pediatric-ai-scribe-v3/test/clinical-assistant-prompt-pool.test.js

const { test } = require('node:test');
const assert = require('node:assert/strict');
const fs = require('node:fs');
const path = require('node:path');

const root = path.join(__dirname, '..');

function read(relativePath) {
  return fs.readFileSync(path.join(root, relativePath), 'utf8');
}

test('clinical assistant starter prompts are Redis or indexed-source backed', () => {
  const route = read('src/routes/clinicalAssistant.js');
  const pool = read('src/utils/clinicalPromptPool.js');
  assert.doesNotMatch(route, /EXAMPLE_CANDIDATES|TOPIC_SUGGESTIONS|topic_suggestions|buildSuggestionAnswer/);
  assert.match(route, /createClinicalPromptPool\(\{[\s\S]*redisCache: redisCache/);
  assert.match(route, /isUsefulIndexedTopicExample/);
  assert.match(pool, /clinical-assistant:prompt-pool:v2/);
  assert.match(pool, /redisBaseKey \+ ':all'/);
  assert.match(pool, /redisBaseKey \+ ':last-good'/);
  assert.match(pool, /redisBaseKey \+ ':category:' \+ category/);
  assert.match(pool, /redisBaseKey \+ ':age:' \+ ageBand/);
  assert.match(pool, /redisBaseKey \+ ':intent:' \+ intent/);
  assert.match(pool, /CLINICAL_ASSISTANT_PROMPT_POOL_TARGET, 1000/);
  // Built once, then only from the admin button: no timer unless the environment asks for one.
  assert.match(pool, /CLINICAL_ASSISTANT_PROMPT_POOL_REFRESH_MS, 0\)/);
  assert.match(pool, /process\.env\.CLINICAL_ASSISTANT_PROMPT_MODEL \|\| 'ds-deepseek-v4\.1-flash'/);
  assert.match(route, /loadStoredPromptPool: loadLatestPromptPoolSnapshot/);
  assert.match(pool, /PEDIATRIC_TAXONOMY/);
  assert.match(pool, /taxonomyWithQuotas\(target\)/);
  assert.match(pool, /age_band: ageBand/);
  assert.match(pool, /function hasPediatricSignal\(prompt, item\)/);
  assert.match(pool, /var examples = await fallbackIndexedExamples\(\)/);
  assert.doesNotMatch(pool, /taxonomyFallbackExamples|taxonomySupplementExamples/);
  assert.doesNotMatch(pool, /return fallbackIndexedExamples\(\)/);
});

test('clinical assistant prompt pool can be regenerated by admins', () => {
  const admin = read('src/routes/adminConfig.js');
  const page = read('public/components/admin.html');
  const js = read('public/js/admin/clinicalAssistant.js');
  assert.match(admin, /\/clinical-assistant\/prompt-pool\/regenerate/);
  assert.match(admin, /\/clinical-assistant\/prompt-pool\/restore/);
  assert.match(page, /btn-regenerate-assistant-prompt-pool/);
  assert.match(page, /btn-restore-assistant-prompt-pool/);
  assert.match(js, /regenerateAssistantPromptPool/);
  assert.match(js, /restoreAssistantPromptPool/);
});

test('clinical assistant prompt forbids relabeling other sources as named sources', () => {
  const answer = read('src/utils/clinicalAnswer.js');
  assert.match(answer, /If the user names a specific source, textbook, guideline, or table/);
  assert.match(answer, /do not claim that another source is from the named source/);
  assert.match(answer, /If the named source is absent from the retrieved sources, say that explicitly/);
});

test('clinical assistant prompt forbids LaTeX-escaped citations', () => {
  const answer = read('src/utils/clinicalAnswer.js');
  assert.match(answer, /Never escape citation brackets/);
  assert.ok(answer.includes(String.raw`write [1], not \\[1\\]`));
});

test('clinical assistant prompt requires bracketed citations in table source columns', () => {
  const answer = read('src/utils/clinicalAnswer.js');
  assert.match(answer, /Source, Source\(s\), Citation, or Citation\(s\) column/);
  assert.match(answer, /must use bracketed citation tokens like \[1\] or \[1, 3\]/);
  assert.match(answer, /never bare numbers like 1 or 1, 3/);
});

