Examples with Ratio org.hl7.fhir.dstu2016may.model.Ratio used on opensource projects

Example 6 with Ratio

use of org.hl7.fhir.dstu2016may.model.Ratio in project quality-measure-and-cohort-service by Alvearie.

the class MeasureEvaluation method evaluate.

protected MeasureReport evaluate(Measure measure, Context context, List<Patient> patients, MeasureReport.MeasureReportType type, boolean isSingle, boolean includeEvaluatedResources) {
    MeasureReportBuilder reportBuilder = new MeasureReportBuilder();
    reportBuilder.buildStatus("complete");
    reportBuilder.buildType(type);
    reportBuilder.buildMeasureReference(measure.getIdElement().getResourceType() + "/" + measure.getIdElement().getIdPart());
    if (type == MeasureReport.MeasureReportType.INDIVIDUAL && CollectionUtils.isNotEmpty(patients)) {
        IdType patientId = patients.get(0).getIdElement();
        reportBuilder.buildPatientReference(patientId.getResourceType() + "/" + patientId.getIdPart());
    }
    reportBuilder.buildPeriod(measurementPeriod);
    MeasureReport report = reportBuilder.build();
    Map<String, Resource> resources = new HashMap<>();
    Map<String, Set<String>> codeToResourceMap = new HashMap<>();
    MeasureScoring measureScoring = MeasureScoring.fromCode(measure.getScoring().getCodingFirstRep().getCode());
    if (measureScoring == null) {
        throw new RuntimeException("Measure scoring is required in order to calculate.");
    }
    List<Measure.MeasureSupplementalDataComponent> sde = measure.getSupplementalData();
    Map<String, Map<String, Integer>> sdeAccumulators = new HashMap<>();
    for (Measure.MeasureGroupComponent group : measure.getGroup()) {
        MeasureReport.MeasureReportGroupComponent reportGroup = new MeasureReport.MeasureReportGroupComponent();
        reportGroup.setId(group.getId());
        report.getGroup().add(reportGroup);
        // Declare variables to avoid a hash lookup on every patient
        // TODO: Isn't quite right, there may be multiple initial populations for a
        // ratio measure...
        Measure.MeasureGroupPopulationComponent initialPopulationCriteria = null;
        Measure.MeasureGroupPopulationComponent numeratorCriteria = null;
        Measure.MeasureGroupPopulationComponent numeratorExclusionCriteria = null;
        Measure.MeasureGroupPopulationComponent denominatorCriteria = null;
        Measure.MeasureGroupPopulationComponent denominatorExclusionCriteria = null;
        Measure.MeasureGroupPopulationComponent denominatorExceptionCriteria = null;
        Map<String, Resource> initialPopulation = null;
        Map<String, Resource> numerator = null;
        Map<String, Resource> numeratorExclusion = null;
        Map<String, Resource> denominator = null;
        Map<String, Resource> denominatorExclusion = null;
        Map<String, Resource> denominatorException = null;
        Map<String, Patient> initialPopulationPatients = null;
        Map<String, Patient> numeratorPatients = null;
        Map<String, Patient> numeratorExclusionPatients = null;
        Map<String, Patient> denominatorPatients = null;
        Map<String, Patient> denominatorExclusionPatients = null;
        Map<String, Patient> denominatorExceptionPatients = null;
        for (Measure.MeasureGroupPopulationComponent pop : group.getPopulation()) {
            MeasurePopulationType populationType = MeasurePopulationType.fromCode(pop.getCode().getCodingFirstRep().getCode());
            if (populationType != null) {
                switch(populationType) {
                    case INITIALPOPULATION:
                        initialPopulationCriteria = pop;
                        initialPopulation = new HashMap<>();
                        if (type == MeasureReport.MeasureReportType.SUBJECTLIST) {
                            initialPopulationPatients = new HashMap<>();
                        }
                        break;
                    case NUMERATOR:
                        numeratorCriteria = pop;
                        numerator = new HashMap<>();
                        if (type == MeasureReport.MeasureReportType.SUBJECTLIST) {
                            numeratorPatients = new HashMap<>();
                        }
                        break;
                    case NUMERATOREXCLUSION:
