pediatric-ai-scribe-v3/shared/clinical/ros-pe-dx.ts

// ============================================================
// ROS / PE systems + common ICD-10 diagnoses + AI formatters.
// Ported verbatim from public/js/shadess.js (@be14578):
//   ROS_SYSTEMS   — 15 systems
//   PE_SYSTEMS    — 17 systems
//   COMMON_DX     — 28 pediatric diagnoses quick-pick
//   formatRosForAI / formatDxForAI — string format the AI receives.
// These tables are clinical reference data — do NOT re-order or
// silently "simplify" them during maintenance. Copy from the vanilla
// source when it changes.
// ============================================================

export interface SystemEntry {
  key: string;
  label: string;
  detail: string;
}

export const ROS_SYSTEMS: ReadonlyArray<SystemEntry> = [
  { key: 'constitutional',   label: 'Constitutional',           detail: 'fever, fatigue, weight loss/gain, appetite' },
  { key: 'eyes',             label: 'Eyes',                     detail: 'vision changes, discharge, redness' },
  { key: 'ent',              label: 'ENT',                      detail: 'ear pain, congestion, sore throat, mouth sores' },
  { key: 'cardiovascular',   label: 'Cardiovascular',           detail: 'chest pain, palpitations, murmur' },
  { key: 'respiratory',      label: 'Respiratory',              detail: 'cough, wheeze, dyspnea' },
  { key: 'gastrointestinal', label: 'Gastrointestinal',         detail: 'nausea, vomiting, diarrhea, constipation, abdominal pain' },
  { key: 'genitourinary',    label: 'Genitourinary',            detail: 'dysuria, frequency, discharge, menstrual' },
  { key: 'musculoskeletal',  label: 'Musculoskeletal',          detail: 'joint pain, swelling, gait issues, back pain' },
  { key: 'skin',             label: 'Skin',                     detail: 'rash, lesions, itch, hair/nail changes' },
  { key: 'neurological',     label: 'Neurological',             detail: 'headache, dizziness, seizures, numbness' },
  { key: 'psychiatric',      label: 'Psychiatric',              detail: 'mood, anxiety, sleep, behavior changes' },
  { key: 'endocrine',        label: 'Endocrine',                detail: 'polyuria/polydipsia, heat/cold intolerance, growth concerns' },
  { key: 'hematologic',      label: 'Hematologic/Lymphatic',    detail: 'bruising, bleeding, lymph nodes' },
  { key: 'allergic',         label: 'Allergic/Immunologic',     detail: 'allergic reactions, frequent infections' },
  { key: 'developmental',    label: 'Developmental/Behavioral', detail: 'milestones, school, social' },
];

export const PE_SYSTEMS: ReadonlyArray<SystemEntry> = [
  { key: 'general',       label: 'General Appearance',       detail: 'WDWN, alert, NAD, etc.' },
  { key: 'peEyes',        label: 'Eyes',                     detail: 'PERRL, conjunctiva, EOM' },
  { key: 'ears',          label: 'Ears',                     detail: 'TMs, canals, hearing' },
  { key: 'nose',          label: 'Nose',                     detail: 'mucosa, septum, turbinates' },
  { key: 'mouthThroat',   label: 'Mouth/Throat',             detail: 'lips, gums, teeth, tonsils, pharynx' },
  { key: 'neck',          label: 'Neck',                     detail: 'lymph nodes, thyroid, masses' },
  { key: 'chestLungs',    label: 'Chest/Lungs',              detail: 'air entry, wheezing, retractions' },
  { key: 'peCv',          label: 'Cardiovascular',           detail: 'S1/S2, murmur, pulses, cap refill' },
  { key: 'abdomen',       label: 'Abdomen',                  detail: 'soft, tenderness, organomegaly, BS' },
  { key: 'guTanner',      label: 'Genitourinary/Tanner',     detail: 'Tanner stage, genitalia, hernias' },
  { key: 'msk',           label: 'Musculoskeletal',          detail: 'strength, ROM, gait, spine' },
  { key: 'extremities',   label: 'Extremities',              detail: 'tone, reflexes, clubbing, edema' },
  { key: 'peSkin',        label: 'Skin',                     detail: 'rashes, lesions, cafe au lait, bruises' },
  { key: 'peNeuro',       label: 'Neurological',             detail: 'CN intact, DTRs, coordination' },
  { key: 'lymphatic',     label: 'Lymphatic',                detail: 'cervical, axillary, inguinal nodes' },
  { key: 'breast',        label: 'Breast',                   detail: 'if indicated by age/Tanner' },
  { key: 'pePsych',       label: 'Psychiatric',              detail: 'affect, mood, behavior during exam' },
];

