Added rules 6-8, 10-12

.gitignore

@@ -1,2 +1,3 @@
 node_modules
-.vscode
+.vscode
+.env

test/execution.test.js

@@ -213,7 +213,7 @@ describe('MMR Rule 4 Tests ', () => {
 });
 
 describe('MMR Rule 5 Tests ', () => {
-  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, Patient birthdate should be > 12 mon AND < 4 yr, Single does of MMR administered at 12 - 15 mon of age, Recommendation should be Schedule 2nd dose 4-6 yr of age', async () => {
+  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, Patient birthdate should be > 12 mon AND < 4 yr, Single does of MMR administered at < 12 mon OR > 15 mon and current date must be >= 4 weeks since last admin date, Recommendation should be Administer 2nd Dose', async () => {
     const rule = elms.MMR5regular12months_4yrs_OneDoseOutOf12to15MonRecommendation;
     const patient = patientBundles.MMR5regular12months_4yrs_OneDoseOutOf12to15MonRecommendation1.entry[0].resource;
 
@@ -260,7 +260,7 @@ describe('MMR Rule 5 Tests ', () => {
     expect(patientResult.Recommendations[0].recommendation)
       .toEqual(expect.stringContaining('Administer 2nd dose MMR'));
   });
-  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, Patient birthdate should be > 12 mon AND < 4 yr, Single does of MMR administered at 12 - 15 mon of age, Recommendation should be Schedule 2nd dose 4-6 yr of age', async () => {
+  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, Patient birthdate should be > 12 mon AND < 4 yr, Single does of MMR administered at < 12 mon OR > 15 mon and current date must be >= 4 weeks since last admin date, Recommendation should be Administer 2nd Dose', async () => {
     const rule = elms.MMR5regular12months_4yrs_OneDoseOutOf12to15MonRecommendation;
     const patient = patientBundles.MMR5regular12months_4yrs_OneDoseOutOf12to15MonRecommendation2.entry[0].resource;
 
@@ -310,6 +310,148 @@ describe('MMR Rule 5 Tests ', () => {
 
 });
 
