diff --git a/src/main/resources/modules/anti_amyloid_beta_monoclonal_antibody_treatment.json b/src/main/resources/modules/anti_amyloid_beta_monoclonal_antibody_treatment.json new file mode 100644 index 0000000000..615926f5a1 --- /dev/null +++ b/src/main/resources/modules/anti_amyloid_beta_monoclonal_antibody_treatment.json @@ -0,0 +1,1417 @@ +{ + "name": "Anti-Amyloid-Beta Monoclonal Antibody Treatment", + "remarks": [ + "A blank module" + ], + "states": { + "Initial": { + "type": "Initial", + "direct_transition": "Wait Until Alzheimer's" + }, + "Check Inclusion Criteria": { + "type": "Simple", + "conditional_transition": [ + { + "transition": "Included", + "condition": { + "condition_type": "Age", + "operator": ">=", + "quantity": 65, + "unit": "years", + "value": 0 + } + }, + { + "transition": "Excluded" + } + ] + }, + "Included": { + "type": "SetAttribute", + "attribute": "anti-ab-mab-ced-study", + "direct_transition": "Check Outcome Criteria", + "value": true + }, + "Excluded": { + "type": "SetAttribute", + "attribute": "anti-ab-mab-ced-study", + "direct_transition": "Negative Outcomes", + "value": false + }, + "Short-Term Memory Loss": { + "type": "Symptom", + "symptom": "amnesia", + "cause": "Dementia", + "probability": 0.5, + "distribution": { + "kind": "UNIFORM", + "parameters": { + "high": 100, + "low": 50 + } + }, + "direct_transition": "Decreased Organization" + }, + "Decreased Organization": { + "type": "Symptom", + "symptom": "Decreased Organization", + "cause": "Dementia", + "probability": 0.5, + "distribution": { + "kind": "UNIFORM", + "parameters": { + "high": 100, + "low": 50 + } + }, + "direct_transition": "Impaired Decision Making" + }, + "Impaired Decision Making": { + "type": "Symptom", + "symptom": "Impaired Decision Making", + "cause": "Dementia", + "probability": 0.5, + "distribution": { + "kind": "UNIFORM", + "parameters": { + "high": 100, + "low": 50 + } + }, + "direct_transition": "Start Assessment Encounter" + }, + "Positron Emission 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"702955000", + "display": "Moderate cognitive impairment (finding)" + } + ], + "assign_to_attribute": "cognitive_impairment", + "direct_transition": "moca_score_moderate" + }, + "Severe cognitive impairment": { + "type": "ConditionOnset", + "codes": [ + { + "system": "SNOMED-CT", + "code": "702956004", + "display": "Severe cognitive impairment (finding)" + } + ], + "assign_to_attribute": "cognitive_impairment", + "direct_transition": "moca_score_severe" + }, + "Requires assistance with all activities of daily living": { + "type": "ConditionOnset", + "codes": [ + { + "system": "SNOMED-CT", + "code": "507581000000100", + "display": "Requires assistance with all activities of daily living (finding)" + } + ], + "direct_transition": "faq_score_moderate", + "assign_to_attribute": "daily_living_impairment" + }, + "Requires continuous supervision for activities of daily living": { + "type": "ConditionOnset", + "codes": [ + { + "system": "SNOMED-CT", + "code": "737362007", + "display": 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Blood amyloid beta levels in healthy, mild cognitive impairment and Alzheimer's disease individuals: replication of diastolic blood pressure correlations and analysis of critical covariates. PLoS One. 2013 Nov 27;8(11):e81334. doi: 10.1371/journal.pone.0081334. PMID: 24312290; PMCID: PMC3842353." + ] + }, + "Patient consented to clinical trial": { + "type": "Observation", + "category": "survey", + "unit": "", + "codes": [ + { + "system": "LOINC", + "code": "19826-7", + "display": "Informed consent obtained" + } + ], + "direct_transition": "Enrollment in clinical trial", + "value_code": { + "system": "SNOMED-CT", + "code": 373066001, + "display": "Yes (qualifier value)" + } + }, + "Check Impairment": { + "type": "Simple", + "direct_transition": "Six item cognitive impairment test" + }, + "End CarePlan": { + "type": "CarePlanEnd", + "direct_transition": "Finish Encounter", + "careplan": "Study Care Plan" + }, + "Study Care Plan": { + "type": "CarePlanStart", + "codes": [ + { + "system": "SNOMED-CT", + "code": "110465008", + "display": "Clinical trial (procedure)" + } + ], + "direct_transition": "Administer Medications", + "reason": "Type of Alzheimer's" + }, + "Adverse Events May Continue": { + "type": "Simple", + "direct_transition": "Wellness 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+ }, + { + "condition_type": "Attribute", + "attribute": "anemia", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "anemia_medication", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "hiv_infection", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "hiv_diagnosis", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "lung_cancer", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "Lung Cancer", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "prostate_cancer", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "breast_cancer_condition", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "colorectal_cancer", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "chf", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "coronary_heart_disease", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "suicide_careplan", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "opioid_addiction", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "seizure", + "operator": "is not nil" + }, + { + "condition_type": "Attribute", + "attribute": "stroke_history", + "operator": "is