library "Prognosi-MRC-by-eGFR-e-albumina" version '4'
using FHIR version '4.0.0'
include "FHIRHelpers" version '4.0.0' called FHIRHelpers 
codesystem "LOINC": 'http://loinc.org' 
valueset "Albumin in Blood, Plasma, or Serum VS": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.151'
code "Glomerular filtration rate/1.73 sq M.predicted code": 'LP31686-6' from "LOINC" display 'Glomerular filtration rate/1.73 sq M.predicted'
code "Albumin [Mass/volume] in Serum or Plasma code": '1751-7' from "LOINC" display 'Albumin [Mass/volume] in Serum or Plasma'
parameter MeasurementPeriod default Interval[@2013-01-01, @2023-01-01)
context Patient

// pinco pallo
define "Albumina <30mg/g":
  QuantityValue(MostRecent([Observation: "Albumin in Blood, Plasma, or Serum VS"])) > 0 'mg/g'
  and QuantityValue(MostRecent([Observation: "Albumin in Blood, Plasma, or Serum VS"])) < 30 'mg/g'


// commento albumina A2
define "baseElement Albumina >=30 e <=300":
  QuantityValue(MostRecent([Observation: "Albumin in Blood, Plasma, or Serum VS"])) >= 30 'mg/g'
  and QuantityValue(MostRecent([Observation: "Albumin in Blood, Plasma, or Serum VS"])) <= 300 'mg/g'


// commento albumina A3
define "baseElement Albumina >300mg/g":
  QuantityValue(MostRecent([Observation: "Albumin in Blood, Plasma, or Serum VS"])) > 300 'mg/g'


// commento egfr G1
define "baseElement Glomerular filtration rate/1.73 sq M.predicted >= 90":
  QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) >= 90 'mL/min/m2'


// commento egfr G2
define "baseElement Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89":
  QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) >= 60 'mL/min/m2'
  and QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) <= 89 'mL/min/m2'


// commento egfr G3a
define "baseElement Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59":
  QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) >= 45 'mL/min/m2'
  and QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) <= 59 'mL/min/m2'


// commento egfr G3b
define "baseElement Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44":
  QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) >= 30 'mL/min/m2'
  and QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) <= 44 'mL/min/m2'


// commento egfr G4
define "baseElement Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29":
  QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) >= 15 'mL/min/m2'
  and QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) <= 29 'mL/min/m2'


// commento egfr G5
define "baseElement Glomerular filtration rate/1.73 sq M.predicted <15":
  QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) > 0 'mL/min/m2'
  and QuantityValue(MostRecent([Observation: "Glomerular filtration rate/1.73 sq M.predicted code"])) < 15 'mL/min/m2'


define "Albumin [Mass/volume] in Serum or Plasma (test)":
  QuantityValue(MostRecent([Observation: "Albumin [Mass/volume] in Serum or Plasma code"])) >= 0 'mg/g'
  and QuantityValue(MostRecent([Observation: "Albumin [Mass/volume] in Serum or Plasma code"])) <= 300 'mg/g'


define "pm40":
  AgeInYears() >= 1 and AgeInYears() <= 39

define "Glomerular filtration rate/1.73 sq M.predicted >= 90":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >= 90"

// pinco pallo
define "baseElement Albumina <30mg/g":
  "Albumina <30mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89"

// pinco pallo
define "baseElement Albumina <30mg/g_1":
  "Albumina <30mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59"

// pinco pallo
define "baseElement Albumina <30mg/g_2":
  "Albumina <30mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44"

// pinco pallo
define "baseElement Albumina <30mg/g_3":
  "Albumina <30mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29"

// pinco pallo
define "baseElement Albumina <30mg/g_4":
  "Albumina <30mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted <15":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted <15"

