Coverage for tasks/ciwa.py : 55%

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1#!/usr/bin/env python
3"""
4camcops_server/tasks/ciwa.py
6===============================================================================
8 Copyright (C) 2012-2020 Rudolf Cardinal (rudolf@pobox.com).
10 This file is part of CamCOPS.
12 CamCOPS is free software: you can redistribute it and/or modify
13 it under the terms of the GNU General Public License as published by
14 the Free Software Foundation, either version 3 of the License, or
15 (at your option) any later version.
17 CamCOPS is distributed in the hope that it will be useful,
18 but WITHOUT ANY WARRANTY; without even the implied warranty of
19 MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
20 GNU General Public License for more details.
22 You should have received a copy of the GNU General Public License
23 along with CamCOPS. If not, see <https://www.gnu.org/licenses/>.
25===============================================================================
27"""
29from typing import Any, Dict, List, Tuple, Type
31from cardinal_pythonlib.stringfunc import strseq
32from sqlalchemy.ext.declarative import DeclarativeMeta
33from sqlalchemy.sql.schema import Column
34from sqlalchemy.sql.sqltypes import Float, Integer
36from camcops_server.cc_modules.cc_constants import CssClass
37from camcops_server.cc_modules.cc_ctvinfo import CTV_INCOMPLETE, CtvInfo
38from camcops_server.cc_modules.cc_db import add_multiple_columns
39from camcops_server.cc_modules.cc_html import (
40 answer,
41 subheading_spanning_two_columns,
42 tr,
43 tr_qa,
44)
45from camcops_server.cc_modules.cc_request import CamcopsRequest
46from camcops_server.cc_modules.cc_snomed import SnomedExpression, SnomedLookup
47from camcops_server.cc_modules.cc_sqla_coltypes import (
48 CamcopsColumn,
49 MIN_ZERO_CHECKER,
50 PermittedValueChecker,
51 SummaryCategoryColType,
52)
53from camcops_server.cc_modules.cc_summaryelement import SummaryElement
54from camcops_server.cc_modules.cc_task import (
55 get_from_dict,
56 Task,
57 TaskHasClinicianMixin,
58 TaskHasPatientMixin,
59)
60from camcops_server.cc_modules.cc_text import SS
61from camcops_server.cc_modules.cc_trackerhelpers import (
62 TrackerLabel,
63 TrackerInfo,
64)
67# =============================================================================
68# CIWA
69# =============================================================================
71class CiwaMetaclass(DeclarativeMeta):
72 # noinspection PyInitNewSignature
73 def __init__(cls: Type['Ciwa'],
74 name: str,
75 bases: Tuple[Type, ...],
76 classdict: Dict[str, Any]) -> None:
77 add_multiple_columns(
78 cls, "q", 1, cls.NSCOREDQUESTIONS - 1,
79 minimum=0, maximum=7,
80 comment_fmt="Q{n}, {s} (0-7, higher worse)",
81 comment_strings=[
82 "nausea/vomiting", "tremor", "paroxysmal sweats", "anxiety",
83 "agitation", "tactile disturbances", "auditory disturbances",
84 "visual disturbances", "headache/fullness in head"
85 ]
86 )
87 super().__init__(name, bases, classdict)
90class Ciwa(TaskHasPatientMixin, TaskHasClinicianMixin, Task,
91 metaclass=CiwaMetaclass):
92 """
93 Server implementation of the CIWA-Ar task.
94 """
95 __tablename__ = "ciwa"
96 shortname = "CIWA-Ar"
97 provides_trackers = True
99 NSCOREDQUESTIONS = 10
100 SCORED_QUESTIONS = strseq("q", 1, NSCOREDQUESTIONS)
102 q10 = CamcopsColumn(
103 "q10", Integer,
104 permitted_value_checker=PermittedValueChecker(minimum=0, maximum=4),
105 comment="Q10, orientation/clouding of sensorium (0-4, higher worse)"
106 )
107 t = Column(
108 "t", Float,
109 comment="Temperature (degrees C)"
110 )
111 hr = CamcopsColumn(
112 "hr", Integer,
113 permitted_value_checker=MIN_ZERO_CHECKER,
114 comment="Heart rate (beats/minute)"
115 )
116 sbp = CamcopsColumn(
117 "sbp", Integer,
118 permitted_value_checker=MIN_ZERO_CHECKER,
119 comment="Systolic blood pressure (mmHg)"
120 )
121 dbp = CamcopsColumn(
122 "dbp", Integer,
123 permitted_value_checker=MIN_ZERO_CHECKER,