not nil" + } + ] + } + }, + { + "transition": "Positive Outcomes" + } + ] + }, + "Positive Outcomes": { + "type": "Simple", + "direct_transition": "Set Cognitive Impairment Level" + }, + "Negative Outcomes": { + "type": "Simple", + "direct_transition": "Set_Cognitive_Impairment_Level" + }, + "Set Cognitive Impairment Level": { + "type": "SetAttribute", + "attribute": "cognitive_impairment_level", + "direct_transition": "Set Daily Living Impairment Level", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 1, + "low": 0 + } + } + }, + "Set_Cognitive_Impairment_Level": { + "type": "SetAttribute", + "attribute": "cognitive_impairment_level", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 3, + "low": 2 + } + }, + "direct_transition": "Set_Daily_Living_Impairment_Level" + }, + "Set Daily Living Impairment Level": { + "type": "SetAttribute", + "attribute": "daily_living_impairment_level", + "direct_transition": "Treatment Effective", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 1, + "low": 0 + } + } + }, + "Set_Daily_Living_Impairment_Level": { + "type": "SetAttribute", + "attribute": "daily_living_impairment_level", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 2, + "low": 1 + } + }, + "direct_transition": "Treatment_Ineffective" + }, + "Treatment Effective": { + "type": "SetAttribute", + "attribute": "anti-ab-mab-ced-study-effective", + "direct_transition": "Set Number of Assessments", + "value": true + }, + "Treatment_Ineffective": { + "type": "SetAttribute", + "attribute": "anti-ab-mab-ced-study-effective", + "value": false, + "direct_transition": "Set Number of Assessments" + }, + "End Minimal Impairment": { + "type": "ConditionEnd", + "direct_transition": "Moderate cognitive impairment", + "condition_onset": "Minimal cognitive impairment" + }, + "End Moderate Impairment": { + "type": "ConditionEnd", + "direct_transition": "Severe cognitive impairment", + "condition_onset": "Moderate cognitive impairment" + }, + "End Assistance with Daily Living": { + "type": "ConditionEnd", + "direct_transition": "Requires continuous supervision for activities of daily living", + "condition_onset": "Requires assistance with all activities of daily living" + }, + "Wait for Approval": { + "type": "Guard", + "allow": { + "condition_type": "Date", + "operator": ">=", + "date": { + "year": 2022, + "month": 4, + "day": 7, + "hour": 0, + "minute": 0, + "second": 0, + "millisecond": 0 + }, + "value": 0 + }, + "direct_transition": "Check Inclusion Criteria", + "remarks": [ + "CMS issued the final NCD (CAG-00460N) for using FDA approved anti-AB mAbs for treatment of Alzheimer's on April 7th, 2022." + ] + }, + "MoCA Normal": { + "type": "DiagnosticReport", + "codes": [ + { + "system": "LOINC", + "code": "72133-2", + "display": "Montreal Cognitive Assessment [MoCA]" + } + ], + "observations": [ + { + "category": "survey", + "unit": "{score}", + "codes": [ + { + "system": "LOINC", + "code": "72172-0", + "display": "Total score [MoCA]" + } + ], + "attribute": "moca_score" + } + ], + "direct_transition": "Check for Adverse Events", + "remarks": [ + "The MoCA scores range from zero to thirty, with a LOWER score indicating great cognitive impairment." + ] + }, + "FAQ Normal": { + "type": "DiagnosticReport", + "codes": [ + { + "system": "LOINC", + "code": "58121-5", + "display": "Prior Functioning ADL/IADL during assessment period [CMS Assessment]" + } + ], + "observations": [ + { + "category": "laboratory", + "unit": "{score}", + "codes": [ + { + "system": "LOINC", + "code": "99991-1", + "display": "Total Score [FAQ]" + } + ], + "attribute": "faq_score" + } + ], + "direct_transition": "Complete MoCA", + "remarks": [ + "The FAQ scores range from zero to thirty, with a HIGHER score indicating greater functional impairment. A cut point of 9 indicates impairment." + ] + }, + "moca_score_normal": { + "type": "SetAttribute", + "attribute": "moca_score", + "direct_transition": "Instrumental activities of daily living assessment", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 30, + "low": 25 + } + } + }, + "moca_score_minimal": { + "type": "SetAttribute", + "attribute": "moca_score", + "direct_transition": "Instrumental activities of daily living assessment", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 25, + "low": 15 + } + } + }, + "moca_score_moderate": { + "type": "SetAttribute", + "attribute": "moca_score", + "direct_transition": "Instrumental activities of daily living assessment", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 15, + "low": 5 + } + } + }, + "moca_score_severe": { + "type": "SetAttribute", + "attribute": "moca_score", + "direct_transition": "Instrumental activities of daily living assessment", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 5, + "low": 0 + } + } + }, + "faq_score_normal": { + "type": "SetAttribute", + "attribute": "faq_score", + "direct_transition": "Check Enrollment", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 8, + "low": 0 + } + } + }, + "faq_score_moderate": { + "type": "SetAttribute", + "attribute": "faq_score", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 20, + "low": 9 + } + }, + "direct_transition": "Check Enrollment" + }, + "faq_score_moderate_2": { + "type": "SetAttribute", + "attribute": "faq_score", + "distribution": { + "kind": "UNIFORM", + "round": false, + "parameters": { + "high": 30, + "low": 20 + } + }, + "direct_transition": "Check Enrollment" + } + }, + "gmf_version": 2 +} \ No newline at end of file