                        numeratorExclusionCriteria = pop;
                        numeratorExclusion = new HashMap<>();
                        if (type == MeasureReport.MeasureReportType.SUBJECTLIST) {
                            numeratorExclusionPatients = new HashMap<>();
                        }
                        break;
                    case DENOMINATOR:
                        denominatorCriteria = pop;
                        denominator = new HashMap<>();
                        if (type == MeasureReport.MeasureReportType.SUBJECTLIST) {
                            denominatorPatients = new HashMap<>();
                        }
                        break;
                    case DENOMINATOREXCLUSION:
                        denominatorExclusionCriteria = pop;
                        denominatorExclusion = new HashMap<>();
                        if (type == MeasureReport.MeasureReportType.SUBJECTLIST) {
                            denominatorExclusionPatients = new HashMap<>();
                        }
                        break;
                    case DENOMINATOREXCEPTION:
                        denominatorExceptionCriteria = pop;
                        denominatorException = new HashMap<>();
                        if (type == MeasureReport.MeasureReportType.SUBJECTLIST) {
                            denominatorExceptionPatients = new HashMap<>();
                        }
                        break;
                    default:
                        throw new UnsupportedOperationException("Measure population, observation and measure population exclusion are used for continuous-variable scoring measures which are not supported");
                }
            }
        }
        switch(measureScoring) {
            case PROPORTION:
            case RATIO:
                {
                    // For each patient in the initial population
                    for (Patient patient : patients) {
                        // Are they in the initial population?
                        boolean inInitialPopulation = evaluatePopulationCriteria(context, patient, initialPopulationCriteria, initialPopulation, initialPopulationPatients, null, null, null);
                        populateResourceMap(context, MeasurePopulationType.INITIALPOPULATION, resources, codeToResourceMap, includeEvaluatedResources);
                        if (inInitialPopulation) {
                            // Are they in the denominator?
                            boolean inDenominator = evaluatePopulationCriteria(context, patient, denominatorCriteria, denominator, denominatorPatients, denominatorExclusionCriteria, denominatorExclusion, denominatorExclusionPatients);
                            populateResourceMap(context, MeasurePopulationType.DENOMINATOR, resources, codeToResourceMap, includeEvaluatedResources);
                            if (inDenominator) {
                                // Are they in the numerator?
                                boolean inNumerator = evaluatePopulationCriteria(context, patient, numeratorCriteria, numerator, numeratorPatients, numeratorExclusionCriteria, numeratorExclusion, numeratorExclusionPatients);
                                populateResourceMap(context, MeasurePopulationType.NUMERATOR, resources, codeToResourceMap, includeEvaluatedResources);
                                if (!inNumerator && inDenominator && (denominatorExceptionCriteria != null)) {
                                    // Are they in the denominator exception?
                                    boolean inException = false;
                                    for (Resource resource : evaluateCriteria(context, patient, denominatorExceptionCriteria)) {
                                        inException = true;
                                        denominatorException.put(resource.getIdElement().getIdPart(), resource);
                                        denominator.remove(resource.getIdElement().getIdPart());
                                        populateResourceMap(context, MeasurePopulationType.DENOMINATOREXCEPTION, resources, codeToResourceMap, includeEvaluatedResources);
                                    }
                                    if (inException) {
