pediatric-ai-scribe-v3/src/routes/wellVisit.js

// ============================================================
// WELL VISIT ROUTES — SSHADESS assessment + note generation
// ============================================================

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');

// Load growth reference and BMI classification data
var scheduleData;
try {
  scheduleData = require('../../public/js/pediatricScheduleData');
} catch(e) {
  scheduleData = {};
}
var GROWTH_REFERENCE = scheduleData.GROWTH_REFERENCE || {};
var BMI_CLASSIFICATION = scheduleData.BMI_CLASSIFICATION || {};

// Map visit age text to GROWTH_REFERENCE keys
function getGrowthRefForAge(ageStr) {
  if (!ageStr) return null;
  var a = ageStr.toLowerCase().trim();
  // Direct key matches
  var directKeys = ['newborn', '1mo', '2mo', '4mo', '6mo', '9mo', '12mo', '15mo', '18mo', '24mo', '30mo', '3y', '4y', '5y'];
  for (var i = 0; i < directKeys.length; i++) {
    if (a.indexOf(directKeys[i]) !== -1) return GROWTH_REFERENCE[directKeys[i]] || null;
  }
  // Age-based range matching
  var ageMatch = a.match(/(\d+)\s*(month|mo|year|y|yr)/i);
  if (ageMatch) {
    var num = parseInt(ageMatch[1]);
    var unit = ageMatch[2].toLowerCase();
    if (unit === 'month' || unit === 'mo') {
      if (num <= 1) return GROWTH_REFERENCE['1mo'];
      if (num <= 3) return GROWTH_REFERENCE['2mo'];
      if (num <= 5) return GROWTH_REFERENCE['4mo'];
      if (num <= 8) return GROWTH_REFERENCE['6mo'];
      if (num <= 11) return GROWTH_REFERENCE['9mo'];
      if (num <= 14) return GROWTH_REFERENCE['12mo'];
      if (num <= 17) return GROWTH_REFERENCE['15mo'];
      if (num <= 23) return GROWTH_REFERENCE['18mo'];
      if (num <= 29) return GROWTH_REFERENCE['24mo'];
      if (num <= 35) return GROWTH_REFERENCE['30mo'];
    }
    if (unit === 'year' || unit === 'y' || unit === 'yr') {
      if (num <= 3) return GROWTH_REFERENCE['3y'];
      if (num <= 4) return GROWTH_REFERENCE['4y'];
      if (num <= 5) return GROWTH_REFERENCE['5y'];
      if (num <= 10) return GROWTH_REFERENCE['6y_to_10y'];
      if (num <= 14) return GROWTH_REFERENCE['11y_to_14y'];
      return GROWTH_REFERENCE['15y_to_21y'];
    }
  }
  if (a.indexOf('newborn') !== -1 || a.indexOf('birth') !== -1) return GROWTH_REFERENCE['newborn'];
  return null;
}

// ── POST generate SSHADESS assessment summary ────────────────────────────
router.post('/well-visit/shadess', authMiddleware, async function(req, res) {
  var start = Date.now();
  try {
    var { domains, patientAge, patientGender, dictationText, model } = req.body;

    if (!domains && !dictationText) {
      return res.status(400).json({ error: 'Provide domain responses or dictation text' });
    }

    // Build structured input text
    var inputText = 'PATIENT: ' + (patientAge || 'Adolescent') + ', ' + (patientGender || 'Unknown gender') + '\n\n';
    inputText += 'SSHADESS SCREENING DATA:\n\n';

    if (dictationText) {
      inputText += 'PHYSICIAN DICTATION:\n' + dictationText + '\n\n';
    }

    if (domains) {
      var domainOrder = ['strengths', 'school', 'home', 'activities', 'drugs', 'emotions', 'sexuality', 'safety'];
      var domainNames = {
        strengths: 'STRENGTHS',
        school: 'SCHOOL',
        home: 'HOME',
        activities: 'ACTIVITIES',
        drugs: 'DRUGS/SUBSTANCES',
        emotions: 'EMOTIONS/EATING',
        sexuality: 'SEXUALITY',
        safety: 'SAFETY'
      };

      domainOrder.forEach(function(key) {
        var d = domains[key];
        if (!d || d.skipped) return;

        inputText += domainNames[key] + ':\n';
        if (d.questions) {
          d.questions.forEach(function(q) {
            if (q.answer !== null && q.answer !== undefined && q.answer !== '') {
              inputText += '  - ' + q.text + ': ' + (q.answer === true || q.answer === 'yes' ? 'YES' : (q.answer === false || q.answer === 'no' ? 'NO' : q.answer)) + '\n';
            }
          });
        }
        if (d.comment && d.comment.trim()) {
          inputText += '  Comments: ' + d.comment + '\n';
        }
        if (d.concern) {
          inputText += '  *** CONCERN FLAGGED ***\n';
        }
        inputText += '\n';
      });
    }

    var result = await callAI([
      { role: 'system', content: PROMPTS.shadessAssessment },
      { role: 'user', content: inputText }
    ], { model });

    var dur = Date.now() - start;
    logger.apiCall(req.user.id, '/api/well-visit/shadess', {
      model: result.model, tokensInput: result.usage?.input_tokens,
      tokensOutput: result.usage?.output_tokens, duration: dur, statusCode: 200
    });

    res.json({ success: true, assessment: result.content, model: result.model });
    logger.audit(req.user.id, 'generate_shadess', 'Generated SSHADESS assessment', req, { category: 'clinical' });
  } catch (e) {
    logger.error('[WellVisit] SHADESS generation failed', e.message);
    res.status(500).json({ error: e.message });
  }
});

