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.
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.
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