Files
HealthLog/src/lib/analytics/bp-in-target.ts
T
Marc-André Bombeck 60359dbcb7 fix(health-score): grade the blood-pressure pillar by clinical proximity
The BP pillar value equalled the binary all-time in-target rate: the
share of paired readings where both systolic and diastolic sat at or
below the age-band ceiling. A borderline stage-1 profile (diastolic a
few mmHg over the ceiling on most readings) collapsed the pillar to the
teens even though the reading is "a bit high", not catastrophic — and
improvement never surfaced because the rate is all-time and binary.

Replace the binary rate AS THE SCORE with a smooth clinical-proximity
grade. A recency-weighted representative reading (45-day half-life) is
mapped per axis onto a 0-100 curve anchored on the same age-band ceiling
the rest of the app uses — optimal ≈ 100, at the ceiling ≈ 85, then
piecewise-linear down through the over-target bands; hypotension is
penalised symmetrically below the clinical floors. The pillar takes the
worse of the two axes, so an elevated diastolic counts without
binary-zeroing the result. A 134/87 profile against a 129/79 ceiling now
reads in the mid-50s.

The in-target rate stays available as a secondary "X% of readings in
range" stat. The healthScore.components.bp shape is unchanged — only the
value moves.
2026-06-07 17:36:13 +02:00

310 lines
12 KiB
TypeScript

/**
* BP-in-target percentage helper.
*
* The "BD im Zielbereich" tile on the dashboard reports the share of
* recent blood-pressure readings that are at or below the user's
* age-band ceiling. Up to v1.4.14 this lived inline in
* `src/app/api/analytics/route.ts` and had two latent bugs that made
* the tile read 0 % even when the user clearly had readings inside the
* target band:
*
* 1. **Wrong denominator (v1.4.14).** The legacy code divided
* `inTarget / sysData.length`, but readings are only countable when
* a matching diastolic exists within 5 minutes. v1.4.15 A4 fixed the
* denominator to count only paired readings.
*
* 2. **Wrong target semantics (v1.4.15 -> v1.4.16 A2 regression).** The
* v1.4.15 fix kept the original "within narrow goal band" semantics:
* `sys >= sysLow && sys <= sysHigh && dia >= diaLow && dia <= diaHigh`.
* With ESH 2023 narrow targets (Sys 120-129, Dia 70-79 for under-65)
* this collapses to 0 % for healthy normotensive users whose
* readings sit BELOW the goal band — the live tenant's actual data has many
* readings like 117/79 (textbook normotensive, well-controlled) that
* were marked OUT of target because sys < 120. Users intuitively
* consider those readings *in target* — and so does clinical
* practice ("BP is well-controlled" = "at goal or below the goal
* ceiling, not implausibly hypotensive"). The v1.4.16 fix changes
* semantics from a narrow band to a one-sided ceiling check with a
* clinical floor for true hypotension:
*
* in-target := sys >= 90 AND sys <= sysHigh
* AND dia >= 50 AND dia <= diaHigh
*
* The 90/50 floors are well below any plausible "normal-low" and
* flag symptomatic hypotension as out-of-target instead of silently
* counting it as good control.
*
* 3. **No fallback when timestamps don't pair (v1.4.15 fix).** Withings
* imports and moodLog.app imports each write sys + dia as separate
* Measurement rows that ought to share a `measuredAt` to the second
* — but rounding through different timezones can drift them by
* minutes. The 5-minute window was tight; data imported with
* hour-level rounding (some legacy Withings ranges) had `timeDiff >
* 5 min`. The fallback to same-Berlin-day pairing covers that.
*
* Pure & deterministic so the unit test suite can pin the exact %.
*/
import type { BpTargets } from "./bp-targets";
export interface BpReading {
measuredAt: Date;
value: number;
}
/**
* Clinical floors below which a reading is symptomatic hypotension and
* NOT a desirable "well-controlled BP" outcome. Roughly mid-band
* shock-onset thresholds; well below any reasonable normotensive
* resting reading.
*/
export const SYS_HYPOTENSION_FLOOR = 90;
export const DIA_HYPOTENSION_FLOOR = 50;
import { toBerlinDayKey } from "@/lib/tz/resolver";
/**
* Pair a systolic reading with its closest diastolic by absolute time
* delta. Returns the time delta (ms) and the matched dia, or `null` if
* the dia list is empty.
