This is the original logic using "Procedure, Performed" and the now inactive findings codes for the size of the tumor.

Inactive codes:
"Neoplasm of prostate primary tumor staging category T1c: Tumor identified by needle biopsy (finding)": '433351000124101'
"Neoplasm of prostate primary tumor staging category T2a: Involves one-half of one lobe or less (finding)": '433361000124104'
"T1a: Prostate tumor incidental histologic finding in 5 percent or less of tissue resected (finding)": '369833007'
"T1b: Prostate tumor incidental histologic finding in greater than 5 percent of tissue resected (finding)": '369834001'

( Last(["Procedure, Performed": "Tumor staging (tumor staging)"] ProstateCancerStaging
with "First Prostate Cancer Treatment during day of Measurement Period" FirstProstateCancerTreatment
such that Global."NormalizeInterval"(ProstateCancerStaging.relevantDatetime, ProstateCancerStaging.relevantPeriod) starts before start of Global."NormalizeInterval"(FirstProstateCancerTreatment.relevantDatetime, FirstProstateCancerTreatment.relevantPeriod)
sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
) ) LastProstateCancerStaging
where ( LastProstateCancerStaging.result ~ "T1a: Prostate tumor incidental histologic finding in 5 percent or less of tissue resected (finding)"
or LastProstateCancerStaging.result ~ "T1b: Prostate tumor incidental histologic finding in greater than 5 percent of tissue resected (finding)"
or LastProstateCancerStaging.result ~ "Neoplasm of prostate primary tumor staging category T1c: Tumor identified by needle biopsy (finding)"
or LastProstateCancerStaging.result ~ "Neoplasm of prostate primary tumor staging category T2a: Involves one-half of one lobe or less (finding)"
)

The new qualifier codes are (which are not specific to Prostate)
1228892002 American Joint Committee on Cancer cT1a (qualifier value)
1228895000 American Joint Committee on Cancer cT1b (qualifier value)
1228899006 American Joint Committee on Cancer cT1c (qualifier value)
1228931008 American Joint Committee on Cancer cT2a (qualifier value)

We are debating if we can keep the original logic and just insert the new qualifier values which is not ideal due to the qualifier being an attribute and not a finding as well as the "Procedure, Performed" appears to be referring to the biopsy.

Our next possible option was to use the qualifiers as the severity of the diagnosis but then we have to consider is the intent to link to diagnosis or to a biopsy (laboratory test or diagnostic study?).

( Last("Prostate Cancer Diagnosis" ProstateCancerDx
with "First Prostate Cancer Treatment during day of Measurement Period" FirstProstateCancerTreatment
such that ProstateCancerDx.prevalencePeriod starts before start of Global."NormalizeInterval"(FirstProstateCancerTreatment.relevantDatetime, FirstProstateCancerTreatment.relevantPeriod)
sort by start of prevalencePeriod
) ) LastProstateCaWithTx
where ( LastProstateCaWithTx.severity ~ "American Joint Committee on Cancer cT1a (qualifier value)"
or LastProstateCaWithTx.severity ~ "American Joint Committee on Cancer cT1b (qualifier value)"
or LastProstateCaWithTx.severity ~ "American Joint Committee on Cancer cT1c (qualifier value)"
or LastProstateCaWithTx.severity ~ "American Joint Committee on Cancer cT2a (qualifier value)"

Logic for Diagnostic study:
( "Prostate Cancer Diagnosis" ProstateCancerDx
where Last(["Diagonostic Study, Performed": "Tumor staging (tumor staging)"] ProstateCancerStaging
with "First Prostate Cancer Treatment during day of Measurement Period" FirstProstateCancerTreatment
such that Global."NormalizeInterval"(ProstateCancerStaging.relevantDatetime, ProstateCancerStaging.relevantPeriod) starts before start of Global."NormalizeInterval"(FirstProstateCancerTreatment.relevantDatetime, FirstProstateCancerTreatment.relevantPeriod)
sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
) ) LastProstateCancerStaging
where ( LastProstateCancerStaging.result ~ "American Joint Committee on Cancer cT1a (qualifier value)"
or LastProstateCancerStaging.result ~ "American Joint Committee on Cancer cT1b (qualifier value)"
or LastProstateCancerStaging.result ~ "American Joint Committee on Cancer cT1c (qualifier value)"
or LastProstateCancerStaging.result ~ "American Joint Committee on Cancer cT2a (qualifier value)"
)

Would like to have your opinion on direction that would best capture provider workflow. This is time sensitive.