                                        if (denominatorExceptionPatients != null) {
                                            denominatorExceptionPatients.put(patient.getIdElement().getIdPart(), patient);
                                        }
                                        if (denominatorPatients != null) {
                                            denominatorPatients.remove(patient.getIdElement().getIdPart());
                                        }
                                    }
                                }
                            }
                        }
                        MeasureSupplementalDataEvaluation.populateSDEAccumulators(context, patient, sdeAccumulators, sde);
                    }
                    // Calculate actual measure score, Count(numerator) / Count(denominator)
                    if (numerator != null && MapUtils.isNotEmpty(denominator)) {
                        reportGroup.setMeasureScore(new Quantity(numerator.size() / (double) denominator.size()));
                    }
                    break;
                }
            case COHORT:
                {
                    // For each patient in the patient list
                    for (Patient patient : patients) {
                        evaluatePopulationCriteria(context, patient, initialPopulationCriteria, initialPopulation, initialPopulationPatients, null, null, null);
                        populateResourceMap(context, MeasurePopulationType.INITIALPOPULATION, resources, codeToResourceMap, includeEvaluatedResources);
                        MeasureSupplementalDataEvaluation.populateSDEAccumulators(context, patient, sdeAccumulators, sde);
                    }
                    break;
                }
            case CONTINUOUSVARIABLE:
                throw new UnsupportedOperationException("Scoring type CONTINUOUSVARIABLE is not supported");
        }
        // Add population reports for each group
        addPopulationCriteriaReport(report, reportGroup, initialPopulationCriteria, initialPopulation != null ? initialPopulation.size() : 0, initialPopulationPatients != null ? initialPopulationPatients.values() : null);
        addPopulationCriteriaReport(report, reportGroup, numeratorCriteria, numerator != null ? numerator.size() : 0, numeratorPatients != null ? numeratorPatients.values() : null);
        addPopulationCriteriaReport(report, reportGroup, numeratorExclusionCriteria, numeratorExclusion != null ? numeratorExclusion.size() : 0, numeratorExclusionPatients != null ? numeratorExclusionPatients.values() : null);
        addPopulationCriteriaReport(report, reportGroup, denominatorCriteria, denominator != null ? denominator.size() : 0, denominatorPatients != null ? denominatorPatients.values() : null);
        addPopulationCriteriaReport(report, reportGroup, denominatorExclusionCriteria, denominatorExclusion != null ? denominatorExclusion.size() : 0, denominatorExclusionPatients != null ? denominatorExclusionPatients.values() : null);
        addPopulationCriteriaReport(report, reportGroup, denominatorExceptionCriteria, denominatorException != null ? denominatorException.size() : 0, denominatorExceptionPatients != null ? denominatorExceptionPatients.values() : null);
    }
    for (Entry<String, Set<String>> entry : codeToResourceMap.entrySet()) {
        ListResource list = new ListResource();
        for (String element : entry.getValue()) {
            ListResource.ListEntryComponent comp = new ListEntryComponent();
            comp.setItem(new Reference('#' + element));
            list.addEntry(comp);
        }
        if (!list.isEmpty()) {
            list.setId(UUID.randomUUID().toString());
            list.setTitle(entry.getKey());
            resources.put(list.getId(), list);
        }
    }
    if (MapUtils.isNotEmpty(resources)) {
        List<Reference> evaluatedResourceIds = new ArrayList<>();
        resources.forEach((key, resource) -> {
            evaluatedResourceIds.add(new Reference(resource.getId()));
        });
        report.setEvaluatedResource(evaluatedResourceIds);
    }
    if (MapUtils.isNotEmpty(sdeAccumulators)) {
        report = MeasureSupplementalDataEvaluation.processAccumulators(report, sdeAccumulators, isSingle, patients);
    }
    return report;
}