*/
function findClosestDia(
sys: BpReading,
diaSeries: BpReading[],
): { dia: BpReading; deltaMs: number } | null {
if (diaSeries.length === 0) return null;
let bestDia = diaSeries[0];
let bestDelta = Math.abs(
diaSeries[0].measuredAt.getTime() - sys.measuredAt.getTime(),
);
for (let i = 1; i < diaSeries.length; i++) {
const candidate = diaSeries[i];
const delta = Math.abs(
candidate.measuredAt.getTime() - sys.measuredAt.getTime(),
);
if (delta < bestDelta) {
bestDelta = delta;
bestDia = candidate;
}
}
return { dia: bestDia, deltaMs: bestDelta };
}
/**
* `true` when a paired reading is at or below the upper bound for both
* sys and dia, AND above the clinical hypotension floors. This is the
* canonical "BP in target" definition shared across every call site
* (dashboard tile, insight cards, AI snapshot, comprehensive endpoint,
* targets endpoint). Exported so the other modules don't drift.
*/
export function isBpReadingInTarget(
sys: number,
dia: number,
targets: BpTargets,
): boolean {
return (
sys >= SYS_HYPOTENSION_FLOOR &&
sys <= targets.sysHigh &&
dia >= DIA_HYPOTENSION_FLOOR &&
dia <= targets.diaHigh
);
}
/**
* Compute the share (0-100, rounded to nearest integer) of paired BP
* readings inside `targets` over the supplied series. Returns `null`
* when no pairs can be formed (caller renders the tile as "no data"
* instead of 0 %).
*
* Pairing strategy:
* 1. For each sys reading, find the closest dia by absolute time
* delta.
* 2. Accept the pair if `deltaMs <= 5 minutes` (legacy bound) — same
* session.
* 3. Otherwise accept the pair if both share the same Berlin
* calendar day (handles imports rounded to the hour or to noon).
* 4. Discard otherwise.
*
* Denominator is the number of accepted pairs, NOT `sysData.length` —
* that was the v1.4.14 bug that made the tile read 0 % when imports
* had drifted timestamps.
*
* In-target check is the one-sided ceiling defined by
* `isBpReadingInTarget()` — see file-header comment for the rationale.
*/
export function computeBpInTargetPct(
sysSeries: BpReading[],
diaSeries: BpReading[],
targets: BpTargets,
): { pct: number; pairs: number } | null {
if (sysSeries.length === 0 || diaSeries.length === 0) return null;
const SAME_SESSION_MS = 5 * 60 * 1000;
let pairs = 0;
let inTarget = 0;
for (const sys of sysSeries) {
const match = findClosestDia(sys, diaSeries);
if (!match) continue;
const sameSession = match.deltaMs <= SAME_SESSION_MS;
const sameBerlinDay =
!sameSession &&
toBerlinDayKey(sys.measuredAt) === toBerlinDayKey(match.dia.measuredAt);
if (!sameSession && !sameBerlinDay) continue;
pairs += 1;
if (isBpReadingInTarget(sys.value, match.dia.value, targets)) {
inTarget += 1;
}
}
if (pairs === 0) return null;
return {
pct: Math.round((inTarget / pairs) * 100),
pairs,
};
}
/**
* v1.15.12 A1 — collect the accepted SYS/DIA pairs (same pairing rules
* as `computeBpInTargetPct`) as timestamped points, for the graded BP
* pillar score. Returns `{ at, sys, dia }` per accepted pair using the
* SYS reading's timestamp as the pair anchor — recency weighting only
* needs ordering, not sub-second precision. Empty when no pairs form.
*/
export function collectBpPairs(
sysSeries: BpReading[],
diaSeries: BpReading[],
): Array<{ at: Date; sys: number; dia: number }> {
if (sysSeries.length === 0 || diaSeries.length === 0) return [];
const SAME_SESSION_MS = 5 * 60 * 1000;
const out: Array<{ at: Date; sys: number; dia: number }> = [];
for (const sys of sysSeries) {
const match = findClosestDia(sys, diaSeries);
if (!match) continue;
const sameSession = match.deltaMs <= SAME_SESSION_MS;
const sameBerlinDay =
!sameSession &&
toBerlinDayKey(sys.measuredAt) === toBerlinDayKey(match.dia.measuredAt);
if (!sameSession && !sameBerlinDay) continue;
out.push({ at: sys.measuredAt, sys: sys.value, dia: match.dia.value });
}
return out;
}
/**
* v1.4.18 A1 → v1.4.19 A1 — windowed in-target shares for the dashboard
* tile.
*
* The "BD im Zielbereich" tile renders three numbers:
* - Headline: the **all-time** in-target % across every paired reading.
* - `7T:` the in-target % over the trailing 7 days.
* - `30T:` the in-target % over the trailing 30 days.
*
* History of the bug:
*
* - Up to v1.4.17 only the 30-day figure was computed; the tile showed
* `avg7={null}, avg30={null}` so `7T: —, 30T: —` rendered the dash
* fallback even when paired readings existed.
