feat(backend): API stage 1 on real data instead of fixtures

Doctor list/card/alerts/ack/connect, dialog events/outbox/history and demo
controls now read the identity and clinical DBs. Rule-based discontinuation
risk index, trend, adherence; every doctor read is audited.

Refs #12

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>

tests/test_api_doctor.py

@@ -0,0 +1,288 @@
+"""API #12: doctor dashboard on real DB data — list, card + audit, 403, alerts, ack → crisis ends, connect, no PII."""
+
+from collections.abc import AsyncIterator
+from datetime import datetime, timedelta
+from types import SimpleNamespace
+
+import httpx
+import pytest
+from sqlalchemy import select
+
+from app.api import doctor_views
+from app.config import Settings
+from app.core import clock
+from app.core.privacy import pseudo_id
+from app.core.types import AlertLevel
+from app.db import identity_repo, repo, session
+from app.db.audit import AuditLog
+from app.db.bootstrap import init_db
+from app.db.clinical import Dose, PatientProfile, Prescription, SafetyPlan
+from app.integrations.base import MemoryNotifier, MemoryOutbox, integrations
+from app.main import app
+
+MEM = "sqlite+aiosqlite:///:memory:"
+DOCTOR = "doc-smirnova"
+OTHER = "doc-other"
+DAY0 = datetime(2026, 10, 5, 9, 0)
+
+# Synthetic patients: token suffix → (name, snils, phone, doctor)
+ANDREY, DMITRY, OLGA, PAVEL, IRINA, STRANGER = (c * 32 for c in "abcdef")
+PEOPLE = {
+    ANDREY: ("Андрей С.", "11122233344", "+79990000001", DOCTOR),
+    DMITRY: ("Дмитрий В.", "22233344455", "+79990000002", DOCTOR),
+    OLGA: ("Ольга К.", "33344455566", "+79990000003", DOCTOR),
+    PAVEL: ("Павел Н.", "44455566677", "+79990000004", DOCTOR),
+    IRINA: ("Ирина М.", "55566677788", "+79990000005", DOCTOR),
+    STRANGER: ("Чужой П.", "66677788899", "+79990000006", OTHER),
+}
+
+
+@pytest.fixture
+async def client(monkeypatch: pytest.MonkeyPatch) -> AsyncIterator[httpx.AsyncClient]:
+    monkeypatch.setattr(clock, "get_settings", lambda: Settings(_env_file=None, demo_clock=True))
+    monkeypatch.setattr(integrations, "notifier", MemoryNotifier())
+    monkeypatch.setattr(integrations, "outbox", MemoryOutbox())
+    clock.set_now(DAY0 + timedelta(days=13))
+    await session.configure(identity_url=MEM, clinical_url=MEM)
+    await init_db()
+    await seed()
+    # No lifespan: the scheduler and the Telegram bot are not started.
+    async with httpx.AsyncClient(transport=httpx.ASGITransport(app=app), base_url="http://test") as c:
+        yield c
+    clock.register_persistence(None, None)
+    clock.reset()
+    await session.configure()
+
+
+async def seed() -> None:
+    now = clock.now()
+    start = (DAY0).date()
+    async with session.get_identity_session() as ids:
+        for token, (name, snils, phone, doctor) in PEOPLE.items():
+            await identity_repo.create_patient(
+                ids,
+                token=token,
+                display_name=name,
+                snils=snils,
+                phone=phone,
+                clinic_id="clinic-1",
+                doctor_id=doctor,
+                now=now,
+                birth_year=1990,
+                sex="m",
+            )
+    async with session.get_clinical_session() as s:
+        for token, (_, _, _, doctor) in PEOPLE.items():
+            await repo.upsert_profile(
+                s, token=token, doctor_id=doctor, modules=["veteran"], therapy_start=start, birth_year=1990, sex="m"
+            )
+            s.add(Prescription(token=token, drug="сертралин", dose="50 мг", schedule={"times": ["08:00"]}))
+        await s.flush()
+        rx = {r.token: r.id for r in (await s.scalars(select(Prescription))).all()}
+
+        # Andrey: acute alert (red), worsening PHQ-9, unscheduled PHQ-9, low mood streak, alcohol, a safety plan.
