clinical-reasoning
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Use coded improvement notation
The logic currently looks for the word increase/decrease, rather than using the coded improvementNotation concepts (holdover from STU3 when it was only defined as text). Update this code to use the improvementNotation concepts
https://github.com/DBCG/cqf-ruler/blob/master/r4/src/main/java/org/opencds/cqf/r4/providers/MeasureOperationsProvider.java#L302