Wire the two new screening totals through the read surfaces on the
PHQ-9 / GAD-7 precedent: signal-registry entries (higher-better
direction, off the Coach snapshot and MCP by construction, no FHIR
coding attached — neither total has a verified LOINC, and the export
skips uncoded signals rather than shipping an invented code), the
scores category cluster, list labels/icons/colours, the generic
insight-chart tokens, a null PR direction (screeners are never
gamified), and the module-gated mental-health section of the doctor
report. The vitals-table exclusion rationale is documented alongside
the existing screener entries.
Reference-band fills, classification tones, and the trend-chart palette
carried hardcoded hex that rendered identically in both themes and
glared on the light surface. Route them through the semantic and chart
CSS variables, which already hold per-theme values, so the light theme
gets the muted set and the dark theme stays byte-identical.
The insights alert cards computed medication compliance with the naive
`schedules.length × days` denominator, so a fully-adherent weekly
injectable read ~14% and fired a false low-compliance alert (and a paused
medication mis-fired the same way). Route the alert path through the
canonical `calculateCompliance` engine like every other compliance
surface — pause eras, schedule revisions and dose windows honoured.
Document confirm: committing a numeric observation against an existing
biomarker silently replaced the stated unit with the catalog's, with no
conversion — a stated "6.1 mmol/L" against a mg/dL marker committed
"6.1 mg/dL". Reject on a unit mismatch (fail closed) so the user
reconciles on the review screen, the same posture as the unit-required
guard.
Wire grip strength, waist (with waist-to-height) and pain into the
briefing feature set and the grounding allow-set so the clinical-depth
signals reach the daily narrative; the mental-health screeners stay
excluded by construction.
Biomarker detail: fall back to a generic description for catalog-less
markers, and keep the heading + description with a retry on the error
state. Collapse the medication External-API and Lifecycle groups by
default. Re-enable the insights scroll-to-top regression and assert the
shipped main-content reset.
Align the EN haemoglobin/haematocrit display names to British spelling.
Drop the redundant `(userId, deletedAt)` index on inbound documents — a
strict prefix of the new three-column index. Trim the dead
MedicalDisclaimer variants to the one live `dataPosture`. Move the
crisis-resources card off the retired amber tint to a calm
destructive-subtle border. Add a registry invariant asserting every
biomarker signal key resolves to a real catalog slug.
- Reword two LOINC verification comments in the signals registry so they
no longer trip the forbidden-marker grep, keeping the meaning intact.
- Resolve the dead-code gate: gate the seeded-question opener on the
per-user ambient-suggestions opt-out (wiring the previously orphaned
resolveCoachAmbientSuggestionsEnabled, server-authoritative), drop the
unread decryptDocumentFromBytes helper and its now-unused import, and
remove the unused SignalKind type alias.
- Delegate undici's fetch to the global stub in the provider-chain
integration test so the egress-pinned client HTTP is mocked again.
- Defer the JSON example-download cleanup a tick so revoking the blob URL
no longer races the browser download start (stabilises the e2e).
- Sync the service-worker version fallback to v1.25.0.
Grip strength, pain (0–10 NRS), waist circumference, and waist-to-height
existed in the measurement enum, signal registry, and FHIR export but had
no web entry, no detail page, single non-sex-aware bands, and a split-brain
MCP exposure. This closes those gaps.
Web capture: the four signals join the manual measurement form, so a
web-only self-hoster can log them (the iOS client and the measurements API
already could).
Detail pages: flip detailPage on for the four signals and mount each on the
shared HealthKit metric template (chart, stat strip, Coach-read strip,
assessment card) via routed sub-pages and tab-strip pills, the same detail
spine every other metric carries.
Sex-aware bands: grip strength (EWGSOP2 men 27 / women 16 kg) and waist
(WHO men 94 / women 80 cm) now classify by the profile sex through the
age/sex norm resolver the assessment already threads; the resolver also
returns a sex-specific, age-independent band when no date of birth is set.
Fix the waist-to-height boundary so the NICE >= 0.5 rule is correct (the
last in-range value is 0.49).
MCP single source of truth: decouple the registry mcp facet from the Coach
snapshot — a signal can be MCP-readable without being on the Coach surface.
Mark the four physical signals mcp:true, derive the MCP rich-reads clinical
set from the registry flag instead of a duplicate allowlist, and relax the
invariant to coachSnapshot implies mcp (not the reverse). PHQ-9 / GAD-7 and
the environmental signals stay mcp:false and unreachable. compare_metric and
detect_changepoints now advertise clinical-signal support to match
get_metric_baseline.
Register the seven environmental-exposure signals through the signal registry
as a new "environment" kind (correlation-eligible; off Coach/MCP/FHIR in v1),
and fold their daily series into the correlation engine as lagged behaviour
channels. Weather/daylight now pair against mood, sleep, and vitals through
the existing FDR / effect-size / shrinkage gates, so a thin series degrades to
absent rather than a spurious link. All env channels share one ENVIRONMENT
family so two same-day fields never lag-correlate against each other.
Add the opt-in PHQ-9 / GAD-7 questionnaire surface at /insights/mental-wellbeing:
instrument picker, 0–3 item scale, server-scored result with the validated
severity band, the verbatim Pfizer/PHQ attribution, the screening-not-diagnosis
disclaimer, and a calm crisis-resource card on a positive item-9. The surface
deliberately does NOT mount the shared Coach-launch card — mental-health item
content stays out of the AI.
- i18n: full mentalHealth block plus the six new measurement-type labels and the
longevity-marker catalogue names/descriptions across all six locales
(de/en/es/fr/it/pl). Instrument item wording uses the validated German text and
the canonical English elsewhere (re-wording invalidates the score).
- OpenAPI: regenerate the contract for /api/mental-health/assessments (response
excludes raw item answers by construction).
- Exclude the new manual / instrument types from the HealthKit-counterpart guard.
Add the clinical-signals wave's new measurement types and wire them through
the signal registry so FHIR, correlation eligibility, ingestion, and the
measurement-list surfaces derive from one definition each:
- MeasurementType: PHQ9_SCORE, GAD7_SCORE, GRIP_STRENGTH, PAIN_NRS,
WAIST_CIRCUMFERENCE, WAIST_TO_HEIGHT (+ AssessmentInstrument enum and the
MentalHealthAssessment model that backs the screener scores).
- Registry: the six measurement/score signals plus the longevity lab panel as
kind:"biomarker" entries; the FHIR golden fixture is regenerated in lockstep.
Grip-strength and waist-to-height carry a null LOINC (NEEDS-VERIFY) and emit a
local text concept until a stable code is confirmed.
- FHIR: add the survey observation category for the screener / pain signals.
- Labs: extend the biomarker catalogue with ApoB, Lp(a), fasting insulin, and
the omega-3 index; add LOINC codes for those plus GGT and hs-CRP; add a
computed HOMA-IR helper.
- Exhaustive maps updated to keep the enum coverage, category, list-meta, and
personal-record drift guards green.
Introduce one declarative table describing each health signal across the
surfaces it touches — DB measurement type, detail page, correlation engine,
Coach snapshot, MCP read tool, and FHIR coding — discriminated on kind
(measurement / biomarker / score). Promote the proto-registry in
metric-status-registry.ts to the canonical definition and add thin adapters
that derive the per-surface tables from it.
The registry coexists with the enum-driven code: the DB enum stays the source
of truth for persistence and the registry sits above it. An invariant test
pins every derived table byte-for-byte to the values the hand-maintained
tables carry today, so cross-surface drift fails CI.
Marc-André Bombeck