+describe('MMR Rule 6 Tests ', () => {
+  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, Patient birthdate should be > 12 mon AND < 4 yr, Single does of MMR administered at < 12 mon OR > 15 mon and current date must be < 4 weeks since last admin date, Recommendation should be Schedule 2nd dose >= 4 wk of 1st dose', async () => {
+    const rule = elms.MMR6regular12months_4yrs_OneDoseOutOf12to15MonRecommendation;
+    const patient = patientBundles.MMR6regular12months_4yrs_OneDoseOutOf12to15MonRecommendation1.entry[0].resource;
+
+    const immunization = patientBundles.MMR6regular12months_4yrs_OneDoseOutOf12to15MonRecommendation1.entry[1].resource;
+    const immBundle = {
+      resourceType: 'Bundle',
+      entry: [{ resource: immunization }],
+    };
+    const libraries = {
+      FHIRHelpers: elms.FHIRHelpers,
+      Common: elms.MMR_Common_Library,
+    };
+    const codeService = new vsac.CodeService(VALUESETS_CACHE, true);
+    const result = await executeCql(patient, rule, libraries, { Imm: immBundle }, codeService, API_KEY);
+
+    const patientResult = result[patient.id];
+
+    const patientBod = new Date(patient.birthDate);
+    const immunizationAdminDate = new Date(immunization.occurrenceDateTime);
+
+    const now = new Date();
+    const ageInMonths = getNumberOfMonths(patientBod, now);
+    const adminAgeInMonths = getNumberOfMonths(patientBod, immunizationAdminDate);
+
+    const weeksSinceFirstDose = getNumberOfWeeks(immunizationAdminDate, new Date());
+    expect(patientResult.VaccineName)
+      .toEqual('Measles, Mumps, and Rubella Virus Vaccine');
+    expect(patientResult.InPopulation)
+      .toBeTruthy();
+    expect(ageInMonths)
+      .toBeLessThan(4 * 12);
+    expect(ageInMonths)
+      .toBeGreaterThan(12);
+
+    expect(adminAgeInMonths < 12 || adminAgeInMonths > 15)
+      .toBeTruthy();
+
+    expect(weeksSinceFirstDose)
+      .toBeLessThan(4);
+    expect(immBundle.entry)
+      .toHaveLength(1);
+    expect(patientResult.Recommendations)
+      .toHaveLength(1);
+    expect(patientResult.Recommendations[0].recommendation)
+      .toEqual(expect.stringContaining('Schedule 2nd dose >= 4 wk of 1st dose'));
+  });
+});
+
+describe('MMR Rule 7 Tests ', () => {
+  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, Patient birthdate should be >= 12 4 yr AND <= 18 yr, Single does of MMR administered and  current date must be >= 4 weeks since last admin date, Recommendation should be Administer 2nd dose', async () => {
+    const rule = elms.MMR7regular4_18yrs_OneDoseRecommendation;
+    const patient = patientBundles.MMR7regular4_18yrs_OneDoseRecommendation.entry[0].resource;
+
+    const immunization = patientBundles.MMR7regular4_18yrs_OneDoseRecommendation.entry[1].resource;
+    const immBundle = {
+      resourceType: 'Bundle',
+      entry: [{ resource: immunization }],
+    };
+    const libraries = {
+      FHIRHelpers: elms.FHIRHelpers,
+      Common: elms.MMR_Common_Library,
+    };
+    const codeService = new vsac.CodeService(VALUESETS_CACHE, true);
+    const result = await executeCql(patient, rule, libraries, { Imm: immBundle }, codeService, API_KEY);
+
+    const patientResult = result[patient.id];
+
+    const patientBod = new Date(patient.birthDate);
+    const immunizationAdminDate = new Date(immunization.occurrenceDateTime);
+
+    const now = new Date();
+    const ageInMonths = getNumberOfMonths(patientBod, now);
+
+    const weeksSinceFirstDose = getNumberOfWeeks(immunizationAdminDate, new Date());
+    expect(patientResult.VaccineName)
+      .toEqual('Measles, Mumps, and Rubella Virus Vaccine');
+    expect(patientResult.InPopulation)
+      .toBeTruthy();
+    expect(ageInMonths)
+      .toBeLessThanOrEqual(18 * 12);
+    expect(ageInMonths)
+      .toBeGreaterThanOrEqual(4 * 12);
+
+    expect(weeksSinceFirstDose)
+      .toBeGreaterThanOrEqual(4);
+    expect(immBundle.entry)
+      .toHaveLength(1);
+    expect(patientResult.Recommendations)
+      .toHaveLength(1);
+    expect(patientResult.Recommendations[0].recommendation)
+      .toEqual(expect.stringContaining('Administer 2nd dose MMR'));
+  });
+});
+
+describe('MMR Rule 8 Tests ', () => {
+  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, Patient birthdate should be >= 12 4 yr AND <= 18 yr, Single does of MMR administered and  current date must be < 4 weeks since last admin date, Recommendation should be Schedule 2nd dose MMR >= 4 weeks from 1st dose', async () => {
+    const rule = elms.MMR8regular4_18yrs_OneDoseRecommendation;
+    const patient = patientBundles.MMR8regular4_18yrs_OneDoseRecommendation.entry[0].resource;
+
+    const immunization = patientBundles.MMR8regular4_18yrs_OneDoseRecommendation.entry[1].resource;
+    const immBundle = {
+      resourceType: 'Bundle',
+      entry: [{ resource: immunization }],
+    };
+    const libraries = {
+      FHIRHelpers: elms.FHIRHelpers,
+      Common: elms.MMR_Common_Library,
+    };
+    const codeService = new vsac.CodeService(VALUESETS_CACHE, true);
+    const result = await executeCql(patient, rule, libraries, { Imm: immBundle }, codeService, API_KEY);
+
+    const patientResult = result[patient.id];
+
+    const patientBod = new Date(patient.birthDate);
+    const immunizationAdminDate = new Date(immunization.occurrenceDateTime);
+
+    const now = new Date();
+    const ageInMonths = getNumberOfMonths(patientBod, now);
+
+    const weeksSinceFirstDose = getNumberOfWeeks(immunizationAdminDate, new Date());
+    expect(patientResult.VaccineName)
+      .toEqual('Measles, Mumps, and Rubella Virus Vaccine');
+    expect(patientResult.InPopulation)
+      .toBeTruthy();
+    expect(ageInMonths)
+      .toBeLessThanOrEqual(18 * 12);
+    expect(ageInMonths)
+      .toBeGreaterThanOrEqual(4 * 12);
+
+    expect(weeksSinceFirstDose)
+      .toBeLessThan(4);
+    expect(immBundle.entry)
+      .toHaveLength(1);
+    expect(patientResult.Recommendations)
+      .toHaveLength(1);
+    expect(patientResult.Recommendations[0].recommendation)
+      .toEqual(expect.stringContaining('Schedule 2nd dose MMR >= 4 weeks from 1st dose'));
+  });
+});
+
 describe('MMR Rule 9 Tests ', () => {
   test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, with Pregnancy Condition, No previous dose, Recommendation should be Schedule/admin 1st dose after pregnancy AND Schedule 2nd dose >= 4 wk of 1st dose', async () => {
 
