appliesResult to StratifierResult in detailed results output

src/calculation/DetailedResultsBuilder.ts

@@ -33,6 +33,9 @@
  populationResults = popAndStratResults.populationResults;
  stratifierResults = popAndStratResults.stratifierResults;
  populationResults = handlePopulationValues(populationResults, populationGroup, measureScoringCode);
+ if (stratifierResults) {
+ stratifierResults = handleStratificationValues(populationGroup, populationResults, stratifierResults);
+ }
  } else {
  // episode of care based measure
  // collect results per episode
@@ -45,6 +48,9 @@
  const popAndStratResults = createPatientPopulationValues(populationGroup, patientResults);
  populationResults = popAndStratResults.populationResults;
  stratifierResults = popAndStratResults.stratifierResults;
+ if (stratifierResults) {
+ stratifierResults = handleStratificationValues(populationGroup, populationResults, stratifierResults);
+ }
  } else {
  populationResults = [];
  stratifierResults = [];
@@ -97,6 +103,9 @@
  }
  });
  });
+ if (stratifierResults) {
+ stratifierResults = handleStratificationValues(populationGroup, populationResults, stratifierResults);
+ }
  }
  }
  const detailedResult: DetailedPopulationGroupResult = {
@@ -305,6 +314,7 @@
  if (strata.criteria?.expression) {
  const value = patientResults[strata.criteria?.expression];
  const result = isStatementValueTruthy(value);
+
  stratifierResults?.push({
  strataCode: strata.code?.text ?? strata.id ?? `strata-${strataIndex++}`,
  result,
@@ -320,6 +330,39 @@
  };
 }
 
+export function handleStratificationValues(
+ populationGroup: fhir4.MeasureGroup,
+ populationResults: PopulationResult[],
+ stratifierResults: StratifierResult[]
+): StratifierResult[] {
+ if (populationGroup.stratifier) {
+ populationGroup.stratifier.forEach(strata => {
+ if (strata.criteria?.expression) {
+ const strataResult = stratifierResults.find(strataRes => strataRes.strataId === strata.id);
+
+ if (strataResult) {
+ // if the cqfm-appliesTo extension is present, then we want to consider the result of that
+ // population in our stratifier result
+ const appliesToExtension = strata.extension?.find(
+ e => e.url === 'http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo'
+ );
+
+ let popValue = true;
+ if (appliesToExtension) {
+ const popCode = appliesToExtension.valueCodeableConcept?.coding?.[0].code;
+ if (popCode) {
+ popValue = populationResults.find(pr => pr.populationType === popCode)?.result ?? true;
+ }
+ }
+ console.log(popValue);
+ strataResult.appliesResult = isStatementValueTruthy(popValue && strataResult.result);
+ }
+ }
+ });
+ }
+ return stratifierResults;
+}
+
 function isStatementValueTruthy(value: any): boolean {
  if (Array.isArray(value) && value.length > 0) {
  return true;

src/types/Calculator.ts

@@ -231,6 +231,12 @@ export interface StratifierResult {
  * True if patient or episode is in stratifier. False if not.
  */
  result: boolean;
+ /**
+ * True if patient or episode is in stratifier AND the population
+ * result it appliesTo is true. False if not. Only implemented for
+ * patient based measures currently.
+ */
+ appliesResult?: boolean;
  strataId?: string;
 }
 

test/unit/DetailedResultsBuilder.test.ts

@@ -3,7 +3,7 @@ import * as DetailedResultsBuilder from '../../src/calculation/DetailedResultsBu
 import { getJSONFixture } from './helpers/testHelpers';
 import { MeasureScoreType, PopulationType } from '../../src/types/Enums';
 import { StatementResults } from '../../src/types/CQLTypes';
-import { PopulationResult, EpisodeResults } from '../../src/types/Calculator';
+import { PopulationResult, EpisodeResults, StratifierResult } from '../../src/types/Calculator';
 import { ELMExpressionRef, ELMQuery, ELMTuple, ELMFunctionRef } from '../../src/types/ELMTypes';
 
 type MeasureWithGroup = fhir4.Measure & {
@@ -1111,6 +1111,120 @@ describe('DetailedResultsBuilder', () => {
  });
  });
 
+ describe('handleStratificationValues', () => {
+ test('it should take population result into consider when appliesTo extension exists', () => {
+ const populationGroup: fhir4.MeasureGroup = {
+ stratifier: [
+ {
+ id: 'example-strata-id',
+ extension: [
+ {
+ url: 'http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-appliesTo',
+ valueCodeableConcept: {
+ coding: [
+ {
+ system: 'http://terminology.hl7.org/CodeSystem/measure-population',
+ code: 'initial-population',
+ display: 'Initial Population'
+ }
+ ]
+ }
+ }
+ ],
+ criteria: {
+ expression: 'strat1',
+ language: 'text/cql'
+ }
+ }
+ ]
+ };
+
+ const populationResults: PopulationResult[] = [
+ {
+ populationType: PopulationType.IPP,
+ criteriaExpression: 'Initial Population',
+ result: false,
+ populationId: 'exampleId'
+ }
+ ];
+
+ const stratifierResults: StratifierResult[] = [
+ {
+ strataCode: 'example-strata-id',
+ result: true,
+ strataId: 'example-strata-id'
+ }
+ ];
+
+ const newStratifierResults = DetailedResultsBuilder.handleStratificationValues(
+ populationGroup,
+ populationResults,
+ stratifierResults
+ );
+
+ expect(newStratifierResults).toBeDefined();
+ expect(newStratifierResults).toHaveLength(1);
+ expect(newStratifierResults).toEqual(
+ expect.arrayContaining([
+ expect.objectContaining({
+ strataId: 'example-strata-id',
+ result: true,
+ appliesResult: false
+ })
+ ])
+ );
+ });
+
+ test('it should not take population result into consideration when appliesTo extension does not exist', () => {
+ const populationGroup: fhir4.MeasureGroup = {
+ stratifier: [
+ {
+ id: 'example-strata-id',
+ criteria: {
+ expression: 'strat1',
+ language: 'text/cql'
+ }
+ }
+ ]
+ };
+
+ const populationResults: PopulationResult[] = [
+ {
+ populationType: PopulationType.IPP,
+ criteriaExpression: 'Initial Population',
+ result: false,
+ populationId: 'exampleId'
+ }
+ ];
+
+ const stratifierResults: StratifierResult[] = [
+ {
+ strataCode: 'example-strata-id',
+ result: true,
+ strataId: 'example-strata-id'
+ }
+ ];
+
+ const newStratifierResults = DetailedResultsBuilder.handleStratificationValues(
+ populationGroup,
+ populationResults,
+ stratifierResults
+ );
+
+ expect(newStratifierResults).toBeDefined();
+ expect(newStratifierResults).toHaveLength(1);
+ expect(newStratifierResults).toEqual(
+ expect.arrayContaining([
+ expect.objectContaining({
+ strataId: 'example-strata-id',
+ result: true,
+ appliesResult: true
+ })
+ ])
+ );
+ });
+ });
+
  describe('ELM JSON Function', () => {
  test('should properly generate episode-based ELM JSON given name and parameter', () => {
  const exampleFunctionName = 'exampleFunction';