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

Examples

Test Cases

​This section lists the test cases that are generated for the CDS Level 3 (L3) logical pathways for breast cancer guidelines for screening and management. The test case templates are generated in advance of developing computable L3 logic that implements the CDS L2 logical pathways. The test cases provide unit tests, both negative and positive, for each of the clinical logic pathways. These test cases consist of synthetic electronic health records for a hypothetical patient as well as the corresponding expected CDS outputs. Listed below are the synthetic electronic health record snippets for each of these test patient fixtures. See the “Testing and Validation” Section for more details.

Please note, the test cases are generated by flow in advance and implemented incrementally as we build the CDS Level 3 computable representation. Some of the test case links will be unspecified initially as code is in development.

Reference HL7 Clinical Practice Guidelines (CPG) on FHIR implementation guide for more information about “levels” of CDS knowledge representation: Clinical Practice Guidelines Knowledge Representation.

PrimaryScreeningDecision

Name
CheckIsIncludedAndNotExcluded_false
IsScreeningEligible_false
IsScreeningEligible_true
JaniceMedford_fdr_breastca_age_45
JosephineGreene-past-breast-pain-adh-biopsy
JustineWallace_brca1
LindaNadler-dcis
MarionHenderson_avg_45_to_54
NadiaWills_palpable_breast_mass
PatriciaLambert_remission_lt_5_years

flow-AverageRisk

Name
eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs
eve-AgeOver54_act-acsavgrecs55-uspstfavgrecs
eve-age40to44_act-acsavgrecs40_act-uspstfavgrecs
eve-age40to44_act-acsavgrecs40_only
eve-ageUnder40_act-acsavgrecs40_act-uspstfavgrecs

flow-DecisionToScreen

Name
act-lactating__act-avgrisk
act-sdmcontinuelifexp__act-lactating__act-avgrisk
act-sdmcontinueage__act-lactating__act-avgrisk
act-sdmcontinueage__act-sdmcontinuelifexp__act-lactating__act-avgrisk
eve-AgeOver74_yes_eve-LifeExp_yes
eve-highriskexclusions__end-decisionhighrisk
act-sdmcontinuelifexp__eve-highriskexclusions__end-decisionhighrisk
eve-AgeOver74__act-sdmcontinueage__eve-highriskexclusions__end-decisionhighrisk
act-sdmcontinueage_act-sdmcontinuelifexp_end-decisionhighrisk
act-avgrisk
act-sdmcontinuelifexp__act-avgrisk
act-sdmcontinueage__act-avgrisk
act-sdmcontinueage__act-sdmcontinuelifexp__act-avgrisk
eve-specialpop_yes_end-decisionspecialpop
act-sdmcontinuelifexp__end-decisionspecialpop

flow-FollowupScreeningResult

Name
JaniceMedford_fdr_breastca_age_45
JosephineGreene-past-breast-pain-adh-biopsy
JustineWallace_brca1
LindaNadler-dcis
MarionHenderson_avg_45_to_54
NadiaWills_palpable_breast_mass
PatriciaLambert_remission_lt_5_years
eve-actionablebirads_no_act-updateduedate
eve-biopsyresult_atypical_act-highriskreferral
eve-biopsyresult_discordant_act-discordantbiopsy
eve-biopsyresult_indeterminate_act-indeterminatebiopsy
eve-biopsyresult_malignant_act-oncreferral
eve-biopsyresult_missing_error
eve-biopsyresult_negative_act-updateduedate
eve-biopsyresult_uknown_error
eve-biradsscore_bi-rads_0_act-incompletescreen
eve-biradsscore_bi-rads_3_act-intervalscreen
eve-biradsscore_mri__bi-rads_4_or_5_act-biopsy
eve-biradsscore_bi-rads_4_or_5_act-biopsy
eve-biradsscore_bi-rads_6_end-followup
eve-biradsscore_bi-rads_missing_error
eve-biradsscore_bi-rads_unknown_error

flow-GeneticRiskReferral

Name
JaniceMedford_fdr_breastca_age_45
JosephineGreene-past-breast-pain-adh-biopsy
JustineWallace_brca1
LindaNadler-dcis
MarionHenderson_avg_45_to_54
NadiaWills_palpable_breast_mass
PatriciaLambert_remission_lt_5_years
eve-fhxgeneinherited_no_eve-brcageneancestry_yes_act-geneticreferral
eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_no_end-nofhx
eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_yes_act-fhxrisktool_act-fhxriskassess
eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_yes_act-fhxriskassess__eve-fhxriskresult_negative_end-geneticrisk
eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_yes_eve-preferredfhxriskmethod_informal_act-fhxriskassess__eve-fhxriskresult_positive_act-geneticreferral
eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_yes_act-fhxrisktool__eve-fhxriskresult_positive_act-geneticreferral
eve-fhxgeneinherited_yes_eve-unkvariantstatus_no_end-variantknown
eve-fhxgeneinherited_yes_eve-unkvariantstatus_yes_act-geneticreferral

