Merge pull request #726 from MBombeck/feat/lab-source-reference-ranges

Carry the reference range printed on the lab report
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Marc-André Bombeck authored and GitHub committed 2026-08-08 02:46:16 +02:00
commit 1c135dfe48
57 files changed
+2281 -175

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+172 -9
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@@ -9147,6 +9147,16 @@ paths:
type: number
referenceHigh:
type: number
sourceReferenceLow:
type: number
sourceReferenceHigh:
type: number
sourceReferenceText:
anyOf:
- type: string
maxLength: 120
- type: string
const: ""
takenAt:
type: string
format: date-time
@@ -9254,6 +9264,22 @@ paths:
anyOf:
- type: number
- type: "null"
sourceReferenceLow:
anyOf:
- type: number
- type: "null"
sourceReferenceHigh:
anyOf:
- type: number
- type: "null"
sourceReferenceText:
anyOf:
- anyOf:
- type: string
maxLength: 120
- type: string
const: ""
- type: "null"
takenAt:
type: string
format: date-time
@@ -9430,6 +9456,12 @@ paths:
type: number
referenceHigh:
type: number
referenceText:
anyOf:
- type: string
maxLength: 120
- type: string
const: ""
takenAt:
type: string
format: date-time
@@ -11616,6 +11648,11 @@ paths:
anyOf:
- type: number
- type: "null"
referenceText:
anyOf:
- type: string
maxLength: 120
- type: "null"
effectiveDate:
anyOf:
- type: string
@@ -32974,6 +33011,30 @@ components:
anyOf:
- type: number
- type: "null"
catalogReferenceLow:
anyOf:
- type: number
- type: "null"
catalogReferenceHigh:
anyOf:
- type: number
- type: "null"
sourceReferenceLow:
anyOf:
- type: number
- type: "null"
sourceReferenceHigh:
anyOf:
- type: number
- type: "null"
sourceReferenceText:
anyOf:
- type: string
- type: "null"
referenceOrigin:
$ref: "#/components/schemas/LabReferenceRangeOrigin"
referenceDivergesFromCatalog:
type: boolean
takenAt:
type: string
source:
@@ -32996,6 +33057,13 @@ components:
- unit
- referenceLow
- referenceHigh
- catalogReferenceLow
- catalogReferenceHigh
- sourceReferenceLow
- sourceReferenceHigh
- sourceReferenceText
- referenceOrigin
- referenceDivergesFromCatalog
- takenAt
- source
- hasNote
@@ -33003,12 +33071,31 @@ components:
- createdAt
- updatedAt
additionalProperties: false
description: A stored lab result. Exactly one of `value` (numeric) or `valueText` (qualitative, e.g. "negativ") is
non-null; `rangeStatus` is always `unknown` for a qualitative row (no number to classify). `biomarkerId` links
the user-scoped catalog marker (null for legacy free-text rows); when linked, `analyte` / `unit` /
`referenceLow` / `referenceHigh` are RESOLVED server-side from the Biomarker — the client renders them and never
recomputes the range. The encrypted note is never echoed in list rows; `hasNote` flags its presence and the
single-resource GET returns the decrypted `note`.
description: >-
A stored lab result. Exactly one of `value` (numeric) or `valueText` (qualitative, e.g. "negativ") is non-null;
`rangeStatus` is always `unknown` for a qualitative row (no number to classify). `biomarkerId` links the
user-scoped catalog marker (null for legacy free-text rows); when linked, `analyte` / `unit` are RESOLVED
server-side from the Biomarker.
Three reference windows ride on the row and the server says which one applies. `referenceLow` / `referenceHigh`
are the window IN FORCE and the one `rangeStatus` was computed from — read these to render the range and you are
correct without doing any resolution of your own. `sourceReferenceLow` / `sourceReferenceHigh` /
`sourceReferenceText` are the range this reading's own report printed (the text verbatim, kept even when no
numbers could be read out of it). `catalogReferenceLow` / `catalogReferenceHigh` are the Biomarker band.
`referenceOrigin` names the winner and `referenceDivergesFromCatalog` is true when the report's window and the
catalog band state different limits — a surface showing only one of the two is showing a partial answer. The
client renders these values and never recomputes the range. The encrypted note is never echoed in list rows;
`hasNote` flags its presence and the single-resource GET returns the decrypted `note`.
LabReferenceRangeOrigin:
type: string
enum:
- source
- catalog
- none
description: Which window `referenceLow` / `referenceHigh` came from. `source` = the range printed on this reading's own
report, which wins for that reading because it is the window the physician evaluated the value against.
`catalog` = the user's Biomarker band, the net for readings with no printed range. `none` = no window on file.
LabReferenceRangeStatus:
type: string
enum:
@@ -33016,9 +33103,9 @@ components:
- below
- above
- unknown
description: "Server-computed, NEUTRAL reference-range verdict. `unknown` when the lab reported no usable bounds.
Inclusive bounds: a value on the limit reads in-range. The badge that renders this must stay calm and
informative — not an alarming red."
description: "Server-computed, NEUTRAL reference-range verdict, always against `referenceLow` / `referenceHigh` (the
window in force for that reading). `unknown` when no usable bounds are on file. Inclusive bounds: a value on the
limit reads in-range. The badge that renders this must stay calm and informative — not an alarming red."
CreateLabResultResponse:
type: object
properties:
@@ -33086,6 +33173,30 @@ components:
anyOf:
- type: number
- type: "null"
catalogReferenceLow:
anyOf:
- type: number
- type: "null"
catalogReferenceHigh:
anyOf:
- type: number
- type: "null"
sourceReferenceLow:
anyOf:
- type: number
- type: "null"
sourceReferenceHigh:
anyOf:
- type: number
- type: "null"
sourceReferenceText:
anyOf:
- type: string
- type: "null"
referenceOrigin:
$ref: "#/components/schemas/LabReferenceRangeOrigin"
referenceDivergesFromCatalog:
type: boolean
takenAt:
type: string
source:
@@ -33110,6 +33221,13 @@ components:
- unit
- referenceLow
- referenceHigh
- catalogReferenceLow
- catalogReferenceHigh
- sourceReferenceLow
- sourceReferenceHigh
- sourceReferenceText
- referenceOrigin
- referenceDivergesFromCatalog
- takenAt
- source
- rangeStatus
@@ -33292,6 +33410,14 @@ components:
anyOf:
- type: number
- type: "null"
referenceText:
anyOf:
- type: string
- type: "null"
description: The reference range EXACTLY as printed on the report, verbatim ("3,5 - 5,0", "< 116", "bis 5,0",
"negativ"). `referenceLow` / `referenceHigh` carry the same window reduced to numbers WHEN it reduces to
numbers; this field carries it either way, so a window stated in words is not lost between the report and
the reading.
takenAt:
anyOf:
- type: string
@@ -33329,6 +33455,7 @@ components:
- unit
- referenceLow
- referenceHigh
- referenceText
- takenAt
- confidence
- biomarkerMatch
@@ -33426,6 +33553,34 @@ components:
anyOf:
- type: number
- type: "null"
catalogReferenceLow:
anyOf:
- type: number
- type: "null"
catalogReferenceHigh:
anyOf:
- type: number
- type: "null"
sourceReferenceLow:
anyOf:
- type: number
- type: "null"
sourceReferenceHigh:
anyOf:
- type: number
- type: "null"
sourceReferenceText:
anyOf:
- type: string
- type: "null"
referenceOrigin:
type: string
enum:
- source
- catalog
- none
referenceDivergesFromCatalog:
type: boolean
takenAt:
type: string
source:
@@ -33453,6 +33608,13 @@ components:
- unit
- referenceLow
- referenceHigh
- catalogReferenceLow
- catalogReferenceHigh
- sourceReferenceLow
- sourceReferenceHigh
- sourceReferenceText
- referenceOrigin
- referenceDivergesFromCatalog
- takenAt
- source
- hasNote
@@ -33460,6 +33622,7 @@ components:
- createdAt
- updatedAt
additionalProperties: false
description: A written reading. Its reference window resolves exactly as it does on `/api/labs` — see `LabResult`.
ListBiomarkersEnvelope:
type: object
properties:
+21 -5
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@@ -281,7 +281,9 @@
"familyHistoryTitle": "Familienanamnese",
"familyHistoryColRelationship": "Verwandtschaft",
"familyHistoryColCondition": "Erkrankung",
"familyHistoryColAgeAtOnset": "Alter bei Beginn"
"familyHistoryColAgeAtOnset": "Alter bei Beginn",
"labsSourceRangeNote": "* Der Referenzbereich stammt aus dem Befund und weicht vom gespeicherten Bereich ab:",
"labsCatalogRangeLabel": "gespeicherter Bereich"
},
"errorBoundary": {
"title": "Da ist etwas schiefgelaufen",
@@ -8047,7 +8049,12 @@
"qualitativePlaceholder": "z. B. negativ",
"qualNegative": "negativ",
"qualPositive": "positiv",
"qualBorderline": "grenzwertig"
"qualBorderline": "grenzwertig",
"sourceRange": "Bereich laut Befund",
"sourceRangePlaceholder": "z. B. 3,5 - 5,0 oder < 5",
"sourceRangeAdd": "+ Bereich aus dem Befund ergänzen",
"sourceRangeHint": "Optional. Gilt nur für diesen Wert; dein gespeicherter Bereich bleibt unverändert.",
"sourceRangeUnparsed": "Wird so übernommen — daraus ließ sich kein Zahlenbereich lesen."
},
"backToLabs": "Zurück zu den Laborwerten",
"hasNote": "Notiz",
@@ -8078,7 +8085,10 @@
"90": "90 T",
"365": "1 J",
"all": "Alle"
}
},
"sourceRangeLabel": "Befundbereich",
"sourceBandLegend": "Zweites Band: der Bereich aus dem Befund vom {date}.",
"sourceBandMixed": "Zweites Band: der Bereich aus dem neuesten Befund. Frühere Befunde im Zeitraum nennen andere Bereiche."
},
"biomarker": {
"manageTitle": "Biomarker",
@@ -8253,11 +8263,17 @@
"fileTooLarge": "Datei ist zu groß (max. 12 MB).",
"fileType": "Lade ein JPEG, PNG, WebP oder PDF hoch.",
"extractFailed": "Der Befund konnte nicht gelesen werden. Versuche ein schärferes Foto.",
"pdfNeedsAnthropic": "PDF-Scannen benötigt einen Claude-Bildanbieter; lade stattdessen ein Foto hoch."
"pdfNeedsAnthropic": "PDF-Scannen benötigt einen Claude-Bildanbieter; lade stattdessen ein Foto hoch.",
"refTextLabel": "Bereich wie gedruckt",
"refTextPlaceholder": "z. B. 3,5 - 5,0"
},
"loadMoreReadings": "Weitere Werte laden",
"documentsLink": "Befund-Dokumente",
"notLinkedYet": "Noch keinem Biomarker zugeordnet"
"notLinkedYet": "Noch keinem Biomarker zugeordnet",
"sourceRange": {
"fromReport": "Befundbereich {range}",
"catalogDiffers": "dein Bereich {range}"
}
},
"modules": {
"cycle": {
+21 -5
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@@ -281,7 +281,9 @@
"familyHistoryTitle": "Family history",
"familyHistoryColRelationship": "Relative",
"familyHistoryColCondition": "Condition",
"familyHistoryColAgeAtOnset": "Age at onset"
"familyHistoryColAgeAtOnset": "Age at onset",
"labsSourceRangeNote": "* The reference range comes from the report itself and differs from the saved range:",
"labsCatalogRangeLabel": "saved range"
},
"errorBoundary": {
"title": "Something went wrong",
@@ -8047,7 +8049,12 @@
"qualitativePlaceholder": "e.g. negative",
"qualNegative": "negative",
"qualPositive": "positive",
"qualBorderline": "borderline"
"qualBorderline": "borderline",
"sourceRange": "Range printed on the report",
"sourceRangePlaceholder": "e.g. 3.5 - 5.0 or < 5",
"sourceRangeAdd": "+ Add the range from the report",
"sourceRangeHint": "Optional. Applies to this reading only; your saved range stays as it is.",
"sourceRangeUnparsed": "Kept as written — no numeric range read from it."
},
"backToLabs": "Back to lab results",
"hasNote": "Note",
@@ -8078,7 +8085,10 @@
"90": "90d",
"365": "1y",
"all": "All"
}
},
"sourceRangeLabel": "Report range",
"sourceBandLegend": "Second band: the range printed on the report of {date}.",
"sourceBandMixed": "Second band: the range printed on the most recent report. Earlier reports in view state different ranges."
},
"biomarker": {
"manageTitle": "Biomarkers",
@@ -8253,11 +8263,17 @@
"fileTooLarge": "File is too large (max 12 MB).",
"fileType": "Upload a JPEG, PNG, WebP, or PDF.",
"extractFailed": "Couldn't read the report. Try a clearer photo.",
"pdfNeedsAnthropic": "PDF scanning needs a Claude vision provider; upload a photo instead."
"pdfNeedsAnthropic": "PDF scanning needs a Claude vision provider; upload a photo instead.",
"refTextLabel": "Range as printed",
"refTextPlaceholder": "e.g. 3.5 - 5.0"
},
"loadMoreReadings": "Load more readings",
"documentsLink": "Lab report documents",
"notLinkedYet": "Not linked to a biomarker yet"
"notLinkedYet": "Not linked to a biomarker yet",
"sourceRange": {
"fromReport": "Report range {range}",
"catalogDiffers": "your range {range}"
}
},
"modules": {
"cycle": {
+21 -5
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@@ -281,7 +281,9 @@
"familyHistoryTitle": "Antecedentes familiares",
"familyHistoryColRelationship": "Parentesco",
"familyHistoryColCondition": "Afección",
"familyHistoryColAgeAtOnset": "Edad de inicio"
"familyHistoryColAgeAtOnset": "Edad de inicio",
"labsSourceRangeNote": "* El rango de referencia procede del propio informe y difiere del rango guardado:",
"labsCatalogRangeLabel": "rango guardado"
},
"errorBoundary": {
"title": "Algo ha salido mal",
@@ -8047,7 +8049,12 @@
"qualitativePlaceholder": "p. ej. negativo",
"qualNegative": "negativo",
"qualPositive": "positivo",
"qualBorderline": "límite"
"qualBorderline": "límite",
"sourceRange": "Rango impreso en el informe",
"sourceRangePlaceholder": "p. ej. 3,5 - 5,0 o < 5",
"sourceRangeAdd": "+ Añadir el rango del informe",
"sourceRangeHint": "Opcional. Se aplica solo a esta lectura; tu rango guardado no cambia.",
"sourceRangeUnparsed": "Se guarda tal cual: no se pudo leer un rango numérico."
},
"backToLabs": "Volver a los resultados",
"hasNote": "Nota",
@@ -8078,7 +8085,10 @@
"90": "90 d",
"365": "1 a",
"all": "Todo"
}
},
"sourceRangeLabel": "Rango del informe",
"sourceBandLegend": "Segunda banda: el rango impreso en el informe del {date}.",
"sourceBandMixed": "Segunda banda: el rango impreso en el informe más reciente. Informes anteriores del periodo indican rangos distintos."
},
"biomarker": {
"manageTitle": "Biomarcadores",
@@ -8253,11 +8263,17 @@
"fileTooLarge": "El archivo es demasiado grande (máx. 12 MB).",
"fileType": "Sube un JPEG, PNG, WebP o PDF.",
"extractFailed": "No se pudo leer el informe. Prueba con una foto más nítida.",
"pdfNeedsAnthropic": "El escaneo de PDF necesita un proveedor de visión de Claude; sube una foto en su lugar."
"pdfNeedsAnthropic": "El escaneo de PDF necesita un proveedor de visión de Claude; sube una foto en su lugar.",
"refTextLabel": "Rango tal como aparece",
"refTextPlaceholder": "p. ej. 3,5 - 5,0"
},
"loadMoreReadings": "Cargar más mediciones",
"documentsLink": "Documentos de resultados",
"notLinkedYet": "Aún no vinculado a un biomarcador"
"notLinkedYet": "Aún no vinculado a un biomarcador",
"sourceRange": {
"fromReport": "Rango del informe {range}",
"catalogDiffers": "tu rango {range}"
}
},
"modules": {
"cycle": {
+21 -5
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@@ -281,7 +281,9 @@
"familyHistoryTitle": "Antécédents familiaux",
"familyHistoryColRelationship": "Lien de parenté",
"familyHistoryColCondition": "Affection",
"familyHistoryColAgeAtOnset": "Âge au début"
"familyHistoryColAgeAtOnset": "Âge au début",
"labsSourceRangeNote": "* La plage de référence provient du compte rendu lui-même et diffère de la plage enregistrée :",
"labsCatalogRangeLabel": "plage enregistrée"
},
"errorBoundary": {
"title": "Une erreur est survenue",
@@ -8047,7 +8049,12 @@
"qualitativePlaceholder": "p. ex. négatif",
"qualNegative": "négatif",
"qualPositive": "positif",
"qualBorderline": "limite"
"qualBorderline": "limite",
"sourceRange": "Plage imprimée sur le compte rendu",
"sourceRangePlaceholder": "p. ex. 3,5 - 5,0 ou < 5",
"sourceRangeAdd": "+ Ajouter la plage du compte rendu",
"sourceRangeHint": "Facultatif. Ne vaut que pour cette mesure ; votre plage enregistrée reste inchangée.",
"sourceRangeUnparsed": "Conservé tel quel : aucune plage numérique n'a pu en être lue."
},
"backToLabs": "Retour aux résultats",
"hasNote": "Note",
@@ -8078,7 +8085,10 @@
"90": "90 j",
"365": "1 a",
"all": "Tout"
}
},
"sourceRangeLabel": "Plage du compte rendu",
"sourceBandLegend": "Deuxième bande : la plage imprimée sur le compte rendu du {date}.",
"sourceBandMixed": "Deuxième bande : la plage imprimée sur le compte rendu le plus récent. Des comptes rendus antérieurs de la période indiquent d'autres plages."
},
"biomarker": {
"manageTitle": "Biomarqueurs",
@@ -8253,11 +8263,17 @@
"fileTooLarge": "Le fichier est trop volumineux (max. 12 Mo).",
"fileType": "Importez un JPEG, PNG, WebP ou PDF.",
"extractFailed": "Impossible de lire le compte rendu. Essayez une photo plus nette.",
"pdfNeedsAnthropic": "Le scan PDF nécessite un fournisseur de vision Claude ; importez plutôt une photo."