// ---- what a starter question has to be ----------------------------------------

function fakePool(overrides) {
  const { createClinicalPromptPool } = require('../src/utils/clinicalPromptPool');
  const store = new Map();
  const redisCache = {
    getJson: async k => store.has(k) ? store.get(k) : null,
    setJson: async (k, v) => { store.set(k, v); }
  };
  return { store, pool: createClinicalPromptPool(Object.assign({
    redisCache, getSetting: async () => '', semanticSearch: async () => ({}), dedupeSources: x => x,
    normalizeMcpSearchResponse: () => [], callAI: async () => ({ content: '{"questions":[]}' })
  }, overrides || {})) };
}

test('a starter question is one concrete thing to learn, not a scenario', () => {
  const { pool } = fakePool();
  const ok = q => pool.isUsefulQuestion(q, { category: 'respiratory', intent: 'management', age_band: 'infant' });
  // What the user refused: "vague nonsense clinical scenarios".
  assert.equal(ok('A 6-week-old with 3 days of projectile non-bilious vomiting, weight down 8% and a chloride of 88: which fluid do you start, and what corrects before theatre is safe?'), false, 'a vignette');
  assert.equal(ok('A 14-year-old on the ward with asthma, SpO2 91% after two salbutamol nebulisers: at what point do you add magnesium?'), false, 'a vignette');
  assert.equal(ok('An infant presents with bilious emesis and a scaphoid abdomen: which imaging comes first?'), false, 'a vignette without an age');
  assert.equal(ok('What is bronchiolitis?'), false, 'a bare definition');
  // What it should hold: mechanisms, distinctions, the numbers that matter.
  assert.equal(ok('Why does pyloric stenosis produce a hypochloraemic metabolic alkalosis in infants, and why is the urine paradoxically acidic?'), true);
  assert.equal(ok('How does a ductal-dependent heart lesion stay silent in a newborn until the duct closes, and what does prostaglandin E1 do?'), true);
  assert.equal(ok('Why are infants under 3 months given broader empiric antibiotic cover for fever than older children?'), true);
  assert.equal(ok('What separates croup from epiglottitis in a child, and why does one respond to dexamethasone?'), true);
});

test('a pool built by an older prompt is served, then rebuilt in the background', async () => {
  let generated = 0;
  const { store, pool } = fakePool({
    callAI: async () => { generated++; return { content: '{"questions":[]}' }; }
  });
  // A fresh pool from the previous prompt version, one day old.
  const old = { generatedAt: Date.now() - 86400000, promptVersion: pool.PROMPT_VERSION - 1, target: 10,
    examples: [{ label: 'Old', prompt: 'Old question?', category: 'respiratory', age_band: 'infant', intent: 'management' }] };
  await pool.writePromptPool(old, { skipStore: true });
  const served = await pool.getAvailableExamples();
  assert.equal(served[0].prompt, 'Old question?', 'the old pool is what the reader gets meanwhile');
  await new Promise(r => setTimeout(r, 20));
  assert.ok(generated > 0 || store.size >= 1, 'a rebuild was started');
  // The same pool stamped with the current version is not stale.
  const fresh = Object.assign({}, old, { promptVersion: pool.PROMPT_VERSION });
  await pool.writePromptPool(fresh, { skipStore: true });
  const again = await pool.refreshIfNeeded(false);
  assert.equal(again[0].prompt, 'Old question?');
});

test('a reply cut off mid-list still yields the questions that finished', () => {
  const { pool } = fakePool();
  // Reach the parser through the public surface it feeds: a refresh with a
  // callAI that answers with truncated JSON.
  const src = require('node:fs').readFileSync(require('node:path').join(__dirname, '..', 'src/utils/clinicalPromptPool.js'), 'utf8');
  assert.match(src, /objects\.forEach\(function \(chunk\)/, 'the salvage exists');
  assert.match(src, /maxTokens: 7000/, 'and the ceiling makes room for cases');
  assert.ok(pool);
});