+        await repo.add_alert(s, token=ANDREY, level=AlertLevel.ACUTE, code="phq9_item9", reason="PHQ-9 п.9", ts=now)
+        await repo.add_scale_result(
+            s, token=ANDREY, scale="phq9", total=12, severity="moderate", complete=True, ts=now - timedelta(days=7)
+        )
+        await repo.add_scale_result(
+            s,
+            token=ANDREY,
+            scale="phq9",
+            total=18,
+            severity="mod_severe",
+            complete=True,
+            ts=now - timedelta(hours=2),
+            scheduled=False,
+            item9=2,
+        )
+        await repo.add_scale_result(
+            s, token=ANDREY, scale="pcl5", total=44, severity="-", complete=True, ts=now - timedelta(days=13)
+        )
+        for i, (mood, sleep, alcohol) in enumerate([(3, "<4", "more"), (2, "4-6", "1-2"), (2, "<4", "none")]):
+            await repo.upsert_checkin(
+                s,
+                token=ANDREY,
+                day=now.date() - timedelta(days=2 - i),
+                now=now,
+                mood=mood,
+                sleep_bucket=sleep,
+                alcohol_bucket=alcohol,
+                med_taken=True,
+            )
+        s.add(
+            SafetyPlan(
+                token=ANDREY, steps=["Позвонить брату", {"who": "Кризисная линия", "phone": "8-800"}], updated_at=now
+            )
+        )
+        # Dmitry: high alert (yellow). Olga: info only (grey).
+        await repo.add_alert(s, token=DMITRY, level=AlertLevel.HIGH, code="pcl5_high", reason="PCL-5 ≥ 50", ts=now)
+        await repo.add_alert(s, token=OLGA, level=AlertLevel.INFO, code="no_contact_3d", reason="Молчит 3 дня", ts=now)
+        # Pavel and Irina: green; Pavel missed doses + voiced quit intent → higher risk, sorted first among greens.
+        for d in range(7):
+            planned = now - timedelta(days=d, hours=1)
+            s.add(
+                Dose(token=PAVEL, prescription_id=rx[PAVEL], planned_at=planned, status="missed" if d < 3 else "taken")
+            )
+            s.add(Dose(token=IRINA, prescription_id=rx[IRINA], planned_at=planned, status="taken"))
+        await repo.upsert_checkin(s, token=PAVEL, day=now.date(), now=now, quit_intent=True, mood=5)
+        # Foreign doctor's patient with an open alert: must never show up for DOCTOR.
+        await repo.add_alert(s, token=STRANGER, level=AlertLevel.ACUTE, code="cssrs_high", reason="C-SSRS", ts=now)
+        await repo.set_dialog_state(
+            s,
+            token=ANDREY,
+            state="crisis",
+            data={"consent": True, "adult": True, "crisis": {"open": True, "opened_at": now.isoformat()}},
+            now=now,
+        )
+
+
+async def audit_rows(action: str) -> list[AuditLog]:
+    async with session.get_clinical_session() as s:
+        return list((await s.scalars(select(AuditLog).where(AuditLog.action == action))).all())
+
+
+async def test_list_order_colours_and_metrics(client: httpx.AsyncClient) -> None:
+    rows = (await client.get(f"/api/v1/doctors/{DOCTOR}/patients")).json()
+    assert [r["token"] for r in rows] == [ANDREY, DMITRY, OLGA, PAVEL, IRINA]
+    assert [r["status_color"] for r in rows] == ["red", "yellow", "grey", "green", "green"]
+    andrey, pavel, irina = rows[0], rows[3], rows[4]
+    assert andrey["display_name"] == "Андрей С." and andrey["age"] == 36
+    assert andrey["top_alert_level"] == "acute" and andrey["open_alerts"] == 1
