition:</i> <a href=\"Questionnaire-ScreeningEligibleQuestionnaire.html\">Screening Eligibleversion: null1.0.0)</a><br/>\n                            \n                            \n                            \n                        </td>\n                    </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n    </table>\n</div>\n</div>"^^rdf:XMLLiteral
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability"^^xsd:anyURI ] ;
fhir:value [
a fhir:code ;
fhir:v "executable"     ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeRepresentationLevel"^^xsd:anyURI ] ;
fhir:value [
a fhir:code ;
fhir:v "structured"     ]
  ] ) ; # 
  fhir:url [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-ScreeningEligible"^^xsd:anyURI] ; # 
  fhir:version [ fhir:v "1.0.0"] ; # 
  fhir:name [ fhir:v "flow-ScreeningEligible"] ; # 
  fhir:title [ fhir:v "Screening Eligible"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/plan-definition-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "eca-rule" ]     ] )
  ] ; # 
  fhir:status [ fhir:v "draft"] ; # 
  fhir:experimental [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:date [ fhir:v "2024-10-22"^^xsd:date] ; # 
  fhir:publisher [ fhir:v "MITRE"] ; # 
  fhir:contact ( [
fhir:name [ fhir:v "MITRE" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "https://www.mitre.org/" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "Determines whether a patient is eligible for routine breast cancer screening. This includes absolute exclusion criteria for which routine screening is not indicated in all guidelines and pathways.\n\nIndividuals who have certain signs or symptoms concerning for breast cancer or other breast diseases are excluded from routine screening pathways and should have diagnostic testing performed."] ; # 
  fhir:copyright [ fhir:v "(C) 2024 The MITRE Corporation. All Rights Reserved. Approved for Public Release: 24-2711. Distribution Unlimited. Unless otherwise noted, this work is available under an Apache 2.0 license. It was produced by the MITRE Corporation for the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention in accordance with the Statement of Work, contract number 75FCMC18D0047, task order number 75D30123F17931."] ; # 
  fhir:approvalDate [ fhir:v "2024-10-22"^^xsd:date] ; # 
  fhir:lastReviewDate [ fhir:v "2024-10-22"^^xsd:date] ; # 
  fhir:author ( [
fhir:name [ fhir:v "The Health FFRDC, operated by The MITRE Corporation, in support of the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention." ]
  ] ) ; # 
  fhir:editor ( [
fhir:name [ fhir:v "Division of Cancer Prevention and Control, Centers for Disease Control and Prevention" ]
  ] ) ; # 
  fhir:reviewer ( [
fhir:name [ fhir:v "Division of Cancer Prevention and Control, Centers for Disease Control and Prevention" ]
  ] ) ; # 
  fhir:endorser ( [
fhir:name [ fhir:v "Division of Cancer Prevention and Control, Centers for Disease Control and Prevention" ]
  ] ) ; # 
  fhir:library ( [ fhir:v "Library/ScreeningEligible|1.0.0"^^xsd:anyURI] ) ; # 
  fhir:action ( [
fhir:id [ fhir:v "IsScreeningEligible" ] ;
fhir:title [ fhir:v "Screening eligible" ] ;
fhir:description [ fhir:v "Patient is eligible for screening" ] ;
    ( fhir:code [
      ( fhir:coding [
fhir:system [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"^^xsd:anyURI ] ;
fhir:code [ fhir:v "eligible" ] ;
fhir:display [ fhir:v "Eligible for screening" ]       ] )     ] ) ;
    ( fhir:documentation [
fhir:type [ fhir:v "citation" ] ;
fhir:label [ fhir:v "USPSTF" ] ;
fhir:display [ fhir:v "Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement" ] ;
fhir:citation [ fhir:v "US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024." ] ;
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ]       ]     ] [
fhir:type [ fhir:v "derived-from" ] ;
fhir:label [ fhir:v "Screening Eligible" ] ;
fhir:display [ fhir:v "Individuals who have certain signs or symptoms concerning for breast cancer or other breast diseases are excluded from routine screening pathways and should have diagnostic testing performed." ]     ] ) ;
    ( fhir:condition [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "CheckIsIncludedAndNotExcluded" ]       ]     ] [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "IsScreeningEligible" ]       ]     ] ) ;
fhir:definition [
a fhir:canonical ;
fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateEligible|1.0.0"^^xsd:anyURI ;
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateEligible|1.0.0>     ]
  ] [
fhir:id [ fhir:v "NotEligibleCurrentBreastCancer" ] ;