124 comment="Diastolic blood pressure (mmHg)"
125 )
126 rr = CamcopsColumn(
127 "rr", Integer,
128 permitted_value_checker=MIN_ZERO_CHECKER,
129 comment="Respiratory rate (breaths/minute)"
130 )
132 MAX_SCORE = 67
134 @staticmethod
135 def longname(req: "CamcopsRequest") -> str:
136 _ = req.gettext
137 return _("Clinical Institute Withdrawal Assessment for Alcohol "
138 "Scale, Revised")
140 def get_trackers(self, req: CamcopsRequest) -> List[TrackerInfo]:
141 return [TrackerInfo(
142 value=self.total_score(),
143 plot_label="CIWA total score",
144 axis_label=f"Total score (out of {self.MAX_SCORE})",
145 axis_min=-0.5,
146 axis_max=self.MAX_SCORE + 0.5,
147 horizontal_lines=[14.5, 7.5],
148 horizontal_labels=[
149 TrackerLabel(17, req.sstring(SS.SEVERE)),
150 TrackerLabel(11, req.sstring(SS.MODERATE)),
151 TrackerLabel(3.75, req.sstring(SS.MILD)),
152 ]
153 )]
155 def get_clinical_text(self, req: CamcopsRequest) -> List[CtvInfo]:
156 if not self.is_complete():
157 return CTV_INCOMPLETE
158 return [CtvInfo(
159 content=f"CIWA total score: {self.total_score()}/{self.MAX_SCORE}"
160 )]
162 def get_summaries(self, req: CamcopsRequest) -> List[SummaryElement]:
163 return self.standard_task_summary_fields() + [
164 SummaryElement(name="total",
165 coltype=Integer(),
166 value=self.total_score(),
167 comment=f"Total score (/{self.MAX_SCORE})"),
168 SummaryElement(name="severity",
169 coltype=SummaryCategoryColType,
170 value=self.severity(req),
171 comment="Likely severity"),
172 ]
174 def is_complete(self) -> bool:
175 return (self.all_fields_not_none(self.SCORED_QUESTIONS) and
176 self.field_contents_valid())
178 def total_score(self) -> int:
179 return self.sum_fields(self.SCORED_QUESTIONS)
181 def severity(self, req: CamcopsRequest) -> str:
182 score = self.total_score()
183 if score >= 15:
184 severity = self.wxstring(req, "category_severe")
185 elif score >= 8:
186 severity = self.wxstring(req, "category_moderate")
187 else:
188 severity = self.wxstring(req, "category_mild")
189 return severity
191 def get_task_html(self, req: CamcopsRequest) -> str:
192 score = self.total_score()
193 severity = self.severity(req)
194 answer_dicts_dict = {}
195 for q in self.SCORED_QUESTIONS:
196 d = {None: None}
197 for option in range(0, 8):
198 if option > 4 and q == "q10":
199 continue
200 d[option] = self.wxstring(req, q + "_option" + str(option))
201 answer_dicts_dict[q] = d
202 q_a = ""
203 for q in range(1, Ciwa.NSCOREDQUESTIONS + 1):
204 q_a += tr_qa(
205 self.wxstring(req, "q" + str(q) + "_s"),
206 get_from_dict(answer_dicts_dict["q" + str(q)],
207 getattr(self, "q" + str(q)))
208 )
209 tr_total_score = tr(
210 req.sstring(SS.TOTAL_SCORE),
211 answer(score) + f" / {self.MAX_SCORE}"
212 )
213 tr_severity = tr_qa(
214 self.wxstring(req, "severity") + " <sup>[1]</sup>",
215 severity
216 )
217 return f"""
218 <div class="{CssClass.SUMMARY}">
219 <table class="{CssClass.SUMMARY}">
220 {self.get_is_complete_tr(req)}
221 {tr_total_score}
222 {tr_severity}
223 </table>
224 </div>
225 <table class="{CssClass.TASKDETAIL}">
226 <tr>
227 <th width="35%">Question</th>
228 <th width="65%">Answer</th>
229 </tr>
230 {q_a}
231 {subheading_spanning_two_columns(
232 self.wxstring(req, "vitals_title"))}
233 {tr_qa(self.wxstring(req, "t"), self.t)}
234 {tr_qa(self.wxstring(req, "hr"), self.hr)}
235 {tr(self.wxstring(req, "bp"),
236 answer(self.sbp) + " / " + answer(self.dbp))}
237 {tr_qa(self.wxstring(req, "rr"), self.rr)}
238 </table>
239 <div class="{CssClass.FOOTNOTES}">
240 [1] Total score ≥15 severe, ≥8 moderate, otherwise
241 mild/minimal.
242 </div>
243 """
245 def get_snomed_codes(self, req: CamcopsRequest) -> List[SnomedExpression]:
246 codes = [SnomedExpression(req.snomed(SnomedLookup.CIWA_AR_PROCEDURE_ASSESSMENT))] # noqa
247 if self.is_complete():
248 codes.append(SnomedExpression(
249 req.snomed(SnomedLookup.CIWA_AR_SCALE),
250 {
251 req.snomed(SnomedLookup.CIWA_AR_SCORE): self.total_score(),
252 }
253 ))
254 return codes