Need to modify the narrative on the First-Contact example page to include the Anaemia test (B.1.1) recommendation.

Create a test case - ideally in a manner that it can be bundled with the IG Tooling - for the B.1.1 recommendation

https://build.fhir.org/ig/WorldHealthOrganization/smart-anc/Questionnaire-ANCA.html

itemExtractionContext is missing for all resources in ANCA Questionnaire
eg:
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-itemExtractionContext",
"valueExpression": {
"language": "application/x-fhir-query",
"expression": "Encounter",
"name": "encounter"
}
}
]

http://build.fhir.org/ig/WorldHealthOrganization/smart-anc/Questionnaire-ANCA.json.html

1. Extraction context is not defined
2. Error in item with linkID 5 : argument 1 has type org.hl7.fhir.r4.model.DateType, got org.hl7.fhir.r4.model.DateTimeType. item.type should be date not dateTime
3. Error in item with linkID 9 : org.hl7.fhir.r4.model.StringType cannot be cast to org.hl7.fhir.r4.model.HumanName

The readme needs to be updated with latest decision table column names in the l2 folder

It would be helpful if there were an example as well.

Iron and folic acid (IFA) supplements for pregnant women (%)

Numerator:

COUNT the number of women who were prescribed iron and folic acid (IFA) tablets at each ANC contact they have had (so far): {ifa_anaemia} = "Done" OR {ifa_high_prev} = "Done" OR {ifa_low_prev} = "Done" OR {ifa_weekly} = "Done"

Denominator:

COUNT of all women whose records were closed (ANC Close form) in the last calendar month due to any of the below reasons. {anc_close_reason} = Live birth Stillbirth Miscarriage Abortion Woman died Lost to follow-up Moved away

Frequency:

Monthly. New indicator gets added on the 1st of every month (for the previous month).

Disaggregations:

{age} categories: 10-14 15-19 20-34 35-49 {educ_level} categories: None Don't know Primary Secondary Higher

https://github.com/WorldHealthOrganization/smart-anc/blob/2fb1d62cd49142a1c2c79b5f08b7552cec0a7ec4/input/vocabulary/valueset/manual/valueset-who-identifier-types.json#L11C20-L11C83

-Where is that defined?

Also to answer Bryn’s question the formula for GA calculation, I’m not sure where that came version came from. From the data dictionary I have the following:

Gestational age from ultrasound: 280 - ({ultrasound_edd} - {today})
Gestational age from last menstrual period (LMP):  (today's date - {lmp}) / 7, shown in weeks and days
Gestational age from symphysis fundal height (SFH) or abdominal palpation: whatever value is entered by the health worker (usually value should be between 4 and 40) 

The trickier part is that equation however is the EDD calculation. So if you need further info, we settled on the following two options (with Nichole Young Lin’s help):

EDD using the first day of the LMP:

1. Prompt user for the date of the first day of the patient's last menstrual period ("LMP")

2. Calculate the estimated due date ("EDD") by taking the start date of the last period and adding a duration of 280 calendar days. The output should be a future date. Of course, this should be mapped to a calendar to account for leap years, etc.

Method 1 Example:

LMP Input: 2019/06/01

EDD Output: 2020/03/07

EDD using the ultrasound:

1. Prompt the user to enter the date of the ultrasound and the estimated gestational age output in weeks (W) and days (D).

2. Convert the input into days using the expression (7*W + D). For the example below, for input (12 weeks, 4 days), the estimated gestational age ("EGA") in days would be 88.

3. Calculated the remaining days ("RD") using the expression (280 - EGA), for example, 280 - 88 = 192

4. Calculate the estimated due date ("EDD") by adding RD days (For example, 192) to today's date, and return the new date (EDD). Of course, this should be mapped to a calendar to account for leap years, etc.