Example 7 with Ratio

use of org.hl7.fhir.dstu2016may.model.Ratio in project org.hl7.fhir.core by hapifhir.

the class NarrativeGenerator method renderLeaf.

private void renderLeaf(ResourceWrapper res, BaseWrapper ew, ElementDefinition defn, XhtmlNode x, boolean title, boolean showCodeDetails, Map<String, String> displayHints) throws FHIRException, UnsupportedEncodingException, IOException {
    if (ew == null)
        return;
    Base e = ew.getBase();
    if (e instanceof StringType)
        x.addText(((StringType) e).getValue());
    else if (e instanceof CodeType)
        x.addText(((CodeType) e).getValue());
    else if (e instanceof IdType)
        x.addText(((IdType) e).getValue());
    else if (e instanceof Extension)
        x.addText("Extensions: Todo");
    else if (e instanceof InstantType)
        x.addText(((InstantType) e).toHumanDisplay());
    else if (e instanceof DateTimeType)
        x.addText(((DateTimeType) e).toHumanDisplay());
    else if (e instanceof Base64BinaryType)
        x.addText(new Base64().encodeAsString(((Base64BinaryType) e).getValue()));
    else if (e instanceof org.hl7.fhir.dstu2.model.DateType)
        x.addText(((org.hl7.fhir.dstu2.model.DateType) e).toHumanDisplay());
    else if (e instanceof Enumeration) {
        Object ev = ((Enumeration<?>) e).getValue();
        // todo: look up a display name if there is one
        x.addText(ev == null ? "" : ev.toString());
    } else if (e instanceof BooleanType)
        x.addText(((BooleanType) e).getValue().toString());
    else if (e instanceof CodeableConcept) {
        renderCodeableConcept((CodeableConcept) e, x, showCodeDetails);
    } else if (e instanceof Coding) {
        renderCoding((Coding) e, x, showCodeDetails);
    } else if (e instanceof Annotation) {
        renderAnnotation((Annotation) e, x);
    } else if (e instanceof Identifier) {
        renderIdentifier((Identifier) e, x);
    } else if (e instanceof org.hl7.fhir.dstu2.model.IntegerType) {
        x.addText(Integer.toString(((org.hl7.fhir.dstu2.model.IntegerType) e).getValue()));
    } else if (e instanceof org.hl7.fhir.dstu2.model.DecimalType) {
        x.addText(((org.hl7.fhir.dstu2.model.DecimalType) e).getValue().toString());
    } else if (e instanceof HumanName) {
        renderHumanName((HumanName) e, x);
    } else if (e instanceof SampledData) {
        renderSampledData((SampledData) e, x);
    } else if (e instanceof Address) {
        renderAddress((Address) e, x);
    } else if (e instanceof ContactPoint) {
        renderContactPoint((ContactPoint) e, x);
    } else if (e instanceof UriType) {
        renderUri((UriType) e, x);
    } else if (e instanceof Timing) {
        renderTiming((Timing) e, x);
    } else if (e instanceof Range) {
        renderRange((Range) e, x);
    } else if (e instanceof Quantity) {
        renderQuantity((Quantity) e, x, showCodeDetails);
    } else if (e instanceof Ratio) {
        renderQuantity(((Ratio) e).getNumerator(), x, showCodeDetails);
        x.addText("/");
        renderQuantity(((Ratio) e).getDenominator(), x, showCodeDetails);
    } else if (e instanceof Period) {
        Period p = (Period) e;
        x.addText(!p.hasStart() ? "??" : p.getStartElement().toHumanDisplay());
        x.addText(" --> ");
        x.addText(!p.hasEnd() ? "(ongoing)" : p.getEndElement().toHumanDisplay());
    } else if (e instanceof Reference) {
        Reference r = (Reference) e;
        XhtmlNode c = x;
        ResourceWithReference tr = null;
        if (r.hasReferenceElement()) {
            tr = resolveReference(res, r.getReference());
            if (!r.getReference().startsWith("#")) {
                if (tr != null && tr.getReference() != null)
                    c = x.addTag("a").attribute("href", tr.getReference());
                else
                    c = x.addTag("a").attribute("href", r.getReference());
            }
        }
        // what to display: if text is provided, then that. if the reference was resolved, then show the generated narrative
        if (r.hasDisplayElement()) {
            c.addText(r.getDisplay());
            if (tr != null) {
                c.addText(". Generated Summary: ");
                generateResourceSummary(c, tr.getResource(), true, r.getReference().startsWith("#"));
            }
        } else if (tr != null) {
            generateResourceSummary(c, tr.getResource(), r.getReference().startsWith("#"), r.getReference().startsWith("#"));
        } else {
            c.addText(r.getReference());
        }
    } else if (e instanceof Resource) {
        return;
    } else if (e instanceof ElementDefinition) {
        x.addText("todo-bundle");
    } else if (e != null && !(e instanceof Attachment) && !(e instanceof Narrative) && !(e instanceof Meta))
        throw new NotImplementedException("type " + e.getClass().getName() + " not handled yet");
}

Example 8 with Ratio

use of org.hl7.fhir.dstu2016may.model.Ratio in project org.hl7.fhir.core by hapifhir.

the class RdfParser method composeRatio.

