// The fixture's reading and check: the preview's real local reader and the real engine, // wrapped in the /api/clinician shapes. Clinician wording for the film's two rules is the PRD's. import type * as T from "../../src/api/types"; import type { Source } from "../../src/types"; import { assess } from "../../server/context"; import { extract, modelReady } from "../../server/model"; import { findingEvidence, patientProfile } from "../../src/flow"; import { notCheckedLines } from "../../src/logic/checks"; import { withEngineOptions } from "./engine-options"; import type { StoredRecord } from "./data"; import { nextId } from "./data"; export type StoredExtraction = T.Extraction & { sources: Source[] }; export const toSources = (records: StoredRecord[]): Source[] => records .filter((r) => r.reading === "read" && r.text) .map((r) => ({ id: r.id, title: r.title, kind: r.type, date: r.recordDate ?? "", text: r.text!, ...(r.clarifies ? { clarification: r.clarifies } : {}) })); /** Reads with the configured model (Meta Muse Spark) when there is one, else the local structured reader. */ export async function readRecords(patientId: string, records: StoredRecord[]): Promise { const sources = toSources(records); const draft = await extract(sources, modelReady()); return { ...draft, id: nextId("ext"), patientId, revision: 0, createdAt: new Date().toISOString(), records: records.filter((r) => !r.clarifies).map((r) => ({ recordId: r.id, title: r.title, status: r.heldBack ? "held_back" : r.reading === "read" ? "read" : r.reading === "failed" ? "failed" : "queued", error: r.reading === "failed" ? r.readingErrorCode ?? "READ_FAILED" : null, })), titles: { [`profile-${patientId}`]: "Patient profile", ...Object.fromEntries(records.map((r) => [r.id, r.title])) }, recordsNotReady: records.filter((r) => r.heldBack || r.reading !== "read").map((r) => ({ recordId: r.id, title: r.title, status: r.heldBack ? "held_back" : r.reading })), decisions: {}, coverageReview: {}, acknowledgedOriginals: false, confirmedHardToRead: [], stale: false, sources, }; } const day = (iso: string) => new Date(`${iso}T12:00:00Z`).toLocaleDateString("en-GB", { day: "numeric", month: "short", year: "numeric", timeZone: "UTC" }); const CLINICIAN_WORDING: Record string) => { title: string; explanation: string }> = { "allergy-penicillin": (facts, placeOf) => { const medicine = facts.find((f) => f.factId && /amoxicillin|ampicillin|augmentin|ampiclox/i.test(f.label)); const allergy = facts.find((f) => /penicillin/i.test(f.label) && !/amoxicillin/i.test(f.label)); return { title: `${medicine?.label ?? "Amoxicillin"} and a recorded Penicillin allergy`, explanation: `${medicine?.label ?? "Amoxicillin"} is in the penicillin class. A Penicillin allergy is recorded${allergy ? ` (${placeOf(allergy.recordId)})` : ""}. Its reaction and severity are not in a form the rules read.`, }; }, "lab-metformin-egfr-45": (facts, placeOf) => { const egfr = facts.find((f) => /egfr/i.test(f.label)); const date = egfr?.detail.split(" · ")[1]; return { title: "Metformin and the latest eGFR result", explanation: `${egfr ? `${egfr.label} (${placeOf(egfr.recordId)}, ${date ? day(date) : "date not recorded"})` : "The latest eGFR"} is in the range where the Metformin label limits the dose to 1,000 mg a day.