// pinco pallo
define "baseElement Albumina <30mg/g_5":
  "Albumina <30mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted >= 90_1":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >= 90"

define "Albumina >=30 e <=300":
  "baseElement Albumina >=30 e <=300"

define "Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89_1":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89"

define "Albumina >=30 e <=300_1":
  "baseElement Albumina >=30 e <=300"

define "Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59_1":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59"

define "Albumina >=30 e <=300_2":
  "baseElement Albumina >=30 e <=300"

define "Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44_1":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44"

define "Albumina >=30 e <=300_3":
  "baseElement Albumina >=30 e <=300"

define "Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29_1":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29"

define "Albumina >=30 e <=300_4":
  "baseElement Albumina >=30 e <=300"

define "Glomerular filtration rate/1.73 sq M.predicted <15_1":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted <15"

define "Albumina >=30 e <=300_5":
  "baseElement Albumina >=30 e <=300"

define "Glomerular filtration rate/1.73 sq M.predicted >= 90_2":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >= 90"

define "Albumina >300mg/g":
  "baseElement Albumina >300mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89_2":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89"

define "Albumina >300mg/g_1":
  "baseElement Albumina >300mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59_2":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59"

define "Albumina >300mg/g_2":
  "baseElement Albumina >300mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44_2":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44"

define "Albumina >300mg/g_3":
  "baseElement Albumina >300mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29_2":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29"

define "Albumina >300mg/g_4":
  "baseElement Albumina >300mg/g"

define "Glomerular filtration rate/1.73 sq M.predicted <15_2":
  "baseElement Glomerular filtration rate/1.73 sq M.predicted <15"

define "Albumina >300mg/g_5":
  "baseElement Albumina >300mg/g"

define "MeetsInclusionCriteria":
  "Albumin [Mass/volume] in Serum or Plasma (test)"

define "MeetsExclusionCriteria":
  "pm40"

define "Verde G1-A1":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >= 90"
  and "baseElement Albumina <30mg/g"

define "Verde G2-A1":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89"
  and "baseElement Albumina <30mg/g_1"

define "Gialla G3a-A1":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59"
  and "baseElement Albumina <30mg/g_2"

define "Arancio G3b-A1":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44"
  and "baseElement Albumina <30mg/g_3"

define "Rosso G4-A1":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29"
  and "baseElement Albumina <30mg/g_4"

define "Rosso scuro G5-A1":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted <15"
  and "baseElement Albumina <30mg/g_5"

define "Gialla G1-A2":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >= 90_1"
  and "Albumina >=30 e <=300"

define "Gialla G2-A2":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89_1"
  and "Albumina >=30 e <=300_1"

define "Arancio G3a-A2":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59_1"
  and "Albumina >=30 e <=300_2"

define "Rosso G3b-A2":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44_1"
  and "Albumina >=30 e <=300_3"

define "Rosso G4-A2":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29_1"
  and "Albumina >=30 e <=300_4"

define "Rosso scuro G5-A2":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted <15_1"
  and "Albumina >=30 e <=300_5"

define "Arancio G1-A3":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >= 90_2"
  and "Albumina >300mg/g"

define "Arancio G2-A3":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >=60 e <=89_2"
  and "Albumina >300mg/g_1"

define "Rosso G3a-A3":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >=45 e <=59_2"
  and "Albumina >300mg/g_2"

define "Rosso G3b-A3":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted>=30 e <=44_2"
  and "Albumina >300mg/g_3"

define "Rosso G4-A3":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted >=15 e <=29_2"
  and "Albumina >300mg/g_4"

define "Rosso scuro G5-A3":
  if "InPopulation" is not true then
    null
  else
  "Glomerular filtration rate/1.73 sq M.predicted <15_2"
  and "Albumina >300mg/g_5"

define "InPopulation":
  "MeetsInclusionCriteria" and not "MeetsExclusionCriteria" 