"pdfNeedsAnthropic": "Le scan PDF nécessite un fournisseur de vision Claude ; importez plutôt une photo.",
"refTextLabel": "Plage telle qu'imprimée",
"refTextPlaceholder": "p. ex. 3,5 - 5,0"
},
"loadMoreReadings": "Charger plus de mesures",
"documentsLink": "Documents de résultats",
"notLinkedYet": "Pas encore lié à un biomarqueur"
"notLinkedYet": "Pas encore lié à un biomarqueur",
"sourceRange": {
"fromReport": "Plage du compte rendu {range}",
"catalogDiffers": "votre plage {range}"
}
},
"modules": {
"cycle": {
+21 -5
View File
@@ -281,7 +281,9 @@
"familyHistoryTitle": "Anamnesi familiare",
"familyHistoryColRelationship": "Parentela",
"familyHistoryColCondition": "Condizione",
"familyHistoryColAgeAtOnset": "Età di esordio"
"familyHistoryColAgeAtOnset": "Età di esordio",
"labsSourceRangeNote": "* L'intervallo di riferimento proviene dal referto stesso e differisce da quello salvato:",
"labsCatalogRangeLabel": "intervallo salvato"
},
"errorBoundary": {
"title": "Qualcosa è andato storto",
@@ -8047,7 +8049,12 @@
"qualitativePlaceholder": "es. negativo",
"qualNegative": "negativo",
"qualPositive": "positivo",
"qualBorderline": "borderline"
"qualBorderline": "borderline",
"sourceRange": "Intervallo stampato sul referto",
"sourceRangePlaceholder": "es. 3,5 - 5,0 oppure < 5",
"sourceRangeAdd": "+ Aggiungi l'intervallo dal referto",
"sourceRangeHint": "Facoltativo. Vale solo per questa misura; l'intervallo salvato resta invariato.",
"sourceRangeUnparsed": "Conservato così com'è: non è stato letto alcun intervallo numerico."
},
"backToLabs": "Torna ai risultati",
"hasNote": "Nota",
@@ -8078,7 +8085,10 @@
"90": "90 g",
"365": "1 a",
"all": "Tutto"
}
},
"sourceRangeLabel": "Intervallo del referto",
"sourceBandLegend": "Seconda banda: l'intervallo stampato sul referto del {date}.",
"sourceBandMixed": "Seconda banda: l'intervallo stampato sul referto più recente. Referti precedenti nel periodo indicano intervalli diversi."
},
"biomarker": {
"manageTitle": "Biomarcatori",
@@ -8253,11 +8263,17 @@
"fileTooLarge": "Il file è troppo grande (max 12 MB).",
"fileType": "Carica un JPEG, PNG, WebP o PDF.",
"extractFailed": "Impossibile leggere il referto. Prova con una foto più nitida.",
"pdfNeedsAnthropic": "La scansione PDF richiede un provider di visione Claude; carica invece una foto."
"pdfNeedsAnthropic": "La scansione PDF richiede un provider di visione Claude; carica invece una foto.",
"refTextLabel": "Intervallo come stampato",
"refTextPlaceholder": "es. 3,5 - 5,0"
},
"loadMoreReadings": "Carica altre misurazioni",
"documentsLink": "Documenti dei referti",
"notLinkedYet": "Non ancora collegato a un biomarcatore"
"notLinkedYet": "Non ancora collegato a un biomarcatore",
"sourceRange": {
"fromReport": "Intervallo del referto {range}",
"catalogDiffers": "il tuo intervallo {range}"
}
},
"modules": {
"cycle": {
+21 -5
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@@ -281,7 +281,9 @@
"familyHistoryTitle": "Wywiad rodzinny",
"familyHistoryColRelationship": "Pokrewieństwo",
"familyHistoryColCondition": "Schorzenie",
"familyHistoryColAgeAtOnset": "Wiek zachorowania"
"familyHistoryColAgeAtOnset": "Wiek zachorowania",
"labsSourceRangeNote": "* Zakres referencyjny pochodzi z samego wyniku i różni się od zapisanego zakresu:",
"labsCatalogRangeLabel": "zapisany zakres"
},
"errorBoundary": {
"title": "Coś poszło nie tak",
@@ -8047,7 +8049,12 @@
"qualitativePlaceholder": "np. ujemny",
"qualNegative": "ujemny",
"qualPositive": "dodatni",
"qualBorderline": "graniczny"
"qualBorderline": "graniczny",
"sourceRange": "Zakres wydrukowany na wyniku",
"sourceRangePlaceholder": "np. 3,5 - 5,0 lub < 5",
"sourceRangeAdd": "+ Dodaj zakres z wyniku",
"sourceRangeHint": "Opcjonalne. Dotyczy tylko tego pomiaru; zapisany zakres pozostaje bez zmian.",
"sourceRangeUnparsed": "Zapisane bez zmian — nie odczytano z tego zakresu liczbowego."
},
"backToLabs": "Wróć do wyników",
"hasNote": "Notatka",
@@ -8078,7 +8085,10 @@
"90": "90 d",
"365": "1 r",
"all": "Wszystko"
}
},
"sourceRangeLabel": "Zakres z wyniku",
"sourceBandLegend": "Drugie pasmo: zakres wydrukowany na wyniku z {date}.",
"sourceBandMixed": "Drugie pasmo: zakres z najnowszego wyniku. Wcześniejsze wyniki w tym okresie podają inne zakresy."
},
"biomarker": {
"manageTitle": "Biomarkery",
@@ -8253,11 +8263,17 @@
"fileTooLarge": "Plik jest za duży (maks. 12 MB).",
"fileType": "Prześlij plik JPEG, PNG, WebP lub PDF.",
"extractFailed": "Nie udało się odczytać wyniku. Spróbuj wyraźniejszego zdjęcia.",
"pdfNeedsAnthropic": "Skanowanie PDF wymaga dostawcy wizji Claude; prześlij zamiast tego zdjęcie."
"pdfNeedsAnthropic": "Skanowanie PDF wymaga dostawcy wizji Claude; prześlij zamiast tego zdjęcie.",
"refTextLabel": "Zakres tak jak wydrukowano",
"refTextPlaceholder": "np. 3,5 - 5,0"
},
"loadMoreReadings": "Wczytaj więcej pomiarów",
"documentsLink": "Dokumenty wyników badań",
"notLinkedYet": "Jeszcze niepowiązane z biomarkerem"
"notLinkedYet": "Jeszcze niepowiązane z biomarkerem",
"sourceRange": {
"fromReport": "Zakres z wyniku {range}",
"catalogDiffers": "twój zakres {range}"
}
},
"modules": {
"cycle": {
@@ -0,0 +1,14 @@
-- Per-reading source reference range on a lab result.
--
-- A lab report prints the window its own method and device produce, right
-- beside the value, and that window is what a physician evaluates against.
-- Until now the document reading pulled the value and dropped the range.
-- These three columns carry it: the derived numeric bounds where the printed
-- string yields them, plus the report's verbatim string, which is stored
-- whether or not it parsed. Nothing is backfilled — an existing row genuinely
-- has no source range on file and stays NULL.
ALTER TABLE "lab_results"
ADD COLUMN "source_reference_low" DOUBLE PRECISION,
ADD COLUMN "source_reference_high" DOUBLE PRECISION,
ADD COLUMN "source_reference_text" TEXT;
+33 -1
View File
@@ -5005,9 +5005,41 @@ model LabResult {
/// reference bounds + range verdict are meaningless for a qualitative row.
valueText String? @map("value_text")
unit String
/// Optional reference-range bounds as reported by the lab.
/// Reference-range bounds stamped onto the row at write time. Despite the
/// name these are NOT the lab's printed range: since v1.18.1 every write
/// path copies the linked `Biomarker`'s `lowerBound` / `upperBound` here as
/// historical truth, so a later catalog edit does not silently rewrite a
/// past reading. The range the LAB printed lives in `sourceReference*`.
referenceLow Float? @map("reference_low")
referenceHigh Float? @map("reference_high")
/// The reference range as PRINTED ON THE SOURCE REPORT for this one reading.
///
/// Labs run different methods on different devices, so the window a
/// physician evaluates against is the one printed beside the value on that
/// report — not a catalog band that averages every lab. These three columns
/// carry it: the parsed numeric bounds where a bound could be derived, and
/// `sourceReferenceText` as the report's own verbatim string ("< 5",
/// "bis 5,0", "negativ", "siehe Befund"). The text is kept whenever the
/// source printed one, parseable or not — absence reads as absence, and a
/// window that could not be derived is never invented.
///
/// Precedence: for a single reading the source bounds win over the catalog
/// band; the catalog stays the net for readings that carry no source range.
/// `resolveEffectiveReferenceRange` in `src/lib/labs/reference-range.ts` is
/// the one place that rule is expressed, and every surface that judges a
/// reading routes through it.
///
/// Plaintext, not `*Encrypted`: that suffix marks user prose (`noteEncrypted`
/// here, `Biomarker.contextEncrypted` next door). This is a structured
/// lab-report field of exactly the class of the plaintext `analyte` / `unit`
/// / `value` / `valueText` columns beside it — `valueText` already carries
/// the actual clinical RESULT ("positiv") in the clear, so encrypting the
/// window that result is judged against would protect strictly less while
/// making the column unreadable to the SQL the read paths run.
sourceReferenceLow Float? @map("source_reference_low")
sourceReferenceHigh Float? @map("source_reference_high")
sourceReferenceText String? @map("source_reference_text")
/// When the sample was taken (UTC instant; wall-clock anchoring is the
/// reader's concern per the schema's UTC-only convention).
takenAt DateTime @map("taken_at")
@@ -724,6 +724,13 @@ const OCR_EXCEPTIONS: Readonly<Record<string, string>> = {
"inserted.unit": OCR_ROW_EXCEPTION,
"inserted.referenceLow": OCR_ROW_EXCEPTION,
"inserted.referenceHigh": OCR_ROW_EXCEPTION,
"inserted.catalogReferenceLow": OCR_ROW_EXCEPTION,
"inserted.catalogReferenceHigh": OCR_ROW_EXCEPTION,
"inserted.sourceReferenceLow": OCR_ROW_EXCEPTION,
"inserted.sourceReferenceHigh": OCR_ROW_EXCEPTION,
"inserted.sourceReferenceText": OCR_ROW_EXCEPTION,
"inserted.referenceOrigin": OCR_ROW_EXCEPTION,
"inserted.referenceDivergesFromCatalog": OCR_ROW_EXCEPTION,
"inserted.takenAt": OCR_ROW_EXCEPTION,
"inserted.source": OCR_ROW_EXCEPTION,
"inserted.hasNote": OCR_ROW_EXCEPTION,
@@ -967,6 +967,9 @@ const handler = apiHandler(
unit: lab.unit,
referenceLow: lab.referenceLow ?? null,
referenceHigh: lab.referenceHigh ?? null,
sourceReferenceLow: lab.sourceReferenceLow ?? null,
sourceReferenceHigh: lab.sourceReferenceHigh ?? null,
sourceReferenceText: lab.sourceReferenceText ?? null,
takenAt: new Date(lab.takenAt),
source: lab.source,
noteEncrypted:
@@ -57,6 +57,7 @@ function editToFactData(edit: InboundFactEdit): FactData {
unit: edit.unit ?? null,
referenceLow: edit.referenceLow ?? null,
referenceHigh: edit.referenceHigh ?? null,
referenceText: edit.referenceText ?? null,
effectiveDate: edit.effectiveDate ?? null,
};
return data;
@@ -46,6 +46,9 @@ export const GET = apiHandler(async () => {
value: true,
referenceLow: true,
referenceHigh: true,
sourceReferenceLow: true,
sourceReferenceHigh: true,
sourceReferenceText: true,
takenAt: true,
},
orderBy: { takenAt: "desc" },
@@ -58,6 +61,9 @@ export const GET = apiHandler(async () => {
value: r.value as number,
referenceLow: r.referenceLow,
referenceHigh: r.referenceHigh,
sourceReferenceLow: r.sourceReferenceLow,
sourceReferenceHigh: r.sourceReferenceHigh,
sourceReferenceText: r.sourceReferenceText,
takenAt: r.takenAt,
})),
);
+35
View File
@@ -143,6 +143,12 @@ export const PUT = apiHandler(
// historical columns the serialiser ignores. Reject the attempt with a
// 422 rather than silently no-op, so the client never believes an edit
// landed. Edit such fields on the Biomarker itself instead.
//
// `sourceReference*` is deliberately NOT on that list. The catalog band is
// a property of the marker; the source window is a property of THIS
// reading — it is what one report printed beside one value — so it is
// editable on a linked row and there is nothing on the biomarker to edit
// it on instead.
const isLinked = existing.biomarkerId !== null;
if (
isLinked &&
@@ -194,6 +200,15 @@ export const PUT = apiHandler(
if (d.unit !== undefined) data.unit = d.unit;
if (d.referenceLow !== undefined) data.referenceLow = d.referenceLow;
if (d.referenceHigh !== undefined) data.referenceHigh = d.referenceHigh;
if (d.sourceReferenceLow !== undefined) {
data.sourceReferenceLow = d.sourceReferenceLow;
}
if (d.sourceReferenceHigh !== undefined) {
data.sourceReferenceHigh = d.sourceReferenceHigh;
}
if (d.sourceReferenceText !== undefined) {
data.sourceReferenceText = d.sourceReferenceText;
}
if (d.takenAt !== undefined) data.takenAt = d.takenAt;
// Inverted-range guard for a PARTIAL bound update. The schema-level
@@ -212,6 +227,20 @@ export const PUT = apiHandler(
errorCode: "labs.update.referenceRangeInvalid",
});
}
// The same partial-update hole exists on the source window, and closes the
// same way.
if (
isInvertedRange(
effectiveBound(d.sourceReferenceLow, existing.sourceReferenceLow),
effectiveBound(d.sourceReferenceHigh, existing.sourceReferenceHigh),
)
) {
return apiError(
"sourceReferenceLow must not exceed sourceReferenceHigh",
422,
{ errorCode: "labs.update.sourceReferenceRangeInvalid" },
);
}
if (d.note !== undefined) {
data.noteEncrypted = d.note ? encryptNoteToBytes(d.note) : null;
}
@@ -239,6 +268,9 @@ export const PUT = apiHandler(
panel: existing.panel,
referenceLow: existing.referenceLow,
referenceHigh: existing.referenceHigh,
sourceReferenceLow: existing.sourceReferenceLow,
sourceReferenceHigh: existing.sourceReferenceHigh,
sourceReferenceText: existing.sourceReferenceText,
takenAt: existing.takenAt,
},
after: {
@@ -249,6 +281,9 @@ export const PUT = apiHandler(
panel: updated.panel,
referenceLow: updated.referenceLow,
referenceHigh: updated.referenceHigh,
sourceReferenceLow: updated.sourceReferenceLow,
sourceReferenceHigh: updated.sourceReferenceHigh,
sourceReferenceText: updated.sourceReferenceText,
takenAt: updated.takenAt,
},
redacted: d.note !== undefined ? ["note"] : [],
+13 -2
View File
@@ -33,6 +33,7 @@ import { withIdempotency } from "@/lib/idempotency";
import { enqueueReminderSatisfy } from "@/lib/jobs/reminder-satisfy";
import { emitDataArrival } from "@/lib/arrivals/emit-shared";
import { resolveOrMintBiomarker } from "@/lib/labs/biomarker-store";
import { parseReferenceRange } from "@/lib/labs/parse-reference-range";
import { serialiseLabResult } from "@/lib/labs/serialise";
import {
linkOcrLabsToVaultDocument,
@@ -151,12 +152,19 @@ async function commitOcrRows(request: NextRequest) {
}
const isQualitative = row.valueText !== undefined;
// The window the scan read off the report. The confirmed numeric bounds
// win over a re-parse of the string (the human may have corrected them on
// the review screen); the string rides along either way.
const printed = parseReferenceRange(row.referenceText, row.unit);
const sourceLow = row.referenceLow ?? printed?.low ?? null;
const sourceHigh = row.referenceHigh ?? printed?.high ?? null;
const sourceText = printed?.text ?? null;
const biomarker = await resolveOrMintBiomarker(user.id, {
analyte: row.analyte,
// A qualitative reading has no numeric unit / range.
unit: isQualitative ? (row.unit ?? "") : (row.unit as string),
referenceLow: isQualitative ? null : (row.referenceLow ?? null),
referenceHigh: isQualitative ? null : (row.referenceHigh ?? null),
referenceLow: isQualitative ? null : sourceLow,
referenceHigh: isQualitative ? null : sourceHigh,
panel: row.panel ?? null,
});
@@ -173,6 +181,9 @@ async function commitOcrRows(request: NextRequest) {
unit: biomarker.unit,
referenceLow: biomarker.lowerBound,
referenceHigh: biomarker.upperBound,
sourceReferenceLow: isQualitative ? null : sourceLow,
sourceReferenceHigh: isQualitative ? null : sourceHigh,
sourceReferenceText: isQualitative ? null : sourceText,
takenAt: row.takenAt,
source: "OCR",
noteEncrypted: null,
+15 -1
View File
@@ -184,6 +184,9 @@ async function postLabResult(request: NextRequest) {
unit,
referenceLow,
referenceHigh,
sourceReferenceLow,
sourceReferenceHigh,
sourceReferenceText,
takenAt,
note,
source,
@@ -248,6 +251,13 @@ async function postLabResult(request: NextRequest) {
unit: biomarker.unit,
referenceLow: biomarker.lowerBound,
referenceHigh: biomarker.upperBound,
// The window this reading's own report printed, kept beside the catalog
// stamp rather than folded into it: it governs THIS reading's verdict,
// and the catalog band stays the net for every reading without one. A
// qualitative reading has no window to record.
sourceReferenceLow: isQualitative ? null : (sourceReferenceLow ?? null),
sourceReferenceHigh: isQualitative ? null : (sourceReferenceHigh ?? null),
sourceReferenceText: isQualitative ? null : (sourceReferenceText ?? null),
takenAt,
// v1.25 (iOS #36) — provenance: the on-device-OCR path posts
// `source: "OCR"`; an omitted field stays "MANUAL" so the legacy
@@ -258,6 +268,7 @@ async function postLabResult(request: NextRequest) {
},
});
invalidateUserHealthScore(user.id);
const dto = serialiseLabResult(created, biomarker);
await auditLog("labResult.create", {
userId: user.id,
@@ -275,6 +286,9 @@ async function postLabResult(request: NextRequest) {
structured: biomarkerId !== undefined,
// v1.25 (iOS #36) — provenance of the reading ("MANUAL" | "OCR").
source: source ?? "MANUAL",
// Which window governs this reading's verdict, so a dashboard can see
// how often a report's own range displaces the catalog band.
referenceOrigin: dto.referenceOrigin,
},
});
@@ -298,5 +312,5 @@ async function postLabResult(request: NextRequest) {
source: "manual",
}).catch(() => {});
return apiSuccess(serialiseLabResult(created, biomarker), 201);
return apiSuccess(dto, 201);
}
@@ -64,6 +64,13 @@ function reading(id: string, value: number, takenAt: string): LabResultDto {
unit: "mg/dL",
referenceLow: 0,
referenceHigh: 100,
catalogReferenceLow: 0,
catalogReferenceHigh: 100,
sourceReferenceLow: null,
sourceReferenceHigh: null,
sourceReferenceText: null,
referenceOrigin: "catalog",
referenceDivergesFromCatalog: false,
takenAt,
source: "MANUAL",
hasNote: false,
+128 -1
View File
@@ -17,6 +17,7 @@ import { Button } from "@/components/ui/button";
import { CHART_HEIGHT_PX } from "@/lib/charts/constants";
import { prefersReducedMotion } from "@/lib/charts/reduced-motion";
import { formatLabValue } from "@/lib/labs/format-value";
import { formatReferenceRange } from "@/lib/labs/reference-range";
import { useTranslations, useFormatters } from "@/lib/i18n/context";
import { RichChartTooltip, type RichTooltipRow } from "../charts/chart-tooltip";
@@ -32,6 +33,15 @@ import type { LabResultDto } from "./types";
* MUTED primary fill — never a danger colour — honouring the no-alarming-
* colour rule. Every reading carries the same y-axis unit because a chart is
* one biomarker only.
