us_quality_core_test_kit 0.1.1 → 0.2.0

data/lib/us_quality_core_test_kit/generator/validation_test_generator.rb

@@ -1,13 +1,71 @@
 # frozen_string_literal: true
 
-require 'us_core_test_kit/generator/validation_test_generator'
-
 require_relative 'naming'
 require_relative 'special_cases'
 
 module USQualityCoreTestKit
   class Generator
-    class ValidationTestGenerator < USCoreTestKit::Generator::ValidationTestGenerator
+    class ValidationTestGenerator
+      attr_accessor :group_metadata, :medication_request_metadata, :base_output_dir
+
+      def initialize(group_metadata, medication_request_metadata = nil, base_output_dir:)
+        self.group_metadata = group_metadata
+        self.medication_request_metadata = medication_request_metadata
+        self.base_output_dir = base_output_dir
+      end
+
+      def output
+        @output ||= ERB.new(template, trim_mode: '-').result(binding)
+      end
+
+      def base_output_file_name
+        "#{class_name.underscore}.rb"
+      end
+
+      def output_file_directory
+        File.join(base_output_dir, directory_name)
+      end
+
+      def output_file_name
+        File.join(output_file_directory, base_output_file_name)
+      end
+
+      def profile_url
+        group_metadata.profile_url
+      end
+
+      def profile_name
+        group_metadata.profile_name
+      end
+
+      def profile_version
+        group_metadata.profile_version
+      end
+
+      def resource_type
+        group_metadata.resource
+      end
+
+      def conformance_expectation
+        read_interaction[:expectation]
+      end
+
+      def generate
+        FileUtils.mkdir_p(output_file_directory)
+        File.write(output_file_name, output)
+
+        test_metadata = {
+          id: test_id,
+          file_name: base_output_file_name
+        }
+
+        if resource_type == 'Medication'
+          medication_request_metadata.add_test(**test_metadata)
+        else
+          group_metadata.add_test(**test_metadata)
+        end
+      end
+
       class << self
         def generate(ig_metadata, base_output_dir)
           ig_metadata.groups
@@ -49,7 +107,7 @@ module USQualityCoreTestKit
       end
 
       def description
-        <<~DESCRIPTION
+        base_description = <<~DESCRIPTION
           #{description_intro}
           It verifies the presence of mandatory elements and that elements with
           required bindings contain appropriate values. CodeableConcept element
@@ -57,6 +115,27 @@ module USQualityCoreTestKit
           to the bound ValueSet. Quantity, Coding, and code element bindings will
           fail if their code/system are not found in the valueset.
         DESCRIPTION
+
+        filter_note = validation_message_filter_note
+        return base_description unless filter_note
+
+        "#{base_description}\n#{filter_note}"
+      end
+
+      def validation_message_filter_note
+        case resource_type
+        when 'Patient'
+          <<~NOTE
+            Note: This test ignores validator messages for `Patient.extension`. This is a workaround for
+            a known validator package interaction where CQL can load US Core 7 definitions into the
+            validator session even though US Quality Core 0.5.0 is based on US Core 6.1.0.
+          NOTE
+        when 'DeviceRequest'
+          <<~NOTE
+            Note: This test ignores a known validator slicing resolution message for
+            `DeviceRequest.modifierExtension`.
+          NOTE
+        end
       end
 