Method 2 Example:

EGA Input: 12 weeks, 4 days; Today's date: 2019/06/13

Calculation: [today + (280-(12*7+4))]

EDD Output: 2019/12/22

Hello, Please look at the link to the Implementation Guide.
Getting error 404

https://build.fhir.org/ig/WorldHealthOrganization/smart-anc/Questionnaire-ANCA.html

items representing fields in Complex Data type should be define in one group

eg:

          "item": [
            {
              "linkId": "PR-name",
              "type": "group",
              "definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.name",
              "item": [
                {
                  "linkId": "PR-name-text",
                  "definition": "http://hl7.org/fhir/StructureDefinition/Patient#Patient.name.given",
                  "type": "string",
                  "text": "First Name"
                },
                {
                  "linkId": "PR-name-family",
                  "definition": "http://hl7.org/fhir/StructureDefinition/datatypes#Patient.name.family",
                  "type": "string",
                  "text": "Family Name"
                }
              ]
            },
            ...
            ...
            ...
       ]

The guideline text for Recommendation A.2.1 has the following remark:

If a woman is diagnosed with anaemia during pregnancy, her daily elemental iron should be increased to 120 mg until her Hb concentration rises to normal (Hb 110 g/L or higher). Thereafter, she can resume the standad daily antenatal iron dose to prevent recurrence of anaemia.

Include this remark as a footnote to the A.2.1 recommendation text.

Also, note that the Folic acid dosage in the pseudocode (functional description) is indicated as 2.8 ug (micrograms), it should be 2.8 mg.

The current decision table tooling generates condition names with the "Should" prefix. This may not always be appropriate, so there should be a way to control the prefix used to generate condition names.

Add a section to the home page that provides introductory material for what is included in this guide and how to read it. Note that the guide is organized based on pages for each recommendation, where each page includes: 1) Narrative content (L1), 2) A functional description (L2), and 3) Computable content (L3).

Also note that the guide is a "Content IG" as described in the CPG-on-FHIR Implementation Guide and provide a link there for further reading.

guidance for when to give 30 vs 60 mg, as follows: “In settings where anaemia in pregnant women is a severe public health problem (i.e. where at least 40% of pregnant women have a blood haemoglobin [Hb] concentration < 11.0 g/dL), a daily dose of 60 mg of elemental iron is preferred over a lower dose.

Add support for Recommendation B.2.4 - Ultrasound Scan

I'm using the IG to test an IG loader tool and get errors from HAPI that I believe show that the IDs are too long for some of the ValueSets.

Here's an example.

400 Bad Request
http://build.fhir.org/ig/WorldHealthOrganization/smart-anc/ValueSet-tetanus-toxoid-containing-vaccine-ttcv-immunization-history-no-doses-choices.json
{
  "resourceType": "OperationOutcome",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Operation Outcome</h1><table border=\"0\"><tr><td style=\"font-weight: bold;\">ERROR</td><td>[]</td><td><pre>Can not process entity with ID[tetanus-toxoid-containing-vaccine-ttcv-immunization-history-no-doses-choices], this is not a valid FHIR ID</pre></td>\n\t\t\t</tr>\n\t\t</table>\n\t</div>"
  },
  "issue": [ {
    "severity": "error",
    "code": "processing",
    "diagnostics": "Can not process entity with ID[tetanus-toxoid-containing-vaccine-ttcv-immunization-history-no-doses-choices], this is not a valid FHIR ID"
  } ]
}

Hepatitis B test result definition is mapped to Procedure.code whereas for Hepatitis C test result definition is mapped to Observation.value[x].

http://build.fhir.org/ig/WorldHealthOrganization/smart-anc/Questionnaire-ANCB9.html

Folic acid should remain at 0.4 mg, even if the mother is anaemic

Need to create profiles for each of the resources referenced by the logic for the included recommendations.

The Action portion of the decision table is generated as a message in the current tooling. There should be a way to specify an activitydefinition to be performed.

https://build.fhir.org/ig/WorldHealthOrganization/smart-anc/Questionnaire-ANCA.html

ANC.A. Registration Questionnaire must include meta tag with profile details, where resource claim to conform to a this profile

eg:
{
"resourceType": "Questionnaire",
"meta": {
"profile": [
"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire|2.7"
]
},
...
...
...
}