*
* A SECOND band draws the window a source report printed, when the readings in
* view carry one. It is visually distinct from the catalog band — an outlined
* band in the chart's secondary hue against the catalog's filled primary — and
* both stay muted; the in/out verdict is the badge's job, never the chart's
* colour. The source window is a per-reading fact, so the band is drawn from
* the NEWEST reading in view that carries one and the legend dates it. When
* the readings in view carry more than one distinct printed window the legend
* says so rather than implying one window covered the whole series.
*/
const RANGE_DAYS = [
@@ -46,6 +56,26 @@ type RangeKey = (typeof RANGE_DAYS)[number]["key"];
interface ChartPoint {
timestamp: number;
value: number;
/** The window this reading was judged against, for the tooltip. */
referenceLow: number | null;
referenceHigh: number | null;
referenceOrigin: LabResultDto["referenceOrigin"];
sourceReferenceText: string | null;
}
/** The source window drawn as the second band, resolved from the readings in view. */
interface SourceBand {
low: number | null;
high: number | null;
/** The reading the band was taken from. */
takenAt: number;
/** True when the readings in view printed more than one distinct window. */
mixed: boolean;
}
/** Identity of a printed window, for counting distinct ones. */
function bandKey(low: number | null, high: number | null): string {
return `${low ?? ""}|${high ?? ""}`;
}
export function LabBiomarkerChart({
@@ -87,9 +117,37 @@ export function LabBiomarkerChart({
return filtered.map((r) => ({
timestamp: new Date(r.takenAt).getTime(),
value: r.value,
referenceLow: r.referenceLow,
referenceHigh: r.referenceHigh,
referenceOrigin: r.referenceOrigin,
sourceReferenceText: r.sourceReferenceText,
}));
}, [readings, range, nowMs]);
// The source band: the newest in-view reading whose report printed a window
// with usable bounds. Readings without one contribute nothing — an absent
// window is absent, not a reason to widen or narrow the band.
const sourceBand = useMemo<SourceBand | null>(() => {
const withWindow = points.filter(
(p) =>
p.referenceOrigin === "source" &&
(p.referenceLow !== null || p.referenceHigh !== null),
);
if (withWindow.length === 0) return null;
const newest = withWindow.reduce((a, b) =>
b.timestamp > a.timestamp ? b : a,
);
const distinct = new Set(
withWindow.map((p) => bandKey(p.referenceLow, p.referenceHigh)),
);
return {
low: newest.referenceLow,
high: newest.referenceHigh,
takenAt: newest.timestamp,
mixed: distinct.size > 1,
};
}, [points]);
// Y domain wraps both the data and the reference window so the band is
// always visible even when every reading sits inside it.
const yDomain = useMemo<[number, number]>(() => {
@@ -97,15 +155,23 @@ export function LabBiomarkerChart({
const candidates = [...values];
if (lowerBound != null) candidates.push(lowerBound);
if (upperBound != null) candidates.push(upperBound);
// The source band has to fit too, or the second band is drawn off-canvas
// and the chart silently shows one window while claiming two.
if (sourceBand?.low != null) candidates.push(sourceBand.low);
if (sourceBand?.high != null) candidates.push(sourceBand.high);
if (candidates.length === 0) return [0, 1];
const min = Math.min(...candidates);
const max = Math.max(...candidates);
const pad = (max - min || Math.abs(max) || 1) * 0.1;
return [min - pad, max + pad];
}, [points, lowerBound, upperBound]);
}, [points, lowerBound, upperBound, sourceBand]);
const animate = !prefersReducedMotion();
const primary = "var(--primary)";
// A second muted hue from the chart palette. Distinct from the primary band
// by hue AND by treatment (outline vs fill), so the two are told apart
// without relying on colour alone.
const secondary = "var(--chart-2)";
return (
<div className="space-y-3">
@@ -185,6 +251,42 @@ export function LabBiomarkerChart({
strokeDasharray="4 4"
/>
) : null}
{/* The source window — outlined, not filled, so it reads as a
second band over the catalog one rather than a second fill
competing with it. Same no-alarm-colour rule. */}
{sourceBand &&
sourceBand.low != null &&
sourceBand.high != null ? (
<ReferenceArea
y1={sourceBand.low}
y2={sourceBand.high}
fill={secondary}
fillOpacity={0.06}
stroke={secondary}
strokeOpacity={0.5}
strokeDasharray="2 3"
/>
) : null}
{sourceBand &&
sourceBand.low != null &&
sourceBand.high == null ? (
<ReferenceLine
y={sourceBand.low}
stroke={secondary}
strokeOpacity={0.6}
strokeDasharray="2 3"
/>
) : null}
{sourceBand &&
sourceBand.high != null &&
sourceBand.low == null ? (
<ReferenceLine
y={sourceBand.high}
stroke={secondary}
strokeOpacity={0.6}
strokeDasharray="2 3"
/>
) : null}
<Tooltip
content={(props) => {
const active = props.active ?? false;
@@ -201,6 +303,22 @@ export function LabBiomarkerChart({
color: primary,
},
];
// Name the window THIS reading was judged against. Two
// readings on one chart can carry different printed windows,
// so the band alone cannot answer it per point.
if (point.referenceOrigin === "source") {
rows.push({
name: t("labs.chart.sourceRangeLabel"),
value:
point.sourceReferenceText ??
`${formatReferenceRange(
point.referenceLow,
point.referenceHigh,
formatLabValue,
)} ${unit}`.trim(),
color: secondary,
});
}
return (
<RichChartTooltip
active
@@ -221,6 +339,15 @@ export function LabBiomarkerChart({
/>
</ComposedChart>
</ResponsiveContainer>
{sourceBand ? (
<p className="text-muted-foreground mt-2 text-xs">
{sourceBand.mixed
? t("labs.chart.sourceBandMixed")
: t("labs.chart.sourceBandLegend", {
date: fmt.dateShortSmart(new Date(sourceBand.takenAt)),
})}
</p>
) : null}
</div>
)}
</div>
+73
View File
@@ -22,6 +22,7 @@ import {
import { Textarea } from "@/components/ui/textarea";
import { apiGet, apiPost } from "@/lib/api/api-fetch";
import { localizedApiError } from "@/lib/api/localized-error";
import { parseReferenceRange } from "@/lib/labs/parse-reference-range";
import { formatReferenceRange } from "@/lib/labs/reference-range";
import { formatLabValue } from "@/lib/labs/format-value";
import { useTranslations } from "@/lib/i18n/context";
@@ -118,6 +119,13 @@ export function LabForm({
const [valueText, setValueText] = useState("");
const [takenAt, setTakenAt] = useState(defaultTakenAtValue);
const [note, setNote] = useState("");
// The window the paper report printed for THIS reading. Optional and folded
// away by default: most entries are typed against a catalog marker and never
// need it, and a field nobody fills is a field in the way. One text input,
// because that is how a report states it — "3,5 - 5,0", "< 5", "bis 5,0".
// The bounds are derived from what is typed; what is typed is kept verbatim.
const [sourceRangeOpen, setSourceRangeOpen] = useState(false);
const [sourceRange, setSourceRange] = useState("");
// v1.30.1 H3 — which submit button is in flight, so the OTHER one doesn't
// also show a spinner. `!== null` replaces the old plain `submitting`
// boolean for every disabled check below.
@@ -193,11 +201,27 @@ export function LabForm({
setPendingAction(keepOpen ? "saveAndAddAnother" : "save");
try {
// Parse client-side so the user sees the derived window before saving,
// and send BOTH: the bounds where they could be read, the text always.
const printed = isQualitative
? null
: parseReferenceRange(sourceRange, selected?.unit);
const created = await apiPost<LabResultDto>("/api/labs", {
biomarkerId,
...(isQualitative
? { valueText: qualitativeValue }
: { value: numericValue }),
...(printed
? {
...(printed.low !== null
? { sourceReferenceLow: printed.low }
: {}),
...(printed.high !== null
? { sourceReferenceHigh: printed.high }
: {}),
sourceReferenceText: printed.text,
}
: {}),
takenAt: new Date(takenAt).toISOString(),
...(note.trim() ? { note: note.trim() } : {}),
});
@@ -221,6 +245,8 @@ export function LabForm({
setValue("");
setValueText("");
setNote("");
// The next analyte off the same report has its own printed window.
setSourceRange("");
setError(null);
onSavedKeepOpen?.(created);
// Return focus to wherever the next entry starts so the flow
@@ -252,6 +278,20 @@ export function LabForm({
)
: "";
// What the typed string resolved to, shown back so the user can see whether
// a window was read out of it before the reading is saved. When none was,
// the hint says the text is kept as written rather than staying silent.
const parsedSourceRange = parseReferenceRange(sourceRange, selected?.unit);
const sourceRangeHint = parsedSourceRange
? parsedSourceRange.low === null && parsedSourceRange.high === null
? t("labs.form.sourceRangeUnparsed")
: `${formatReferenceRange(
parsedSourceRange.low,
parsedSourceRange.high,
formatLabValue,
)} ${selected?.unit ?? ""}`.trim()
: "";
const footerNode = (
<>
{onCancel ? (
@@ -415,6 +455,39 @@ export function LabForm({
</p>
) : null}
{resultType === "numeric" ? (
<div className="space-y-1.5">
{sourceRangeOpen ? (
<>
<Label htmlFor="lab-sourceRange">
{t("labs.form.sourceRange")}
</Label>
<Input
id="lab-sourceRange"
value={sourceRange}
onChange={(e) => setSourceRange(e.target.value)}
placeholder={t("labs.form.sourceRangePlaceholder")}
maxLength={120}
autoFocus
/>
<p className="text-muted-foreground text-xs">
{sourceRangeHint || t("labs.form.sourceRangeHint")}
</p>
</>
) : (
<Button
type="button"
variant="ghost"
size="sm"
className="text-muted-foreground h-auto px-0 text-xs"
onClick={() => setSourceRangeOpen(true)}
>
{t("labs.form.sourceRangeAdd")}
</Button>
)}
</div>
) : null}
<div className="space-y-1.5">
<Label htmlFor="lab-note">{t("labs.form.note")}</Label>
<Textarea
+8 -1
View File
@@ -35,6 +35,7 @@ import { useTranslations } from "@/lib/i18n/context";
import { queryKeys } from "@/lib/query-keys";
import { ReferenceRangeBadge } from "./reference-range-badge";
import { SourceRangeNote } from "./source-range-note";
import type { LabResultDetailDto, LabResultDto } from "./types";
const NOTE_MAX_LENGTH = 2000;
@@ -356,7 +357,13 @@ export function LabHistoryList({ readings }: { readings: LabResultDto[] }) {
{formatDateShort(r.takenAt, true)}
</TableCell>
<TableCell>
<ReferenceRangeBadge status={r.rangeStatus} />
<div className="flex flex-col items-start gap-1">
<ReferenceRangeBadge status={r.rangeStatus} />
<SourceRangeNote
reading={r}
className="text-muted-foreground text-xs"
/>
</div>
</TableCell>
<TableCell className="text-muted-foreground text-sm">
{r.hasNote ? t("labs.hasNote") : ""}
+5
View File
@@ -23,6 +23,7 @@ import { applyOrder, useModuleListPrefs } from "@/lib/module-list-prefs";
import { LabTrendSparkline } from "./lab-trend-sparkline";
import { ReferenceRangeBadge } from "./reference-range-badge";
import { SourceRangeNote } from "./source-range-note";
import type { LabResultDto, LabResultListResponse } from "./types";
interface MarkerGroup {
@@ -316,6 +317,10 @@ export function LabList({ onAddFirst }: { onAddFirst?: () => void } = {}) {
)}
</span>
) : null}
<SourceRangeNote
reading={group.latest}
className="text-xs"
/>
<span className="text-xs">
{formatDate(group.latest.takenAt)}
</span>
@@ -76,6 +76,7 @@ function toCommitRow(row: OcrReviewRow): OcrCommitRowInput | null {
takenAt: takenAt.toISOString(),
...(row.referenceLow !== null ? { referenceLow: row.referenceLow } : {}),
...(row.referenceHigh !== null ? { referenceHigh: row.referenceHigh } : {}),
...(row.referenceText ? { referenceText: row.referenceText } : {}),
};
}
+3
View File
@@ -16,6 +16,8 @@ export interface OcrReviewRow {
unit: string | null;
referenceLow: number | null;
referenceHigh: number | null;
/** The reference range as printed on the scanned report, verbatim. */
referenceText: string | null;
/** ISO calendar day (YYYY-MM-DD) or null. */
takenAt: string | null;
confidence: OcrExtractedRowDto["confidence"];
@@ -39,6 +41,7 @@ export function seedReviewRows(
unit: row.unit,
referenceLow: row.referenceLow,
referenceHigh: row.referenceHigh,
referenceText: row.referenceText,
takenAt: row.takenAt ?? fallbackDate,
confidence: row.confidence,
biomarkerMatch: row.biomarkerMatch,
+26
View File
@@ -247,6 +247,32 @@ export function OcrRowEditor({
</div>
) : null}
{/* The window as the report printed it. Editable, because the human is
reviewing a transcription: the two bounds above are the derived
reading of this string, and correcting the string is how a range the
parser could not read ("bis 5,0", "negativ") still reaches the row
instead of being dropped. */}
{!isQualitative ? (
<div className="space-y-1">
<Label htmlFor={`${fieldId}-refText`} className="text-xs">
{t("labs.ocr.refTextLabel")}
</Label>
<Input
id={`${fieldId}-refText`}
value={row.referenceText ?? ""}
placeholder={t("labs.ocr.refTextPlaceholder")}
maxLength={120}
onChange={(e) => {
const raw = e.target.value;
onChange({
...row,
referenceText: raw.trim() === "" ? null : raw,
});
}}
/>
</div>
) : null}
{valueUnreadable ? (
<p className="text-muted-foreground flex items-center gap-1.5 text-xs">
<AlertCircle aria-hidden className="h-3.5 w-3.5" />
+69
View File
@@ -0,0 +1,69 @@
"use client";
import { formatLabValue } from "@/lib/labs/format-value";
import { formatReferenceRange } from "@/lib/labs/reference-range";
import { useTranslations } from "@/lib/i18n/context";
import type { LabResultDto } from "./types";
/**
* The reference window a reading's own report printed, shown wherever that
* reading is shown.
*
* Renders nothing for a reading with no printed window — most of them — so it
* costs no space on the common row. When the report DID state a window it
* names it, verbatim where the report gave words; and when that window and the
* catalog band disagree it names the catalog band too. A reader told only
* "3,9–5,4" and a reader told only "3,5–5,0" draw different conclusions from
* the same number, so a surface that shows one silently is showing a partial
* answer.
*
* Neutral by construction: no tint, no icon, muted text. The in/out verdict is
* the badge's job — this element states where the window came from, nothing
* about whether the value is good news.
*/
export function SourceRangeNote({
reading,
className,
}: {
reading: Pick<
LabResultDto,
| "unit"
| "referenceLow"
| "referenceHigh"
| "catalogReferenceLow"
| "catalogReferenceHigh"
| "sourceReferenceText"
| "referenceOrigin"
| "referenceDivergesFromCatalog"
>;
className?: string;
}) {
const { t } = useTranslations();
if (reading.referenceOrigin !== "source") return null;
const printed =
reading.sourceReferenceText ??
`${formatReferenceRange(
reading.referenceLow,
reading.referenceHigh,
formatLabValue,
)} ${reading.unit}`.trim();
const catalog = formatReferenceRange(
reading.catalogReferenceLow,
reading.catalogReferenceHigh,
formatLabValue,
);
return (
<span className={className}>
{t("labs.sourceRange.fromReport", { range: printed })}
{reading.referenceDivergesFromCatalog && catalog
? ` · ${t("labs.sourceRange.catalogDiffers", {
range: `${catalog} ${reading.unit}`.trim(),
})}`
: null}
</span>
);
}
+21 -1
View File
@@ -1,4 +1,7 @@
import type { ReferenceRangeStatus } from "@/lib/validations/labs";
import type {
ReferenceRangeOrigin,
ReferenceRangeStatus,
} from "@/lib/validations/labs";
/** A lab-result row as the list / create endpoints serialise it. */
export interface LabResultDto {
@@ -12,8 +15,25 @@ export interface LabResultDto {
/** v1.18.9 — qualitative result text ("negativ" / …); null for a numeric row. */
valueText: string | null;
unit: string;
/**
* The window this reading is judged against and the one `rangeStatus` was
* computed from: the range its own report printed when it carries one, the
* catalog band otherwise. Render these and the range shown always matches
* the verdict shown.
