A lab report's reference range reaches the record by four paths. Three of
them validate that the floor does not exceed the ceiling; the document
path did not, and the catalog store writes what it is handed. An
integration run against a real Postgres confirmed the consequence: a
100/30 pair landed on the row and on the freshly minted biomarker, so
every later reading of that analyte inherited a window that cannot be
true and a high value came back reassuring.
Dropping beats swapping. A transposed pair says the transcription is
wrong, not which of the two numbers is, and inventing an order would
state something the report never printed. The verbatim string survives
either way, so nothing the document actually said is lost.
Three points, answering according to what each one is:
- the extraction schema drops the pair, because every field there is
catch-guarded so one bad value cannot sink a 120-fact document
- the review-screen edit refuses with the wording the lab schemas
already use, because a person can see both numbers and fix them
- the commit path drops it as the last gate, which is what covers facts
staged before this rule existed and confirmed afterwards
parseReferenceRange has answered a transposed PRINTED window this way
since it was written, and the commit path already counts a window it
could not read at all. This extends both to the case that was readable
and cannot be true.
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.
Marc-André Bombeck