       def description_intro

data/lib/us_quality_core_test_kit/generator/value_extractor.rb

@@ -1,10 +1,154 @@
 # frozen_string_literal: true
 
-require 'us_core_test_kit/generator/value_extractor'
-
 module USQualityCoreTestKit
   class Generator
-    class ValueExactor < USCoreTestKit::Generator::ValueExactor
+    class ValueExactor
+      attr_accessor :ig_resources, :resource, :profile_elements
+
+      def initialize(ig_resources, resource, profile_elements)
+        self.ig_resources = ig_resources
+        self.resource = resource
+        self.profile_elements = profile_elements
+      end
+
+      def values_from_fixed_codes(profile_element, type)
+        return [] unless type == 'CodeableConcept'
+
+        elements = profile_elements.select do |element|
+          element.path == "#{profile_element.path}.coding.code" && element.fixedCode.present?
+        end
+
+        elements.map(&:fixedCode)
+      end
+
+      def values_from_pattern_coding(profile_element, type)
+        return [] unless type == 'CodeableConcept'
+
+        elements = profile_elements.select do |element|
+          element.path == "#{profile_element.path}.coding" && element.patternCoding.present?
+        end
+
+        elements.map { |element| element.patternCoding.code }
+      end
+
+      def values_from_pattern_codeable_concept(profile_element, type)
+        return [] unless type == 'CodeableConcept'
+
+        elements = profile_elements.select do |element|
+          element.path == profile_element.path && element.patternCodeableConcept.present? && element.min.positive?
+        end
+
+        elements.map { |element| element.patternCodeableConcept.coding.first.code }
+      end
+
+      def value_set_binding(the_element)
+        the_element&.binding
+      end
+
+      def value_set(the_element)
+        binding = value_set_binding(the_element)
+        target_valueset = binding&.valueSet
+
+        additional_binding_ext = binding&.extension&.find do |ext|
+          ext.url == 'http://hl7.org/fhir/tools/StructureDefinition/additional-binding' &&
+            ext.extension.any? { |sub_ext| sub_ext.url == 'purpose' && sub_ext.valueCode == 'minimum' }
+        end
+
+        min_valueset_ext = binding&.extension&.find do |ext|
+          ext.url == 'http://hl7.org/fhir/StructureDefinition/elementdefinition-minValueSet'
+        end
+
+        if additional_binding_ext.present?
+          min_valueset = additional_binding_ext.extension.find { |ext| ext.url == 'valueSet' }
+
+          target_valueset = min_valueset.valueCanonical if min_valueset.present?
+        elsif min_valueset_ext.present?
+          target_valueset = min_valueset_ext.valueCanonical
+        end
+
+        ig_resources.value_set_by_url(target_valueset)
+      end
+
+      def bound_systems(the_element)
+        bound_systems_from_valueset(value_set(the_element))
+      end
+
+      def bound_systems_from_valueset(value_set)
+        value_set&.compose&.include&.map do |include_element|
+          if include_element.concept.present?
+            include_element
+          elsif include_element.system.present? && include_element.filter&.empty?
+            # Cannot process intensional value set with filters
+            ig_resources.code_system_by_url(include_element.system)
+          elsif include_element.valueSet.present?
+            include_element.valueSet.map do |vs|
+              a_value_set = ig_resources.value_set_by_url(vs)
+              bound_systems_from_valueset(a_value_set)
+            end
+          end
+        end&.flatten&.compact
+      end
+
+      def codes_from_value_set_binding(the_element)
+        codes_from_system_code_pair(codings_from_value_set_binding(the_element))
+      end
+
+      def codes_from_system_code_pair(codings)
+        codings.present? ? codings.map { |coding| coding[:code] }.compact.uniq : []
+      end
+
+      def codings_from_value_set_binding(the_element)
+        return [] if the_element.nil?
+
+        bound_systems = bound_systems(the_element)
+
+        return codings_from_bound_systems(bound_systems) if bound_systems.present?
+
+        expansion_contains = value_set_expansion_contains(the_element)
+
+        return [] if expansion_contains.blank?
+
+        expansion_contains.map { |contains| { system: contains.system, code: contains.code } }.compact.uniq
+      end
+
+      def codings_from_bound_systems(bound_systems)
+        return [] unless bound_systems.present?
+
+        bound_systems.flat_map do |bound_system|
+          case bound_system
+          when FHIR::ValueSet::Compose::Include
+            bound_system.concept.map { |concept| { system: bound_system.system, code: concept.code } }
+          when FHIR::CodeSystem
+            bound_system.concept.map { |concept| { system: bound_system.url, code: concept.code } }
+          else
+            []
+          end
+        end.uniq
+      end
+
+      def value_set_expansion_contains(element)
+        value_set(element)&.expansion&.contains
+      end
+
+      def fhir_metadata(current_path)
+        FHIR.const_get(resource)::METADATA[current_path]
+      end
+
+      def values_from_resource_metadata(paths)
+        values = []
+
+        paths.each do |current_path|
+          current_metadata = fhir_metadata(current_path)
+
+          next unless current_metadata&.dig('valid_codes').present?
+
+          values += current_metadata['valid_codes'].flat_map do |system, codes|
+            codes.map { |code| { system:, code: } }
+          end
+        end
+
+        values
+      end
     end
   end
 end