fhir:title [ fhir:v "Not eligible for screening" ] ;
fhir:description [ fhir:v "This patient is not eligible for screening.\n\nReferenced guidelines apply to individuals assigned female at birth. Routine screening of cis-gender individuals assigned male at birth is not recommended. For transgender women, consider specialist referral.\n\nAdditional resources: ACR Appropriateness Criteria® Transgender Breast Cancer Screening; UCSF guidelines 'Screening for breast cancer in transgender women'" ] ;
    ( fhir:code [
      ( fhir:coding [
fhir:system [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"^^xsd:anyURI ] ;
fhir:code [ fhir:v "noteligible" ] ;
fhir:display [ fhir:v "Not eligible for screening" ]       ] )     ] ) ;
    ( fhir:documentation [
fhir:type [ fhir:v "citation" ] ;
fhir:label [ fhir:v "USPSTF" ] ;
fhir:display [ fhir:v "Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement" ] ;
fhir:citation [ fhir:v "US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024." ] ;
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ]       ]     ] [
fhir:type [ fhir:v "derived-from" ] ;
fhir:label [ fhir:v "Screening Eligible" ] ;
fhir:display [ fhir:v "Individuals who have certain signs or symptoms concerning for breast cancer or other breast diseases are excluded from routine screening pathways and should have diagnostic testing performed." ]     ] [
fhir:type [ fhir:v "documentation" ] ;
fhir:label [ fhir:v "ACR" ] ;
fhir:display [ fhir:v "ACR Appropriateness Criteria® Transgender Breast Cancer Screening" ] ;
fhir:citation [ fhir:v "Brown, Ann, et al. \"ACR appropriateness criteria® transgender breast cancer screening.\" Journal of the American College of Radiology 18.11 (2021): S502-S515." ] ;
fhir:url [ fhir:v "https://www.jacr.org/article/S1546-1440(21)00730-4/fulltext"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://www.jacr.org/article/S1546-1440(21)00730-4/fulltext"^^xsd:anyURI ]       ]     ] [
fhir:type [ fhir:v "documentation" ] ;
fhir:label [ fhir:v "UCSF" ] ;
fhir:display [ fhir:v "UCSF Transgender Care & Treatment Guidelines: Screening for breast cancer in transgender women" ] ;
fhir:url [ fhir:v "https://transcare.ucsf.edu/guidelines/breast-cancer-women"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://transcare.ucsf.edu/guidelines/breast-cancer-women"^^xsd:anyURI ]       ]     ] ) ;
    ( fhir:condition [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "CheckIsIncludedAndNotExcluded" ]       ]     ] [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "ExistsNotEligibleNotAssignedFemaleAtBirth" ]       ]     ] ) ;
fhir:definition [
a fhir:canonical ;
fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0"^^xsd:anyURI ;
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0>     ] ;
    ( fhir:dynamicValue [
fhir:path [ fhir:v "reasonCode[0].coding[0]" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "ScreeningEligibleReason" ]       ]     ] )
  ] [
fhir:id [ fhir:v "NotEligibleCurrentBreastCancer" ] ;
fhir:title [ fhir:v "Refer to Oncologic care plan" ] ;
fhir:description [ fhir:v "This patient is not eligible for routine screening and should be referred to a specialist for management.\n\nBreast cancer within 5 years may require enhanced surveillance including diagnostic mammogram. Refer to patient's Oncologic treatment team or Survivorship Care Plan for patient specific guidance." ] ;
    ( fhir:code [
      ( fhir:coding [
fhir:system [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"^^xsd:anyURI ] ;
fhir:code [ fhir:v "noteligible" ] ;
fhir:display [ fhir:v "Not eligible for screening" ]       ] )     ] ) ;
    ( fhir:documentation [
fhir:type [ fhir:v "citation" ] ;
fhir:label [ fhir:v "USPSTF" ] ;
fhir:display [ fhir:v "Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement" ] ;
fhir:citation [ fhir:v "US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024." ] ;
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ]       ]     ] [
fhir:type [ fhir:v "derived-from" ] ;
fhir:label [ fhir:v "Screening Eligible" ] ;
fhir:display [ fhir:v "Individuals who have certain signs or symptoms concerning for breast cancer or other breast diseases are excluded from routine screening pathways and should have diagnostic testing performed." ]     ] ) ;
    ( fhir:condition [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "CheckIsIncludedAndNotExcluded" ]       ]     ] [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "ExistsNotEligibleCurrentBreastCancer" ]       ]     ] ) ;
fhir:definition [
a fhir:canonical ;
fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0"^^xsd:anyURI ;
