- An acked crisis is not raised again for the same signal: re-raised only if a newer triggering scale exists
(seen live: AUDIT-C 0/0/0 re-fired the acked PHQ-9 item 9 crisis).
- In an open crisis every non-acute message gets a reply (agent for questions, support otherwise) plus
emergency contacts; acute messages still get the fixed script.
- Questions and medicine mentions without «?» are answered mid-questionnaire; free-text steps (check-in,
side effects, question states) keep parsing their input.
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
A question asked mid-questionnaire, mid-check-in or during a crisis is answered right away (agent →
guidelines/instruction); the pending question is re-shown with its buttons (engine remembers the last
prompt), in a crisis the answer carries the emergency contacts and the crisis stays open until the doctor's
ack. Acute messages still get the fixed crisis script. OpenRouter blocks RF IPs: OPENROUTER_PROXY_URL routes
the agent through an HTTP proxy, as vobot does.
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
Clinical review of the questionnaires (ADR-013):
- Red-flag block first in stage 1 (config/instruments/red_flags.yaml); any «Да» stops the
questionnaire with an acute alert and the help screen of its category.
- One crisis rule: the crisis screen opens at a HIGH C-SSRS risk only; moderate stops and goes
to a psychiatrist (24 h as a guide), low is a flag with the safety plan. PHQ-9 item 9 with a
negative screener is a discrepancy flag; without a completed screener it asks the C-SSRS at once.
config/questionnaire.yaml: cssrs_positive_policy graded (C01).
- Every crisis leaves a callback task for the doctor on duty (post_crisis_call, one per patient)
and the app asks how the person is the next day, the safety plan one tap away.
- Routing: risk and flags first, scales second; PCL-5 >= 50 no longer means a priority
appointment (pcl5_severe is moderate on the dashboard too).
- Crisis numbers live only in config/texts/crisis.yaml; texts and the agent prompt refer to them
via {phone:<key>}. Fixes the children's helpline offered to adults by the chat agent.
Refs #92
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
Conflict in app/api/routes.py: /demo/personas keeps the dev version (demo console, DB patients
with scenarios); the patient app gets its own /patient/demo-personas (synthetic ЕМИАС accounts).
Anonymous sign-in now always creates a doctor-less pseudonymous profile, since the dialog API
of #12 serves known profiles only.
Refs #77
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
- Sign-in: centred ЕМИАС card without the sidebar; anonymous entry asks «Депрессия / ПТСР».
- Stage 1 is the same for everyone and follows the fixed order of the MVP questionnaire:
PHQ-2 → trauma filter/TSQ → RUS-AUDIT-S → C-SSRS → context; stage 2 only where stage 1
is positive. Starts without a profile.
- After stage 1 the patient sees a preliminary result (screening, not a diagnosis), stored
with the record; it switches on the diary modules (depression / PTSD).
- Stage 2 diary: morning (sleep, sleep quality, alcohol) and evening (mood, medication,
3 PHQ-9 items in rotation, short PCL-5); C-SSRS since last contact only under risk;
flags on weekly means against the personal norm; scheduled full scales with change
(remission, response, worsening).
- Questionnaire log: GET /me/{token}/results and the «Мои результаты» screen.
- Questionnaires centred without the sidebar and without scale names; «Продолжить позже»
goes home; confirmations are toasts; free-text comments are optional.
- Demo policy config/questionnaire_demo.yaml (INTAKE_DEMO only, not a clinical approval).
ADR-012.
Refs #77
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
- menu button «Вопрос о лечении» -> kb.question -> rag.answer (KR quote + source)
or «уточните у врача»; dose questions get a fixed doctor redirect
- free text in idle that looks like a question (no check-in signals, not a drug
question) -> knowledge base; no answer -> the usual support phrase
- routing order unchanged: consent/safety first, side effects/quit/alcohol -> check-in,
own drug -> med_qa (instruction only, SPEC §7 p.5)
- question cues, small talk and texts in config/texts/knowledge.yaml; scrub placeholders
before "что такое X" no longer hide the definition question
Refs #64
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
- No same-day C-SSRS repeat: a risk screen completed within cssrs_cooldown_hours is not queued again
after PHQ-9 item 9 >= 1 (scale crisis path, rule schedule_scale, scale_due); crisis script and alerts stay.
- Scale intro registry: register_scale_intro(scale_id, text_or_fn); start_scale(intro=None) uses it.
veteran_daily migrated from per-scale on_enter hooks.
- Prefix triggers "button:<prefix>:*" with trigger_payload(event); medication buttons carry the dose
(med:taken:<dose_id>, ...), med_pending dropped; payload-less legacy buttons answer as stale.
- Abandoned-step timeout: settings.abandon_after_hours (default 6 h) returns abandonable states
(daily.*, meds.*, scale.* not in onboarding) to idle before the next event; never in crisis or with intake on.
Refs #56
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
Daily check-in (mood → dose → sleep/nightmares → alcohol → free text with
extract_checkin, buttons win over the LLM, progressive upsert of
daily_checkins), medication reminder flow (taken / skip with reason /
side effects → doses + daily_checkins), medication question menu via
med_qa, med_info rule reactions from the drug instruction excerpt,
«записаться раньше» request recorded for lane B, friendly intros for
scheduled scales. actions.py: additive med_info handler hook.
Refs #37
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
Start screening of the veteran module: peer-tone intro, trauma exposure gate for
PC-PTSD-5, PCL-5/PHQ-9/AUDIT-C via scale sessions (sex asked if unknown), weapon
access question stored as facts for lane B with a safe-storage block on risk,
plain-language result, modules enabled in profile, FAQ, resume after a crisis.
Refs #36
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
Deep-link /start <code> binds the chat via IdentityProvider, text and
button presses go to get_engine().handle(), replies render as inline
keyboards and are sent verbatim (no parse_mode). TelegramOutbox delivers
scheduler pushes to bound chats and falls back to the previous outbox.
No-op without TG_BOT_TOKEN; logs carry no text or chat ids.
Refs #11
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01DfbiLXFJswz2EK3qtWF7S7
build_structured() aggregates a PatientCard into scores, flags and
adherence (no patient text, no names); build_summary() sends it through
the LLM gateway, falls back to a config-driven template, keeps an open
acute alert first and caches per (token, provider, data hash).
Refs #19
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
Topic from engine or keyword classifier, section via integrations.drug_info,
sentence retrieval by keyword overlap (dosing sentences dropped), LLM only
rephrases the excerpt through gateway.phrase("med_answer") with forbidden-output
and added-content guards; dose questions and missing answers -> None + fallback text.
Refs #15
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
Single entry point app/llm/gateway.py: extract_item, extract_checkin,
risk_classify, phrase, summarize_for_doctor. Two-level design:
LLMProvider (transport, GigaChat) and LLMTasks (PromptedTasks over a
provider, or rule-based MockTasks). Shared policy in the gateway:
assert_scrubbed backstop, confidence threshold 0.5, risk failure -> NONE,
forbidden-output filter with config/texts/phrases.yaml fallbacks.
Refs #7
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
One Postgres with isolated identity/clinical databases and roles (ADR-003),
FastAPI /health, Streamlit placeholder, typed settings with offline defaults.
Refs #1
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
ElebobaandClaude Opus 5.5
Arxip222