Replace the CompletionParams { systemPrompt, userPrompt } string pair with a
structured { system, messages[] } request across all five AI clients. One
refactor unlocks three things: provider prompt-caching (Anthropic cache_control
on the stable system prefix, OpenAI/Codex automatic prefix cache, with
cachedInputTokens surfaced for observability), the tool-calling wire surface,
and clean multi-turn.
Each client maps the new shape to its own wire and degrades unsupported
features silently: the local OpenAI-compatible server never receives a tools
field (most reject unknown keys), and prompt-caching is best-effort everywhere.
CompletionResult gains toolCalls, finishReason and cachedInputTokens; the tool
types and per-provider mapping ship now, the tool-use loop does not.
Vision inputs fold into the user turn's content parts via singleUserTurn, with
each provider's pre-existing block ordering preserved. The corrective-retry
paths append to the last user message rather than a flat string. The Coach
keeps assembling one user turn so its snapshot-once and grounding behaviour is
unchanged. No wire schema visible to API consumers changed.
Behaviour is unchanged across every surface; the full suite stays green.
Image input rides the ChatGPT-OAuth codex/responses endpoint via the
input_image content block (protocol spec 2b) — no vision API key. The
codex client folds params.images into input_image blocks alongside the
input_text; text-only calls keep the prior byte-identical wire. The
vision gate now resolves codex capability against the working slug
(GPT-5.x / gpt-4o-class multimodal) instead of a blanket false, with the
OCR capability resolver feeding the codex slug rather than the user's
aiModel. A non-multimodal slug or an image-block rejection degrades to a
clean extract failure / local-OCR text mode.
Replace the separate, capability-gated scan button with a single Add
menu: "Scan a document" (OCR) or "Add a value manually". The scan entry
appears only when the capability probe reports a usable mode, and routes
to native vision or local in-browser OCR (tesseract.js, lazy-loaded,
deu+eng, images only) per the resolved mode. Add the local-OCR opt-in
toggle to the Labs settings page with honest "less accurate — review
every value" copy.
Surface range confidence prominently on the OCR review screen for new
numeric biomarkers, where the extracted range becomes the catalog range:
flag low range-confidence or a missing range so the user verifies it.
Add an opt-in in-browser OCR path so a user whose provider cannot read
images (ChatGPT-OAuth/Codex, a text-only model) can still scan a lab
report. The capability probe gains a `mode` field: `vision` when the
provider reads the image directly, `text` when local OCR is enabled and
any provider is configured, or null. The extract route grows a text
branch that accepts the in-browser-OCR'd text as JSON and structures it
through the existing schema + review/commit flow; the raw image never
reaches the server in text mode. New `labsLocalOcrEnabled` user column
(migration 0184, default off) gates it, with a dedicated PATCH endpoint.
Resolve a vision-capable provider, gate with consent + a 6/hour rate bucket +
a reserved per-day token budget, then transcribe an uploaded photo or PDF into
structured proposed rows. The raw upload stays in memory only and is never
persisted. The commit route writes only the rows a human confirmed, resolving
or minting a biomarker per row with source OCR and skipping commit-time
duplicates. The capability probe drives whether the UI shows the scan entry.
Extracted text is treated as untrusted; the review screen is the safety
boundary.
Add first-class qualitative lab findings (positive / negative / borderline
serology) alongside the existing numeric path. A LabResult is now EITHER a
numeric reading (value + unit, optional reference bounds) OR a qualitative one
(valueText, e.g. "negativ"), never both, never neither.
- schema: make `value` nullable, add `value_text`; migration 0181 is additive
(DROP NOT NULL + ADD COLUMN), every existing numeric row is untouched.
- validation: numeric-XOR-qualitative refine on create + update; unit/bounds
apply to the numeric path only; valueText capped at 120 chars. The single
resource PUT rejects a cross-type edit.
- serialise: carry valueText through both DTOs; a qualitative row reports the
neutral `unknown` range verdict (no number to classify).
- FHIR: a qualitative result emits valueCodeableConcept — SNOMED qualifier
value for confidently-known terms (Negative 260385009, Positive 10828004,
Not detected 260415000, Detected 260373001), text-only for borderline /
grenzwertig and any unrecognised term. The raw text always rides .text.