*/
referenceLow: number | null;
referenceHigh: number | null;
/** The catalog marker's band, so both windows can be drawn. */
catalogReferenceLow: number | null;
catalogReferenceHigh: number | null;
/** The window the source report printed; the text verbatim, bounds when derivable. */
sourceReferenceLow: number | null;
sourceReferenceHigh: number | null;
sourceReferenceText: string | null;
/** Which window is in force. */
referenceOrigin: ReferenceRangeOrigin;
/** True when the report's window and the catalog band state different limits. */
referenceDivergesFromCatalog: boolean;
takenAt: string;
source: string;
hasNote: boolean;
+1
View File
@@ -33,6 +33,7 @@ export interface OcrCommitRowInput {
unit?: string;
referenceLow?: number;
referenceHigh?: number;
referenceText?: string;
takenAt: string;
}
+11 -10
View File
@@ -37,7 +37,7 @@
* is always owner-scoped and safe to read), so the block is `null` only when the
* account has no recent readings.
*/
import { classifyReferenceRange } from "@/lib/labs/reference-range";
import { classifyAgainstEffectiveRange } from "@/lib/labs/reference-range";
import { resolveLabFields } from "@/lib/labs/serialise";
import { sanitizeForPrompt } from "@/lib/insights/sanitize";
import { prisma } from "@/lib/db";
@@ -131,6 +131,9 @@ export async function buildLabsSnapshotBlock(
unit: true,
referenceLow: true,
referenceHigh: true,
sourceReferenceLow: true,
sourceReferenceHigh: true,
sourceReferenceText: true,
takenAt: true,
biomarkerId: true,
biomarker: {
@@ -181,15 +184,13 @@ export async function buildLabsSnapshotBlock(
referenceLow: resolved.referenceLow,
referenceHigh: resolved.referenceHigh,
// A qualitative row has nothing to compare against the bounds → neutral
// "unknown", never a fabricated verdict. A numeric row classifies.
rangeStatus:
row.value === null
? "unknown"
: classifyReferenceRange(
row.value,
resolved.referenceLow,
resolved.referenceHigh,
),
// "unknown", never a fabricated verdict. A numeric row classifies against
// the window in force for it — the report's own range when it carries
// one, the catalog band otherwise. Same rule as every other lab surface.
rangeStatus: classifyAgainstEffectiveRange(
row.value,
resolved.effectiveRange,
),
takenAt: row.takenAt.toISOString(),
});
@@ -20,10 +20,18 @@ export function buildClinicalRecordsNotesSection(
// v1.17.1 — structured lab-results section. Populated when the `labs`
// toggle is ON (default) and the user recorded at least one result in the
// window. One row per analyte (latest reading), with the lab's reference
// range and a NEUTRAL in/out-of-range marker — informative, never an
// alarming red. The marker is a quiet glyph (↓ / ↑ / —), not a colour, so
// the clinical PDF stays calm.
// window. One row per analyte (latest reading), with the reference range and
// a NEUTRAL in/out-of-range marker — informative, never an alarming red. The
// marker is a quiet glyph (↓ / ↑ / —), not a colour, so the clinical PDF
// stays calm.
//
// The reference column prints the window the reading was JUDGED against, and
// when that window came off the source report it prints the report's own
// string verbatim — a clinician comparing this table against the original
// report should read the same characters. A reading whose report window
// differs from the catalog band carries a footnote marker, and the catalog
// band is named beneath the table, because "3,9–5,4" and "3,5–5,0" disagree
// about the same number and a table that shows only one is a partial answer.
if (data.labResults && data.labResults.length > 0) {
y = ensureSpace(y, 6 + 18);
doc.setFontSize(14);
@@ -54,6 +62,23 @@ export function buildClinicalRecordsNotesSection(
}
};
// The reference cell: the report's own string when the report stated the
// window, else the formatted catalog band. A divergence gets a "*" the
// note under the table explains.
const referenceCell = (
lr: NonNullable<typeof data.labResults>[number],
): string => {
const printed =
lr.referenceOrigin === "source" && lr.sourceReferenceText
? lr.sourceReferenceText
: rangeText(lr.referenceLow, lr.referenceHigh);
return lr.referenceDivergesFromCatalog ? `${printed} *` : printed;
};
const diverging = data.labResults.filter(
(lr) => lr.referenceDivergesFromCatalog,
);
const labRows = data.labResults.map((lr) => {
// v1.18.9 — a qualitative reading (`value === null`) prints its result
// text in the value column and has no numeric range / status glyph.
@@ -63,7 +88,7 @@ export function buildClinicalRecordsNotesSection(
isQualitative
? (lr.valueText ?? "")
: `${num(lr.value as number)} ${lr.unit}`.trim(),
isQualitative ? "—" : rangeText(lr.referenceLow, lr.referenceHigh),
isQualitative ? "—" : referenceCell(lr),
isQualitative
? ""
: statusGlyph(lr.value as number, lr.referenceLow, lr.referenceHigh),
@@ -107,6 +132,30 @@ export function buildClinicalRecordsNotesSection(
y =
(doc as jsPDF & { lastAutoTable: { finalY: number } }).lastAutoTable
.finalY + 8;
// Name every diverging marker's catalog band, so the reader can see both
// windows rather than being told only that they differ.
if (diverging.length > 0) {
y = ensureSpace(y, 4 + diverging.length * 4);
doc.setFontSize(8);
doc.setFont("helvetica", "normal");
doc.setTextColor(110, 110, 110);
doc.text(t("doctorReport.labsSourceRangeNote"), margin, y);
y += 4;
for (const lr of diverging) {
doc.text(
`* ${lr.analyte}: ${t("doctorReport.labsCatalogRangeLabel")} ${rangeText(
lr.catalogReferenceLow,
lr.catalogReferenceHigh,
)} ${lr.unit}`.trim(),
margin,
y,
);
y += 4;
}
doc.setTextColor(30, 30, 30);
y += 4;
}
}
// v1.18.1 P4 — illness / condition episodes overlapping the window. Present
+15
View File
@@ -241,8 +241,23 @@ export interface DoctorReportData {
*/
valueText: string | null;
unit: string;
/**
* The reference window this reading is judged against: the range printed
* on its own report when it carries one, the catalog band otherwise.
* Resolved server-side through `resolveEffectiveReferenceRange` so the PDF
* marker, the FHIR `referenceRange`, and the API verdict agree.
*/
referenceLow: number | null;
referenceHigh: number | null;
/** The catalog band, kept so the PDF can name a divergence. */
catalogReferenceLow: number | null;
catalogReferenceHigh: number | null;
/** The window the source report printed, verbatim; null when it printed none. */
sourceReferenceText: string | null;
/** Which of the two windows `referenceLow` / `referenceHigh` came from. */
referenceOrigin: "source" | "catalog" | "none";
/** True when the report's window and the catalog band state different limits. */
referenceDivergesFromCatalog: boolean;
/** ISO timestamp of the latest reading. */
takenAt: string;
/** Count of readings for this analyte in the window (≥ 1). */
+20 -2
View File
@@ -11,6 +11,7 @@
* Split out of the aggregator with the selection rework.
*/
import { prisma } from "@/lib/db";
import { resolveEffectiveReferenceRange } from "@/lib/labs/reference-range";
import { getEvent } from "@/lib/logging/context";
import { decryptAllergyReaction } from "@/lib/doctor-report-helpers";
import type { DoctorReportData } from "@/lib/doctor-report-types";
@@ -42,6 +43,9 @@ export async function loadLabResults(
unit: true,
referenceLow: true,
referenceHigh: true,
sourceReferenceLow: true,
sourceReferenceHigh: true,
sourceReferenceText: true,
takenAt: true,
},
});
@@ -52,14 +56,28 @@ export async function loadLabResults(
for (const r of rows) {
const key = r.analyte.toLowerCase();
const prev = byAnalyte.get(key);
// The row already stamps the catalog band it was written under; the
// reading's own report window, when present, is what the physician read
// the value against, so it wins here exactly as it does on every other
// lab surface.
const range = resolveEffectiveReferenceRange(
r.referenceLow,
r.referenceHigh,
r,
);
byAnalyte.set(key, {
panel: r.panel,
analyte: r.analyte,
value: r.value,
valueText: r.valueText,
unit: r.unit,
referenceLow: r.referenceLow,
referenceHigh: r.referenceHigh,
referenceLow: range.low,
referenceHigh: range.high,
catalogReferenceLow: range.catalogLow,
catalogReferenceHigh: range.catalogHigh,
sourceReferenceText: range.sourceText,
referenceOrigin: range.origin,
referenceDivergesFromCatalog: range.divergesFromCatalog,
takenAt: r.takenAt.toISOString(),
count: (prev?.count ?? 0) + 1,
});
+24 -2
View File
@@ -15,6 +15,12 @@
* as-needed medication with notifications off — a record of what the patient
* takes, never a prescription action. An Observation never carries a
* range-flag; the reference bounds ride along only as the document stated them.
*
* The window the report printed beside a value is carried onto the reading, not
* dropped. Until now it only seeded a freshly minted catalog marker, which meant
* that for every analyte the user already had, the range printed on the report
* was read and then thrown away. It now lands on the row's `sourceReference*`
* columns and governs that reading's verdict.
*/
import { encryptToBytes } from "@/lib/ai/coach/bytes-codec";
import { prisma } from "@/lib/db";
@@ -22,6 +28,7 @@ import { invalidateUserHealthScore } from "@/lib/cache/invalidate";
import { emitDataArrival } from "@/lib/arrivals/emit-shared";
import { decryptFactData } from "@/lib/documents/store";
import { resolveOrMintBiomarker } from "@/lib/labs/biomarker-store";
import { parseReferenceRange } from "@/lib/labs/parse-reference-range";
import type { ExtractedFact } from "@/generated/prisma/client";
import type {
ConditionFactData,
@@ -66,11 +73,21 @@ async function commitObservation(
"A numeric value needs a unit before it can be saved",
);
}
// The printed window, read once. `referenceText` is what the report wrote;
// the parser derives bounds from it where it can, and where it cannot the
// string still survives onto the row. A document staged before the field
// existed has no text, and the numeric bounds the model reported are then
// the whole of what it stated.
const printed = parseReferenceRange(data.referenceText, data.unit);
const sourceLow = printed?.low ?? data.referenceLow;
const sourceHigh = printed?.high ?? data.referenceHigh;
const sourceText = printed?.text ?? null;
const biomarker = await resolveOrMintBiomarker(userId, {
analyte: data.label,
unit: isQualitative ? (data.unit ?? "") : (data.unit as string),
referenceLow: isQualitative ? null : data.referenceLow,
referenceHigh: isQualitative ? null : data.referenceHigh,
referenceLow: isQualitative ? null : sourceLow,
referenceHigh: isQualitative ? null : sourceHigh,
panel: null,
});
// Fail closed on a unit mismatch against an EXISTING marker. A freshly
@@ -101,6 +118,11 @@ async function commitObservation(
unit: biomarker.unit,
referenceLow: biomarker.lowerBound,
referenceHigh: biomarker.upperBound,
// The report's own window for THIS reading. A qualitative result has no
// window to record.
sourceReferenceLow: isQualitative ? null : sourceLow,
sourceReferenceHigh: isQualitative ? null : sourceHigh,
sourceReferenceText: isQualitative ? null : sourceText,
takenAt: statedDateOrNow(data.effectiveDate),
source: "DOCUMENT",
noteEncrypted: null,
+12 -2
View File
@@ -74,7 +74,8 @@ Extract these fact types:
- code + codeSystem ("LOINC"): ONLY if a code is printed, else null.
- value: the numeric result OR null. valueText: the qualitative result text (e.g. "negative") OR null. Set EXACTLY ONE.
- unit: the printed unit, or null. NEVER convert or normalise a unit.
- referenceLow / referenceHigh: the printed reference bounds as numbers, or null. Do NOT flag the value against them.
- referenceText: the reference range EXACTLY as printed beside the value, verbatim and complete, including its operator and unit if written (for example "3,5 - 5,0", "< 5", "bis 5,0", "\u2265 3,5", "150.000 - 400.000 /\u00b5l", "negativ"). Copy the characters; do NOT reformat, convert, or normalise them. Null only when no range is printed for that value.
- referenceLow / referenceHigh: the SAME range reduced to two numbers, when it reduces to two numbers, else null. Do NOT flag the value against them.
- effectiveDate: the stated measurement date (YYYY-MM-DD), else null.
3. MEDICATION_STATEMENT — a medication the patient is/was taking, as recorded. Capture:
- label: the drug name, verbatim.
@@ -91,7 +92,7 @@ For EVERY fact also capture:
Do not emit a fact you cannot read — omit it rather than invent one. Also capture reportDate: the document's stated report/collection date (YYYY-MM-DD), or null, and kind: "DOCTOR_REPORT", "DISCHARGE_LETTER", or "OTHER".
Respond ONLY with a JSON object of this exact shape:
{ "reportDate": string|null, "kind": "DOCTOR_REPORT"|"DISCHARGE_LETTER"|"OTHER"|null, "facts": [ { "type": "CONDITION"|"OBSERVATION"|"MEDICATION_STATEMENT", "label": string, "code": string|null, "codeSystem": "SNOMED"|"ICD10"|"LOINC"|"RXNORM"|"ATC"|null, "clinicalStatus": string|null, "verificationStatus": string|null, "value": number|null, "valueText": string|null, "unit": string|null, "referenceLow": number|null, "referenceHigh": number|null, "dose": string|null, "medicationStatus": string|null, "effectiveDate": string|null, "sourceText": string, "page": number|null, "confidence": number } ] }`;
{ "reportDate": string|null, "kind": "DOCTOR_REPORT"|"DISCHARGE_LETTER"|"OTHER"|null, "facts": [ { "type": "CONDITION"|"OBSERVATION"|"MEDICATION_STATEMENT", "label": string, "code": string|null, "codeSystem": "SNOMED"|"ICD10"|"LOINC"|"RXNORM"|"ATC"|null, "clinicalStatus": string|null, "verificationStatus": string|null, "value": number|null, "valueText": string|null, "unit": string|null, "referenceText": string|null, "referenceLow": number|null, "referenceHigh": number|null, "dose": string|null, "medicationStatus": string|null, "effectiveDate": string|null, "sourceText": string, "page": number|null, "confidence": number } ] }`;
const USER_PROMPT = `Transcribe the clinical document in the attached file into the JSON schema described in the system prompt. Reproduce only what is written — do not interpret. Return only the JSON object.`;
@@ -172,6 +173,7 @@ function mapFactData(raw: ExtractedFactRaw): FactData | null {
unit: raw.unit,
referenceLow: raw.referenceLow,
referenceHigh: raw.referenceHigh,
referenceText: raw.referenceText,
effectiveDate,
};
return data;
@@ -309,6 +311,14 @@ export async function runInboundExtraction(
unanchored,
conditions: facts.filter((f) => f.factType === "CONDITION").length,
observations: facts.filter((f) => f.factType === "OBSERVATION").length,
// How many transcribed observations arrived with the window the report
// printed beside them. A collapse here is the extraction quietly going
// back to dropping the range.
observationsWithRange: facts.filter(
(f) =>
f.factType === "OBSERVATION" &&
((f.data as ObservationFactData).referenceText ?? null) !== null,
).length,
medications: facts.filter((f) => f.factType === "MEDICATION_STATEMENT")
.length,
needsReview: facts.filter((f) => f.needsReview).length,
+7
View File
@@ -54,6 +54,10 @@ export interface LabResultBackupEntry {
unit: string;
referenceLow: number | null;
referenceHigh: number | null;
/** The window the reading's own source report printed, verbatim + derived. */
sourceReferenceLow: number | null;
sourceReferenceHigh: number | null;
sourceReferenceText: string | null;
takenAt: string;
source: string;
/** Human-readable cross-reference into `biomarkers` below, not an id. */
@@ -336,6 +340,9 @@ export async function buildRecordsBackupSection(
unit: r.unit,
referenceLow: r.referenceLow,
referenceHigh: r.referenceHigh,
sourceReferenceLow: r.sourceReferenceLow,
sourceReferenceHigh: r.sourceReferenceHigh,
sourceReferenceText: r.sourceReferenceText,
takenAt: r.takenAt.toISOString(),
source: r.source,
biomarkerName: r.biomarker?.name ?? null,
@@ -54,6 +54,11 @@ describe("lab-result FHIR Observations", () => {
unit: "mg/dL",
referenceLow: null,
referenceHigh: 116,
catalogReferenceLow: null,
catalogReferenceHigh: null,
sourceReferenceText: null,
referenceOrigin: "catalog" as const,
referenceDivergesFromCatalog: false,
takenAt: "2026-04-20T08:00:00.000Z",
count: 2,
},
@@ -65,6 +70,11 @@ describe("lab-result FHIR Observations", () => {
unit: "%",
referenceLow: 4,
referenceHigh: 5.6,
catalogReferenceLow: null,
catalogReferenceHigh: null,
sourceReferenceText: null,
referenceOrigin: "catalog" as const,
referenceDivergesFromCatalog: false,
takenAt: "2026-04-21T08:00:00.000Z",
count: 1,
},
@@ -137,6 +147,11 @@ describe("lab-result FHIR Observations", () => {
unit: "mg/L",
referenceLow: null,
referenceHigh: null,
catalogReferenceLow: null,
catalogReferenceHigh: null,
sourceReferenceText: null,
referenceOrigin: "catalog" as const,
referenceDivergesFromCatalog: false,
takenAt: "2026-04-22T08:00:00.000Z",
count: 1,
},
@@ -178,6 +193,11 @@ describe("lab-result LOINC + canonical UCUM coding (v1.18.8)", () => {
unit,
referenceLow: null,
referenceHigh: null,
catalogReferenceLow: null,
catalogReferenceHigh: null,
sourceReferenceText: null,
referenceOrigin: "catalog" as const,
referenceDivergesFromCatalog: false,
takenAt: "2026-04-20T08:00:00.000Z",
count: 1,
},
@@ -264,6 +284,11 @@ describe("qualitative lab-result FHIR Observations (v1.18.9)", () => {
unit: "",
referenceLow: null,
referenceHigh: null,
catalogReferenceLow: null,
catalogReferenceHigh: null,
sourceReferenceText: null,
referenceOrigin: "catalog" as const,
referenceDivergesFromCatalog: false,
takenAt: "2026-04-20T08:00:00.000Z",
count: 1,
},
+14 -3
View File
@@ -7,8 +7,15 @@
* `code.text` for the common biomarkers, and stamps the canonical UCUM `code`
* on the value WHEN the recorded unit matches the mapped canonical symbol. An
* analyte that does NOT resolve keeps the honest text-only `code` +
* display-only `unit` (no fabricated terminology). The lab's reference bounds
* map onto R4 `referenceRange`.
