ZZ_AnnualWellnessAssessmentMeasure_AllOrNothing

["Encounter, Performed": "Annual Wellness Visit"] AWV
	with ["Patient Characteristic Birthdate": "Birthdate"] BirthDate
		such that "CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 65
			and AWV.relevantPeriod during "Measurement Period"

if ScreeningForAlcoholMisuse."Initial Population"
	and ( ScreeningForAlcoholMisuse."Denominator"
			and not ScreeningForAlcoholMisuse."Denominator Exclusions"
	) then 1 else 0 + if HypertensionAssessment."Initial Population"
	and HypertensionAssessment."Denominator" then 1 else 0 + if ScreeningForBreastCancer."Initial Population"
	and ( ScreeningForBreastCancer."Denominator"
			and not ScreeningForBreastCancer."Denominator Exclusions"
	) then 1 else 0 + if ScreeningForColorectalCancer."Initial Population"
	and ( ScreeningForColorectalCancer."Denominator"
			and not ScreeningForColorectalCancer."Denominator Exclusions"
	) then 1 else 0 + if ScreeningForDepression."Initial Population"
	and ( ScreeningForDepression."Denominator"
			and not ScreeningForDepression."Denominator Exclusions"
	) then 1 else 0

["Patient Characteristic Birthdate"] P
	where ScreeningForAlcoholMisuse."Initial Population"
		or HypertensionAssessment."Initial Population"
		or ScreeningForBreastCancer."Initial Population"
		or ScreeningForColorectalCancer."Initial Population"
		or ScreeningForDepression."Initial Population"

["Patient Characteristic Birthdate"] P
	where ( ScreeningForAlcoholMisuse."Denominator"
			and not ScreeningForAlcoholMisuse."Denominator Exclusions"
	)
		or HypertensionAssessment."Denominator"
		or ( ScreeningForBreastCancer."Denominator"
				and not ScreeningForBreastCancer."Denominator Exclusions"
		)
		or ( ScreeningForColorectalCancer."Denominator"
				and not ScreeningForColorectalCancer."Denominator Exclusions"
		)
		or ( ScreeningForDepression."Denominator"
				and not ScreeningForDepression."Denominator Exclusions"
		)

if ScreeningForAlcoholMisuse."Initial Population"
	and ( ScreeningForAlcoholMisuse."Denominator"
			and not ScreeningForAlcoholMisuse."Denominator Exclusions"
	)
	and ScreeningForAlcoholMisuse."Numerator" then 1 else 0 + if HypertensionAssessment."Initial Population"
	and HypertensionAssessment."Denominator"
	and HypertensionAssessment."Numerator" then 1 else 0 + if ScreeningForBreastCancer."Initial Population"
	and ( ScreeningForBreastCancer."Denominator"
			and not ScreeningForBreastCancer."Denominator Exclusions"
	)
	and ScreeningForBreastCancer."Numerator" then 1 else 0 + if ScreeningForColorectalCancer."Initial Population"
	and ( ScreeningForColorectalCancer."Denominator"
			and not ScreeningForColorectalCancer."Denominator Exclusions"
	)
	and ScreeningForColorectalCancer."Numerator" then 1 else 0 + if ScreeningForDepression."Initial Population"
	and ( ScreeningForDepression."Denominator"
			and not ScreeningForDepression."Denominator Exclusions"
	)
	and ScreeningForDepression."Numerator" then 1 else 0

["Patient Characteristic Ethnicity": "Ethnicity"]

["Patient Characteristic Payer": "Payer"]

["Patient Characteristic Race": "Race"]

["Patient Characteristic Sex": "ONC Administrative Sex"] 

true

exists ( ["Diagnosis": "Alcohol abuse or dependence"] Dx
		with AWV."Annual Wellness Encounters" AWV
			such that Dx.prevalencePeriod overlaps before AWV.relevantPeriod
)

exists ( AWV."Annual Wellness Encounters" )

exists ( ["Assessment, Performed": "AUDIT C Total Score (in points)"] AuditC
		with AWV."Annual Wellness Encounters" AWV
			such that AuditC.authorDatetime 12 months or less on or before end of AWV.relevantPeriod
)
	or exists ( ( ( ["Assessment, Performed": "Frequency of Drinking in the Past Year"] DrinkingFrequency
				where DrinkingFrequency.result in "Never Response"
		)
			union ( ["Assessment, Performed": "Alcohol Abuse Screening"] AlcoholAbuse
					where AlcoholAbuse.result in "Current Non Drinker of Alcohol"
			) ) Assessment
			with AWV."Annual Wellness Encounters" AWV
				such that Assessment.authorDatetime 12 months or less on or before end of AWV.relevantPeriod
	)