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0>     ] ;
    ( fhir:dynamicValue [
fhir:path [ fhir:v "reasonCode[0].coding[0]" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "ScreeningEligibleReason" ]       ]     ] )
  ] [
fhir:id [ fhir:v "NotEligibleBreastSymptomsOrFindings" ] ;
fhir:title [ fhir:v "Not eligible for screening" ] ;
fhir:description [ fhir:v "This patient is not eligible for screening.\n\nNew breast symptoms or exam findings, or chronic symptoms or findings which have progressively worsened, should undergo diagnostic testing rather than routine screening." ] ;
    ( fhir:code [
      ( fhir:coding [
fhir:system [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"^^xsd:anyURI ] ;
fhir:code [ fhir:v "noteligible" ] ;
fhir:display [ fhir:v "Not eligible for screening" ]       ] )     ] ) ;
    ( fhir:documentation [
fhir:type [ fhir:v "citation" ] ;
fhir:label [ fhir:v "USPSTF" ] ;
fhir:display [ fhir:v "Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement" ] ;
fhir:citation [ fhir:v "US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024." ] ;
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ]       ]     ] [
fhir:type [ fhir:v "derived-from" ] ;
fhir:label [ fhir:v "Screening Eligible" ] ;
fhir:display [ fhir:v "Individuals who have certain signs or symptoms concerning for breast cancer or other breast diseases are excluded from routine screening pathways and should have diagnostic testing performed." ]     ] ) ;
    ( fhir:condition [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "CheckIsIncludedAndNotExcluded" ]       ]     ] [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "ExistsNotEligibleBreastSymptomsOrFindings" ]       ]     ] ) ;
fhir:definition [
a fhir:canonical ;
fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0"^^xsd:anyURI ;
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0>     ] ;
    ( fhir:dynamicValue [
fhir:path [ fhir:v "reasonCode[0].coding[0]" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "ScreeningEligibleReason" ]       ]     ] )
  ] [
fhir:id [ fhir:v "NotEligibleBilateralMastectomy" ] ;
fhir:title [ fhir:v "Not eligible for screening" ] ;
fhir:description [ fhir:v "This patient is not eligible for screening.\n\nThis patient has had bilateral mastectomy and does not meet the eligibility requirements for routine breast cancer screening." ] ;
    ( fhir:code [
      ( fhir:coding [
fhir:system [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"^^xsd:anyURI ] ;
fhir:code [ fhir:v "noteligible" ] ;
fhir:display [ fhir:v "Not eligible for screening" ]       ] )     ] ) ;
    ( fhir:documentation [
fhir:type [ fhir:v "citation" ] ;
fhir:label [ fhir:v "USPSTF" ] ;
fhir:display [ fhir:v "Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement" ] ;
fhir:citation [ fhir:v "US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024." ] ;
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"^^xsd:anyURI ]       ]     ] [
fhir:type [ fhir:v "derived-from" ] ;
fhir:label [ fhir:v "Screening Eligible" ] ;
fhir:display [ fhir:v "Individuals who have certain signs or symptoms concerning for breast cancer or other breast diseases are excluded from routine screening pathways and should have diagnostic testing performed." ]     ] ) ;
    ( fhir:condition [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "CheckIsIncludedAndNotExcluded" ]       ]     ] [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "ExistsNotEligibleBilateralMastectomy" ]       ]     ] ) ;
fhir:definition [
a fhir:canonical ;
fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0"^^xsd:anyURI ;
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0>     ] ;
    ( fhir:dynamicValue [
fhir:path [ fhir:v "reasonCode[0].coding[0]" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "ScreeningEligibleReason" ]       ]     ] )
  ] [
fhir:title [ fhir:v "Screening Eligible Missing Data" ] ;
fhir:description [ fhir:v "Error due to missing required data for inclusion and exclusion evaluation." ] ;
    ( fhir:condition [
fhir:kind [ fhir:v "applicability" ] ;
fhir:expression [
fhir:language [ fhir:v "text/cql-identifier" ] ;
fhir:expression [ fhir:v "MissingAgeOrBirthdate" ] ;
fhir:reference [ fhir:v "Library/ScreeningEligible|1.0.0"^^xsd:anyURI ]       ]     ] ) ;
fhir:definition [
a fhir:canonical ;
fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/Questionnaire/ScreeningEligibleQuestionnaire|1.0.0"^^xsd:anyURI ;
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/Questionnaire/ScreeningEligibleQuestionnaire|1.0.0>     ]
  ] ) . #