data/lib/us_quality_core_test_kit/generator.rb

@@ -9,6 +9,9 @@ require_relative 'generator/must_support_test_generator'
 require_relative 'generator/provenance_revinclude_search_test_generator'
 require_relative 'generator/reference_resolution_test_generator'
 require_relative 'generator/group_generator'
+require_relative 'generator/practitioner_address_test_generator'
+require_relative 'generator/interpreter_required_extension_test_generator'
+require_relative 'generator/document_reference_custodian_test_generator'
 require_relative 'generator/suite_generator'
 
 module USQualityCoreTestKit
@@ -36,12 +39,17 @@ module USQualityCoreTestKit
 
       # Generation
       FileUtils.mkdir_p(base_output_dir)
+
       generate_search_tests
       generate_read_tests
       generate_provenance_revinclude_search_tests
       generate_validation_tests
       generate_must_support_tests
       generate_reference_resolution_tests
+      generate_practitioner_address_tests
+      generate_interpreter_required_extension_test_generator
+      generate_document_reference_custodian_tests
+
       generate_groups
       generate_suites
 
@@ -91,6 +99,18 @@ module USQualityCoreTestKit
       GroupGenerator.generate(ig_metadata, base_output_dir)
     end
 
+    def generate_practitioner_address_tests
+      PractitionerAddressTestGenerator.generate(ig_metadata, base_output_dir)
+    end
+
+    def generate_interpreter_required_extension_test_generator
+      InterpreterRequiredExtensionTestGenerator.generate(ig_metadata, base_output_dir)
+    end
+
+    def generate_document_reference_custodian_tests
+      DocumentReferenceCustodianTestGenerator.generate(ig_metadata, base_output_dir)
+    end
+
     def generate_suites
       SuiteGenerator.generate(ig_metadata, base_output_dir)
     end

data/lib/us_quality_core_test_kit/igs/us.quality-core-0.5.0/ValueSet-SmokingStatusType.json

@@ -0,0 +1,74 @@
+{
+  "resourceType": "ValueSet",
+  "id": "2.16.840.1.113762.1.4.1267.6",
+  "meta": {
+    "versionId": "5",
+    "lastUpdated": "2024-02-27T16:29:13.000-05:00",
+    "profile": [
+      "http://hl7.org/fhir/StructureDefinition/shareablevalueset",
+      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-valueset-cqfm",
+      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-valueset-cqfm"
+    ]
+  },
+  "extension": [
+    {
+      "url": "http://hl7.org/fhir/StructureDefinition/valueset-effectiveDate",
+      "valueDate": "2024-02-22"
+    }
+  ],
+  "url": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6",
+  "identifier": [
+    {
+      "system": "urn:ietf:rfc:3986",
+      "value": "urn:oid:2.16.840.1.113762.1.4.1267.6"
+    }
+  ],
+  "version": "20240222",
+  "name": "SmokingStatusType",
+  "title": "Smoking Status Type",
+  "status": "active",
+  "date": "2024-02-22T01:11:38-05:00",
+  "publisher": "HL7 US Realm Program Management Steward",
+  "expansion": {
+    "identifier": "urn:uuid:4846dfb3-7d88-40a1-a541-64a4faa5fb25",
+    "timestamp": "2024-06-04T17:17:43-04:00",
+    "total": 4,
+    "offset": 0,
+    "parameter": [
+      {
+        "name": "count",
+        "valueInteger": 1000
+      },
+      {
+        "name": "offset",
+        "valueInteger": 0
+      }
+    ],
+    "contains": [
+      {
+        "system": "http://loinc.org",
+        "version": "2.77",
+        "code": "11367-0",
+        "display": "History of Tobacco use"
+      },
+      {
+        "system": "http://snomed.info/sct",
+        "version": "http://snomed.info/sct/731000124108/version/20240301",
+        "code": "401201003",
+        "display": "Cigarette pack-years (observable entity)"
+      },
+      {
+        "system": "http://loinc.org",
+        "version": "2.77",
+        "code": "72166-2",
+        "display": "Tobacco smoking status"
+      },
+      {
+        "system": "http://snomed.info/sct",
+        "version": "http://snomed.info/sct/731000124108/version/20240301",
+        "code": "782516008",
+        "display": "Number of calculated pack years for cumulative lifetime tobacco exposure (observable entity)"
+      }
+    ]
+  }
+}

