Comments (5)
jeffeastman
commented on June 25, 2024
Here's another test that has 7 existing Oxycontin 15mg Rx in the database for Jared Baldwin but still returns ok with the 8th Rx:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"hook": "medication-prescribe",
"hookInstance": "5bacb720-f493-4fe7-8750-c02595cbb72b",
"fhirServer": "http://54.165.182.195:8080/cqf-ruler/baseDstu3",
"user": "Practitioner-2516",
"patient": "Patient-6513",
"context": [
{
"resourceType": "MedicationRequest",
"status": "active",
"medicationCodeableConcept": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1049545",
"display": "oxyCODONE Hydrochloride 15 MG [OxyCONTIN]"
}
]
},
"subject": {
"reference": "Patient/Patient-6513",
"display": "Jared Gentry Baldwin [23]"
},
"authoredOn": "2017-01-01T00:00:00-05:00",
"reasonCode": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "82423001",
"display": "Chronic pain"
}
],
"text": "Chronic pain"
}
],
"dosageInstruction": [
{
"text": "Take 15mg three times daily",
"timing": {
"repeat": {
"count": 1,
"durationUnit": "d",
"frequency": 3,
"frequencyMax": 3,
"period": 1
}
},
"asNeededBoolean": false,
"doseQuantity": {
"value": 15,
"unit": "mg",
"system": "http://unitsofmeasure.org",
"code": "mg"
}
}
],
"dispenseRequest": {
"quantity": {
"value": 30,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
}
}
}]
}
Response = 200
{
"cards": [
{}
]
}
from cqf-ruler.
c-schuler
commented on June 25, 2024
Hmm. I wonder if it is being ignored because they are duplicate prescriptions, which would be an odd real-world scenario. I will try to test with several different prescriptions to see if it makes a difference.
from cqf-ruler.
jeffeastman
commented on June 25, 2024
If you want to test with some richer data you can try. In particular testNewJaredBaldwinOxycodoneRx is ignoring all the 7 identical Oxy Rx with different dates and ids. Maybe the logic is using a set rather than a list? That might explain it.
testJerryFentaNYLPrefetchFentaNYL:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
},
{
"summary": "High risk for opioid overdose - taper now",
"indicator": "warning",
"detail": "Total morphine milligram equivalent (MME) is 504.000mg/d. Taper to less than 50."
}
]
}
testJerryOxyCODONE15mgPrefetchFentaNYL:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
},
{
"summary": "High risk for opioid overdose - taper now",
"indicator": "warning",
"detail": "Total morphine milligram equivalent (MME) is 526.500mg/d. Taper to less than 50."
}
]
}
testJerryFentaNYLNoPrefetch:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
},
{
"summary": "High risk for opioid overdose - taper now",
"indicator": "warning",
"detail": "Total morphine milligram equivalent (MME) is 504.000mg/d. Taper to less than 50."
}
]
}
testJerryOxyCODONE80mgPrefetchFentaNYL:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
},
{
"summary": "High risk for opioid overdose - taper now",
"indicator": "warning",
"detail": "Total morphine milligram equivalent (MME) is 624.000mg/d. Taper to less than 50."
}
]
}
testJerryCODONE15mgPrefix3RxOxyCODONE15mg:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
}
]
}
testJerryOxyCODONE80mgNoPrefix:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
},
{
"summary": "High risk for opioid overdose - taper now",
"indicator": "warning",
"detail": "Total morphine milligram equivalent (MME) is 120.00mg/d. Taper to less than 50."
}
]
}
testNewJaredBaldwinFlexerilRx:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
}
]
}
testNewJaredBaldwinOxycodoneRx:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
}
]
}
testNewTerryZavalaXanaxTripleThreatRx:
Sending 'POST' request to URL: http://54.165.182.195:8080/cqf-ruler/cds-services/cdc-opioid-guidance
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
},
{
"summary": "High risk for opioid overdose - taper now",
"indicator": "warning",
"detail": "Total morphine milligram equivalent (MME) is 120.00mg/d. Taper to less than 50."
}
]
}
from cqf-ruler.
jeffeastman
commented on June 25, 2024
The prefetch component still seems to be missing in the MME, which is the same as that calculated with no prefetch.
{
"hook": "medication-prescribe",
"hookInstance": "5bacb720-f493-4fe7-8750-c02595cbb72b",
"fhirServer": "http://localhost:8080/cqf-ruler/baseDstu3/",
"user": "Practitioner-2516",
"patient": "Patient-1121",
"context": [
{
"resourceType": "MedicationRequest",
"status": "active",
"medicationCodeableConcept": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "197696",
"display": "Fentanyl 75 MCG/HR 3 Day Transdermal Patch"
}
]
},
"subject": {
"reference": "Patient/Patient-1121",
"display": "Jerry Phillip Goodwall [80]"
},
"authoredOn": "2017-01-01T00:00:00-05:00",
"reasonCode": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "82423001",
"display": "Chronic pain"
}
],
"text": "Chronic pain"
}
],
"dosageInstruction": [
{
"text": "Apply once every three days for pain.",
"timing": {
"repeat": {
"count": 1,
"durationUnit": "d",
"frequency": 1,
"period": 3,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseQuantity": {
"value": 1,
"unit": "tbl",
"system": "http://unitsofmeasure.org",
"code": "tbl"
}
}
],
"dispenseRequest": {
"quantity": {
"value": 30,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
}
}
}
],
"prefetch": {
"medication": {
"resource": {
"resourceType": "Bundle",
"entry": [
{
"resource": {
"resourceType": "MedicationRequest",
"status": "active",
"medicationCodeableConcept": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "197696",
"display": "Fentanyl 75 MCG/HR 3 Day Transdermal Patch"
}
]
},
"subject": {
"reference": "Patient/Patient-1121",
"display": "Jerry Phillip Goodwall [80]"
},
"authoredOn": "2017-01-01T00:00:00-05:00",
"reasonCode": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "82423001",
"display": "Chronic pain"
}
],
"text": "Chronic pain"
}
],
"dosageInstruction": [
{
"text": "Apply once every three days for pain.",
"timing": {
"repeat": {
"count": 1,
"durationUnit": "d",
"frequency": 1,
"period": 3,
"periodUnit": "d"
}
},
"asNeededBoolean": false,
"doseQuantity": {
"value": 1,
"unit": "tbl",
"system": "http://unitsofmeasure.org",
"code": "tbl"
}
}
],
"dispenseRequest": {
"quantity": {
"value": 30,
"unit": "day",
"system": "http://unitsofmeasure.org",
"code": "d"
}
}
}
}
]
}
}
}
}
produces:
Response = 200
{
"cards": [
{
"links": [
{
"label": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
},
{
"label": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
]
},
{
"summary": "High risk for opioid overdose - taper now",
"indicator": "warning",
"detail": "Total morphine milligram equivalent (MME) is 179.99999820mg/d. Taper to less than 50."
}
]
}
from cqf-ruler.
c-schuler
commented on June 25, 2024
@jeffeastman is this still an issue? If not, please close. Thanks!
from cqf-ruler.
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