define "Recommendation": 
  if "Verde G1-A1" then 'Controlli annuali (Normale G1-A1)'
  else if "Verde G2-A1" then 'Controlli annuali (Verde G2-A1)'
  else if "Gialla G1-A2" then 'Cautela e controlli almeno una volta all\'anno (Gialla G1-A2)'
  else if "Gialla G2-A2" then 'Cautela e controlli almeno una volta all\'anno (Gialla G2-A2)'
  else if "Gialla G3a-A1" then 'Cautela e controlli almeno una volta all anno (Gialla G3a-A1)'
  else if "Arancio G1-A3" then 'Controlli due volte all anno (Arancio G1-A3)'
  else if "Arancio G2-A3" then 'Controlli due volte all\'anno (Arancio G2-A3)'
  else if "Arancio G3a-A2" then 'Controlli due volte all anno (Arancio G3a-A2)'
  else if "Arancio G3b-A1" then 'Controlli due volte all anno (Arancio G3b-A1)'
  else if "Rosso G3a-A3" then 'Controlli fino a tre volte l anno (Rosso G3a-A3)'
  else if "Rosso G3b-A2" then 'Controlli fino a tre volte l anno (Rosso G3b-A2)'
  else if "Rosso G3b-A3" then 'Controlli fino a tre volte l anno (Rosso G3b-A3)'
  else if "Rosso G4-A1" then 'Controlli fino a tre volte l anno (Rosso G4-A1)'
  else if "Rosso G4-A2" then 'Controlli fino a tre volte l anno (Rosso G4-A2)'
  else if "Rosso G4-A3" then 'Controlli fino a tre volte l anno (Rosso G4-A3)'
  else if "Rosso scuro G5-A1" then 'Monitoraggio fino a 4 volte o più all anno (almeno ogni 1-3 mesi) (Rosso scuro G5-A1)'
  else if "Rosso scuro G5-A2" then 'Monitoraggio fino a 4 volte o più all anno (almeno ogni 1-3 mesi) (Rosso scuro G5-A2)'
  else if "Rosso scuro G5-A3" then 'Monitoraggio fino a 4 volte o più all anno (almeno ogni 1-3 mesi) (Rosso scuro G5-A3)'
  else null
  

define "Rationale":
  if "Verde G1-A1" then null
  else if "Verde G2-A1" then null
  else if "Gialla G1-A2" then null
  else if "Gialla G2-A2" then null
  else if "Gialla G3a-A1" then null
  else if "Arancio G1-A3" then null
  else if "Arancio G2-A3" then null
  else if "Arancio G3a-A2" then null
  else if "Arancio G3b-A1" then null
  else if "Rosso G3a-A3" then null
  else if "Rosso G3b-A2" then null
  else if "Rosso G3b-A3" then null
  else if "Rosso G4-A1" then null
  else if "Rosso G4-A2" then null
  else if "Rosso G4-A3" then null
  else if "Rosso scuro G5-A1" then null
  else if "Rosso scuro G5-A2" then null
  else if "Rosso scuro G5-A3" then null
  else null

define "Links":
  if "Verde G1-A1" then null
  else if "Verde G2-A1" then null
  else if "Gialla G1-A2" then null
  else if "Gialla G2-A2" then null
  else if "Gialla G3a-A1" then null
  else if "Arancio G1-A3" then null
  else if "Arancio G2-A3" then null
  else if "Arancio G3a-A2" then null
  else if "Arancio G3b-A1" then null
  else if "Rosso G3a-A3" then null
  else if "Rosso G3b-A2" then null
  else if "Rosso G3b-A3" then null
  else if "Rosso G4-A1" then null
  else if "Rosso G4-A2" then null
  else if "Rosso G4-A3" then null
  else if "Rosso scuro G5-A1" then null
  else if "Rosso scuro G5-A2" then null
  else if "Rosso scuro G5-A3" then null
  else null

define "Errors":
  if "Recommendation" is null then
    {'Raccomandazione non trovata'}
  else
    {''}


define function MostRecent(ObsList List<Observation>):
  Last(ObsList O sort by Coalesce(
    (effective as FHIR.dateTime).value,
    (effective as FHIR.instant).value,
    (effective as FHIR.Period)."end".value,
    (effective as FHIR.Period)."start".value,
    issued.value)
  )

define function QuantityValue(Obs Observation):
  FHIRHelpers.ToQuantity(Obs.value as FHIR.Quantity)