feat(labs): keep the reference range a report prints beside a value

A lab runs its own method on its own device, so the window a physician
evaluates a value against is the one printed next to it on that report,
not a catalog band averaged over every lab. Reading a report pulled the
value and dropped that range: the extraction asked for it, the commit
handed it to the biomarker resolver, and the resolver only uses it when
it mints a NEW marker. For every analyte the user already had — the
normal case after a first panel — the printed range was read and then
thrown away.

Add `sourceReferenceLow` / `sourceReferenceHigh` / `sourceReferenceText`
to `LabResult` and carry the range from the report to the reading. The
text is stored whether or not numbers can be read out of it, because
"bis 5,0" and "negativ" state a window too; a range that could not be
parsed is kept verbatim, never replaced with invented bounds.

`resolveEffectiveReferenceRange` is the one place the precedence lives:
the source window wins for that single reading, and the catalog stays
the net for readings without one. A printed string with no derivable
bound does not displace the catalog. Every surface that judges a
reading routes through it — the API verdict, the doctor report, the
insights blocks and per-marker assessment, the coach snapshot, the MCP
read and the FHIR `referenceRange` — so a value cannot read in range on
one surface and out on another.

The API keeps `referenceLow` / `referenceHigh` as the window in force,
so a client that reads only those two renders the right range and the
right verdict with no change of its own; the catalog band, the source
window, its origin and a divergence flag ride alongside for clients
that want to show both.

Read side: the chart draws the source window as a second, visually
distinct band with the reading it came from named beneath it, the
reading rows name the printed range and the catalog band where the two
disagree, and the doctor-report PDF prints the report's own string with
a footnote naming the saved range. Entry side: one optional field on
the lab form, folded away until asked for, and the printed range is
editable on the scan review screen.

The range parser covers the notations German and English reports
actually print — two-sided, one-sided, comma or dot decimals, thousands
separators, trailing units — reads units without ever converting them,
and refuses to guess on anything ambiguous.
This commit is contained in:
Marc-André Bombeck committed 2026-08-07 21:40:41 +02:00
1 parent 3778e70ff5
commit fd2bd67ff3
57 files changed
+2281 -175

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@@ -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,