+    assert (andrey["phq9_last"], andrey["pcl5_last"], andrey["trend"]) == (18, 44, "up")
+    assert andrey["drug"] == "сертралин 50 мг" and andrey["therapy_day"] == 13
+    assert andrey["last_event"] == "PHQ-9 п.9"  # the alert is newer than the last scale
+    assert rows[1]["last_event"] == "PCL-5 ≥ 50"
+    factors = " ".join(andrey["discontinuation_risk"]["factors"])
+    assert "настроение ≤ 3 3 дн. подряд" in factors and "алкоголь 2 дн. из 7" in factors
+    assert pavel["adherence_7d"] == pytest.approx(4 / 7, abs=0.01)
+    assert irina["adherence_7d"] == 1.0 and irina["discontinuation_risk"]["score"] == 0
+    assert pavel["discontinuation_risk"]["score"] == 30 + 25  # 3 missed days + quit intent
+    assert pavel["discontinuation_risk"]["level"] == "medium"
+    assert len(await audit_rows("view_patient_list")) == 1
+
+
+async def test_card_writes_audit_and_has_series(client: httpx.AsyncClient) -> None:
+    r = await client.get(f"/api/v1/patients/{ANDREY}", params={"doctor_id": DOCTOR})
+    assert r.status_code == 200
+    card = r.json()
+    metrics = {(p["metric"], p["value"], p["scheduled"]) for p in card["series"]}
+    assert ("phq9", 18.0, False) in metrics and ("phq9", 12.0, True) in metrics
+    assert ("sleep_hours", 3.0, True) in metrics and ("sleep_hours", 5.0, True) in metrics
+    assert ("alcohol", 2.0, True) in metrics and ("mood", 2.0, True) in metrics
+    assert card["safety_plan"] == ["Позвонить брату", "Кризисная линия: 8-800"]
+    assert card["alerts"][0]["patient_name"] == "Андрей С." and card["alerts"][0]["color"] == "red"
+    assert card["prescriptions"][0]["schedule"] == {"times": ["08:00"]}
+    assert card["summary"]
+    rows = await audit_rows("view_patient")
+    assert len(rows) == 1 and rows[0].actor == DOCTOR and rows[0].token == ANDREY
+
+
+async def test_card_forbidden_for_foreign_doctor(client: httpx.AsyncClient) -> None:
+    r = await client.get(f"/api/v1/patients/{ANDREY}", params={"doctor_id": OTHER})
+    assert r.status_code == 403
+    assert await audit_rows("view_patient") == []
+    assert len(await audit_rows("view_patient_denied")) == 1
+    assert (await client.get("/api/v1/patients/" + "0" * 32, params={"doctor_id": DOCTOR})).status_code == 404
+
+
+async def test_alerts_feed_since_id_and_open_only(client: httpx.AsyncClient) -> None:
+    alerts = (await client.get(f"/api/v1/doctors/{DOCTOR}/alerts")).json()
+    assert {a["token"] for a in alerts} == {ANDREY, DMITRY, OLGA}  # no foreign patient
+    assert all(a["patient_name"] for a in alerts)
+    top = max(a["id"] for a in alerts)
+    assert (await client.get(f"/api/v1/doctors/{DOCTOR}/alerts", params={"since_id": top})).json() == []
+    assert len(await audit_rows("view_alerts")) == 1  # empty poll is not a disclosure
+
+
+async def test_ack_acute_ends_crisis(client: httpx.AsyncClient) -> None:
+    alerts = (await client.get(f"/api/v1/doctors/{DOCTOR}/alerts", params={"open_only": True})).json()
+    acute = next(a for a in alerts if a["token"] == ANDREY)
+    assert (await client.post(f"/api/v1/alerts/{acute['id']}/ack", json={"doctor_id": OTHER})).status_code == 403
+    r = await client.post(f"/api/v1/alerts/{acute['id']}/ack", json={"doctor_id": DOCTOR})
+    assert r.status_code == 200
+    out = r.json()
+    assert out["acked_by"] == DOCTOR and out["acked_at"] and out["patient_name"] == "Андрей С."