export interface DxEntry { code: string; name: string }

export const COMMON_DX: ReadonlyArray<DxEntry> = [
  { code: 'Z00.129', name: 'Routine child health exam, no abnormal findings' },
  { code: 'Z00.121', name: 'Routine child health exam, with abnormal findings' },
  { code: 'J06.9',   name: 'Upper Respiratory Infection, NOS' },
  { code: 'J02.9',   name: 'Acute pharyngitis, NOS' },
  { code: 'J03.90',  name: 'Acute tonsillitis, NOS' },
  { code: 'H66.90',  name: 'Otitis media, NOS' },
  { code: 'J20.9',   name: 'Acute bronchitis' },
  { code: 'J45.20',  name: 'Mild intermittent asthma, uncomplicated' },
  { code: 'J45.30',  name: 'Mild persistent asthma' },
  { code: 'A09',     name: 'Gastroenteritis/colitis' },
  { code: 'L20.9',   name: 'Atopic dermatitis, NOS' },
  { code: 'L30.9',   name: 'Dermatitis NOS' },
  { code: 'R50.9',   name: 'Fever NOS' },
  { code: 'R10.9',   name: 'Abdominal pain NOS' },
  { code: 'R05.9',   name: 'Cough' },
  { code: 'B34.9',   name: 'Viral infection NOS' },
  { code: 'Z23',     name: 'Immunization encounter' },
  { code: 'Z41.9',   name: 'Procedure for non-remedial reason' },
  { code: 'K21.0',   name: 'GERD with esophagitis' },
  { code: 'K21.9',   name: 'GERD without esophagitis' },
  { code: 'F90.0',   name: 'ADHD, predominantly inattentive' },
  { code: 'F90.2',   name: 'ADHD, combined type' },
  { code: 'F41.1',   name: 'Generalized anxiety disorder' },
  { code: 'F32.9',   name: 'Major depressive episode NOS' },
  { code: 'E11.9',   name: 'Type 2 diabetes' },
  { code: 'E03.9',   name: 'Hypothyroidism NOS' },
  { code: 'M54.5',   name: 'Low back pain' },
  { code: 'G43.909', name: 'Migraine NOS' },
];

// Per-system status — undefined/'' = Not Reviewed → omit when formatted.
export type RosStatus = '' | 'wnl' | 'abnormal' | 'notrev';

export interface RosCell { status?: RosStatus; note?: string }
export type RosData = Record<string, RosCell>;

// Format ROS/PE for the AI. Mirrors window.formatRosForAI exactly —
// tells the AI which systems to expand with pertinent negatives vs
// which to treat as abnormal findings to describe.
export function formatRosForAI(
  systems: ReadonlyArray<SystemEntry>,
  data: RosData,
  heading: string,
): string {
  const lines: string[] = [heading + ':'];
  let hasAny = false;
  for (const sys of systems) {
    const cell = data[sys.key] || {};
    if (!cell.status) continue;
    hasAny = true;
    if (cell.status === 'wnl') {
      lines.push('  ' + sys.label + ': NORMAL [domain: ' + sys.detail + ']');
    } else if (cell.status === 'abnormal') {
      lines.push('  ' + sys.label + ': ABNORMAL' + (cell.note ? ' — ' + cell.note : '') + ' [domain: ' + sys.detail + ']');
    } else {
      lines.push('  ' + sys.label + ': Not reviewed');
    }
  }
  return hasAny ? lines.join('\n') : '';
}

// Format diagnoses list for the AI. Mirrors window.formatDxForAI.
export function formatDxForAI(dx: ReadonlyArray<DxEntry>, freetext?: string): string {
  const lines: string[] = [];
  for (const d of dx) {
    lines.push((d.code ? d.code + ' ' : '') + d.name);
  }
  const t = (freetext || '').trim();
  if (t) lines.push(t);
  return lines.length ? 'Diagnoses:\n' + lines.map((l) => '  - ' + l).join('\n') : '';
}