* display-only `unit` (no fabricated terminology).
*
* The reference bounds map onto R4 `referenceRange`, and they are the SAME
* bounds the app's own verdict uses: the window the reading's source report
* printed when it carries one, the catalog band otherwise, already resolved
* upstream in `loadLabResults`. When the source report stated its window in
* words the bounds could not be read from ("negativ", "siehe Befund"), that
* string rides on `referenceRange.text` so a receiver still gets what the lab
* wrote rather than a silently empty element.
*/
import type { DoctorReportData } from "@/lib/doctor-report-data";
import { LOINC_SYSTEM, UCUM_SYSTEM } from "@/lib/fhir/loinc-map";
@@ -82,8 +89,11 @@ export function labObservations(
// The bounds are stated in the SAME unit as the value, so they carry the
// SAME coding — a bare unit beside a coded value leaves a receiver unable
// to compare the two.
const sourceText =
lab.referenceOrigin === "source" ? lab.sourceReferenceText : null;
const hasBounds = lab.referenceLow !== null || lab.referenceHigh !== null;
const referenceRange: FhirObservationReferenceRange[] | undefined =
lab.referenceLow !== null || lab.referenceHigh !== null
hasBounds || sourceText
? [
{
...(lab.referenceLow !== null
@@ -92,6 +102,7 @@ export function labObservations(
...(lab.referenceHigh !== null
? { high: quantity(lab.referenceHigh) }
: {}),
...(sourceText ? { text: sourceText } : {}),
},
]
: undefined;
+7
View File
@@ -117,6 +117,13 @@ export interface FhirObservation {
export interface FhirObservationReferenceRange {
low?: FhirQuantity;
high?: FhirQuantity;
/**
* R4 `referenceRange.text`. Carries the window the source report printed,
* verbatim, when the reading has one. A receiver that cannot use the bounds
* (because the report stated a qualitative window like "negativ", or a
* one-sided one) still reads what the lab wrote.
*/
text?: string;
}
export interface FhirDosage {
@@ -19,7 +19,14 @@ function row(
analyte: string,
value: number,
day: string,
opts: { unit?: string; low?: number | null; high?: number | null } = {},
opts: {
unit?: string;
low?: number | null;
high?: number | null;
sourceLow?: number | null;
sourceHigh?: number | null;
sourceText?: string | null;
} = {},
): LabChangeRow {
return {
analyte,
@@ -27,6 +34,9 @@ function row(
value,
referenceLow: opts.low ?? null,
referenceHigh: opts.high ?? null,
sourceReferenceLow: opts.sourceLow ?? null,
sourceReferenceHigh: opts.sourceHigh ?? null,
sourceReferenceText: opts.sourceText ?? null,
takenAt: new Date(`${day}T08:00:00.000Z`),
};
}
+27 -10
View File
@@ -29,7 +29,10 @@ import {
} from "@/lib/ai/prompts/biomarker";
import { openerArchetypeHint } from "@/lib/ai/prompts/opener-archetype";
import type { Locale } from "@/lib/i18n/config";
import { classifyReferenceRange } from "@/lib/labs/reference-range";
import {
classifyAgainstEffectiveRange,
resolveEffectiveReferenceRange,
} from "@/lib/labs/reference-range";
import { getNoKeyBiomarkerStatusText } from "@/lib/insights/no-key-fallbacks";
import { hashInsightSnapshot } from "@/lib/insights/snapshot-hash";
import { runStatusCompletion } from "@/lib/insights/status-provider";
@@ -158,7 +161,17 @@ export async function generateBiomarkerStatus(args: {
},
orderBy: { takenAt: "desc" },
take: SNAPSHOT_READING_CAP,
select: { id: true, value: true, takenAt: true },
select: {
id: true,
value: true,
takenAt: true,
// The window this reading's own report printed, when it carries one.
// The verdict below is the reading's, not the marker's, so it has to
// read the reading's window — see `resolveEffectiveReferenceRange`.
sourceReferenceLow: true,
sourceReferenceHigh: true,
sourceReferenceText: true,
},
});
if (rows.length === 0) {
annotate({
@@ -174,6 +187,14 @@ export async function generateBiomarkerStatus(args: {
takenAt: r.takenAt,
}));
const latest = readings[0];
// The window the latest reading is judged against: its own report's range
// when that reading carries one, the catalog band otherwise. One rule, the
// same one the API DTO, the doctor report and the coach snapshot apply.
const latestRange = resolveEffectiveReferenceRange(
marker.lowerBound,
marker.upperBound,
rows[0],
);
const totalCount = await prisma.labResult.count({
where: {
userId: args.userId,
@@ -226,7 +247,7 @@ export async function generateBiomarkerStatus(args: {
locale,
promptVersion: PROMPT_VERSION,
count: totalCount,
bounds: { lower: marker.lowerBound, upper: marker.upperBound },
bounds: { lower: latestRange.low, upper: latestRange.high },
latest: {
id: latest.id,
takenAt: latest.takenAt.toISOString(),
@@ -252,11 +273,7 @@ export async function generateBiomarkerStatus(args: {
// Ascending series (oldest → newest) for the trend summary the prompt reads.
const ascending = [...readings].reverse();
const summary = summarizeSeries(ascending.map((r) => ({ value: r.value })));
const latestStatus = classifyReferenceRange(
latest.value,
marker.lowerBound,
marker.upperBound,
);
const latestStatus = classifyAgainstEffectiveRange(latest.value, latestRange);
const snapshot = {
locale,
@@ -266,8 +283,8 @@ export async function generateBiomarkerStatus(args: {
name: marker.name,
unit: marker.unit,
referenceRange:
marker.lowerBound != null || marker.upperBound != null
? { lower: marker.lowerBound, upper: marker.upperBound }
latestRange.low != null || latestRange.high != null
? { lower: latestRange.low, upper: latestRange.high }
: null,
},
dataCoverage: {
@@ -590,6 +590,9 @@ export async function fetchLabDraws(
unit: true,
referenceLow: true,
referenceHigh: true,
sourceReferenceLow: true,
sourceReferenceHigh: true,
sourceReferenceText: true,
panel: true,
value: true,
takenAt: true,
+8 -9
View File
@@ -10,7 +10,7 @@
* point (`extractFeatures`) stays in the hub.
*/
import { prisma } from "@/lib/db";
import { classifyReferenceRange } from "@/lib/labs/reference-range";
import { classifyAgainstEffectiveRange } from "@/lib/labs/reference-range";
import { calendarDaysUntil } from "@/lib/measurement-reminders/due-day";
import { resolveLabFields } from "@/lib/labs/serialise";
import { readRollupBuckets } from "@/lib/rollups/measurement-rollups";
@@ -164,6 +164,9 @@ export async function readLabsBriefingBlock(
valueText: true,
referenceLow: true,
referenceHigh: true,
sourceReferenceLow: true,
sourceReferenceHigh: true,
sourceReferenceText: true,
takenAt: true,
biomarkerId: true,
biomarker: {
@@ -198,14 +201,10 @@ export async function readLabsBriefingBlock(
for (const list of byMarker.values()) {
const latest = list[0];
const resolved = resolveLabFields(latest, latest.biomarker);
const rangeStatus =
latest.value === null
? ("unknown" as const)
: classifyReferenceRange(
latest.value,
resolved.referenceLow,
resolved.referenceHigh,
);
const rangeStatus = classifyAgainstEffectiveRange(
latest.value,
resolved.effectiveRange,
);
// Trend = latest numeric reading vs the immediately prior numeric reading.
let trend: "rising" | "falling" | "flat" | null = null;
+16 -9
View File
@@ -4,9 +4,11 @@
* Groups the user's numeric lab results by panel DATE (the calendar day of
* `takenAt`, UTC), finds the two most-recent dates, and for every analyte that
* appears in BOTH the latest and the previous panel reports the signed delta,
* the direction, and where the latest value sits against its reference band
* (`classifyReferenceRange`). Qualitative (valueText-only) results carry no
* numeric value, so they are skipped — a delta is meaningless for them.
* the direction, and where the latest value sits against the reference window
* in force for it — the range that reading's own report printed when it has
* one, the catalog band otherwise, resolved through the shared
* `resolveEffectiveReferenceRange`. Qualitative (valueText-only) results carry
* no numeric value, so they are skipped — a delta is meaningless for them.
*
* Pure + Prisma-free so the present / absent states are unit-testable: it is
* absent when there are fewer than two panel dates, no analyte is shared, or
@@ -14,12 +16,14 @@
* only — a delta is not a diagnosis.
*/
import {
classifyReferenceRange,
classifyAgainstEffectiveRange,
resolveEffectiveReferenceRange,
type ReferenceRangeStatus,
type SourceReferenceRange,
} from "@/lib/labs/reference-range";
/** A single numeric lab reading. */
export interface LabChangeRow {
/** A single numeric lab reading, with both windows it could be judged against. */
export interface LabChangeRow extends SourceReferenceRange {
analyte: string;
unit: string;
value: number;
@@ -150,10 +154,13 @@ export function summariseLabChanges(
previous: previousRow.value,
delta,
direction,
status: classifyReferenceRange(
status: classifyAgainstEffectiveRange(
latestRow.value,
latestRow.referenceLow,
latestRow.referenceHigh,
resolveEffectiveReferenceRange(
latestRow.referenceLow,
latestRow.referenceHigh,
latestRow,
),
),
});
}
@@ -0,0 +1,128 @@
import { describe, expect, it } from "vitest";
import {
classifyAgainstEffectiveRange,
resolveEffectiveReferenceRange,
} from "@/lib/labs/reference-range";
const NO_SOURCE = {
sourceReferenceLow: null,
sourceReferenceHigh: null,
sourceReferenceText: null,
};
describe("resolveEffectiveReferenceRange", () => {
it("falls back to the catalog band when the reading carries no source window", () => {
const eff = resolveEffectiveReferenceRange(3.5, 5, NO_SOURCE);
expect(eff).toMatchObject({
low: 3.5,
high: 5,
origin: "catalog",
catalogLow: 3.5,
catalogHigh: 5,
sourceText: null,
divergesFromCatalog: false,
});
});
it("reports no window when neither side states one", () => {
expect(resolveEffectiveReferenceRange(null, null, NO_SOURCE)).toMatchObject(
{ low: null, high: null, origin: "none", divergesFromCatalog: false },
);
});
it("lets the source window win over the catalog band for that reading", () => {
const eff = resolveEffectiveReferenceRange(3.5, 5, {
sourceReferenceLow: 3.9,
sourceReferenceHigh: 5.4,
sourceReferenceText: "3,9 - 5,4",
});
expect(eff).toMatchObject({
low: 3.9,
high: 5.4,
origin: "source",
catalogLow: 3.5,
catalogHigh: 5,
sourceText: "3,9 - 5,4",
divergesFromCatalog: true,
});
});
it("does not call an identical window a divergence", () => {
const eff = resolveEffectiveReferenceRange(3.5, 5, {
sourceReferenceLow: 3.5,
sourceReferenceHigh: 5,
sourceReferenceText: "3,5 - 5,0",
});
expect(eff.origin).toBe("source");
expect(eff.divergesFromCatalog).toBe(false);
});
it("takes a one-sided source window whole, not merged with the catalog", () => {
// A report that prints "< 5" states a ceiling and NO floor. Borrowing the
// catalog's floor would invent a window the report never stated.
const eff = resolveEffectiveReferenceRange(3.5, 5, {
sourceReferenceLow: null,
sourceReferenceHigh: 4.2,
sourceReferenceText: "< 4,2",
});
expect(eff).toMatchObject({
low: null,
high: 4.2,
origin: "source",
divergesFromCatalog: true,
});
});
it("does not displace the catalog for a printed window with no derivable bound", () => {
// "negativ" is carried through verbatim, but it is not an argument for
// discarding the catalog band.
const eff = resolveEffectiveReferenceRange(3.5, 5, {
sourceReferenceLow: null,
sourceReferenceHigh: null,
sourceReferenceText: "negativ",
});
expect(eff).toMatchObject({
low: 3.5,
high: 5,
origin: "catalog",
sourceText: "negativ",
divergesFromCatalog: false,
});
});
it("reports a source window as no divergence when the catalog has none", () => {
const eff = resolveEffectiveReferenceRange(null, null, {
sourceReferenceLow: 3.9,
sourceReferenceHigh: 5.4,
sourceReferenceText: "3,9 - 5,4",
});
expect(eff.origin).toBe("source");
expect(eff.divergesFromCatalog).toBe(false);
});
});
describe("classifyAgainstEffectiveRange", () => {
it("judges a reading by the source window, not the catalog band", () => {
// 5.2 sits inside the catalog band (3.5–5.0 would call it high) but the
// report that produced this value states 3.9–5.4, so it is in range.
const eff = resolveEffectiveReferenceRange(3.5, 5, {
sourceReferenceLow: 3.9,
sourceReferenceHigh: 5.4,
sourceReferenceText: "3,9 - 5,4",
});
expect(classifyAgainstEffectiveRange(5.2, eff)).toBe("in-range");
expect(classifyAgainstEffectiveRange(3.7, eff)).toBe("below");
expect(classifyAgainstEffectiveRange(5.5, eff)).toBe("above");
});
it("keeps the catalog verdict for a reading with no source window", () => {
const eff = resolveEffectiveReferenceRange(3.5, 5, NO_SOURCE);
expect(classifyAgainstEffectiveRange(5.2, eff)).toBe("above");
});
it("never classifies a qualitative reading", () => {
const eff = resolveEffectiveReferenceRange(3.5, 5, NO_SOURCE);
expect(classifyAgainstEffectiveRange(null, eff)).toBe("unknown");
});
});
@@ -0,0 +1,219 @@
import { describe, expect, it } from "vitest";
import { parseReferenceRange } from "@/lib/labs/parse-reference-range";
/**
* Real-shaped strings, taken from the notation German and English lab reports
* actually print. The parser's contract is asymmetric on purpose: deriving a
* bound is best-effort, KEEPING the printed string is mandatory. Every case
* below therefore asserts the verbatim text survives, and only the cases that
* can be read without guessing assert bounds.
*/
describe("parseReferenceRange — two-sided windows", () => {
it.each([
["3.5-5.0", 3.5, 5],
["3,5-5,0", 3.5, 5],
["3.5 - 5.0", 3.5, 5],
["3,5 – 5,0", 3.5, 5],
["3,5 — 5,0", 3.5, 5],
["3,5 bis 5,0", 3.5, 5],
["3.5 to 5.0", 3.5, 5],
["3,5 ... 5,0", 3.5, 5],
["3,5 .. 5,0", 3.5, 5],
["von 3,5 bis 5,0", 3.5, 5],
["[3,5 - 5,0]", 3.5, 5],
["(3.5-5.0)", 3.5, 5],
])("reads %s as %s..%s", (raw, low, high) => {
const parsed = parseReferenceRange(raw);
expect(parsed).toEqual({ low, high, text: raw.trim() });
});
it("reads a negative lower bound (base excess prints one)", () => {
expect(parseReferenceRange("-2,0 bis +3,0")).toEqual({
low: -2,
high: 3,
text: "-2,0 bis +3,0",
});
});
it("reads a German thousands separator as one number, not a decimal", () => {
// Platelets print as "150.000 - 400.000 /µl" on a German report. Reading
// the dot as a decimal point would yield a 150–400 window and silently
// flag every normal count as wildly high.
expect(parseReferenceRange("150.000 - 400.000")).toEqual({
low: 150000,
high: 400000,
text: "150.000 - 400.000",
});
});
it("reads an English thousands separator", () => {
expect(parseReferenceRange("150,000 - 400,000")).toEqual({
low: 150000,
high: 400000,
text: "150,000 - 400,000",
});
});
it("refuses a transposed window rather than swapping it", () => {
// Swapping would be a guess about which digit the lab meant to print.
expect(parseReferenceRange("5,0 - 3,5")).toEqual({
low: null,
high: null,
text: "5,0 - 3,5",
});
});
});
describe("parseReferenceRange — one-sided windows", () => {
it.each([
["< 5", 5],
["<5,0", 5],
["≤ 5", 5],
["<= 5", 5],
["bis 5,0", 5],
["bis zu 5,0", 5],
["max. 5,0", 5],
["max 5", 5],
["kleiner 5", 5],
["unter 5", 5],
["up to 5.0", 5],
])("reads %s as an upper bound of %s", (raw, high) => {
expect(parseReferenceRange(raw)).toEqual({
low: null,
high,
text: raw.trim(),
});
});
it.each([
["> 3.5", 3.5],
[">3,5", 3.5],
["≥ 3,5", 3.5],
[">= 3.5", 3.5],
["ab 3,5", 3.5],
["min. 3,5", 3.5],
["mind. 3,5", 3.5],
["mindestens 3,5", 3.5],
["größer 3,5", 3.5],
["groesser 3,5", 3.5],
["über 3,5", 3.5],
])("reads %s as a lower bound of %s", (raw, low) => {
expect(parseReferenceRange(raw)).toEqual({
low,
high: null,
text: raw.trim(),
});
});
});
describe("parseReferenceRange — units", () => {
it("reads a window that carries the reading's own unit", () => {
expect(parseReferenceRange("3,5 - 5,0 mmol/l", "mmol/L")).toEqual({
low: 3.5,
high: 5,
text: "3,5 - 5,0 mmol/l",
});
});
it("reads a trailing unit when the caller states none", () => {
expect(parseReferenceRange("0,5 - 1,2 mg/dl")).toEqual({
low: 0.5,
high: 1.2,
text: "0,5 - 1,2 mg/dl",
});
});
it("refuses bounds when the printed unit contradicts the reading's unit", () => {
// Converting mmol/L into mg/dL is interpretation and needs an analyte-
// specific factor. Keeping the string and no bounds is the honest answer.