//TODO:
/*OR:
        AND: Union of:
            "Risk Category Assessment: Frequency of Drinking in the Past Year (result: Times Per Week Or Month Response)"
            "Risk Category Assessment: Alcohol Abuse Screening (result: Current Drinker of Alcohol)"
            <= 12 month(s) ends before end of "Occurrence A of Encounter, Performed: Annual Wellness Visit"
        AND: Union of:
            "Risk Category Assessment: Frequency of Four or More Drinks on One Occasion in Past Year (result: Heavy Drinking Days in Past Year Response)"
            "Risk Category Assessment: Frequency of Four or More Drinks on One Occasion in Past Year (result >= 0 )"
            <= 12 month(s) ends before end of "Occurrence A of Encounter, Performed: Annual Wellness Visit"*/
	or exists ( ( ( ["Assessment, Performed": "Frequency of Drinking in the Past Year"] DrinkingFrequency
				where DrinkingFrequency.result in "Times Per Week Or Month Response"
		)
			union ( ["Assessment, Performed": "Alcohol Abuse Screening"] AlcoholAbuse
					where AlcoholAbuse.result in "Current Drinker of Alcohol"
			) ) Assessment
			with AWV."Annual Wellness Encounters" AWV
				such that Assessment.authorDatetime 12 months or less on or before end of AWV.relevantPeriod
	)

"Initial Population"

exists (AWV."Annual Wellness Encounters")

exists ( ["Physical Exam, Performed"] Exam
		with AWV."Annual Wellness Encounters" WellnessEncounter
			such that Exam.relevantPeriod during "Measurement Period"
		where exists ( Exam.components Systolic
				where Systolic.code in "Systolic Blood Pressure"
					and Systolic.result is not null
		)
			and exists ( Exam.components Diastolic
					where Diastolic.code in "Diastolic Blood Pressure"
						and Diastolic.result is not null
			)
)

exists ( ["Patient Characteristic Birthdate": "Birthdate"] BirthDate
		where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")< 75
			and exists ( ["Patient Characteristic Sex": "Female"] )
)

exists ( ["Procedure, Performed": "Bilateral Mastectomy"] Bilateral
		where Bilateral.relevantPeriod ends on or before end of "Measurement Period"
)
	or Count(["Procedure, Performed": "Unilateral Mastectomy"] Unilateral
			where Unilateral.relevantPeriod ends on or before end of "Measurement Period"
	)= 2

exists ( AWV."Annual Wellness Encounters" )

exists ( ["Diagnostic Study, Performed": "Mammography"] Mammogram
		where Mammogram.result is not null
			and Mammogram.relevantPeriod ends 26 months or less on or before end of "Measurement Period"
)

exists ( ["Patient Characteristic Birthdate": "Birthdate"] BirthDate
		where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")< 75
)

exists ( ["Procedure, Performed": "Total Colectomy"] Colectomy
		where Colectomy.relevantPeriod ends before end of "Measurement Period"
)
	or exists ( ["Diagnosis": "Malignant Neoplasm of Colon"] Neoplasm
			where Neoplasm.prevalencePeriod starts before end of "Measurement Period"
	)

exists ( AWV."Annual Wellness Encounters" )

exists ( ["Procedure, Performed": "Colonoscopy"] Colonoscopy
		where Colonoscopy.relevantPeriod ends 9 years or less on or before end of "Measurement Period"
)
	or exists ( ["Laboratory Test, Performed": "Fecal Occult Blood Test (FOBT)"] FOBT
			where FOBT.authorDatetime during "Measurement Period"
				and FOBT.result is not null
	)
	or exists ( ["Procedure, Performed": "Flexible Sigmoidoscopy"] Sigmoidoscopy
			where Sigmoidoscopy.relevantPeriod ends 4 years or less on or before end of "Measurement Period"
	)

"Initial Population"

exists(

["Diagnosis": "Depression or Bipolar Disorder"] Bipolar
with AWV."Annual Wellness Encounters" AWV
such that Bipolar.prevalencePeriod overlaps before AWV.relevantPeriod


)

exists ( AWV."Annual Wellness Encounters" )

exists ( ["Assessment, Performed": "PHQ 2 Total Score (in points)"] PHQ_2
		with AWV."Annual Wellness Encounters" AWV
			such that PHQ_2.authorDatetime 12 months or less on or before end of AWV.relevantPeriod
)

years between ToDate(BirthDateTime)and ToDate(AsOf)

DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)

years between ToDate(BirthDateTime)and ToDate(AsOf)

DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)

"Numerator Score" / "Denominator Score"