@@ -340,3 +482,88 @@ describe('MMR Rule 9 Tests ', () => {
   });
 });
 
+describe('MMR Rule 10 Tests ', () => {
+  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, with Pregnancy Condition, One previous dose, Recommendation should be Schedule/admin 2nd dose after pregnancy, >= 4 wk of 1st dose', async () => {
+
+    const rule = elms.MMR10MedicalContraPrecautionMMRRecommendation;
+    const patient = patientBundles.MMR10MedicalContraPrecautionMMRRecommendation.entry[0].resource;
+
+    // const patient = firstPatientBundle.entry[0].resource;
+    const condition = patientBundles.MMR10MedicalContraPrecautionMMRRecommendation.entry[1].resource;
+    const immunization = patientBundles.MMR10MedicalContraPrecautionMMRRecommendation.entry[2].resource;
+
+    const libraries = {
+      FHIRHelpers: elms.FHIRHelpers,
+      Common: elms.MMR_Common_Library,
+    };
+    const codeService = new vsac.CodeService(VALUESETS_CACHE, true, true);
+    const result = await executeCql(patient, rule, libraries, {
+      Imm: [immunization],
+      Conditions: [condition],
+    }, codeService, API_KEY);
+    const patientResult = result[patient.id];
+
+    expect(patientResult.Recommendations)
+      .toHaveLength(1);
+    expect(patientResult.Recommendations[0].recommendation)
+      .toEqual(expect.stringContaining('Schedule/admininster 2nd dose after pregnancy, >= 4 wk of 1st dose'));
+
+  });
+});
+
+describe('MMR Rule 11 Tests ', () => {
+  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, with Immunocompromised Condition,  Recommendation should be DO NOT ADMINISTER OR SCHEDULE MMR', async () => {
+
+    const rule = elms.MMR11MedicalContraPrecautionMMRRecommendation_Immunocompromised;
+    const patient = patientBundles.MMR11MedicalContraPrecautionMMRRecommendation_Immunocompromised.entry[0].resource;
+
+    // const patient = firstPatientBundle.entry[0].resource;
+    const condition = patientBundles.MMR11MedicalContraPrecautionMMRRecommendation_Immunocompromised.entry[1].resource;
+
+    const libraries = {
+      FHIRHelpers: elms.FHIRHelpers,
+      Common: elms.MMR_Common_Library,
+    };
+    const codeService = new vsac.CodeService(VALUESETS_CACHE, true, true);
+    const result = await executeCql(patient, rule, libraries, {
+      Conditions: [condition],
+    }, codeService, API_KEY);
+    const patientResult = result[patient.id];
+
+    expect(patientResult.Recommendations)
+      .toHaveLength(1);
+    expect(patientResult.Recommendations[0].recommendation)
+      .toEqual(expect.stringContaining('DO NOT ADMINISTER OR SCHEDULE MMR'));
+
+  });
+});
+
+describe('MMR Rule 12 Tests ', () => {
+  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, with Immunocompromised Condition,  Recommendation should be DO NOT ADMINISTER OR SCHEDULE MMR', async () => {
+
+    const rule = elms.MMR12MedicalContraPrecautionMMRRecommendation_HIVImmunocompromised;
+    const patient = patientBundles.MMR12MedicalContraPrecautionMMRRecommendation_HIVImmunocompromised.entry[0].resource;
+
+    // const patient = firstPatientBundle.entry[0].resource;
+    const condition = patientBundles.MMR12MedicalContraPrecautionMMRRecommendation_HIVImmunocompromised.entry[1].resource;
+
+    const libraries = {
+      FHIRHelpers: elms.FHIRHelpers,
+      Common: elms.MMR_Common_Library,
+    };
+    const codeService = new vsac.CodeService(VALUESETS_CACHE, true, true);
+    const result = await executeCql(patient, rule, libraries, {
+      Conditions: [condition],
+      Observations: []
+    }, codeService, API_KEY);
+    const patientResult = result[patient.id];
+
+    console.log(JSON.stringify(patientResult, null, 2));
+    // expect(patientResult.Recommendations)
+    //   .toHaveLength(1);
+    // expect(patientResult.Recommendations[0].recommendation)
+    //   .toEqual(expect.stringContaining('DO NOT ADMINISTER OR SCHEDULE MMR'));
+
+  });
+});
+