const parsed = parseReferenceRange("3,5 - 5,0 mmol/l", "mg/dL");
expect(parsed).toEqual({
low: null,
high: null,
text: "3,5 - 5,0 mmol/l",
});
});
it("matches units case- and space-insensitively", () => {
expect(parseReferenceRange("< 5 MG/DL", "mg/dl")).toEqual({
low: null,
high: 5,
text: "< 5 MG/DL",
});
});
it("tolerates a percent window against a percent reading", () => {
expect(parseReferenceRange("4,0 - 6,0 %", "%")).toEqual({
low: 4,
high: 6,
text: "4,0 - 6,0 %",
});
});
});
describe("parseReferenceRange — text the parser must not invent bounds for", () => {
it.each([
"negativ",
"negative",
"nicht nachweisbar",
"siehe Befund",
"n.n.",
"unauffällig",
"altersabhängig",
"methodenabhängig",
])("keeps %s verbatim with no bounds", (raw) => {
expect(parseReferenceRange(raw)).toEqual({
low: null,
high: null,
text: raw,
});
});
it("keeps a bare number verbatim without treating it as a bound", () => {
// "5,0" alone states neither a ceiling nor a floor; picking one would be
// the parser deciding what the report meant.
expect(parseReferenceRange("5,0")).toEqual({
low: null,
high: null,
text: "5,0",
});
});
it("keeps a three-number string verbatim", () => {
expect(parseReferenceRange("3,5 - 5,0 - 7,0")).toEqual({
low: null,
high: null,
text: "3,5 - 5,0 - 7,0",
});
});
it("caps an over-long string rather than storing a whole paragraph", () => {
const parsed = parseReferenceRange("x".repeat(500));
expect(parsed?.text).toHaveLength(120);
expect(parsed?.low).toBeNull();
expect(parsed?.high).toBeNull();
});
it("collapses internal whitespace so the stored string stays one line", () => {
expect(parseReferenceRange(" 3,5\n\t- 5,0 ")).toEqual({
low: 3.5,
high: 5,
text: "3,5 - 5,0",
});
});
});
describe("parseReferenceRange — absence", () => {
it.each([null, undefined, "", " "])("returns null for %s", (raw) => {
expect(parseReferenceRange(raw)).toBeNull();
});
it("refuses a non-finite bound", () => {
expect(parseReferenceRange("1e999 - 2e999")).toEqual({
low: null,
high: null,
text: "1e999 - 2e999",
});
});
});
+3
View File
@@ -17,6 +17,9 @@ const baseRow: LabRow = {
unit: "mg/dl", // lowercase legacy unit
referenceLow: null,
referenceHigh: 100, // stale per-row bound
sourceReferenceLow: null,
sourceReferenceHigh: null,
sourceReferenceText: null,
takenAt: new Date("2026-01-01T08:00:00.000Z"),
source: "MANUAL",
biomarkerId: "bm_1",
+15 -6
View File
@@ -24,6 +24,7 @@ import {
} from "@/lib/ai/types";
import { AI_BUDGETS } from "@/lib/ai/ai-budgets";
import { prisma } from "@/lib/db";
import { parseReferenceRange } from "@/lib/labs/parse-reference-range";
import { annotate } from "@/lib/logging/context";
import {
extractedLabsSchema,
@@ -42,7 +43,8 @@ Extract every analyte reading you can read. For each reading capture:
- value: the numeric result as a number, OR null if the result is qualitative text.
- valueText: the qualitative result text (e.g. "negativ", "positiv", "nicht nachweisbar"), OR null if the result is numeric.
- unit: the measurement unit (e.g. "mg/dL", "%", "ng/mL"), or null if none is printed or the reading is qualitative.
- referenceLow / referenceHigh: the reference-range bounds as numbers, or null. A one-sided range like "< 116" sets referenceHigh only; "> 40" sets referenceLow only.
- referenceText: the reference range EXACTLY as printed beside the value, verbatim and complete, including its operator and unit if written (for example "3,5 - 5,0", "< 116", "bis 5,0", "150.000 - 400.000 /\u00b5l", "negativ"). Copy the characters; do NOT reformat, convert, or normalise them. Null only when no range is printed for that row.
- referenceLow / referenceHigh: the SAME range reduced to numbers, when it reduces to numbers, else null. A one-sided range like "< 116" sets referenceHigh only; "> 40" sets referenceLow only.
- takenAt: the per-row collection date in ISO 8601 (YYYY-MM-DD) if a date is printed for that row, else null.
- confidence: an object { analyte, value, unit, range } with a 0..1 score for how legible each field was. Use a low score when a field is blurred, ambiguous, or you had to guess.
@@ -51,7 +53,7 @@ Set EXACTLY ONE of value / valueText per reading. Never invent a value you canno
Also capture reportDate: the report's collection/sample date in ISO 8601 (YYYY-MM-DD), or null.
Respond ONLY with a JSON object of this exact shape:
{ "reportDate": string|null, "rows": [ { "analyte": string, "value": number|null, "valueText": string|null, "unit": string|null, "referenceLow": number|null, "referenceHigh": number|null, "takenAt": string|null, "confidence": { "analyte": number, "value": number, "unit": number, "range": number } } ] }`;
{ "reportDate": string|null, "rows": [ { "analyte": string, "value": number|null, "valueText": string|null, "unit": string|null, "referenceText": string|null, "referenceLow": number|null, "referenceHigh": number|null, "takenAt": string|null, "confidence": { "analyte": number, "value": number, "unit": number, "range": number } } ] }`;
const USER_PROMPT = `Transcribe the lab report in the attached image into the JSON schema described in the system prompt. Return only the JSON object.`;
@@ -70,7 +72,8 @@ Extract every analyte reading you can identify. For each reading capture:
- value: the numeric result as a number, OR null if the result is qualitative text. German reports use a decimal comma (e.g. "5,4") — emit it as 5.4.
- valueText: the qualitative result text (e.g. "negativ", "positiv", "nicht nachweisbar"), OR null if the result is numeric.
- unit: the measurement unit (e.g. "mg/dL", "%", "ng/mL"), or null if none is printed or the reading is qualitative.
- referenceLow / referenceHigh: the reference-range bounds as numbers, or null. A one-sided range like "< 116" sets referenceHigh only; "> 40" sets referenceLow only.
- referenceText: the reference range EXACTLY as printed beside the value, verbatim and complete, including its operator and unit if written (for example "3,5 - 5,0", "< 116", "bis 5,0", "150.000 - 400.000 /\u00b5l", "negativ"). Copy the characters; do NOT reformat, convert, or normalise them. Null only when no range is printed for that row.
- referenceLow / referenceHigh: the SAME range reduced to numbers, when it reduces to numbers, else null. A one-sided range like "< 116" sets referenceHigh only; "> 40" sets referenceLow only.
- takenAt: the per-row collection date in ISO 8601 (YYYY-MM-DD) if a date is printed for that row, else null.
- confidence: an object { analyte, value, unit, range } with a 0..1 score for how confident you are in each field. Use a LOW score when the OCR text was garbled, ambiguous, or you had to guess — the text is lossy, so be conservative.
@@ -79,7 +82,7 @@ Set EXACTLY ONE of value / valueText per reading. Never invent a value you canno
Also capture reportDate: the report's collection/sample date in ISO 8601 (YYYY-MM-DD), or null.
Respond ONLY with a JSON object of this exact shape:
{ "reportDate": string|null, "rows": [ { "analyte": string, "value": number|null, "valueText": string|null, "unit": string|null, "referenceLow": number|null, "referenceHigh": number|null, "takenAt": string|null, "confidence": { "analyte": number, "value": number, "unit": number, "range": number } } ] }`;
{ "reportDate": string|null, "rows": [ { "analyte": string, "value": number|null, "valueText": string|null, "unit": string|null, "referenceText": string|null, "referenceLow": number|null, "referenceHigh": number|null, "takenAt": string|null, "confidence": { "analyte": number, "value": number, "unit": number, "range": number } } ] }`;
/** A normalised ISO date string (YYYY-MM-DD) or null. */
function normaliseDate(raw: string | null): string | null {
@@ -130,6 +133,7 @@ async function annotateRow(
): Promise<OcrExtractedRowDto> {
const analyte = row.analyte.trim();
const takenAt = normaliseDate(row.takenAt) ?? reportDate;
const printed = parseReferenceRange(row.referenceText, row.unit);
// Biomarker match — case-insensitive on the catalog identity, presence-only.
const existingBiomarker = await prisma.biomarker.findFirst({
@@ -175,8 +179,13 @@ async function annotateRow(
value: row.value,
valueText: row.valueText,
unit: row.unit,
referenceLow: row.referenceLow,
referenceHigh: row.referenceHigh,
// Both readings of the printed window travel to the review screen: the
// derived bounds where the string yields them, and the string itself
// either way. A window the parser could not read is still the window the
// lab printed, so the user sees it and it reaches the row.
referenceLow: printed?.low ?? row.referenceLow,
referenceHigh: printed?.high ?? row.referenceHigh,
referenceText: printed?.text ?? null,
takenAt,
confidence: row.confidence,
biomarkerMatch: existingBiomarker ? "existing" : "new",
+207
View File
@@ -0,0 +1,207 @@
/**
* Free-text reference-range parser for the range a lab report prints beside a
* value.
*
* A report states its window in prose, not in columns: "3,5 - 5,0", "< 5",
* "bis 5,0", "≥ 3,5", "150.000 - 400.000 /µl", or a word like "negativ" that
* carries no window at all. The document-reading path and the manual entry
* form both hand that string here.
*
* The contract is deliberately asymmetric:
*
* - KEEPING the printed string is mandatory. `text` always carries what the
* report said, whitespace-normalised and length-capped, whether or not a
* bound could be derived from it. A window this parser cannot read is not
* a window that gets thrown away.
* - DERIVING bounds is best-effort and refuses on ambiguity. A string that
* does not match one of the notations below yields `low: null, high: null`
* beside the text. Absence reads as absence — the parser never picks a
* plausible bound out of a string it did not understand, because a fake
* window silently reclassifies a reading as normal or abnormal.
*
* Notations read (German and English, comma- or dot-decimal):
*
* two-sided 3.5-5.0 · 3,5 – 5,0 · 3,5 bis 5,0 · 3.5 to 5.0 · 3,5 ... 5,0
* von 3,5 bis 5,0 · [3,5 - 5,0] · (3.5-5.0)
* upper only < 5 · ≤ 5 · <= 5 · bis 5,0 · bis zu 5,0 · max. 5,0 ·
* kleiner 5 · unter 5 · up to 5.0 · less than 5
* lower only > 3.5 · ≥ 3,5 · >= 3.5 · ab 3,5 · min. 3,5 · mindestens 3,5 ·
* größer 3,5 · über 3,5 · at least 3.5
*
* Units are read, never converted. A window may carry the unit the report
* printed it in; when the caller states the reading's own unit and the two
* disagree, the bounds are refused and only the text survives. Converting
* mmol/L into mg/dL needs a per-analyte factor, so doing it here would be the
* parser deciding what the report meant.
*/
/** What a printed range yielded. `text` is set whenever the input was non-empty. */
export interface ParsedReferenceRange {
/** Lower bound, or null when the notation states none / could not be read. */
low: number | null;
/** Upper bound, or null when the notation states none / could not be read. */
high: number | null;
/** The printed string, whitespace-normalised and capped. Never null here. */
text: string;
}
/**
* Storage cap for the verbatim string. A reference-range cell is a few
* characters; anything longer is a mis-segmented paragraph, and truncating it
* keeps a runaway transcription out of the column.
*/
export const SOURCE_REFERENCE_TEXT_MAX = 120;
/** Magnitude ceiling. Beyond this a "bound" is a transcription artefact. */
const MAX_ABS_BOUND = 1e12;
/** One number token: optional sign, digits, any number of `.`/`,` groups. */
const NUM = String.raw`[+-]?\d+(?:[.,]\d+)*`;
/** Infix separators for a two-sided window. */
const TWO_SIDED_SEP = String.raw`(?:-|–|—|‒|…|\.{2,3}|bis\s+zu|bis|to|until)`;
/** Prefixes that state a ceiling only. */
const UPPER_PREFIX = String.raw`(?:<=|<|≤|bis\s+zu|bis|max\.|maximal|max|kleiner\s+als|kleiner|unter|höchstens|hoechstens|up\s+to|less\s+than|below)`;
/** Prefixes that state a floor only. */
const LOWER_PREFIX = String.raw`(?:>=|>|≥|ab|mind\.|mindestens|minimal|min\.|min|größer\s+als|größer|groesser\s+als|groesser|über|ueber|at\s+least|greater\s+than|above)`;
/**
* Trailing unit tail. Deliberately whitespace-free and comma-free: a real unit
* symbol ("mmol/l", "mg/dL", "%", "/µl", "10^9/L") never contains either, and
* refusing anything that does keeps a third number ("3,5 - 5,0 - 7,0") from
* being swallowed as if it were a unit.
*/
const UNIT_TAIL = String.raw`(?:\s*([^\s,]{1,24}))?`;
const TWO_SIDED_RE = new RegExp(
`^(${NUM})\\s*${TWO_SIDED_SEP}\\s*(${NUM})${UNIT_TAIL}$`,
"iu",
);
const UPPER_RE = new RegExp(`^${UPPER_PREFIX}\\s*(${NUM})${UNIT_TAIL}$`, "iu");
const LOWER_RE = new RegExp(`^${LOWER_PREFIX}\\s*(${NUM})${UNIT_TAIL}$`, "iu");
/** Leading words that only introduce the window ("von 3,5 bis 5,0"). */
const LEADING_FILLER_RE = /^(?:von|from|ref\.?|referenz|reference)\s+/iu;
/**
* Read one number token into a JS number, or null when its separators are
* ambiguous.
*
* Separator rules, in order:
* 1. Both `.` and `,` present → the LAST one is the decimal mark, the other
* groups thousands ("1.234,56" and "1,234.56" both read as 1234.56).
* 2. One separator kind, appearing more than once → all thousands
* ("1.234.567").
* 3. One separator, appearing once, group ≠ 3 digits → decimal ("3,5").
* 4. One separator, appearing once, group = 3 digits → ambiguous in the
* general case. Read as thousands only when the group is "000", which is
* how a German report prints a rounded count ("150.000 - 400.000 /µl");
* reading that as 150 would flag every normal platelet count as wildly
* high. Any other 3-digit group ("1.234" — 1234 or 1.234?) is refused.
*
* The limit of rule 4 is real: a report that prints "5.000" meaning five with
* three decimal places is read as five thousand. The verbatim text is stored
* either way, so the printed window is never lost — only the derived bound is.
*/
function readNumber(token: string): number | null {
const sign = token.startsWith("-") ? -1 : 1;
const body = token.replace(/^[+-]/u, "");
const dots = (body.match(/\./gu) ?? []).length;
const commas = (body.match(/,/gu) ?? []).length;
let normalised: string;
if (dots > 0 && commas > 0) {
const decimalMark =
body.lastIndexOf(".") > body.lastIndexOf(",") ? "." : ",";
const grouping = decimalMark === "." ? "," : ".";
normalised = body.split(grouping).join("").replace(decimalMark, ".");
} else if (dots + commas === 0) {
normalised = body;
} else if (dots > 1 || commas > 1) {
normalised = body.replace(/[.,]/gu, "");
} else {
const idx = body.search(/[.,]/u);
const group = body.slice(idx + 1);
if (group.length !== 3) {
normalised = `${body.slice(0, idx)}.${group}`;
} else if (group === "000") {
normalised = body.slice(0, idx) + group;
} else {
return null;
}
}
const value = sign * Number(normalised);
if (!Number.isFinite(value) || Math.abs(value) > MAX_ABS_BOUND) return null;
return value;
}
/** Compare a printed unit against the reading's unit, ignoring case + spaces. */
function unitsAgree(printed: string | undefined, reading: string | undefined) {
if (!printed) return true;
if (!reading || !reading.trim()) return true;
const norm = (u: string) => u.replace(/\s+/gu, "").toLowerCase();
return norm(printed) === norm(reading);
}
/**
* Parse the reference range a lab report printed for one reading.
*
* @param raw the printed string, exactly as transcribed.
* @param unit the reading's own unit, when known. A printed window in a
* different unit yields text-only — never a converted bound.
* @returns null when there was nothing printed at all.
*/
export function parseReferenceRange(
raw: string | null | undefined,
unit?: string | null,
): ParsedReferenceRange | null {
if (raw === null || raw === undefined) return null;
const text = raw
.replace(/\s+/gu, " ")
.trim()
.slice(0, SOURCE_REFERENCE_TEXT_MAX);
if (text === "") return null;
const noBounds: ParsedReferenceRange = { low: null, high: null, text };
// Strip a bracket wrapper and an introducing word for MATCHING only — the
// stored text stays exactly what the report printed.
let candidate = text;
const bracketed = /^[[(](.*)[\])]$/u.exec(candidate);
if (bracketed) candidate = bracketed[1].trim();
candidate = candidate.replace(LEADING_FILLER_RE, "").trim();
const two = TWO_SIDED_RE.exec(candidate);
if (two) {
if (!unitsAgree(two[3], unit ?? undefined)) return noBounds;
const low = readNumber(two[1]);
const high = readNumber(two[2]);
if (low === null || high === null) return noBounds;
// A transposed window is a transcription error, and swapping it would be a
// guess about which digit the lab meant. Refuse the bounds, keep the text.
if (low > high) return noBounds;
return { low, high, text };
}
const upper = UPPER_RE.exec(candidate);
if (upper) {
if (!unitsAgree(upper[2], unit ?? undefined)) return noBounds;
const high = readNumber(upper[1]);
return high === null ? noBounds : { low: null, high, text };
}
const lower = LOWER_RE.exec(candidate);
if (lower) {
if (!unitsAgree(lower[2], unit ?? undefined)) return noBounds;
const low = readNumber(lower[1]);
return low === null ? noBounds : { low, high: null, text };
}
// Anything else — "negativ", "siehe Befund", a bare number, prose — keeps its
// text and states no window.
return noBounds;
}
+110
View File
@@ -61,3 +61,113 @@ export function formatReferenceRange(
if (hasLow) return `≥ ${formatNumber(low as number)}`;
return opts?.emptyText ?? "";
}
/**
* The reference range a lab report printed beside ONE reading, as stored on
* `LabResult.sourceReference*`.