- UI: a numeric/qualitative toggle in the lab form; list, history, detail,
chart, sparkline, and the doctor-report PDF all render qualitative readings
as their text and never plot or divide on a null value.
- i18n: new labs.form keys across all six locales.
- openapi: response carries a nullable value + valueText; regenerated.
One-shot prettier pass so the new format:check gate starts from a clean
baseline. Formatting only — no behaviour change. Generator-owned and
vendored artifacts stay untouched via .prettierignore.
Add a 'showing latest N of M' hint to the lab list and biomarker detail
when the 500-row cap truncates. Drop the inaccurate amend comment from the
edit history, justify the inline-SVG vs Recharts sparkline split, remove
the unused BiomarkerPanelKey export, and document the deliberate UX-only
(non-server) module gate on the labs + biomarkers routes. New labs i18n
keys added across all six locales.
The catalog GET eagerly threw on the first un-decryptable context row,
500ing the whole list. The list serializer now decrypts fail-soft (null
on a bad-key/malformed row) via decryptContextSoft, bounding the
fail-closed blast radius to one marker; the single-resource GET stays the
authoritative throwing read for the plaintext context.
A PUT that moves a single reference bound past the row's stored other
bound slipped through the schema refine (which only fires when both bounds
arrive together). Both the lab-result and biomarker routes now merge the
effective bounds and 422 on low > high. Editing catalog-resolved fields
(analyte/unit/panel/range) on a linked reading is also rejected rather than
silently no-oped. Shared isInvertedRange/effectiveBound helpers with tests.
The edit sheet loaded the decrypted note from the single-resource GET and
sent note:null on a load miss, silently wiping a note that simply could
not be read. The submit path now omits the note key entirely in that case
(server preserves the stored ciphertext), disables the textarea, and shows
a hint. Decision encoded in a pure resolveNoteForUpdate helper with tests.
A free-text lab write resolves or mints a user-scoped biomarker by
(userId, lower(analyte)) so no LabResult row ever persists unlinked. An
existing marker is reused as-is (its unit/range stay authoritative); a
miss mints one from the reading's own spelling. Every reading is now
editable and detail-navigable, and the boot-time backfill becomes a pure
pre-upgrade migration. Closes the unlinked-row dead-end and the contract
hole in one path.
Add a user-scoped Biomarker catalog so a marker is defined once — name,
unit, lower/upper bound, optional encrypted context, panel — and every
later reading just links it. New /api/biomarkers CRUD plus a structured
/api/labs create path: a biomarkerId resolves the unit + reference range
server-side, so the list and detail DTOs carry the resolved values and
the client never recomputes the range. Lab reads include the linked
marker and fall back to the legacy free-text fields for unlinked rows.
Add a lab-result restore endpoint for the delete-Undo affordance, a
shared serialiser, a static common-panel seed list, and tests for
catalog validation, structured-entry resolution, and the context codec.
Reference-range classification + low/high range rendering was implemented three
times (validations, PDF core, lab list). Extract a single classifier and a
structure-only range formatter that takes a per-surface number formatter, so
each surface keeps its own number formatting while sharing the canonical
classification. Behaviour is unchanged per surface and now covered by one test.
The annual-blood-panel auto-resolve that findLatestLabResultForAnalytes was
meant to feed never got wired into the Vorsorge reminder, so the export sits
with zero callers and the labAnalyteTrend query-key has no consumer (the
sparkline is prop-fed and there is no labs trend endpoint). Remove both so the
knip gate is clean; the Vorsorge lab read-back can come back with the wiring
that needs it.
Record discrete biomarker readings (HbA1c, LDL, ferritin, TSH, …) with
their value, unit, reference range and sample date. The store pairs with
the annual blood-panel reminder, which until now had nowhere to record
the result it reminds the user to obtain.
The list/create/update/delete endpoints narrow userId from the session,
build the write data field-by-field, soft-delete via deletedAt, and
encrypt the optional note at rest. A neutral three-state reference-range
classifier (in-range / below / above / unknown) is computed
server-side so every surface renders the same calm verdict.
findLatestLabResultForAnalytes exposes the read point the blood-panel
reminder consults to mark itself satisfied, without coupling the two.
Marc-André Bombeck