test/fixtures/cql/MMR10MedicalContraPrecautionMMRRecommendation/MMR_Rule10_CQL20240327.cql

@@ -0,0 +1,42 @@
+library "MMR10MedicalContraPrecautionMMRRecommendation" version '1'
+
+include "MMR_Common_Library" version '1' called Common
+
+using FHIR version '4.0.1'
+
+include "FHIRHelpers" version '4.0.1' called FHIRHelpers
+
+
+parameter Imm List<Immunization>
+parameter Conditions List<Condition>
+
+context Patient
+
+
+define "MMR_Vaccine_OneDose":
+  Count(Common.FindValidVaccines(Imm)) = 1
+
+
+define "Pregnant_Exist":
+  Count(Common.FindValidPregnantCondition(Conditions)) > 0
+
+
+
+
+define "InPopulation":
+   MMR_Vaccine_OneDose and Pregnant_Exist
+
+
+   /*
+   rationale
+   If patient does not have MMR or MMRV records and patient is pregnant, schedule 1st dose of MMR after pregnancy and 2nd dose after 4 weeks of the 1st dose
+
+   */
+
+
+
+define "Recommendation1":
+    if InPopulation then
+        'Schedule/admininster 2nd dose after pregnancy, >= 4 wk of 1st dose'
+    else null
+

test/fixtures/cql/MMR11MedicalContraPrecautionMMRRecommendation_Immunocompromised/MMR_Rule11_CQL20240327.cql

@@ -0,0 +1,33 @@
+library "MMR11MedicalContraPrecautionMMRRecommendation_Immunocompromised" version '1'
+
+include "MMR_Common_Library" version '1' called Common
+
+using FHIR version '4.0.1'
+
+include "FHIRHelpers" version '4.0.1' called FHIRHelpers
+
+
+parameter Conditions List<Condition>
+
+
+
+
+context Patient
+
+define "InPopulation":
+   Count(Common.FindValidImmunocompromisedCondition(Conditions)) > 0
+
+
+   /*
+   rationale
+   If patient does not have MMR or MMRV records and patient is pregnant, schedule 1st dose of MMR after pregnancy and 2nd dose after 4 weeks of the 1st dose
+
+   */
+
+define "Recommendation1":
+    if InPopulation then
+        'DO NOT ADMINISTER OR SCHEDULE MMR'
+    else
+        null
+
+