data/lib/us_quality_core_test_kit/igs/us.quality-core-1.0.0-ballot/ValueSet-AdvanceHealthcareDirectiveCategoriesLOINC.json

@@ -0,0 +1,73 @@
+{
+  "resourceType": "ValueSet",
+  "id": "2.16.840.1.113883.11.20.9.69.4",
+  "meta": {
+    "versionId": "47",
+    "lastUpdated": "2025-04-02T01:08:06.000-04:00",
+    "profile": [
+      "http://hl7.org/fhir/StructureDefinition/shareablevalueset",
+      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-valueset-cqfm",
+      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-valueset-cqfm"
+    ]
+  },
+  "language": "en",
+  "extension": [
+    {
+      "url": "http://hl7.org/fhir/StructureDefinition/valueset-author",
+      "valueContactDetail": {
+        "name": "ADVault Author"
+      }
+    },
+    {
+      "url": "http://hl7.org/fhir/StructureDefinition/resource-lastReviewDate",
+      "valueDate": "2025-04-02"
+    },
+    {
+      "url": "http://hl7.org/fhir/StructureDefinition/valueset-effectiveDate",
+      "valueDateTime": "2025-04-02"
+    },
+    {
+      "url": "http://hl7.org/fhir/StructureDefinition/artifact-effectivePeriod",
+      "valuePeriod": {
+        "start": "2025-04-02"
+      }
+    }
+  ],
+  "url": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.69.4",
+  "identifier": [
+    {
+      "system": "urn:ietf:rfc:3986",
+      "value": "urn:oid:2.16.840.1.113883.11.20.9.69.4"
+    }
+  ],
+  "version": "20250402",
+  "name": "AdvanceHealthcareDirectiveCategoriesLOINC",
+  "title": "Advance Healthcare Directive Categories LOINC",
+  "status": "active",
+  "date": "2025-04-02T01:08:06-04:00",
+  "publisher": "ADVault",
+  "jurisdiction": [
+    {
+      "extension": [
+        {
+          "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
+          "valueCode": "unknown"
+        }
+      ]
+    }
+  ],
+  "purpose": "(Clinical Focus: Categories of advance healthcare directive documents.),(Data Element Scope: Used for concepts that categorize advance healthcare directive documents and document reference indexes for search and retrieval.),(Inclusion Criteria: Includes high-level concepts from LOINC that indicate a advance healthcare directive document.),(Exclusion Criteria: Exclude concepts from LOINC that indicate a specific type of advance healthcare directive document.)",
+  "compose": {
+    "include": [
+      {
+        "system": "http://loinc.org",
+        "concept": [
+          {
+            "code": "42348-3",
+            "display": "Advance directives"
+          }
+        ]
+      }
+    ]
+  }
+}

data/lib/us_quality_core_test_kit/igs/us.quality-core-1.0.0-ballot/ValueSet-SmokingStatusType.json