`, }; }, }; const plainTitle = (title: string) => title.replace(/^(Call today|Get help now|Ask this week|Good to know):\s*/i, "").replace(/\btheir\b/g, "a recorded"); export function runCheckRun( ex: StoredExtraction, records: StoredRecord[], ranBy: string, withheldSome: boolean, newMedicineNames: string[], reactions: Record = {}, ): T.CheckRun { const assessment = assess(ex.sources, ex.decisions, ex.fingerprint, ex.acknowledgedOriginals, ex, ex.coverageReview); const title = (id: string) => records.find((r) => r.id === id)?.title ?? "Record"; const refs = assessment.contextual.what_we_checked.references; const details: Record = {}; for (const finding of assessment.contextual.findings) { const facts: T.FactRef[] = findingEvidence(assessment, finding).map((f) => ({ factId: f.id, label: f.label, detail: f.detail, recordId: f.sourceId, recordTitle: title(f.sourceId), line: f.line, quote: f.quote, })); const placeOf = (id: string) => records.find((r) => r.id === id)?.place ?? title(id); const wording = CLINICIAN_WORDING[finding.ruleId]?.(facts, placeOf) ?? { title: plainTitle(finding.title), explanation: finding.clinical || finding.why }; details[finding.id] = { findingId: finding.id, ruleId: finding.ruleId, ruleReviewed: assessment.contextual.rulesReviewed, // As the backend: the engine's clinician option wrote the film's two, the rest come from the rule's note. wording: CLINICIAN_WORDING[finding.ruleId] ? "engine" : "derived", clinicianTitle: wording.title, clinicianExplanation: wording.explanation, references: finding.source_ids.map((id) => { const ref = refs.find((r) => r.id === id); return { name: ref?.name ?? id, version: null, section: null, date: null, url: ref?.url ?? null }; }), factsUsed: facts, questions: [], }; } const profile = patientProfile(assessment); const missingFactors: T.MissingFactor[] = profile .filter((p) => p.status === "missing") .map((p) => ({ id: p.id, label: p.label, reason: p.note, questions: [] })); const meds = assessment.includedFacts.filter((f) => f.kind === "medicine"); const monitoring: T.CheckRun["monitoring"] = assessment.contextual.tests_to_ask_about.map((t) => ({ test: t.test, medicines: [...new Set(meds.filter((m) => t.why.toLowerCase().includes(m.label.toLowerCase())).map((m) => m.label))], onFile: t.last_result_at, status: t.status, })); if (missingFactors.some((m) => m.id === "weight")) monitoring.push({ test: "Weight", medicines: [], onFile: null, status: "no_result" }); const products = Object.values(assessment.coverageReview ?? {}).length ? (assessment.coverage ?? []).filter((c) => assessment.coverageReview?.[c.id]).map((c) => c.text) : []; const notChecked: T.NotChecked = { productsWithoutRules: [...new Set(products)], unconfirmedFacts: assessment.excludedFacts.length + ex.unparsed.length, rulesAwaitingReview: assessment.contextual.rulesReviewed ? 0 : 8, checkInAnswers: true, other: assessment.contextual.what_we_couldnt_check.some((c) => c.reason === "condition") ? [`Conditions are recorded but no rule reads them: ${assessment.contextual.what_we_couldnt_check.filter((c) => c.reason === "condition").map((c) => c.item).join(", ")}.`] : [], }; const egfrFact = assessment.includedFacts.find((f) => f.kind === "lab" && /^egfr /i.test(f.label)); const egfr = egfrFact ? { value: Number(egfrFact.label.split(" ")[1]), date: egfrFact.detail.split(" · ")[1] ?? "" } : null; assessment.contextual = withEngineOptions( assessment.contextual, Object.fromEntries(Object.values(details).map((d) => [d.findingId, { title: d.clinicianTitle, explanation: d.clinicianExplanation }])), reactions, meds.map((m) => ({ id: m.id, label: m.label, detail: m.detail })), notCheckedLines(notChecked, assessment.contextual.rulesReviewed), egfr && Number.isFinite(egfr.value) ? egfr : null, ); const before = assessment.baseline.findings.length; const after = assessment.contextual.findings.length; const added = assessment.addedRuleIds.length; const urgentIds = assessment.contextual.findings.filter((f) => f.tier === "get_help_now").map((f) => f.id); return { id: nextId("chk"), patientId: ex.patientId, extractionId: ex.id, revision: ex.revision, ranAt: new Date().toISOString(), ranBy, checkedOn: new Date(Date.now() + 3_600_000).toISOString().slice(0, 10), summary: { before, after, added, headline: added ? `Personalized: ${added} ${added === 1 ? "finding" : "findings"} the medication list alone did not show.