*/
export interface SourceReferenceRange {
sourceReferenceLow: number | null;
sourceReferenceHigh: number | null;
sourceReferenceText: string | null;
}
/** Where the bounds a reading is judged against came from. */
export type ReferenceRangeOrigin = "source" | "catalog" | "none";
/** The bounds one reading is judged against, plus how they were arrived at. */
export interface EffectiveReferenceRange {
/** The bound the verdict uses. */
low: number | null;
high: number | null;
origin: ReferenceRangeOrigin;
/** The catalog band, kept alongside so a surface can show both. */
catalogLow: number | null;
catalogHigh: number | null;
/** The printed window, kept verbatim. Null when the report stated none. */
sourceText: string | null;
/**
* True when the source window is in force AND the catalog states a window
* that differs from it. This is the case a reader must be told about: the
* same number reads differently against the two, so a surface that shows
* only one of them is showing a partial answer.
*/
divergesFromCatalog: boolean;
}
/** Two bounds are the same window when both ends match (null included). */
function sameWindow(
aLow: number | null,
aHigh: number | null,
bLow: number | null,
bHigh: number | null,
): boolean {
return aLow === bLow && aHigh === bHigh;
}
/**
* Resolve the reference window ONE reading is judged against.
*
* A lab runs its own method on its own device, and the physician reads the
* value against the window printed on that report. So for a reading that
* carries a source window, the source window wins — for that reading alone.
* The catalog band stays the net for every reading that carries none.
*
* A source window counts as stating a window only when it yields at least one
* numeric bound. A printed string with no derivable bound ("negativ", "siehe
* Befund") is carried through as `sourceText` but never displaces the catalog:
* a range that could not be read is not an argument for having no range.
*
* This function is the ONLY place that precedence is expressed. Every surface
* that classifies a reading — the API DTO, the doctor report, insights, the
* coach snapshot, the MCP read, the FHIR export — routes through it, so a
* reading cannot read as in-range on one surface and out on another.
*/
export function resolveEffectiveReferenceRange(
catalogLow: number | null | undefined,
catalogHigh: number | null | undefined,
source: SourceReferenceRange | null | undefined,
): EffectiveReferenceRange {
const cLow = catalogLow ?? null;
const cHigh = catalogHigh ?? null;
const sLow = source?.sourceReferenceLow ?? null;
const sHigh = source?.sourceReferenceHigh ?? null;
const sourceText = source?.sourceReferenceText ?? null;
if (sLow !== null || sHigh !== null) {
return {
low: sLow,
high: sHigh,
origin: "source",
catalogLow: cLow,
catalogHigh: cHigh,
sourceText,
divergesFromCatalog:
(cLow !== null || cHigh !== null) &&
!sameWindow(sLow, sHigh, cLow, cHigh),
};
}
return {
low: cLow,
high: cHigh,
origin: cLow !== null || cHigh !== null ? "catalog" : "none",
catalogLow: cLow,
catalogHigh: cHigh,
sourceText,
divergesFromCatalog: false,
};
}
/**
* Classify one reading against its effective window. Qualitative readings
* (no numeric value) always report `"unknown"` — there is nothing to compare
* against bounds, and a fabricated verdict is worse than none.
*/
export function classifyAgainstEffectiveRange(
value: number | null,
effective: EffectiveReferenceRange,
): ReferenceRangeStatus {
if (value === null) return "unknown";
return classifyReferenceRange(value, effective.low, effective.high);
}
+138 -58
View File
@@ -10,13 +10,40 @@
* - If the row is unlinked (legacy / pre-backfill), it falls back to its own
* free-text `analyte` / `unit` / `reference*` columns.
*
* Either way the verdict (`rangeStatus`) is computed from the RESOLVED bounds
* via `classifyReferenceRange`. The DTO carries the resolved values so the web
* client AND the iOS client render the same numbers — neither recomputes the
* range or guesses the unit. This is the server-authoritative-parity rule for
* Labs.
* On top of that the reading's OWN printed window wins. A lab report states
* the range its method and device produce right beside the value, and that is
* the window a physician evaluates against; the catalog band is the net for
* readings that carry none. `resolveEffectiveReferenceRange` owns that
* precedence and this file is one of its callers, not a second copy of it.
*
* The DTO therefore carries three windows and says which one is in force:
*
* - `referenceLow` / `referenceHigh` — the EFFECTIVE bounds, the ones
* `rangeStatus` was computed from. A client that reads only these fields
* (including an iOS build that predates the source window) renders the
* right numbers and the right verdict with no change of its own.
* - `catalogReferenceLow` / `catalogReferenceHigh` — the catalog band, so a
* surface can paint both and show where they part.
* - `sourceReferenceLow` / `sourceReferenceHigh` / `sourceReferenceText` —
* what the report printed, the last verbatim.
*
* `referenceOrigin` names which window is in force and
* `referenceDivergesFromCatalog` flags the case a reader must be told about.
* Every value is resolved server-side; neither client recomputes a range,
* guesses a unit, or re-derives the verdict.
*
* The two serialisers below spell every field out rather than spreading a
* shared helper: `written-outcome-response-consumer-guard` walks these object
* literals to enumerate the response leaves and pair each with a client
* reader, and a spread of a function call hides them from it. A field added
* here must be visible there.
*/
import { classifyReferenceRange } from "@/lib/labs/reference-range";
import {
classifyAgainstEffectiveRange,
resolveEffectiveReferenceRange,
type EffectiveReferenceRange,
type ReferenceRangeOrigin,
} from "@/lib/labs/reference-range";
/** The minimal biomarker shape the resolver needs (no encrypted context). */
export interface ResolvedBiomarker {
@@ -40,6 +67,10 @@ export interface LabRow {
unit: string;
referenceLow: number | null;
referenceHigh: number | null;
/** The window the source report printed for THIS reading. */
sourceReferenceLow: number | null;
sourceReferenceHigh: number | null;
sourceReferenceText: string | null;
takenAt: Date;
source: string;
biomarkerId: string | null;
@@ -48,60 +79,95 @@ export interface LabRow {
updatedAt: Date;
}
/**
* Resolve the canonical name / unit / bounds / panel for a lab row, preferring
* the linked biomarker over the legacy per-row fields. Returns a plain shape
* the list + detail serialisers both build on.
*/
export function resolveLabFields(
row: Pick<
LabRow,
| "analyte"
| "unit"
| "referenceLow"
| "referenceHigh"
| "panel"
| "biomarkerId"
>,
biomarker: ResolvedBiomarker | null | undefined,
): {
/** The columns `resolveLabFields` needs off a lab row. */
export type LabFieldRow = Pick<
LabRow,
| "analyte"
| "unit"
| "referenceLow"
| "referenceHigh"
| "sourceReferenceLow"
| "sourceReferenceHigh"
| "sourceReferenceText"
| "panel"
| "biomarkerId"
>;
/** What every lab surface reads off a row: identity, unit, and one window. */
export interface ResolvedLabFields {
analyte: string;
unit: string;
panel: string | null;
/** The bounds in force for this reading — source window first, catalog next. */
referenceLow: number | null;
referenceHigh: number | null;
panel: string | null;
} {
if (biomarker) {
return {
analyte: biomarker.name,
unit: biomarker.unit,
referenceLow: biomarker.lowerBound,
referenceHigh: biomarker.upperBound,
panel: biomarker.panel,
};
}
return {
analyte: row.analyte,
unit: row.unit,
referenceLow: row.referenceLow,
referenceHigh: row.referenceHigh,
panel: row.panel,
};
/** The catalog band, so a surface can show both windows. */
catalogReferenceLow: number | null;
catalogReferenceHigh: number | null;
/** What the source report printed for this reading. */
sourceReferenceLow: number | null;
sourceReferenceHigh: number | null;
sourceReferenceText: string | null;
referenceOrigin: ReferenceRangeOrigin;
referenceDivergesFromCatalog: boolean;
/** The resolved window as one value, for callers that pass it on. */
effectiveRange: EffectiveReferenceRange;
}
/**
* v1.18.9 — the reference-range verdict for a row. A qualitative row (no
* numeric `value`) has nothing to compare against the bounds, so it always
* reports `"unknown"` — the neutral, no-verdict state — never a fabricated
* in/out classification. A numeric row classifies against the resolved bounds.
* Resolve the canonical name / unit / window / panel for a lab row.
*
* Two resolutions happen here, in this order:
*
* 1. Identity + catalog band: the linked biomarker wins over the row's legacy
* free-text columns (an unlinked pre-backfill row falls back to its own).
* 2. The window in force: the reading's printed source range wins over the
* catalog band, through `resolveEffectiveReferenceRange`.
*
* Every lab surface calls this, so the window a reading is judged against is
* the same on the API, the doctor report, insights, the coach, MCP and FHIR.
*/
function rowRangeStatus(
value: number | null,
referenceLow: number | null,
referenceHigh: number | null,
) {
if (value === null) return "unknown" as const;
return classifyReferenceRange(value, referenceLow, referenceHigh);
export function resolveLabFields(
row: LabFieldRow,
biomarker: ResolvedBiomarker | null | undefined,
): ResolvedLabFields {
const identity = biomarker
? {
analyte: biomarker.name,
unit: biomarker.unit,
panel: biomarker.panel,
catalogLow: biomarker.lowerBound,
catalogHigh: biomarker.upperBound,
}
: {
analyte: row.analyte,
unit: row.unit,
panel: row.panel,
catalogLow: row.referenceLow,
catalogHigh: row.referenceHigh,
};
const effectiveRange = resolveEffectiveReferenceRange(
identity.catalogLow,
identity.catalogHigh,
row,
);
return {
analyte: identity.analyte,
unit: identity.unit,
panel: identity.panel,
referenceLow: effectiveRange.low,
referenceHigh: effectiveRange.high,
catalogReferenceLow: effectiveRange.catalogLow,
catalogReferenceHigh: effectiveRange.catalogHigh,
sourceReferenceLow: row.sourceReferenceLow,
sourceReferenceHigh: row.sourceReferenceHigh,
sourceReferenceText: effectiveRange.sourceText,
referenceOrigin: effectiveRange.origin,
referenceDivergesFromCatalog: effectiveRange.divergesFromCatalog,
effectiveRange,
};
}
/**
@@ -123,13 +189,21 @@ export function serialiseLabResult(
unit: resolved.unit,
referenceLow: resolved.referenceLow,
referenceHigh: resolved.referenceHigh,
catalogReferenceLow: resolved.catalogReferenceLow,
catalogReferenceHigh: resolved.catalogReferenceHigh,
sourceReferenceLow: resolved.sourceReferenceLow,
sourceReferenceHigh: resolved.sourceReferenceHigh,
sourceReferenceText: resolved.sourceReferenceText,
referenceOrigin: resolved.referenceOrigin,
referenceDivergesFromCatalog: resolved.referenceDivergesFromCatalog,
takenAt: row.takenAt.toISOString(),
source: row.source,
hasNote: row.noteEncrypted !== null,
rangeStatus: rowRangeStatus(
// A qualitative row has no number to place against bounds, so it reports
// the neutral "unknown" rather than a fabricated in/out verdict.
rangeStatus: classifyAgainstEffectiveRange(
row.value,
resolved.referenceLow,
resolved.referenceHigh,
resolved.effectiveRange,
),
createdAt: row.createdAt.toISOString(),
updatedAt: row.updatedAt.toISOString(),
@@ -156,13 +230,19 @@ export function serialiseLabResultDetail(
unit: resolved.unit,
referenceLow: resolved.referenceLow,
referenceHigh: resolved.referenceHigh,
catalogReferenceLow: resolved.catalogReferenceLow,
catalogReferenceHigh: resolved.catalogReferenceHigh,
sourceReferenceLow: resolved.sourceReferenceLow,
sourceReferenceHigh: resolved.sourceReferenceHigh,
sourceReferenceText: resolved.sourceReferenceText,
referenceOrigin: resolved.referenceOrigin,
referenceDivergesFromCatalog: resolved.referenceDivergesFromCatalog,
takenAt: row.takenAt.toISOString(),
source: row.source,
note,
rangeStatus: rowRangeStatus(
rangeStatus: classifyAgainstEffectiveRange(
row.value,
resolved.referenceLow,
resolved.referenceHigh,
resolved.effectiveRange,
),
createdAt: row.createdAt.toISOString(),
updatedAt: row.updatedAt.toISOString(),
+8 -9
View File
@@ -48,7 +48,7 @@ import {
type MetricStatusMetricId,
} from "@/lib/insights/metric-status-registry";
import { allSignals, getSignal } from "@/lib/signals/registry";
import { classifyReferenceRange } from "@/lib/labs/reference-range";
import { classifyAgainstEffectiveRange } from "@/lib/labs/reference-range";
import { resolveLabFields } from "@/lib/labs/serialise";
import { sanitizeValueText } from "@/lib/ai/coach/labs-snapshot";
import { encodeOffsetCursor } from "@/lib/mcp/pagination";
@@ -1316,6 +1316,9 @@ export async function getLabHistory(
unit: true,
referenceLow: true,
referenceHigh: true,
sourceReferenceLow: true,
sourceReferenceHigh: true,
sourceReferenceText: true,
takenAt: true,
biomarkerId: true,
biomarker: {
@@ -1350,14 +1353,10 @@ export async function getLabHistory(
unit: resolved.unit,
referenceLow: resolved.referenceLow,
referenceHigh: resolved.referenceHigh,
rangeStatus:
row.value === null
? "unknown"
: classifyReferenceRange(
row.value,
resolved.referenceLow,
resolved.referenceHigh,
),
rangeStatus: classifyAgainstEffectiveRange(
row.value,
resolved.effectiveRange,
),
takenAt: row.takenAt.toISOString(),
};
});
+15 -2
View File
@@ -44,7 +44,13 @@ listLabResultsSchema.meta({
const rangeStatusEnum = z.enum(["in-range", "below", "above", "unknown"]).meta({
id: "LabReferenceRangeStatus",
description:
"Server-computed, NEUTRAL reference-range verdict. `unknown` when the lab reported no usable bounds. Inclusive bounds: a value on the limit reads in-range. The badge that renders this must stay calm and informative — not an alarming red.",
"Server-computed, NEUTRAL reference-range verdict, always against `referenceLow` / `referenceHigh` (the window in force for that reading). `unknown` when no usable bounds are on file. Inclusive bounds: a value on the limit reads in-range. The badge that renders this must stay calm and informative — not an alarming red.",
});
const referenceOriginEnum = z.enum(["source", "catalog", "none"]).meta({
id: "LabReferenceRangeOrigin",
description:
"Which window `referenceLow` / `referenceHigh` came from. `source` = the range printed on this reading's own report, which wins for that reading because it is the window the physician evaluated the value against. `catalog` = the user's Biomarker band, the net for readings with no printed range. `none` = no window on file.",
});
const labResultRow = z
@@ -60,6 +66,13 @@ const labResultRow = z
unit: z.string(),
referenceLow: z.number().nullable(),
referenceHigh: z.number().nullable(),
catalogReferenceLow: z.number().nullable(),
catalogReferenceHigh: z.number().nullable(),
sourceReferenceLow: z.number().nullable(),
sourceReferenceHigh: z.number().nullable(),
sourceReferenceText: z.string().nullable(),
referenceOrigin: referenceOriginEnum,
referenceDivergesFromCatalog: z.boolean(),
takenAt: z.string(),
source: z.string(),
hasNote: z.boolean(),
@@ -70,7 +83,7 @@ const labResultRow = z
.meta({
id: "LabResult",
description:
'A stored lab result. Exactly one of `value` (numeric) or `valueText` (qualitative, e.g. "negativ") is non-null; `rangeStatus` is always `unknown` for a qualitative row (no number to classify). `biomarkerId` links the user-scoped catalog marker (null for legacy free-text rows); when linked, `analyte` / `unit` / `referenceLow` / `referenceHigh` are RESOLVED server-side from the Biomarker — the client renders them and never recomputes the range. The encrypted note is never echoed in list rows; `hasNote` flags its presence and the single-resource GET returns the decrypted `note`.',
"A stored lab result. Exactly one of `value` (numeric) or `valueText` (qualitative, e.g. \"negativ\") is non-null; `rangeStatus` is always `unknown` for a qualitative row (no number to classify). `biomarkerId` links the user-scoped catalog marker (null for legacy free-text rows); when linked, `analyte` / `unit` are RESOLVED server-side from the Biomarker.\n\nThree reference windows ride on the row and the server says which one applies. `referenceLow` / `referenceHigh` are the window IN FORCE and the one `rangeStatus` was computed from — read these to render the range and you are correct without doing any resolution of your own. `sourceReferenceLow` / `sourceReferenceHigh` / `sourceReferenceText` are the range this reading's own report printed (the text verbatim, kept even when no numbers could be read out of it). `catalogReferenceLow` / `catalogReferenceHigh` are the Biomarker band. `referenceOrigin` names the winner and `referenceDivergesFromCatalog` is true when the report's window and the catalog band state different limits — a surface showing only one of the two is showing a partial answer. The client renders these values and never recomputes the range. The encrypted note is never echoed in list rows; `hasNote` flags its presence and the single-resource GET returns the decrypted `note`.",
});
const labResultDetail = labResultRow
+16 -1
View File
@@ -53,6 +53,10 @@ const extractedRow = z
unit: z.string().nullable(),
referenceLow: z.number().nullable(),
referenceHigh: z.number().nullable(),
referenceText: z.string().nullable().meta({
description:
'The reference range EXACTLY as printed on the report, verbatim ("3,5 - 5,0", "< 116", "bis 5,0", "negativ"). `referenceLow` / `referenceHigh` carry the same window reduced to numbers WHEN it reduces to numbers; this field carries it either way, so a window stated in words is not lost between the report and the reading.',
}),
takenAt: z.string().nullable(),
confidence: extractConfidence,
biomarkerMatch: z.enum(["new", "existing"]),
@@ -87,6 +91,13 @@ const committedRow = z
unit: z.string(),
referenceLow: z.number().nullable(),
referenceHigh: z.number().nullable(),
catalogReferenceLow: z.number().nullable(),
catalogReferenceHigh: z.number().nullable(),
sourceReferenceLow: z.number().nullable(),
sourceReferenceHigh: z.number().nullable(),
sourceReferenceText: z.string().nullable(),
referenceOrigin: z.enum(["source", "catalog", "none"]),
referenceDivergesFromCatalog: z.boolean(),
takenAt: z.string(),
source: z.string(),
hasNote: z.boolean(),
@@ -94,7 +105,11 @@ const committedRow = z
createdAt: z.string(),
updatedAt: z.string(),
})
.meta({ id: "OcrCommittedLabResult" });
.meta({
id: "OcrCommittedLabResult",
description:
"A written reading. Its reference window resolves exactly as it does on `/api/labs` — see `LabResult`.",
});
const commitResponse = z
.object({
+5
View File
@@ -708,6 +708,11 @@ const labResultBackupSchema = z
unit: z.string().min(1),
referenceLow: z.number().nullable().optional(),
referenceHigh: z.number().nullable().optional(),
// Optional so a backup written before these columns existed still
// restores; absent reads as "this reading had no source window on file".
sourceReferenceLow: z.number().nullable().optional(),
sourceReferenceHigh: z.number().nullable().optional(),
sourceReferenceText: z.string().nullable().optional(),
takenAt: isoDateTime,
source: z.string().min(1),
biomarkerName: z.string().nullable().optional(),
+18
View File
@@ -167,6 +167,15 @@ export const extractedFactRawSchema = z.object({
unit: nullableText(80),
referenceLow: z.number().finite().nullable().catch(null),
referenceHigh: z.number().finite().nullable().catch(null),
/**
* Observation: the reference range EXACTLY as printed, verbatim. A report
* writes its window in prose ("3,5 - 5,0", "< 5", "bis 5,0", "negativ"), and
* `referenceLow` / `referenceHigh` above can only carry the cases that
* reduce to two numbers. This field is what stops every other case from
* being dropped on the floor — the string is kept whether or not the parser
* gets bounds out of it.