@@ -0,0 +1,74 @@
+{
+  "resourceType": "ValueSet",
+  "id": "2.16.840.1.113762.1.4.1267.6",
+  "meta": {
+    "versionId": "5",
+    "lastUpdated": "2024-02-27T16:29:13.000-05:00",
+    "profile": [
+      "http://hl7.org/fhir/StructureDefinition/shareablevalueset",
+      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-valueset-cqfm",
+      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-valueset-cqfm"
+    ]
+  },
+  "extension": [
+    {
+      "url": "http://hl7.org/fhir/StructureDefinition/valueset-effectiveDate",
+      "valueDate": "2024-02-22"
+    }
+  ],
+  "url": "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.6",
+  "identifier": [
+    {
+      "system": "urn:ietf:rfc:3986",
+      "value": "urn:oid:2.16.840.1.113762.1.4.1267.6"
+    }
+  ],
+  "version": "20240222",
+  "name": "SmokingStatusType",
+  "title": "Smoking Status Type",
+  "status": "active",
+  "date": "2024-02-22T01:11:38-05:00",
+  "publisher": "HL7 US Realm Program Management Steward",
+  "expansion": {
+    "identifier": "urn:uuid:4846dfb3-7d88-40a1-a541-64a4faa5fb25",
+    "timestamp": "2024-06-04T17:17:43-04:00",
+    "total": 4,
+    "offset": 0,
+    "parameter": [
+      {
+        "name": "count",
+        "valueInteger": 1000
+      },
+      {
+        "name": "offset",
+        "valueInteger": 0
+      }
+    ],
+    "contains": [
+      {
+        "system": "http://loinc.org",
+        "version": "2.77",
+        "code": "11367-0",
+        "display": "History of Tobacco use"
+      },
+      {
+        "system": "http://snomed.info/sct",
+        "version": "http://snomed.info/sct/731000124108/version/20240301",
+        "code": "401201003",
+        "display": "Cigarette pack-years (observable entity)"
+      },
+      {
+        "system": "http://loinc.org",
+        "version": "2.77",
+        "code": "72166-2",
+        "display": "Tobacco smoking status"
+      },
+      {
+        "system": "http://snomed.info/sct",
+        "version": "http://snomed.info/sct/731000124108/version/20240301",
+        "code": "782516008",
+        "display": "Number of calculated pack years for cumulative lifetime tobacco exposure (observable entity)"
+      }
+    ]
+  }
+}

data/lib/us_quality_core_test_kit/interpreter_required_extension_test.rb

@@ -0,0 +1,42 @@
+# frozen_string_literal: true
+
+module USQualityCoreTestKit
+  module InterpreterRequiredExtensionTest
+    def scratch_patient_resources
+      scratch[:patient_resources] ||= {}
+    end
+
+    def scratch_encounter_resources
+      scratch[:encounter_resources] ||= {}
+    end
+
+    def scratch_patient_and_encounter_resources
+      all_resources = scratch_patient_resources[:all]
+      all_resources.push(*scratch_encounter_resources[:all])
+      all_resources
+    end
+
+    def interpreter_required_extension_url
+      'http://hl7.org/fhir/us/core/StructureDefinition/us-core-interpreter-needed'
+    end
+
+    def interpreter_required_extension_exists?(resource)
+      resource.extension.present? && resource.extension.any? do |extension|
+        extension.url == interpreter_required_extension_url
+      end
+    end
+
+    def verify_interpreter_required_extension_exists
+      patient_and_encounter_resources = scratch_patient_and_encounter_resources
+
+      extension_found = patient_and_encounter_resources.any? do |resource|
+        interpreter_required_extension_exists?(resource)
+      end
+
+      assert(extension_found, %(
+        A certifying Server system SHALL support the US Core Interpreter Needed Extension on at least one of the US
+        Core Quality Patient or US Quality Core Encounter Profiles, but the extension was not found on either profile.
+      ))
+    end
+  end
+end

data/lib/us_quality_core_test_kit/metadata.rb

@@ -10,8 +10,10 @@ module USQualityCoreTestKit
 
     description <<~DESCRIPTION
       The US Quality Core Test Kit validates server and client implementations
-      against the [US Quality Core Implementation Guide
-      v0.5.0](https://fhir.org/guides/onc/us-quality-core/).
+      against the following US Quality Core versions:
+
+      * [2026 US Quality Core Implementation Guide v0.5.0](https://fhir.org/guides/onc/us-quality-core/) (USCDI+ Quality V1)
+      * [US Quality Core Implementation Guide v1.0.0-ballot](http://hl7.org/fhir/us/quality-core/1.0.0-202609-ballot/en) (Draft USCDI+ Quality V2)
 