// ── POST generate full well visit encounter note ─────────────────────────
router.post('/well-visit/note', authMiddleware, async function(req, res) {
  var start = Date.now();
  try {
    var {
      patientAge, patientGender, visitAge,
      vitals, measurements,
      transcript, dictation,
      screenings, vaccines,
      shadessAssessment,
      parentConcerns,
      ros, physicalExam, diagnoses,
      physicianMemories,
      noteStyle, // 'full' | 'short'
      model
    } = req.body;

    if (!patientAge && !visitAge) {
      return res.status(400).json({ error: 'Patient age or visit age required' });
    }

    // Assemble context
    var context = 'WELL CHILD VISIT\n';
    context += 'Patient: ' + (patientAge || visitAge) + ', ' + (patientGender || 'Unknown') + '\n\n';

    if (vitals) {
      context += 'VITAL SIGNS:\n' + vitals + '\n\n';
    }
    if (measurements) {
      context += 'MEASUREMENTS/GROWTH:\n' + measurements + '\n\n';
    }
    if (parentConcerns) {
      context += 'PARENT/PATIENT CONCERNS:\n' + parentConcerns + '\n\n';
    }
    if (transcript) {
      context += 'ENCOUNTER TRANSCRIPT/DICTATION:\n' + transcript + '\n\n';
    } else if (dictation) {
      context += 'PHYSICIAN DICTATION:\n' + dictation + '\n\n';
    }
    if (screenings) {
      context += 'SCREENINGS COMPLETED:\n' + screenings + '\n\n';
    }
    if (vaccines) {
      context += 'IMMUNIZATIONS TODAY:\n' + vaccines + '\n\n';
    }
    if (shadessAssessment) {
      context += 'SSHADESS PSYCHOSOCIAL ASSESSMENT:\n' + shadessAssessment + '\n\n';
    }
    if (ros) {
      context += ros + '\n\n';
    }
    if (physicalExam) {
      context += physicalExam + '\n\n';
    }
    if (diagnoses) {
      context += diagnoses + '\n\n';
    }
    if (physicianMemories) {
      context += '[STYLE HINTS (low priority — only apply if relevant to the current note, never copy content from these examples)]\n' + physicianMemories + '\n[END STYLE HINTS]\n\n';
    }

    // Add growth reference and feeding guidance for this age
    var growthRef = getGrowthRefForAge(patientAge || visitAge);
    if (growthRef) {
      context += 'GROWTH/NUTRITION GUIDANCE (AAP reference for this age):\n';
      if (growthRef.weight) context += 'Expected weight gain: ' + growthRef.weight + '\n';
      if (growthRef.length) context += 'Expected length/height gain: ' + growthRef.length + '\n';
      if (growthRef.headCirc) context += 'Expected head circumference gain: ' + growthRef.headCirc + '\n';
      if (growthRef.feeding && growthRef.feeding.length) {
        context += 'Feeding guidance:\n';
        growthRef.feeding.forEach(function(f) { context += '  - ' + f + '\n'; });
      }
      if (growthRef.bmiClassification && BMI_CLASSIFICATION.categories) {
        context += 'BMI Classification (AAP 2023 / CDC Extended BMI):\n';
        BMI_CLASSIFICATION.categories.forEach(function(c) {
          context += '  - ' + c.label + ': ' + c.range + ' → ' + c.action + '\n';
        });
      }
      context += '\n';
    }

    var prompt = (noteStyle === 'short') ? PROMPTS.wellVisitShort : PROMPTS.wellVisitNote;

    var result = await callAI([
      { role: 'system', content: prompt },
      { role: 'user', content: context }
    ], { model });

    var dur = Date.now() - start;
    logger.apiCall(req.user.id, '/api/well-visit/note', {
      model: result.model, tokensInput: result.usage?.input_tokens,
      tokensOutput: result.usage?.output_tokens, duration: dur, statusCode: 200
    });

    res.json({ success: true, note: result.content, model: result.model });
    logger.audit(req.user.id, 'generate_well_visit', 'Generated well visit note', req, { category: 'clinical' });
  } catch (e) {
    logger.error('[WellVisit] Note generation failed', e.message);
    res.status(500).json({ error: e.message });
  }
});

module.exports = router;