*/
referenceText: nullableText(120),
/** MedicationStatement: dose + stated status (verbatim). */
dose: nullableText(120),
medicationStatus: nullableText(64),
@@ -237,6 +246,14 @@ export interface ObservationFactData {
unit: string | null;
referenceLow: number | null;
referenceHigh: number | null;
/**
* The reference range as printed on the report, verbatim.
*
* Optional because it genuinely is: a fact staged before this field existed
* carries no key for it, and that is an honest absence rather than a shim
* for a caller we do not ship. Read it as `?? null`.
*/
referenceText?: string | null;
effectiveDate: string | null;
}
@@ -379,6 +396,7 @@ const observationEditSchema = z
unit: optText(80),
referenceLow: z.number().finite().nullable().optional(),
referenceHigh: z.number().finite().nullable().optional(),
referenceText: optText(120),
effectiveDate: isoDate,
})
// Numeric XOR qualitative, mirroring the lab-result discipline. A null/absent
+20
View File
@@ -78,6 +78,13 @@ export const extractedRowSchema = z.object({
unit: z.string().trim().max(80).nullable().catch(null),
referenceLow: z.number().finite().nullable().catch(null),
referenceHigh: z.number().finite().nullable().catch(null),
/**
* The reference range EXACTLY as printed, verbatim. The two numeric bounds
* above can only carry a window that reduces to two numbers; a report that
* prints "bis 5,0" or "negativ" states a window all the same, and this is
* what keeps it instead of dropping it.
*/
referenceText: z.string().trim().max(120).nullable().catch(null),
takenAt: z.string().nullable().catch(null),
confidence: extractedConfidenceSchema,
});
@@ -107,6 +114,8 @@ export interface OcrExtractedRowDto {
unit: string | null;
referenceLow: number | null;
referenceHigh: number | null;
/** The reference range as printed on the report, verbatim. */
referenceText: string | null;
takenAt: string | null;
confidence: {
analyte: number;
@@ -150,6 +159,17 @@ export const ocrCommitRowSchema = z
unit: z.string().trim().min(1).max(40).optional(),
referenceLow,
referenceHigh,
/**
* The window the scanned report printed for this row. Confirmed by the
* human on the review screen alongside everything else, and written onto
* the reading rather than only used to seed a new catalog marker.
*/
referenceText: z
.string()
.trim()
.max(120)
.optional()
.or(z.literal("").transform(() => undefined)),
takenAt: takenAtField,
})
// Numeric XOR qualitative: exactly one of value / valueText.
+60
View File
@@ -14,6 +14,7 @@
*/
import { z } from "zod/v4";
import { SOURCE_REFERENCE_TEXT_MAX } from "@/lib/labs/parse-reference-range";
import { validateEntryInstant } from "@/lib/validations/entry-instant";
/**
@@ -63,6 +64,29 @@ const optionalNote = z
const referenceLow = z.number().finite().optional();
const referenceHigh = z.number().finite().optional();
/**
* The reference range the SOURCE REPORT printed for this one reading.
*
* Distinct from `referenceLow` / `referenceHigh` above, which seed (and are
* stamped from) the catalog marker's band. A lab runs its own method on its
* own device, so the window a physician evaluates against is the one on that
* report; these fields carry it, and `resolveEffectiveReferenceRange` lets it
* win for that reading alone.
*
* `sourceReferenceText` is what was printed, verbatim. It is accepted with or
* without derivable bounds: a window stated as "negativ" or "siehe Befund"
* still belongs on the record, and dropping it because no number could be read
* out of it is exactly the loss this field exists to stop.
*/
const sourceReferenceLow = z.number().finite().optional();
const sourceReferenceHigh = z.number().finite().optional();
const sourceReferenceText = z
.string()
.trim()
.max(SOURCE_REFERENCE_TEXT_MAX)
.optional()
.or(z.literal("").transform(() => undefined));
/**
* v1.18.1 — optional link to a user-scoped `Biomarker` (the catalog row).
* When set, the structured-entry path resolves the unit + reference range
@@ -101,6 +125,9 @@ export const createLabResultSchema = z
unit: requiredText(40).optional(),
referenceLow,
referenceHigh,
sourceReferenceLow,
sourceReferenceHigh,
sourceReferenceText,
takenAt: takenAtField,
note: optionalNote,
source,
@@ -142,6 +169,19 @@ export const createLabResultSchema = z
message: "referenceLow must not exceed referenceHigh",
path: ["referenceLow"],
},
)
// Same guard on the source window. A transposed window is a client error
// here for the same reason: nothing downstream can tell it from a real one.
.refine(
(d) =>
d.valueText !== undefined ||
d.sourceReferenceLow === undefined ||
d.sourceReferenceHigh === undefined ||
d.sourceReferenceLow <= d.sourceReferenceHigh,
{
message: "sourceReferenceLow must not exceed sourceReferenceHigh",
path: ["sourceReferenceLow"],
},
);
export type CreateLabResultInput = z.infer<typeof createLabResultSchema>;
@@ -164,6 +204,9 @@ export const updateLabResultSchema = z
unit: requiredText(40).optional(),
referenceLow: referenceLow.or(z.null()),
referenceHigh: referenceHigh.or(z.null()),
sourceReferenceLow: sourceReferenceLow.or(z.null()),
sourceReferenceHigh: sourceReferenceHigh.or(z.null()),
sourceReferenceText: sourceReferenceText.or(z.null()),
takenAt: takenAtField.optional(),
note: optionalNote.or(z.null()),
})
@@ -183,6 +226,18 @@ export const updateLabResultSchema = z
message: "referenceLow must not exceed referenceHigh",
path: ["referenceLow"],
},
)
.refine(
(d) =>
d.sourceReferenceLow === undefined ||
d.sourceReferenceLow === null ||
d.sourceReferenceHigh === undefined ||
d.sourceReferenceHigh === null ||
d.sourceReferenceLow <= d.sourceReferenceHigh,
{
message: "sourceReferenceLow must not exceed sourceReferenceHigh",
path: ["sourceReferenceLow"],
},
);
export type UpdateLabResultInput = z.infer<typeof updateLabResultSchema>;
@@ -246,7 +301,12 @@ export type ListLabResultsInput = z.infer<typeof listLabResultsSchema>;
* implementation. Re-exported here for the existing import sites.
*/
export {
classifyAgainstEffectiveRange,
classifyReferenceRange,
formatReferenceRange,
resolveEffectiveReferenceRange,
type EffectiveReferenceRange,
type ReferenceRangeOrigin,
type ReferenceRangeStatus,
type SourceReferenceRange,
} from "@/lib/labs/reference-range";
@@ -0,0 +1,298 @@
/**
* The whole path a printed reference range travels, against a real Postgres.
*
* The failure this pins is a two-ended one: until now the document reading
* pulled the value off a lab report and dropped the range printed beside it,
* and every end of that pipe looked healthy on its own. So the assertions here
* follow ONE range through the real assembly rather than checking each end in
* isolation:
*
* extract → the staged fact carries the printed string
* commit → the written row carries the derived bounds AND the string
* read → the API DTO serves both windows and says which is in force
* verdict → the reading is judged against the REPORT's window, not the
* catalog band — the case where the two disagree is the point
* report → the doctor-report payload and the FHIR bundle agree with it
*
* The catalog band is deliberately set so that the same number reads
* "in-range" against the report and "above" against the catalog. A test whose
* two windows agree cannot tell whether the precedence rule is wired at all.
*/
import { NextRequest } from "next/server";
import { beforeEach, describe, expect, it, vi } from "vitest";
import { cookieJar } from "./mock-next-headers";
import { getPrismaClient, truncateAllTables } from "./setup";
const USER_ID = "user-lab-source-range";
vi.mock("next/headers", async () => {
const { cookieJar, headerJar } = await import("./mock-next-headers");
return {
headers: vi.fn(async () => ({
get: (name: string) => headerJar.get(name.toLowerCase()) ?? null,
})),
cookies: vi.fn(async () => ({
get: (name: string) => {
const value = cookieJar.get(name);
return value ? { name, value } : undefined;
},
set: (name: string, value: string) => {
cookieJar.set(name, value);
},
delete: (name: string) => {
cookieJar.delete(name);
},
})),
};
});
vi.mock("@/lib/db-compat", () => ({
ensureDbCompatibility: vi.fn().mockResolvedValue(undefined),
}));
beforeEach(async () => {
await truncateAllTables(getPrismaClient());
cookieJar.clear();
const prisma = getPrismaClient();
await prisma.user.create({
data: {
id: USER_ID,
username: "lab-source-range",
email: "lab-source-range@example.test",
},
});
const session = await prisma.session.create({
data: { userId: USER_ID, expiresAt: new Date(Date.now() + 3_600_000) },
});
cookieJar.set("healthlog_session", session.id);
});
/** The catalog band the marker carries. 5.2 sits ABOVE this window. */
const CATALOG = { lowerBound: 3.5, upperBound: 5.0 };
/** The window the report printed. 5.2 sits INSIDE this one. */
const PRINTED = "3,9 - 5,4";
const VALUE = 5.2;
async function seedMarker() {
return getPrismaClient().biomarker.create({
data: { userId: USER_ID, name: "Kalium", unit: "mmol/L", ...CATALOG },
});
}
function postReq(body: unknown): NextRequest {
return new NextRequest("http://localhost/api/labs", {
method: "POST",
headers: { "content-type": "application/json" },
body: JSON.stringify(body),
});
}
async function readDto(analyte = "Kalium") {
const { GET } = await import("@/app/api/labs/route");
const res = await GET(
new NextRequest(`http://localhost/api/labs?analyte=${analyte}`),
);
expect(res.status).toBe(200);
const body = await res.json();
return body.data.results[0];
}
describe("a printed reference range, end to end", () => {
it("survives the document path onto the row and governs its verdict", async () => {
const prisma = getPrismaClient();
const marker = await seedMarker();
// The document path, through the REAL commit helper the confirm route
// calls. The fact carries what a report prints: a value, a unit, and a
// window stated in German notation beside it.
const { commitApprovedFact } = await import("@/lib/documents/commit");
const { encryptFactData, encryptFactProvenance } =
await import("@/lib/documents/store");
const doc = await prisma.inboundDocument.create({
data: {
userId: USER_ID,
filename: "befund.pdf",
mimeType: "application/pdf",
byteSize: 1024,
contentEncrypted: Buffer.from("stand-in for the stored bytes"),
status: "EXTRACTED",
},
});
const fact = await prisma.extractedFact.create({
data: {
documentId: doc.id,
userId: USER_ID,
factType: "OBSERVATION",
status: "APPROVED",
confidence: 0.9,
needsReview: false,
dataEncrypted: encryptFactData({
label: "Kalium",
code: null,
codeSystem: null,
value: VALUE,
valueText: null,
unit: "mmol/L",
referenceLow: null,
referenceHigh: null,
referenceText: PRINTED,
effectiveDate: "2026-07-01",
}),
provenanceEncrypted: encryptFactProvenance({
sourceText: "Kalium 5,2 mmol/l 3,9 - 5,4",
anchored: true,
sourceOffset: 0,
page: 0,
confidence: 0.9,
}),
},
});
const ref = await commitApprovedFact(USER_ID, fact);
expect(ref.recordType).toBe("labResult");
// The row carries BOTH readings of the printed window: the bounds derived
// from it and the string itself.
const row = await prisma.labResult.findUniqueOrThrow({
where: { id: ref.recordId },
});
expect(row.sourceReferenceLow).toBe(3.9);
expect(row.sourceReferenceHigh).toBe(5.4);
expect(row.sourceReferenceText).toBe(PRINTED);
// The catalog stamp is untouched — the marker already existed, so the
// document's window did not rewrite the user's own band.
expect(row.referenceLow).toBe(CATALOG.lowerBound);
expect(row.referenceHigh).toBe(CATALOG.upperBound);
const markerAfter = await prisma.biomarker.findUniqueOrThrow({
where: { id: marker.id },
});
expect(markerAfter.lowerBound).toBe(CATALOG.lowerBound);
expect(markerAfter.upperBound).toBe(CATALOG.upperBound);
// The read side serves both windows, names the winner, and flags that the
// two disagree.
const dto = await readDto();
expect(dto).toMatchObject({
value: VALUE,
referenceLow: 3.9,
referenceHigh: 5.4,
catalogReferenceLow: CATALOG.lowerBound,
catalogReferenceHigh: CATALOG.upperBound,
sourceReferenceLow: 3.9,
sourceReferenceHigh: 5.4,
sourceReferenceText: PRINTED,
referenceOrigin: "source",
referenceDivergesFromCatalog: true,
});
// The verdict is the point. Against the catalog band 5.2 is above range;
// against the window the lab printed it is inside it, and the lab's window
// is the one the physician read the value against.
expect(dto.rangeStatus).toBe("in-range");
// The doctor report reads the same window, and prints the report's own
// string rather than a reformatted version of it.
const { loadLabResults } =
await import("@/lib/doctor-report/clinical-records");
const labs = await loadLabResults(
USER_ID,
new Date("2026-01-01T00:00:00.000Z"),
new Date("2026-12-31T23:59:59.000Z"),
);
expect(labs?.[0]).toMatchObject({
referenceLow: 3.9,
referenceHigh: 5.4,
catalogReferenceLow: CATALOG.lowerBound,
catalogReferenceHigh: CATALOG.upperBound,
sourceReferenceText: PRINTED,
referenceOrigin: "source",
referenceDivergesFromCatalog: true,
});
// FHIR exports the same window — a receiver that trusts referenceRange
// must not be handed the catalog band while the app shows another.
const { labObservations } = await import("@/lib/fhir/resources/labs");
let seq = 0;
const observations = labObservations(
{ labResults: labs } as Parameters<typeof labObservations>[0],
() => `obs-${++seq}`,
);
expect(observations[0].referenceRange?.[0]).toMatchObject({
low: { value: 3.9 },
high: { value: 5.4 },
text: PRINTED,
});
});
it("keeps a window it cannot read as text and leaves the catalog in force", async () => {
const prisma = getPrismaClient();
await seedMarker();
const { POST } = await import("@/app/api/labs/route");
const marker = await prisma.biomarker.findFirstOrThrow({
where: { userId: USER_ID },
});
const res = await POST(
postReq({
biomarkerId: marker.id,
value: VALUE,
sourceReferenceText: "siehe Befund",
takenAt: "2026-07-02T08:00:00.000Z",
}),
);
expect(res.status).toBe(201);
const row = await prisma.labResult.findFirstOrThrow({
where: { userId: USER_ID },
});
// The string is on the record — absence would be the old failure, and a
// fabricated bound would be worse than either.
expect(row.sourceReferenceText).toBe("siehe Befund");
expect(row.sourceReferenceLow).toBeNull();
expect(row.sourceReferenceHigh).toBeNull();
const dto = await readDto();
expect(dto).toMatchObject({
sourceReferenceText: "siehe Befund",
referenceOrigin: "catalog",
referenceDivergesFromCatalog: false,
referenceLow: CATALOG.lowerBound,
referenceHigh: CATALOG.upperBound,
});
// No derivable window means the catalog stays the net, so the catalog's
// verdict stands.
expect(dto.rangeStatus).toBe("above");
});
it("carries the window through a backup round trip", async () => {
const prisma = getPrismaClient();
const marker = await seedMarker();
await prisma.labResult.create({
data: {
userId: USER_ID,
biomarkerId: marker.id,
analyte: "Kalium",
unit: "mmol/L",
value: VALUE,
referenceLow: CATALOG.lowerBound,
referenceHigh: CATALOG.upperBound,
sourceReferenceLow: 3.9,
sourceReferenceHigh: 5.4,
sourceReferenceText: PRINTED,
takenAt: new Date("2026-07-01T08:00:00.000Z"),
},
});
const { buildRecordsBackupSection } =
await import("@/lib/export/records-backup");
const backup = await buildRecordsBackupSection(prisma, USER_ID, {
purpose: "disaster-recovery",
});
expect(backup.labResults[0]).toMatchObject({
sourceReferenceLow: 3.9,
sourceReferenceHigh: 5.4,
sourceReferenceText: PRINTED,
});
});
});