Colorectal Cancer Screening and Management (CRCSM) Clinical Decision Support (CDS) Implementation Guide
0.1.0 - ci-build

Colorectal Cancer Screening and Management (CRCSM) Clinical Decision Support (CDS) Implementation Guide - Local Development build (v0.1.0) 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 colorectal 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.

flow-ScreeningEligible

Name
eve-HxTotalColectomy_no_eve-ActiveCRC_yes_end-1
eve-HxTotalColectomy_yes_end-1
eve-HxTotalColectomy_no_eve-ActiveCRC_no_eve-Symptomatic_no_act-ScreeningEligible
eve-HxTotalColectomy_no_eve-ActiveCRC_no_eve-Symptomatic_yes_act-Diagnostic
inc-AgeAtLeast18_MostRecentAgeValue_yes
inc-AgeAtLeast18_error
inc-AgeAtLeast18_no
inc-AgeAtLeast18_yes

flow-DecisionToScreen

Name
HankCarlson
StellaParker
FannyFamiglietti
eve-Age86AndOlder_yes_act-HarmsLikelyOutweighBenefits
eve-Age86AndOlder_no_eve-AgeOver76_yes_act-SelectivelyOfferScreening__eve-LifeExp10_no_eve-riskFactors_no_act-AvgRiskEligible
eve-Age86AndOlder_no_eve-AgeOver76_yes_act-SelectivelyOfferScreening__eve-LifeExp10_yes_act-sdmcontinuelifexp__eve-riskFactors_no_act-AvgRiskEligible
eve-Age86AndOlder_no_eve-AgeOver76_no_eve-LifeExp10_no_eve-riskFactors_no_act-AvgRiskEligible
eve-Age86AndOlder_no_eve-AgeOver76_no_eve-LifeExp10_yes_act-sdmcontinuelifexp__eve-riskFactors_no_act-AvgRiskEligible
eve-Age86AndOlder_no_eve-AgeOver76_yes_act-SelectivelyOfferScreening__eve-LifeExp10_no_eve-riskFactors_yes_act-incRiskEligible
eve-Age86AndOlder_no_eve-AgeOver76_yes_act-SelectivelyOfferScreening__eve-LifeExp10_yes_act-sdmcontinuelifexp__eve-riskFactors_yes_act-incRiskEligible
eve-Age86AndOlder_no_eve-AgeOver76_no_eve-LifeExp10_no_eve-riskFactors_yes_act-incRiskEligible
eve-Age86AndOlder_no_eve-AgeOver76_no_eve-LifeExp10_yes_act-sdmcontinuelifexp__eve-riskFactors_yes_act-incRiskEligible

flow-IncreasedRiskExclusions

Name
HankCarlson
FannyFamiglietti
eve-HereditarySyndrome_no_eve-IBD_no_eve-HxCRC_no_eve-FamilyHx_yes_act-FamilyHxCRC
eve-HereditarySyndrome_yes_act-CRCHereditarySyndrome
eve-HereditarySyndrome_no_eve-IBD_no_eve-HxCRC_yes_act-HxCRC
eve-HereditarySyndrome_no_eve-IBD_no_eve-HxCRC_no_eve-FamilyHx_no_eve-HxPolyps_no_act-AvgRiskScreeningEligible
eve-HereditarySyndrome_no_eve-IBD_no_eve-HxCRC_no_eve-FamilyHx_no_eve-HxPolyps_yes_act-HxPolyps
eve-HereditarySyndrome_no_eve-IBD_yes_act-IBD

flow-USPSTFAvgRisk

Name
StellaParker
eve-AgeOver45_no_act-RecommendStartScreeningAt45
eve-AgeOver45_yes_eve-priorScreeningExists_no_act-updateDueDateNow
eve-AgeOver45_yes_eve-priorScreeningExists_yes_act-determineDueDate

HighLevel

Name
ColinCarlson
EduardElder
FannyFamiglietti
FranColette
HankCarlson
HollyHereditary
IsaacBrown
OllieOncken
PaulinePolyanski
PollyStuart
SallySimpson
StellaParker

PrimaryScreeningDecision

Name
CheckIsIncludedAndNotExcluded_false
ColinCarlson
EduardElder
FannyFamiglietti
HankCarlson
HollyHereditary
IsScreeningEligible_false_ActiveCRC
IsScreeningEligible_false_HxTotalColectomy
IsScreeningEligible_false_Symptomatic
IsScreeningEligible_true
IsaacBrown
PaulinePolyanski
PollyStuart
SallySimpson
StellaParker

flow-ScreeningDue

Name
eve-nextdueexists_yes_eve-DetermineIfDueForScreening_due_act-orderTest
eve-nextdueexists_yes_eve-DetermineIfDueForScreening_notdue_end-1
eve-nextdueexists_yes_eve-DetermineIfDueForScreening_overdue_act-patientOutreach_act-orderTest
eve-nextdueexists_no_act-determinedue

flow-ScreeningIncomplete

Name
eve-pendingColonoscopy_act-testpending
eve-pendingCTC_act-testpending
eve-pendingFlexSig_act-testpending
eve-pendinggFOBT_act-testpending
eve-pendingsDNAFIT_act-testpending

flow-FollowUp

Name
FranColette
OllieOncken
PollyStuart
eve-lastTestColonoscopy_no_eve-lastTestStool_no_eve-lastTestFlexSig_no_eve-lastTestCTC_no_end-1
eve-lastTestColonoscopy_no_eve-lastTestStool_no_eve-lastTestFlexSig_no_eve-lastTestCTC_yes_eve-inconclusiveCTColonography_no_eve-abnormalCTColonography_no_end-1
eve-lastTestColonoscopy_no_eve-lastTestStool_no_eve-lastTestFlexSig_no_eve-lastTestCTC_yes_eve-inconclusiveCTColonography_no_eve-abnormalCTColonography_yes_act-FollowUpColonoscopy
eve-lastTestColonoscopy_no_eve-lastTestStool_no_eve-lastTestFlexSig_no_eve-lastTestCTC_yes_eve-inconclusiveCTColonography_yes_act-repeatScreening
eve-lastTestColonoscopy_no_eve-lastTestStool_no_eve-lastTestFlexSig_yes_eve-abnormalFlexSig_no_end-1
eve-lastTestColonoscopy_no_eve-lastTestStool_no_eve-lastTestFlexSig_yes_eve-abnormalFlexSig_yes_act-FollowUpColonoscopy
eve-lastTestColonoscopy_no_eve-lastTestStool_yes_eve-inconclusiveStoolTest_no_eve-abnormalStoolTest_no_end-1
eve-lastTestColonoscopy_no_eve-lastTestStool_yes_eve-inconclusiveStoolTest_no_eve-abnormalStoolTest_yes_act-FollowUpColonoscopy
eve-lastTestColonoscopy_no_eve-lastTestStool_yes_eve-inconclusiveStoolTest_yes_act-repeatScreening
eve-lastTestColonoscopy_yes_end-1
eve-lastTestColonoscopy_yes_eve-colonoscopyFindingCRC_no_eve-recommendedInterval_no_eve-colonoscopyFindingPolyps_no_end-1
eve-lastTestColonoscopy_yes_eve-colonoscopyFindingCRC_no_eve-recommendedInterval_no_eve-colonoscopyFindingPolyps_yes_act-followUpColonoscopist
eve-lastTestColonoscopy_yes_eve-colonoscopyFindingCRC_no_eve-recommendedInterval_yes_end-1
eve-lastTestColonoscopy_yes_eve-colonoscopyFindingCRC_yes_act-oncologyReferral