flow-HighRiskExclusions

Name
eve-atypicalbx__eve-highlifetimerisk__act-acshighriskmammo__act-acshighriskmri
eve-acsgeneticrisk__act-acshighriskmammo__act-acshighriskmri
act-acsmammoatypicalbx_act-acsatypicalbx_warning_missing
eve-geneticrisk_yes_eve-acsgeneticrisk_no_act-othergeneticrisk
act-startat25yand8yafterRT
act-noexclusions
eve-hxbreastca_yes_eve-hxbreastcawithin5y_no_act-acsintriskmammo
act-hxbreastcawithin5y

flow-HighRiskReferral

Name
JaniceMedford_fdr_breastca_age_45
JosephineGreene-past-breast-pain-adh-biopsy
JustineWallace_brca1
LindaNadler-dcis
MarionHenderson_avg_45_to_54
NadiaWills_palpable_breast_mass
PatriciaLambert_remission_lt_5_years
eve-atypicalbxpop__act-HighRiskReferralAtypicalBiopsy_warning_missing
eve-atypicalbxpop__act-HighRiskReferral_act-estlifexpectancy
eve-chestxrtpop__act-HighRiskReferral
eve-fhxbrca_eve-ageAtLeast35_act-HighRiskAssessment
eve-fhxbrca_eve-fiveyrriskpop_lt5y_act-HighRiskAssessment
eve-fiveyrrisklowpop_eve-ageAtLeast35_act-ConsiderHighRiskReferral
eve-fiveyrriskpop_eve-ageAtLeast35_act-HighRiskReferral
eve-geneticriskpop__act-HighRiskReferral
eve-personalriskfactors__act-HighRiskAssessment
exc-hxbrca

flow-ScreeningDue

Name
Denominator_Exclusion_Has_Hospice
eve-nextdueexists_yes_eve-screeninginterval_unknown_eve-due_not_due_end-notdue1
eve-nextdueexists_yes_eve-screeninginterval_annual_eve-dueannual_due
eve-nextdueexists_yes_eve-screeninginterval_annual_eve-dueannual_not_due_end-notdue2
eve-nextdueexists_yes_eve-screeninginterval_annual_eve-dueannual_overdue_act-overdue
eve-nextdueexists_yes_eve-screeninginterval_biennial_eve-duebiennial_due
eve-nextdueexists_yes_eve-screeninginterval_biennial_eve-duebiennial_not_due_end-notdue3
eve-nextdueexists_yes_eve-screeninginterval_biennial_eve-duebiennial_overdue_act-overdue
eve-nextdueexists_no_eve-noscreening27mo_yes_act-determinedue
eve-nextdueexists_yes_eve-screeninginterval_unknown_eve-due_due
eve-nextdueexists_yes_eve-screeninginterval_unknown_eve-due_overdue_act-overdue

flow-ScreeningEligible

Name
eve-female_yes_eve-breastca_yes_end-noteligible
act-eligible
eve-breastfindings_yes_act-dxtesting
eve-breastsymptoms_yes_act-dxtesting
eve-female_no_end-noteligible
eve-mastectomy_yes_end-noteligible
inc-AgeAtLeast18_MostRecentAgeValue_yes
inc-AgeAtLeast18_error
inc-AgeAtLeast18_no
inc-AgeAtLeast18_yes
inc-assignedfemaleatbirthortransfemale_no
inc-assignedfemaleatbirthortransfemale_yes

flow-ScreeningTestIncomplete

Name
eve-pendingbiopsy_act-testpending
eve-pendingmammo_act-testpending

flow-SpecialPopulations

Name
eve-highlifetimerisk_eve-acs_act-acshighriskmammo_act-acshighriskmri
eve-firstdeggenetic_eve-acs_act-firstdeggeneticmammo-firstdeggeneticmri
eve-breastdensitycord_act-performriskassessment
eve-fhxbrcarisk_eve-acs_act-performriskassessment
eve-fhxbrcarisk_uspstf_only