All remaining backend files renamed:
src/middleware/auth.ts, logging.ts (2 files)
src/utils/*.ts (20 files: ai, auditQueue, config, crypto,
embeddings, errors, fileType, logger, models,
notify, passwords, platform, promptSafe,
prompts, redact, sessions, transcribe*,
ttsGoogle)
src/db/database.ts, migrate.ts (2 files)
Spot-fixes to satisfy tsc (all within the spirit of 'no behavior
change' — added `: any` annotations where the original JS relied on
duck typing that tsc's default inference narrows too aggressively):
utils/ai.ts — body, converseParams, request literals + fallback
result object + err.code/model/message casts. AI client has lots
of provider-specific ad-hoc object shapes; Day 5 will replace the
`any`s with proper provider-response interfaces.
utils/embeddings.ts — payload + request as `any`; generateEmbedding
call sites pass `undefined as any` for the now-required second
arg (model) until we refactor the signature.
utils/prompts.ts — PROMPTS typed as Record<string, any> so
.loadFromDb / .updatePrompt / .getAllPrompts attachments after
the const literal compile.
utils/transcribeLocal.ts — buildArgs() has two `var args = [...]`
in the same function scope (var-hoisted); both now typed as
any[] so they don't type-clash across conditionals.
Backend is now 54 of 54 TypeScript files, permissive mode.
`npm run typecheck` EXIT 0. Prod container still running the old
JS image — no Dockerfile change yet.
Next: Day 5 flips strict: true, fixes every error tsc surfaces, adds
Vitest + Zod + Knip tooling.
Replaces the generic one-line-per-component format with a step-level
checklist. Each exam component now contains 3–13 discrete steps, each
with its own Normal/Abnormal/Skip toggle and optional abnormal note.
Physician ticks the exam off step-by-step; report generation
summarises at the component level but knows exactly which steps were
performed.
Example — previously the adolescent "Cranial nerves (II–XII)" was a
single row: "How to perform: Full formal adult-pattern exam. Expected:
All cranial nerves intact." That's unhelpful. Now it's 14 discrete
steps: CN I, CN II acuity, CN II fields, CN II fundoscopy, CN II/III
pupils, CN III/IV/VI EOM, CN V sensation V1/V2/V3, CN V motor, CN V
corneal, CN VII forehead/eye-close/smile/puff, CN VIII, CN IX/X, CN
XI, CN XII — each with specific method and expected finding. Same
depth for MSK: scoliosis = 5 discrete steps (standing inspection,
Adam forward-bend, rib-hump check, scoliometer, plumb-line), joint
stability = 8 named tests (Lachman, anterior drawer, varus/valgus,
McMurray, apprehension, Neer/Hawkins, anterior drawer ankle, talar
tilt), Beighton = 5 per-joint measurements, etc.
Sources cited in code header: Bates' Guide 13th ed, Nelson Textbook
22nd ed, Hutchison's Clinical Methods 25th ed, Fenichel Clinical
Pediatric Neurology 8th ed.
Backend route accepts the flat step array (grouped by component on
the server), passes structured text to the AI with methods and
expected findings per step. Prompts updated to summarise at the
component level rather than step-by-step, so output is clinically
readable.
Scope: MSK + Neuro × 6 age groups (newborn, infant, toddler, preschool,
school-age, adolescent). More systems follow the same pattern —
append to PE_DATA.
New top-level tab (positioned after Catch-Up Schedule) combining two
functions:
1. Study reference — for each (age group, system) shows OSCE-style
components with technique, expected normal finding, and abnormal-
feature watch-list.
2. Documentation generator — physician marks each component
Normal / Abnormal (with free-text detail) / Skip; AI produces a
two-section report (Technique + Findings), narrative or structured
list format.
Scope v1: MSK + Neuro × 6 age groups (newborn, infant, toddler,
preschool, school-age, adolescent). More systems can be added to the
embedded PE_DATA in peGuide.js without route changes.
Files:
- src/routes/peGuide.js — POST /api/generate-pe-narrative (mirrors
milestone-narrative pattern: AppRole-level
injection guard, clinical audit category,
PHI redaction upstream already in place)
- src/utils/prompts.js — peGuideNarrative + peGuideList prompts,
structured two-section output
- public/components/pe-guide.html — demographics bar + sub-pills + cards
- public/js/peGuide.js — embedded PE_DATA (all clinical content),
render + state + AI call
- public/index.html — tab button, section, script include
- server.js — mount route at /api
No schema change. No PHI stored — findings live in memory only, exported
via existing copy/read-aloud/Nextcloud actions.
- WNL/Normal systems now expand to 1-3 specific pertinent negatives instead of
just "WNL" — varies each time, relates to chief complaint and differential
(e.g., Skin: "no rash, no petechiae, no bruising" instead of "WNL")
- Abnormal systems: AI expands physician's brief note into clinical description
favoring most common presentation, adds only 1-2 related pertinent negatives
(e.g., "pimples on face" → "inflammatory papules on bilateral cheeks...")
- Format function now passes system domain details for context
- Rules applied to well visit (full + short) and sick visit prompts
- Growth reference data by age (newborn through 21y): expected weight/length/HC
gains per day/month/year, puberty growth spurt details
- Feeding/nutrition guidance by age: formula amounts, breastfeeding frequency,
solid food introduction timeline, juice limits, milk transitions, calorie needs
- BMI/obesity classification per AAP 2023 CPG + CDC Extended BMI:
Underweight, Healthy, Overweight, Obesity Class I/II/III with action items
(≥120% and ≥140% of 95th percentile thresholds)
- Weight-for-length guidance for children <2 years
- "By Visit" panel now shows growth reference + feeding guidance + BMI table
- Well visit AI prompt updated to include growth assessment, BMI classification,
and feeding counseling in generated notes
- Backend injects age-appropriate growth/nutrition data into AI context
Replace checkmark/X symbol format with plain numbered sentences:
achieved → 'Can walk independently'
not achieved → 'Cannot walk' / 'Does not yet use 2-word sentences'
