cdss-testing-harness

A utility for translating, executing, and testing CQL libraries, specifically for the CDSS4PCP project

This project is forked from cql-testing-harness and modified for additional functionality for testing CDS Vaccine rules.

Prerequisites

• Docker
• Node.js

Users also need to configure a .env file in your CQL repository, defining the following values:

TRANSLATION_SERVICE_URL=http://localhost:8080/cql/translator   # An endpoint exposing a CQL translation service
INPUT_CQL=./test/fixtures/cql                                  # Folder(s) containing all CQL to translate
OUTPUT_ELM=./test/fixtures/elm                                 # Folder where translated ELM will be saved
VALUESETS=./test/fixtures/valuesets                            # Folder where CQL-dependent valuesets live
PATIENTS=./test/fixtures/patients                              # Folder storing patient files used as test fixtures
VSAC_API_KEY=your_key                                          # UMLS API key that will be used to download valuesets. For increased security, store the API key in a env variable instead

The INPUT_CQL value can take multiple directories, separated by a comma, in order to tell the testing harness to look in more than one directory for CQL files.

INPUT_CQL='cqlDir1,cqlDir2,cqlDir3'

Notable Dependencies

• cql-exec-vsac: Used for identifying and downloading valuesets within CQL rules
• cdss-common: The common module that is used for executing CQL rules in thee CDSS4PCP project

Usage

Scripts

test-cql

test-cql [-n] [-t path/to/test/directory]

• -n: When this option is included, the script will not start a new cql-translation-service docker container. When using this option, ensure you have an instance of the translation service running on your machine at the URL specified in .env
• -t: This option allows you to specify a specific directory or pattern that jest should use to run the tests. If omitted, the script will use jest's default which is any file that ends in .test.js

This script will do the following:

1. Start a cql-translation-service docker container
2. Translate all CQL in theINPUT_CQL directory into ELM JSON and write it to OUTPUT_ELM. This will only occur if CQL files in the INPUT_CQL have changed and the ELM needs to be updated
3. Run the unit tests present in the specified test directory

translate-cql

translate-cql

This script will only do step 2. from above: translate all CQL in theINPUT_CQL directory into ELM JSON and write it to OUTPUT_ELM. This will only occur if CQL files in the INPUT_CQL have changed and the ELM needs to be updated

Utilities

Fixture Loading

loadJSONFromDirectory(pathToDir): loads all JSON files in pathToDir and returns the contents as an array

• pathToDir (string): absolute path to the directory containing the JSON files

loadJSONFixture(pathToFixture): loads the JSON file present at pathToFixture and returns the parsed contents

• pathToFixture (string): absolute path to the JSON file

defaultLoadElm(): loads the ELM JSON present at the OUTPUT_ELM value specified in .env

defaultLoadPatients(): loads all of the patient bundle JSONs present at the PATIENTS value specified in .env

defaultLoadValuesets(): loads all of the ValueSet JSON files present at the VALUESETS value specified in .env

Full Example

1. Setup .env with necessary content

# .env contents
TRANSLATION_SERVICE_URL=http://localhost:8080/cql/translator   # An endpoint exposing a CQL translation service
INPUT_CQL=./test/fixtures/cql                                  # Folder(s) containing all CQL to translate
OUTPUT_ELM=./test/fixtures/elm                                 # Folder where translated ELM will be saved
VALUESETS=./test/fixtures/valuesets                            # Folder where CQL-dependent valuesets live
PATIENTS=./test/fixtures/patients                              # Folder storing patient files used as test fixtures
VSAC_API_KEY=your_key                                          # UMLS API key that will be used to download valuesets. For increased security, store the API key in a env variable instead

2. Create a test for your CQL:

/* example.test.js */


const dotenv = require('dotenv');
const vsac = require('cql-exec-vsac');
const {
  executeCql,
} = require('cdss-common/src/cdss-module');
const {
  defaultLoadElm,
  defaultLoadPatients,
} = require('../src');
const {
  getNumberOfMonths,
  getNumberOfWeeks,
} = require('./timeUtil');


// Initialize the env variables
dotenv.config();

const API_KEY = process.env.VSAC_API_KEY;
const VALUESETS_CACHE = process.env.VALUESETS;
let elms;
let patientBundles;


beforeAll(() => {
  // Set up necessary data for cql-execution
  elms = defaultLoadElm();

  // patientBundles = defaultCustomPatients();
  const bundles = defaultLoadPatients();
  patientBundles = {};
  bundles.forEach((bundle) => {
    patientBundles[bundle.id] = bundle;
  });
});

describe('MMR Rule 1 Tests', () => {
  test('VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, Patient birthdate should be < 12 mon, No previous dose, Recommendations should be Schedule 1st dose 12-15 mon of age AND Schedule 2nd dose 4-6 yr of age', async () => {
    const rule = elms.MMR1regularyoungerthan12monthsNoMMRRecommendation;

    const patient = patientBundles.MMR1.entry[0].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': [] }, codeService, API_KEY);
    expect(result)
      .not
      .toBeNull();
    const patientResult = result[patient.id];

    const patientBod = new Date(patient.birthDate);

    expect(patientResult.VaccineName)
      .toEqual('Measles, Mumps, and Rubella Virus Vaccine');
    
    expect(patientResult.Recommendations)
      .toHaveLength(2);
    expect(patientResult.Recommendations[0].recommendation)
      .toEqual(expect.stringContaining('Recommendation 1: Schedule 1st dose MMR when patient is 12-15 months'));

    expect(patientResult.Recommendations[1].recommendation)
      .toEqual(expect.stringContaining('Recommendation 2: Schedule 2nd dose MMR when patient is 4-6 years'));
  });
});

4. Run the test script to translate the CQL into ELM and get the execution results to use in unit test assertions:

   npm run test-cql

   Example output:

> [email protected] test-cql
> node ./src/scripts/run.js

> Starting cql-translation-service
26a543ed9ac3fcce8e308c6de1ae008db189be0e7765f50006dfbf2a51f36d29
> Waiting for server
.> Translating CQL
Wrote ELM to C:\Users\C2\Documents\Clemson\Assistantship\cdss-testing-harness\test\fixtures\elm\FHIRHelpers.json
Wrote ELM to C:\Users\C2\Documents\Clemson\Assistantship\cdss-testing-harness\test\fixtures\elm\MMR1\MMR1.json
Wrote ELM to C:\Users\C2\Documents\Clemson\Assistantship\cdss-testing-harness\test\fixtures\elm\MMR_Common_Library.json
> Running unit tests
 PASS  test/MMR_Positive.test.js
  MMR Rule 1 Tests
    √ VaccineName should be Measles, Mumps, and Rubella Virus Vaccine, Patient birthdate should be < 12 mon, No previous dose, Recommendations should be Schedule 1st dose 12-15 mon of age AND Schedule 2nd dose 4-6 yr of age (134 ms)                                                                                                                                                                                                                                

Test Suites: 1 passed, 1 total                                                                                                                                                                                                      
Tests:       1 passed, 1 total                                                                                                                                                                                                      
Snapshots:   0 total
Time:        2.038 s, estimated 3 s
Ran all test suites.
> Stopping cql-translation-service
cql-translation-service