` : after ? `${after} findings for clinician review.` : "No findings. This does not mean the prescription is safe.", subline: "Each finding links back to the record lines it came from. The clinician makes every decision.", }, urgentReview: { show: urgentIds.length > 0, findingIds: urgentIds, line: urgentIds.length ? "Urgent review: phone the patient before the next dose." : null }, latest: true, newInformation: null, informationTool: "MARMAR Context shows information and where it came from. The clinician makes every decision.", assessment, recordTitles: Object.fromEntries(records.map((r) => [r.id, r.title])), details, marks: [], missingFactors, newMedicineIds: meds.filter((m) => newMedicineNames.includes(m.label.toLowerCase())).map((m) => m.id), monitoring, notChecked, withheldSome, versions: { engine: assessment.contextual.engineVersion, rules: assessment.contextual.rulesVersion, rulesReviewed: assessment.contextual.rulesReviewed, signedOffOnly: false, optionsVersion: null, }, }; } /** The printable page the backend answers for format=pdf (it has no PDF library): escaped text, no scripts. */ export function printableHtml(title: string, lines: string[]): string { const esc = (s: string) => s.replace(/[&<>"']/g, (c) => `&#${c.charCodeAt(0)};`); return `${esc(title)}

${esc(title)}

${lines .map((l) => (l ? `

${esc(l)}

` : "")) .join("")}`; } /** The readable export: patient, sources, decisions, both results, findings, marks, versions. */ export function exportLines(check: T.CheckRun, patientName: string, clinicianName: string, records: StoredRecord[]): string[] { const a = check.assessment; const lines = [ `Patient: ${patientName}`, `Checked: ${check.ranAt} by ${clinicianName}`, `Engine ${check.versions.engine}, rules ${check.versions.rules}${check.versions.rulesReviewed ? "" : " (rules not yet reviewed)"}`, "", `The medication list alone: ${a.baseline.findings.length} findings. Personalized: ${a.contextual.findings.length} findings.`, a.contextual.findings.length ? "" : "No findings. This does not mean the prescription is safe.", "Findings, for clinician review:", ...a.contextual.findings.flatMap((f) => { const d = check.details[f.id]; const mark = check.marks.filter((m) => m.findingId === f.id).at(-1); return [ `- ${d?.clinicianTitle ?? f.title} (${f.tier})`, ` ${d?.clinicianExplanation ?? f.clinical}`, ...(d?.factsUsed ?? []).map((x) => ` Based on: ${x.label}, ${x.recordTitle} line ${x.line}: "${x.quote}"`), ...(d?.references ?? []).map((r) => ` Reference: ${r.name}${r.version ? `, ${r.version}` : ", version not recorded"}`), mark ? ` Marked ${mark.kind.replace("_", " ")} by ${mark.by}${mark.reason ? `: ${mark.reason}` : ""}` : " Not marked", ]; }), "", "Records and review decisions:", ...records.map((r) => `- ${r.title}${r.place ? `, ${r.place}` : ""}${r.recordDate ? `, ${r.recordDate}` : ""}`), ...a.includedFacts.map((f) => ` Included: ${f.label} (${f.detail})`), ...a.excludedFacts.map((f) => ` Excluded: ${f.label} (${f.detail})`), "", "Not checked:", ...check.notChecked.productsWithoutRules.map((p) => `- ${p}: recorded, no rules for this product yet`), `- ${check.notChecked.unconfirmedFacts} facts or lines not confirmed for the check`, `- ${check.notChecked.rulesAwaitingReview} rule changes waiting for clinical review`, "- Answers from check-ins: no rule reads them", ...check.notChecked.other.map((o) => `- ${o}`), "", "MARMAR Context shows information and where it came from. The clinician makes every decision.", ]; return lines; }