protected void composeRatio(Complex parent, String parentType, String name, Ratio element, int index) {
    if (element == null)
        return;
    Complex t;
    if (Utilities.noString(parentType))
        t = parent;
    else {
        t = parent.predicate("fhir:" + parentType + '.' + name);
    }
    composeElement(t, "Ratio", name, element, index);
    if (element.hasNumerator())
        composeQuantity(t, "Ratio", "numerator", element.getNumerator(), -1);
    if (element.hasDenominator())
        composeQuantity(t, "Ratio", "denominator", element.getDenominator(), -1);
}

Example 9 with Ratio

use of org.hl7.fhir.dstu2016may.model.Ratio in project org.hl7.fhir.core by hapifhir.

the class JsonParser method composeType.

protected void composeType(String prefix, Type type) throws IOException {
    if (type == null)
        ;
    else if (type instanceof Age)
        composeAge(prefix + "Age", (Age) type);
    else if (type instanceof Count)
        composeCount(prefix + "Count", (Count) type);
    else if (type instanceof Money)
        composeMoney(prefix + "Money", (Money) type);
    else if (type instanceof Distance)
        composeDistance(prefix + "Distance", (Distance) type);
    else if (type instanceof Duration)
        composeDuration(prefix + "Duration", (Duration) type);
    else if (type instanceof SimpleQuantity)
        composeSimpleQuantity(prefix + "SimpleQuantity", (SimpleQuantity) type);
    else if (type instanceof Period)
        composePeriod(prefix + "Period", (Period) type);
    else if (type instanceof Coding)
        composeCoding(prefix + "Coding", (Coding) type);
    else if (type instanceof Range)
        composeRange(prefix + "Range", (Range) type);
    else if (type instanceof Quantity)
        composeQuantity(prefix + "Quantity", (Quantity) type);
    else if (type instanceof Attachment)
        composeAttachment(prefix + "Attachment", (Attachment) type);
    else if (type instanceof Ratio)
        composeRatio(prefix + "Ratio", (Ratio) type);
    else if (type instanceof Annotation)
        composeAnnotation(prefix + "Annotation", (Annotation) type);
    else if (type instanceof SampledData)
        composeSampledData(prefix + "SampledData", (SampledData) type);
    else if (type instanceof Reference)
        composeReference(prefix + "Reference", (Reference) type);
    else if (type instanceof CodeableConcept)
        composeCodeableConcept(prefix + "CodeableConcept", (CodeableConcept) type);
    else if (type instanceof Identifier)
        composeIdentifier(prefix + "Identifier", (Identifier) type);
    else if (type instanceof Signature)
        composeSignature(prefix + "Signature", (Signature) type);
    else if (type instanceof TriggerDefinition)
        composeTriggerDefinition(prefix + "TriggerDefinition", (TriggerDefinition) type);
    else if (type instanceof ElementDefinition)
        composeElementDefinition(prefix + "ElementDefinition", (ElementDefinition) type);
    else if (type instanceof Timing)
        composeTiming(prefix + "Timing", (Timing) type);
    else if (type instanceof ModuleMetadata)
        composeModuleMetadata(prefix + "ModuleMetadata", (ModuleMetadata) type);
    else if (type instanceof ActionDefinition)
        composeActionDefinition(prefix + "ActionDefinition", (ActionDefinition) type);
    else if (type instanceof Address)
        composeAddress(prefix + "Address", (Address) type);
    else if (type instanceof HumanName)
        composeHumanName(prefix + "HumanName", (HumanName) type);
    else if (type instanceof DataRequirement)
        composeDataRequirement(prefix + "DataRequirement", (DataRequirement) type);
    else if (type instanceof Meta)
