diff --git a/public/components/bedside.html b/public/components/bedside.html
index c2c936b..6e3ff05 100644
--- a/public/components/bedside.html
+++ b/public/components/bedside.html
@@ -65,6 +65,7 @@
+
@@ -519,5 +520,88 @@
+
+
+
Suture Selector
+
Pick a site and modifiers — get material, size, technique, removal day, and warnings. Recommendation only; clinical judgment overrides.
+
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+
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+
+
+
+
Reviewing note for high-yield items...
';
+
+ fetch('/api/dont-miss', {
+ method: 'POST',
+ headers: getAuthHeaders(),
+ body: JSON.stringify({
+ noteText: noteText,
+ noteType: noteType || '',
+ patientAge: patientAge || '',
+ chiefComplaint: chiefComplaint || ''
+ })
+ })
+ .then(function(r) { return r.json(); })
+ .then(function(data) {
+ if (!data.success || !data.points || data.points.length === 0) {
+ container.classList.add('hidden');
+ return;
+ }
+ var html = '' +
+ '';
+ data.points.forEach(function(p) {
+ var why = p.why ? '
' + escHtml(p.why) + '
' : '';
+ html += '
' +
+ '
' + escHtml(p.point) + '
' +
+ why + '
';
+ });
+ html += '
Select a site to see recommendation.
'; return; }
+ var r = recommend(inp);
+ if (!r) { el.innerHTML = 'Unknown site.
'; return; }
+
+ var html = '' +
+ 'Suture recommendation — ' + r.site + '
';
+
+ html += '';
+ html += '
Closure plan: ' + r.closure + '
';
+ html += '
Material: ' + r.material + '
';
+ html += '
Size: ' + r.size + '
';
+ html += '
Technique: ' + r.technique + '
';
+ if (r.removalDays) html += '
Suture removal: ' + r.removalDays + ' days
';
+ else html += '
Suture removal: not required (absorbable)
';
+ html += '
' +
+ 'Adhesive alternative: ' + r.glue + '
';
+ }
+
+ if (r.warnings.length) {
+ html += '' +
+ '
Warning:' +
+ r.warnings.map(function(w) { return '- ' + w + '
'; }).join('') + '
' +
+ '
Site notes:' +
+ r.notes.map(function(n) { return '- ' + n + '
'; }).join('') + '
Tetanus: ' + r.tetanus + '
';
+
+ html += S.ref('Roberts & Hedges Clinical Procedures in Emergency Medicine, 7e (2019), Ch. 36. Fleisher & Ludwig Pediatric Emergency Medicine, 8e (2021). AAP Section on Emergency Medicine — Pediatric laceration repair. UpToDate (Pope JV) — Skin laceration repair with sutures. Suggestions only — verify against your local protocol and the patient in front of you.');
+
+ el.innerHTML = html;
+}
+
+export function init() {
+ document.addEventListener('change', function(e) {
+ if (!e.target || !e.target.id) return;
+ if (e.target.id.indexOf('sut-') === 0) render();
+ });
+ document.addEventListener('click', function(e) {
+ var pill = e.target.closest && e.target.closest('[data-em="sutures"]');
+ if (pill) setTimeout(render, 0);
+ });
+ document.addEventListener('tabChanged', function() { setTimeout(render, 100); });
+}
diff --git a/public/js/liveEncounter.js b/public/js/liveEncounter.js
index 4554cfd..a528e8d 100644
--- a/public/js/liveEncounter.js
+++ b/public/js/liveEncounter.js
@@ -214,6 +214,7 @@
outputCard.scrollIntoView({ behavior: 'smooth' });
showToast('HPI generated!', 'success');
if (typeof suggestBillingCodes === 'function') suggestBillingCodes('enc-hpi-text', data.hpi, 'hpi', document.getElementById('enc-age').value, document.getElementById('enc-setting').value);
+ if (typeof suggestDontMiss === 'function') suggestDontMiss('enc-hpi-text', data.hpi, 'hpi', document.getElementById('enc-age').value);
} else showToast(data.error || 'Failed', 'error');
})
.catch(function(err) { hideBusy(); showToast(err.message, 'error'); });
diff --git a/public/js/sickVisit.js b/public/js/sickVisit.js
index 660b3c5..f5dbe64 100644
--- a/public/js/sickVisit.js
+++ b/public/js/sickVisit.js
@@ -339,6 +339,7 @@
if (outCard) { outCard.classList.remove('hidden'); outCard.scrollIntoView({ behavior: 'smooth' }); }
showToast('Sick visit note generated!', 'success');
if (typeof suggestBillingCodes === 'function') suggestBillingCodes('sick-note-text', data.note, 'sickvisit', document.getElementById('sick-age').value);
+ if (typeof suggestDontMiss === 'function') suggestDontMiss('sick-note-text', data.note, 'sickvisit', document.getElementById('sick-age').value, document.getElementById('sick-cc').value);
} else {
showToast(data.error || 'Generation failed', 'error');
}
diff --git a/server.js b/server.js
index d05152c..4dc100a 100644
--- a/server.js
+++ b/server.js
@@ -298,6 +298,7 @@ app.use('/api/sessions', require('./src/routes/sessions'));
app.use('/api', require('./src/routes/wellVisit'));
app.use('/api', require('./src/routes/sickVisit'));
app.use('/api', require('./src/routes/edEncounters'));
+app.use('/api', require('./src/routes/dontMiss'));
app.use('/api/user', require('./src/routes/userPreferences'));
app.use('/api/admin/learning', require('./src/routes/learningAI'));
diff --git a/src/routes/dontMiss.js b/src/routes/dontMiss.js
new file mode 100644
index 0000000..6c86e6d
--- /dev/null
+++ b/src/routes/dontMiss.js
@@ -0,0 +1,79 @@
+// ============================================================
+// DON'T-MISS TOOLTIP ROUTE — post-note "what to clarify or
+// consider" suggestions for sick visit + encounter HPI tabs.