       <!-- break -->
 
@@ -25,18 +27,21 @@ module USQualityCoreTestKit
 
       ## Status
 
-      These tests are a DRAFT intended to allow US Quality Core implementers to
-      perform preliminary checks of their implementations against the
-      [US Quality Core conformance requirements](https://fhir.org/guides/onc/us-quality-core/general-requirements.html)
-      and provide feedback on the tests. Future versions may validate
-      additional requirements or change how these requirements are tested.
+      These tests are DRAFT tests intended to allow US Quality Core
+      implementers to perform preliminary checks of their implementations
+      against the relevant conformance requirements and provide feedback on the
+      tests. Future versions may validate additional requirements or change how
+      these requirements are tested.
 
       ## Scope
 
-      The scope of this test kit is intended to match the conformance scope
-      defined by US Quality Core v0.5.0. The IG is derived from QI-Core STU 6
-      and includes inherited profiles to ease adoption, but its conformance
-      requirements are focused on USCDI+ Quality V1 data. The IG's
+      The test kit has separate suites for each supported implementation guide.
+      The v0.5.0 suites cover USCDI+ Quality V1 data, and the v1.0.0-ballot
+      suites cover Draft USCDI+ Quality V2 data.
+
+      The 2026 US Quality Core Implementation Guide v0.5.0 is derived from
+      QI-Core STU 6 and includes inherited profiles to ease adoption, but its
+      conformance requirements are focused on USCDI+ Quality V1 data. The v0.5.0 IG's
       [USCDI+ Quality mapping](https://fhir.org/guides/onc/us-quality-core/uscdiquality.html)
       identifies the in-scope V1 data elements. For conformance,
       implementations are expected to support profile types with at least one
@@ -48,7 +53,7 @@ module USQualityCoreTestKit
       The US Quality Core Server Suite verifies support for the IG's in-scope
       profile, element, and API requirements. It includes:
 
-      * Support for in-scope US Quality Core and US Core profiles that implement USCDI+ Quality V1 data elements
+      * Support for in-scope US Quality Core and US Core profiles that implement USCDI+ Quality V1 or Draft USCDI+ Quality V2 data elements, as applicable to the selected suite
       * Support for USCDI+ Quality-flagged elements and inherited US Core MustSupport elements
       * Support for FHIR read and search operations required by the [US Quality Core Server CapabilityStatement](https://fhir.org/guides/onc/us-quality-core/CapabilityStatement-us-quality-core-server.html)
       * Support for base FHIR requirements and terminology bindings, with validation performed by the HL7 FHIR Validator using tx.fhir.org
@@ -62,11 +67,14 @@ module USQualityCoreTestKit
       * The ability to request profile-conformant data from Inferno's simulated US Quality Core server
       * Support for read and search interaction requests described by the [US Quality Core CapabilityStatements](https://fhir.org/guides/onc/us-quality-core/capability-statements.html)
 
-      ## Repository
+      ## Repository and Documentation
 
       The [US Quality Core Test Kit](https://github.com/inferno-framework/us-quality-core-test-kit)
       repository contains the source code for this test kit.
 
+      For setup and test-use guidance, see the [US Quality Core Test Kit
+      documentation](https://github.com/inferno-framework/us-quality-core-test-kit/wiki),
+      including the [Preset Walkthrough](https://github.com/inferno-framework/us-quality-core-test-kit/wiki/Preset-Walkthrough).
 
       ## Providing Feedback and Reporting Issues
 
@@ -85,7 +93,9 @@ module USQualityCoreTestKit
 
     suite_ids %i[
       us_quality_core_v050
+      us_quality_core_v100_ballot
       us_quality_core_client_v050
+      us_quality_core_client_v100_ballot
     ]
 
     tags ['US Quality Core']