        composeMeta(prefix + "Meta", (Meta) type);
    else if (type instanceof ParameterDefinition)
        composeParameterDefinition(prefix + "ParameterDefinition", (ParameterDefinition) type);
    else if (type instanceof ContactPoint)
        composeContactPoint(prefix + "ContactPoint", (ContactPoint) type);
    else if (type instanceof MarkdownType) {
        composeMarkdownCore(prefix + "Markdown", (MarkdownType) type, false);
        composeMarkdownExtras(prefix + "Markdown", (MarkdownType) type, false);
    } else if (type instanceof UnsignedIntType) {
        composeUnsignedIntCore(prefix + "UnsignedInt", (UnsignedIntType) type, false);
        composeUnsignedIntExtras(prefix + "UnsignedInt", (UnsignedIntType) type, false);
    } else if (type instanceof CodeType) {
        composeCodeCore(prefix + "Code", (CodeType) type, false);
        composeCodeExtras(prefix + "Code", (CodeType) type, false);
    } else if (type instanceof IdType) {
        composeIdCore(prefix + "Id", (IdType) type, false);
        composeIdExtras(prefix + "Id", (IdType) type, false);
    } else if (type instanceof OidType) {
        composeOidCore(prefix + "Oid", (OidType) type, false);
        composeOidExtras(prefix + "Oid", (OidType) type, false);
    } else if (type instanceof PositiveIntType) {
        composePositiveIntCore(prefix + "PositiveInt", (PositiveIntType) type, false);
        composePositiveIntExtras(prefix + "PositiveInt", (PositiveIntType) type, false);
    } else if (type instanceof UuidType) {
        composeUuidCore(prefix + "Uuid", (UuidType) type, false);
        composeUuidExtras(prefix + "Uuid", (UuidType) type, false);
    } else if (type instanceof IntegerType) {
        composeIntegerCore(prefix + "Integer", (IntegerType) type, false);
        composeIntegerExtras(prefix + "Integer", (IntegerType) type, false);
    } else if (type instanceof DateTimeType) {
        composeDateTimeCore(prefix + "DateTime", (DateTimeType) type, false);
        composeDateTimeExtras(prefix + "DateTime", (DateTimeType) type, false);
    } else if (type instanceof DateType) {
        composeDateCore(prefix + "Date", (DateType) type, false);
        composeDateExtras(prefix + "Date", (DateType) type, false);
    } else if (type instanceof DecimalType) {
        composeDecimalCore(prefix + "Decimal", (DecimalType) type, false);
        composeDecimalExtras(prefix + "Decimal", (DecimalType) type, false);
    } else if (type instanceof UriType) {
        composeUriCore(prefix + "Uri", (UriType) type, false);
        composeUriExtras(prefix + "Uri", (UriType) type, false);
    } else if (type instanceof Base64BinaryType) {
        composeBase64BinaryCore(prefix + "Base64Binary", (Base64BinaryType) type, false);
        composeBase64BinaryExtras(prefix + "Base64Binary", (Base64BinaryType) type, false);
    } else if (type instanceof TimeType) {
        composeTimeCore(prefix + "Time", (TimeType) type, false);
        composeTimeExtras(prefix + "Time", (TimeType) type, false);
    } else if (type instanceof StringType) {
        composeStringCore(prefix + "String", (StringType) type, false);
        composeStringExtras(prefix + "String", (StringType) type, false);
    } else if (type instanceof BooleanType) {
        composeBooleanCore(prefix + "Boolean", (BooleanType) type, false);
        composeBooleanExtras(prefix + "Boolean", (BooleanType) type, false);
    } else if (type instanceof InstantType) {
        composeInstantCore(prefix + "Instant", (InstantType) type, false);
        composeInstantExtras(prefix + "Instant", (InstantType) type, false);
    } else
        throw new Error("Unhandled type");
}