+// Hard cap of 5 points. Separate AI pass after note generation
+// so the existing note-generation routes stay untouched.
+// ============================================================
+
+var express = require('express');
+var router = express.Router();
+var { callAI } = require('../utils/ai');
+var PROMPTS = require('../utils/prompts');
+var { authMiddleware } = require('../middleware/auth');
+var logger = require('../utils/logger');
+var { wrapUserText, INJECTION_GUARD } = require('../utils/promptSafe');
+
+router.use(authMiddleware);
+
+function extractJson(raw) {
+ var t = String(raw || '').trim();
+ t = t.replace(/^```(?:json)?\s*/i, '').replace(/\s*```$/i, '');
+ var s = t.indexOf('{');
+ if (s > 0) t = t.substring(s);
+ var e = t.lastIndexOf('}');
+ if (e > -1 && e < t.length - 1) t = t.substring(0, e + 1);
+ try { return JSON.parse(t); } catch (err) { return null; }
+}
+
+// ── POST /dont-miss — return up to 5 high-yield items ─────
+// Body:
+// noteText — generated note (required)
+// noteType — 'hpi' | 'sickvisit' (informational, included in context)
+// patientAge — string, optional but strongly preferred
+// chiefComplaint — string, optional (sick visit has it; encounter HPI doesn't)
+// model — optional override
+// Returns: { success, points: [{point, why}], model }
+router.post('/dont-miss', async function (req, res) {
+ var start = Date.now();
+ try {
+ var { noteText, noteType, patientAge, chiefComplaint, model } = req.body;
+ if (!noteText || !noteText.trim()) {
+ return res.status(400).json({ error: 'noteText is required' });
+ }
+
+ var context = 'NOTE TYPE: ' + (noteType || 'unknown') + '\n';
+ context += 'PATIENT AGE: ' + (patientAge || 'unknown') + '\n';
+ if (chiefComplaint && chiefComplaint.trim()) {
+ context += 'CHIEF COMPLAINT: ' + wrapUserText('chief_complaint', chiefComplaint) + '\n';
+ }
+ context += '\nGENERATED NOTE:\n' + wrapUserText('note', noteText);
+
+ var result = await callAI([
+ { role: 'system', content: PROMPTS.dontMissTooltip + INJECTION_GUARD },
+ { role: 'user', content: context }
+ ], { model: model, maxTokens: 1500 });
+
+ var parsed = extractJson(result.content);
+ var points = (parsed && Array.isArray(parsed.points)) ? parsed.points : [];
+ points = points
+ .filter(function (p) { return p && p.point; })
+ .map(function (p) { return { point: String(p.point).trim(), why: String(p.why || '').trim() }; })
+ .slice(0, 5); // hard cap defense, even if the model ignored the prompt cap
+
+ var dur = Date.now() - start;
+ logger.apiCall(req.user.id, '/api/dont-miss', {
+ model: result.model,
+ tokensInput: result.usage && result.usage.input_tokens,
+ tokensOutput: result.usage && result.usage.output_tokens,
+ duration: dur,
+ statusCode: 200
+ });
+
+ res.json({ success: true, points: points, model: result.model });
+ } catch (e) {
+ logger.error('[dontMiss] failed', e.message);
+ res.status(500).json({ error: 'Request failed' });
+ }
+});
+
+module.exports = router;
diff --git a/src/utils/prompts.js b/src/utils/prompts.js
index dfc5d66..fc8d5e3 100644
--- a/src/utils/prompts.js
+++ b/src/utils/prompts.js
@@ -448,7 +448,35 @@ CRITICAL RULES:
- Use ONLY information present in the note and transcript
- Do NOT invent data points, interventions, or diagnoses
- Be conservative when ambiguous — pick the lower level
-- The levelRationale must reference specific elements actually documented in the encounter`
+- The levelRationale must reference specific elements actually documented in the encounter`,
+
+ // ======================== DON'T-MISS TOOLTIP (post-note) ========================
+ // Used after sick visit / encounter HPI generation. Hard cap of 5 points.
+ // Returns JSON only — rendered next to the note as a side panel.
+ dontMissTooltip: `You are an expert pediatrician reviewing a generated clinical note for a colleague. Your job is to surface the highest-yield "don't miss" items the physician should clarify, document, or consider — tailored to the note's chief complaint and the patient's age.
+${CORE_RULES}
+
+OUTPUT FORMAT — STRICT JSON ONLY, no preamble, no code fences, no commentary:
+{
+ "points": [
+ {"point": "", "why": ""},
+ ...
+ ]
+}
+
+HARD CAP: at most 5 points. Quality over quantity. If only 2 high-yield items exist, return 2.
+
+WHAT TO SURFACE:
+- Important questions the physician should clarify (e.g. "Ask about toxic ingestion" for an obtunded toddler)
+- Documentation gaps a chart-reviewer would flag (e.g. "Document immunization status for this fever in infant <3mo")
+- High-yield differentials worth ruling out for this age + complaint
+- Reassessment / return precautions worth emphasizing
+
+WHAT TO AVOID:
+- Items already clearly documented in the note
+- Generic boilerplate ("consider differential diagnosis")
+- Treatment recommendations (this is a documentation/clinical-reasoning prompt, not a treatment plan)
+- Padding to reach 5 — fewer is fine`
};
// ── DB override support ────────────────────────────────────────────────────