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Marc-André Bombeck
a5b3715a46
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.
87 lines
3.4 KiB
TypeScript
87 lines
3.4 KiB
TypeScript
/**
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* v1.18.9 — qualitative lab result → SNOMED CT concept (or honest text-only).
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*
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* A qualitative serology result ("negativ" / "positiv" / "nicht nachweisbar")
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* has no number, so its FHIR Observation carries a `valueCodeableConcept`
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* instead of a `valueQuantity`. This module maps the common German / English
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* result terms onto a small set of WELL-ESTABLISHED SNOMED CT qualifier-value
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* concepts. The raw recorded text ALWAYS rides `.text`; a coded `coding` is
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* added only when the term resolves CONFIDENTLY. When in doubt the result stays
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* text-only — never a fabricated code — mirroring the conservative stance of
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* the `lab-loinc` and `illness-snomed` mappers.
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*
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* Concepts (SNOMED CT International, qualifier value, REFERENCED not
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* redistributed per the licence):
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* - 260385009 "Negative" — negativ / negative
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* - 10828004 "Positive" — positiv / positive
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* - 260415000 "Not detected" — nicht nachweisbar / not detected
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* - 260373001 "Detected" — nachweisbar / detected
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*
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* Borderline / grenzwertig is DELIBERATELY left text-only: the candidate
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* "Borderline" qualifier concept could not be confidently verified, and an
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* unverified code is worse than an honest `.text`. Any unrecognised term
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* likewise stays text-only.
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*
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* Systems: SNOMED CT — http://snomed.info/sct
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*/
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import type { FhirCodeableConcept } from "@/lib/fhir/types";
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/**
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* SNOMED CT system URI. Inlined (rather than imported from `resources.ts`) to
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* keep this leaf module free of the heavy `resources.ts` import graph and avoid
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* an import cycle — `resources.ts` consumes THIS module.
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*/
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const SNOMED_SYSTEM = "http://snomed.info/sct";
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interface QualitativeConcept {
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code: string;
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display: string;
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}
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/**
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* Normalised result term → SNOMED qualifier-value concept. The left side is the
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* lower-cased, whitespace-collapsed recorded text. Only confidently-known terms
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* appear; everything else falls through to text-only.
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*/
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const QUALITATIVE_SNOMED: Record<string, QualitativeConcept> = {
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// Negative-like
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negativ: { code: "260385009", display: "Negative" },
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negative: { code: "260385009", display: "Negative" },
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neg: { code: "260385009", display: "Negative" },
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"nicht nachweisbar": { code: "260415000", display: "Not detected" },
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"not detected": { code: "260415000", display: "Not detected" },
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// Positive-like
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positiv: { code: "10828004", display: "Positive" },
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positive: { code: "10828004", display: "Positive" },
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pos: { code: "10828004", display: "Positive" },
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nachweisbar: { code: "260373001", display: "Detected" },
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detected: { code: "260373001", display: "Detected" },
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};
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/** Collapse a recorded qualitative term to a lookup key. */
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function normaliseQualitativeKey(text: string): string {
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return text.trim().toLowerCase().replace(/\s+/g, " ");
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}
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/**
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* Build the `valueCodeableConcept` for a qualitative lab result. The raw text
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* always rides `.text`; a SNOMED `coding` is added only for a confidently-
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* recognised term. Borderline / grenzwertig and any unknown term stay
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* text-only.
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*/
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export function qualitativeValueConcept(
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valueText: string,
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): FhirCodeableConcept {
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const concept = QUALITATIVE_SNOMED[normaliseQualitativeKey(valueText)];
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if (!concept) {
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return { text: valueText };
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}
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return {
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coding: [
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{ system: SNOMED_SYSTEM, code: concept.code, display: concept.display },
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],
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text: valueText,
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};
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}
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