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Marc-André Bombeck
86f0e5d2cb
The nine-rung verdict ladder was written for the opt-in dashboard hero. That hero was retired when the digest-driven Today rail became the single promoted hero, and its i18n copy was dropped across every locale in the same change, but the resolver stayed behind. Since then it has had no caller outside its own tests: nothing renders it and no string exists for any of its variants. Every rung it computed already has a live owner. Dose states ride the digest's dose_window item, an elevated-at-rest window rides tension_window, the score delta rides the digest score block the Today hero paints its chip from, weight drift and sleep deficit and a silent stretch are the coach nudge cron's own triggers, and a crisis blood-pressure reading is the safety-floor engine's. Wiring a renderer back on would rebuild the second hero the retirement removed. - Delete the resolver, its ladder suite, and the client-safety import walk that pinned its bundle graph. - Fold the two shared nudge thresholds back into the cron. The leaf module existed only so a client component could read them without dragging the server graph along; there is no such component now. - Repoint the score-config guard off the verdict onto the digest fields the Today hero actually reads, so it still fails on the assembly it was written for. - Repoint the clinical-floors notes off the retired surface.
82 lines
4.6 KiB
TypeScript
82 lines
4.6 KiB
TypeScript
/**
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* Canonical clinical safety floors — ONE source of truth (v1.21.0, D3-H1).
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*
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* Before this module the "is this a crisis?" thresholds were defined in three
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* places with a divergent diastolic floor: the safety-floor notification engine
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* and the Coach acute clause used 180/120, while a third surface used 180/110 —
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* so a reading like 170/112 read as a crisis in one place and stayed calm in
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* the other two on the same row.
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*
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* This leaf holds the absolute, guideline-backed floors as plain constants and
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* every consumer imports from here:
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* - `src/lib/illness/safety-floors.ts` (the confirm-before-alarm engine),
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* - `src/lib/insights/metric-status-registry.ts` (the fever band line),
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* - `src/lib/signals/registry.ts` (the signal severity bands),
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* - and the `safetyAcute` / `safetyGlp1` Coach contracts in
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* `src/lib/ai/prompts/shared-contracts.ts`, which bind their prose numbers
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* to these exports rather than hardcoding literals — see the comment at
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* each constant.
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*
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* CLIENT-SAFE: dependency-free literals only. The fever band reaches the
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* browser through `metric-status-registry.ts`, which the `"use client"` metric
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* status card renders, so a server import added here would land in the client
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* bundle. Do NOT add any import to this file — no prisma, no `node:` builtins,
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* no server graph. Constants only.
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*
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* Units: mmHg (BP), mg/dL (glucose), °C (temperature) — HealthLog canonical
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* store units throughout.
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*
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* Citations (general guidance, not medical advice; wide individual variation):
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* - BP ≥ 180/120: ACC/AHA 2017; AHA "Management of Elevated BP in the Acute
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* Care Setting" 2024. The number is identical for emergency vs non-
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* emergency — symptoms are the differentiator, not the value. The crisis
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* DIASTOLIC floor is 120, not the 110 one surface once used: 120 is the
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* hypertensive-urgency standard, so the wider 110 net is dropped to keep
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* every surface telling one story (D3-H1).
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* - Low BP (SBP < 90): NHLBI low-blood-pressure guidance; Hypotension —
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* StatPearls/NIH 2024.
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* - Hypoglycemia: ADA Standards of Care §6 — Level 1 alert < 70 mg/dL,
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* Level 2 (clinically significant) < 54 mg/dL.
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* - Hyperglycemia / DKA: ADA Standards of Care 2026 — DKA hyperglycemia
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* criterion ≥ 200 mg/dL; ~10% of DKA is euglycemic, so a glucose value
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* alone cannot rule it out. We never show "all clear" below 200 and reserve
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* the urgent escalation for a sustained very-high band (≥ 250 mg/dL).
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* - Fever: J Gen Intern Med systematic review (2019) — population
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* oral-equivalent fever line ≥ 38.0 °C (single-reading band); the illness
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* engine escalates only a SUSTAINED fever at ≥ 38.5 °C (multi-day adverse
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* run). These are two intentional lines for two questions; they live here
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* together so the band and the escalation are visibly the same pair.
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* - SpO₂: red-flag floor ≤ 92% (sustained-low escalation).
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*/
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/* ── blood pressure ─────────────────────────────────────────────────────── */
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/** Hypertensive-crisis floor: systolic ≥ this (mmHg). */
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export const BP_SYS_CRITICAL = 180;
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/**
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* Hypertensive-crisis floor: diastolic ≥ this (mmHg). 120 (ACC/AHA), the
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* single crisis diastolic floor across the notification engine, the signal
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* bands, and the Coach acute clause (D3-H1 — one surface once used 110).
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*/
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export const BP_DIA_CRITICAL = 120;
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/** Symmetric low-BP cautionary floor: systolic < this (mmHg). */
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export const BP_SYS_HYPOTENSIVE_FLOOR = 90;
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/* ── glucose (mg/dL) ────────────────────────────────────────────────────── */
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/** Hypoglycemia Level-1 alert: glucose < this. */
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export const GLUCOSE_HYPO_FLOOR = 70;
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/** Hypoglycemia Level-2 (clinically significant): glucose < this. */
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export const GLUCOSE_HYPO_SEVERE_FLOOR = 54;
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/** Hyperglycemia urgent escalation (sustained very-high seek-care trigger). */
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export const GLUCOSE_HYPER_FLOOR = 250;
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/* ── temperature (°C) ───────────────────────────────────────────────────── */
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/** Single-reading fever band line (status cards). */
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export const FEVER_BAND_C = 38.0;
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/** Sustained-fever escalation floor (illness engine red flag). */
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export const FEVER_RED_FLAG_C = 38.5;
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/** Sustained-low SpO₂ red-flag floor (%). */
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export const SPO2_RED_FLAG_PCT = 92;
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