* - v1.4.18 A1 wired `avg7` + `avg30` from `computeBpInTargetWindows`,
* BUT the analytics route also routed the **headline**
* (`bpInTargetPct`) through `windows.last30Days?.pct` — i.e. the
* headline was a literal copy of `bpInTargetPct30d`. For the live tenant's prod
* data (572 paired readings since 2022, recent 30 days = 50 %, all-time
* ≈ 11 %) the tile rendered `50 %` headline, `7T: 50, 30T: 50` and
* looked algorithmically pinned to 50/50/50. That was hypothesis-1
* from the v1.4.19 A1 brief: "the 7T/30T branches reuse the all-time
* percentage" — actually the *other* direction (the all-time headline
* reused the 30-day value).
* - v1.4.19 A1 surfaces a third `allTime` window so the headline gets
* the genuinely-different aggregate. Callers must use `allTime` for
* the headline now; the test suite pins this contract.
*
* `null` for any window means "no paired readings in that window"; the
* caller renders the "—" placeholder instead of `0`. Caller must pass
* UNFILTERED series for `allTime` to produce the correct value — the
* helper does the windowing internally.
*/
const DAY_MS = 24 * 60 * 60 * 1000;
export function computeBpInTargetWindows(
sysSeries: BpReading[],
diaSeries: BpReading[],
targets: BpTargets,
now: Date = new Date(),
): {
last7Days: { pct: number; pairs: number } | null;
last30Days: { pct: number; pairs: number } | null;
allTime: { pct: number; pairs: number } | null;
/**
* v1.4.22 W5 reconcile (Code-H2) — period-aligned 30-day window
* shifted back by one month (now-60d … now-30d). Used by the
* BD-Zielbereich tile's comparison-overlay caption when the user's
* `comparisonBaseline === "lastMonth"` so the rendered "Δ X% vs.
* last month" is honest. Null when the prior window has no pairs.
*/
priorMonth: { pct: number; pairs: number } | null;
/**
* v1.4.22 W5 reconcile (Code-H2) — same shape, shifted back one
* year (now-395d … now-365d) for `comparisonBaseline === "lastYear"`.
*/
priorYear: { pct: number; pairs: number } | null;
} {
const sevenDaysAgoMs = now.getTime() - 7 * DAY_MS;
const thirtyDaysAgoMs = now.getTime() - 30 * DAY_MS;
const sixtyDaysAgoMs = now.getTime() - 60 * DAY_MS;
const oneYearMinus30DaysAgoMs = now.getTime() - 365 * DAY_MS;
const oneYearAgoMs = now.getTime() - 395 * DAY_MS;
const sysLast7 = sysSeries.filter(
(r) => r.measuredAt.getTime() >= sevenDaysAgoMs,
);
const diaLast7 = diaSeries.filter(
(r) => r.measuredAt.getTime() >= sevenDaysAgoMs,
);
const sysLast30 = sysSeries.filter(
(r) => r.measuredAt.getTime() >= thirtyDaysAgoMs,
);
const diaLast30 = diaSeries.filter(
(r) => r.measuredAt.getTime() >= thirtyDaysAgoMs,
);
// Period-aligned prior windows. Same 30-day arc, shifted by 30 / 365
// days respectively. Bounds are inclusive on the lower end and
// exclusive on the upper to avoid double-counting the boundary
// reading in both windows.
const sysPriorMonth = sysSeries.filter(
(r) =>
r.measuredAt.getTime() >= sixtyDaysAgoMs &&
r.measuredAt.getTime() < thirtyDaysAgoMs,
);
const diaPriorMonth = diaSeries.filter(
(r) =>
r.measuredAt.getTime() >= sixtyDaysAgoMs &&
r.measuredAt.getTime() < thirtyDaysAgoMs,
);
const sysPriorYear = sysSeries.filter(
(r) =>
r.measuredAt.getTime() >= oneYearAgoMs &&
r.measuredAt.getTime() < oneYearMinus30DaysAgoMs,
);
const diaPriorYear = diaSeries.filter(
(r) =>
r.measuredAt.getTime() >= oneYearAgoMs &&
r.measuredAt.getTime() < oneYearMinus30DaysAgoMs,
);
return {
last7Days: computeBpInTargetPct(sysLast7, diaLast7, targets),
last30Days: computeBpInTargetPct(sysLast30, diaLast30, targets),
// v1.4.19 A1 — independent aggregate over EVERY paired reading. The
// analytics route now routes the dashboard tile's headline through
// this so it stops mirroring `last30Days`.
allTime: computeBpInTargetPct(sysSeries, diaSeries, targets),
priorMonth: computeBpInTargetPct(sysPriorMonth, diaPriorMonth, targets),
priorYear: computeBpInTargetPct(sysPriorYear, diaPriorYear, targets),
};
}