Example 10 with Ratio

use of org.hl7.fhir.dstu2016may.model.Ratio in project org.hl7.fhir.core by hapifhir.

the class NarrativeGenerator method renderLeaf.

private void renderLeaf(ResourceWrapper res, BaseWrapper ew, ElementDefinition defn, XhtmlNode x, boolean title, boolean showCodeDetails, Map<String, String> displayHints) throws FHIRException, UnsupportedEncodingException, IOException {
    if (ew == null)
        return;
    Base e = ew.getBase();
    if (e instanceof StringType)
        x.addText(((StringType) e).getValue());
    else if (e instanceof CodeType)
        x.addText(((CodeType) e).getValue());
    else if (e instanceof IdType)
        x.addText(((IdType) e).getValue());
    else if (e instanceof Extension)
        x.addText("Extensions: Todo");
    else if (e instanceof InstantType)
        x.addText(((InstantType) e).toHumanDisplay());
    else if (e instanceof DateTimeType)
        x.addText(((DateTimeType) e).toHumanDisplay());
    else if (e instanceof Base64BinaryType)
        x.addText(new Base64().encodeAsString(((Base64BinaryType) e).getValue()));
    else if (e instanceof org.hl7.fhir.dstu2016may.model.DateType)
        x.addText(((org.hl7.fhir.dstu2016may.model.DateType) e).toHumanDisplay());
    else if (e instanceof Enumeration) {
        Object ev = ((Enumeration<?>) e).getValue();
        // todo: look up a display name if there is one
        x.addText(ev == null ? "" : ev.toString());
    } else if (e instanceof BooleanType)
        x.addText(((BooleanType) e).getValue().toString());
    else if (e instanceof CodeableConcept) {
        renderCodeableConcept((CodeableConcept) e, x, showCodeDetails);
    } else if (e instanceof Coding) {
        renderCoding((Coding) e, x, showCodeDetails);
    } else if (e instanceof Annotation) {
        renderAnnotation((Annotation) e, x);
    } else if (e instanceof Identifier) {
        renderIdentifier((Identifier) e, x);
    } else if (e instanceof org.hl7.fhir.dstu2016may.model.IntegerType) {
        x.addText(Integer.toString(((org.hl7.fhir.dstu2016may.model.IntegerType) e).getValue()));
    } else if (e instanceof org.hl7.fhir.dstu2016may.model.DecimalType) {
        x.addText(((org.hl7.fhir.dstu2016may.model.DecimalType) e).getValue().toString());
    } else if (e instanceof HumanName) {
        renderHumanName((HumanName) e, x);
    } else if (e instanceof SampledData) {
        renderSampledData((SampledData) e, x);
    } else if (e instanceof Address) {
        renderAddress((Address) e, x);
    } else if (e instanceof ContactPoint) {
        renderContactPoint((ContactPoint) e, x);
    } else if (e instanceof UriType) {
        renderUri((UriType) e, x);
    } else if (e instanceof Timing) {
        renderTiming((Timing) e, x);
    } else if (e instanceof Range) {
        renderRange((Range) e, x);
    } else if (e instanceof Quantity) {
        renderQuantity((Quantity) e, x, showCodeDetails);
    } else if (e instanceof Ratio) {
        renderQuantity(((Ratio) e).getNumerator(), x, showCodeDetails);
        x.addText("/");
        renderQuantity(((Ratio) e).getDenominator(), x, showCodeDetails);
    } else if (e instanceof Period) {
        Period p = (Period) e;
        x.addText(!p.hasStart() ? "??" : p.getStartElement().toHumanDisplay());
        x.addText(" --> ");
        x.addText(!p.hasEnd() ? "(ongoing)" : p.getEndElement().toHumanDisplay());
    } else if (e instanceof Reference) {
        Reference r = (Reference) e;
        XhtmlNode c = x;
        ResourceWithReference tr = null;
        if (r.hasReferenceElement()) {
            tr = resolveReference(res, r.getReference());
            if (!r.getReference().startsWith("#")) {
                if (tr != null && tr.getReference() != null)
                    c = x.addTag("a").attribute("href", tr.getReference());
                else
                    c = x.addTag("a").attribute("href", r.getReference());
            }
        }
        // what to display: if text is provided, then that. if the reference was resolved, then show the generated narrative
        if (r.hasDisplayElement()) {
            c.addText(r.getDisplay());
            if (tr != null) {
                c.addText(". Generated Summary: ");
                generateResourceSummary(c, tr.getResource(), true, r.getReference().startsWith("#"));
            }
        } else if (tr != null) {
            generateResourceSummary(c, tr.getResource(), r.getReference().startsWith("#"), r.getReference().startsWith("#"));
        } else {
            c.addText(r.getReference());
        }
    } else if (e instanceof Resource) {
        return;
    } else if (e instanceof ElementDefinition) {
        x.addText("todo-bundle");
    } else if (e != null && !(e instanceof Attachment) && !(e instanceof Narrative) && !(e instanceof Meta))
        throw new NotImplementedException("type " + e.getClass().getName() + " not handled yet");
}