+    async with session.get_clinical_session() as s:
+        state = await repo.get_dialog_state(s, ANDREY)
+        profile = await s.get(PatientProfile, ANDREY)
+    assert state is not None and state.state == "idle" and state.data["crisis"]["open"] is False
+    assert profile is not None and profile.status_color == "green"
+    assert isinstance(integrations.outbox, MemoryOutbox)
+    assert integrations.outbox.drain(ANDREY)  # "crisis closed" message waits for the console
+    assert len(await audit_rows("ack_alert")) == 1
+    rows = (await client.get(f"/api/v1/doctors/{DOCTOR}/patients")).json()
+    assert next(x for x in rows if x["token"] == ANDREY)["status_color"] == "green"
+
+
+async def test_connect_creates_patient_and_redeemable_code(client: httpx.AsyncClient) -> None:
+    body = {
+        "doctor_id": DOCTOR,
+        "display_name": "Сергей Т.",
+        "birth_year": 1988,
+        "sex": "m",
+        "snils": "123-456-789 01",
+        "drug": "сертралин",
+        "dose": "50 мг",
+        "times": ["08:00", "20:00"],
+        "instructions": "после еды",
+        "modules": ["veteran", "depression"],
+    }
+    r = await client.post("/api/v1/patients/connect", json=body)
+    assert r.status_code == 200
+    out = r.json()
+    assert out["token"] == pseudo_id("12345678901")
+    assert out["deep_link"] == f"/console?code={out['code']}"
+    assert "12345678901" not in r.text and "123-456-789" not in r.text
+    async with session.get_identity_session() as ids:
+        assert await identity_repo.redeem_connect_code(ids, code=out["code"], now=clock.now()) == out["token"]
+    async with session.get_clinical_session() as s:
+        profile = await repo.get_profile(s, out["token"])
+        rx = await s.scalar(select(Prescription).where(Prescription.token == out["token"]))
+    assert profile is not None and profile.therapy_start == clock.today() and profile.doctor_id == DOCTOR
+    assert rx is not None and rx.schedule["times"] == ["08:00", "20:00"]
+    assert len(await audit_rows("connect_patient")) == 1
+    card = (await client.get(f"/api/v1/patients/{out['token']}", params={"doctor_id": DOCTOR})).json()
+    assert card["prescriptions"][0]["instructions"] == "после еды"
+    assert card["patient"]["therapy_day"] == 0 and card["patient"]["status_color"] == "green"
+    assert (await client.post("/api/v1/patients/connect", json=body)).status_code == 409
+
+
+async def test_no_pii_in_doctor_responses(client: httpx.AsyncClient) -> None:
+    texts = [
+        (await client.get(f"/api/v1/doctors/{DOCTOR}/patients")).text,
+        (await client.get(f"/api/v1/patients/{ANDREY}", params={"doctor_id": DOCTOR})).text,
+        (await client.get(f"/api/v1/doctors/{DOCTOR}/alerts")).text,
+    ]
+    for _, snils, phone, _ in PEOPLE.values():
+        for text in texts:
+            assert snils not in text and phone not in text and phone[1:] not in text
+
+
+def test_risk_index_all_factors_capped() -> None:
+    now = datetime(2026, 10, 18, 12, 0).astimezone()
+    days = [now.date() - timedelta(days=i) for i in range(4)]
+    checkins = [
+        SimpleNamespace(
+            day=d, mood=2, med_taken=False, side_effects=["nausea"], quit_intent=True, alcohol_bucket="more"
+        )
+        for d in days
+    ]
+    data = doctor_views.PatientData(
+        profile=SimpleNamespace(therapy_start=days[-1] - timedelta(days=10)),  # type: ignore[arg-type]
+        checkins=checkins,  # type: ignore[arg-type]
+        results=[],
+        doses=[],
+        prescriptions=[],
+        alerts=[SimpleNamespace(code="quit_intent", acked_at=None)],  # type: ignore[list-item]
+    )
+    risk = doctor_views.discontinuation_risk(data, now)
+    assert risk.score == 100 and risk.level == "high"
+    assert risk.factors == [
+        "пропуски приёма 4/7 дн.",
+        "побочные эффекты 4 дн. подряд",
+        "хотел бросить (день 13)",
+        "не разобран сигнал «хочет бросить»",
+        "настроение ≤ 3 4 дн. подряд",
+        "алкоголь 4 дн. из 7",
+    ]