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0a92266bab |
@@ -6,6 +6,15 @@ GIGACHAT_CREDENTIALS=
|
||||
GIGACHAT_SCOPE=GIGACHAT_API_PERS
|
||||
GIGACHAT_MODEL=GigaChat
|
||||
|
||||
# --- Chat agent: auto | off | mock | openrouter | gigachat. OpenRouter = temporary, synthetic data only.
|
||||
CHAT_AGENT=auto
|
||||
OPENROUTER_API_KEY=
|
||||
OPENROUTER_MODEL=google/gemini-2.5-flash-lite
|
||||
|
||||
# --- Voice input (speech-to-text): auto | off | mock | openrouter. OpenRouter = synthetic data only (ADR-014).
|
||||
STT_PROVIDER=auto
|
||||
STT_MODEL=google/gemini-2.5-flash
|
||||
|
||||
# --- Pseudonymisation key: 32+ random bytes, hex. Generate: python -c "import secrets;print(secrets.token_hex(32))"
|
||||
PSEUDO_KEY=
|
||||
|
||||
@@ -18,10 +27,15 @@ CLINICAL_DB_URL=postgresql+asyncpg://clinical_app:clinical_app@localhost:5432/cl
|
||||
|
||||
# --- Telegram: prototype on synthetic data only; prod channel is MAX / Gosuslugi. Empty = bot disabled.
|
||||
TG_BOT_TOKEN=
|
||||
# http://user:pass@host:port or socks5://… — needed on the RF server (docker has no route to Telegram over IPv4)
|
||||
TG_PROXY_URL=
|
||||
DOCTOR_NOTIFY_CHAT_ID=
|
||||
|
||||
# --- Demo virtual clock (ADR-005)
|
||||
DEMO_CLOCK=true
|
||||
# Questionnaires of the intake (#53) on synthetic data, demo only (needs DEMO_CLOCK). The clinical release gate in
|
||||
# config/intake_runtime.yaml stays closed; without a signed routing policy every finished intake goes to review.
|
||||
INTAKE_DEMO=false
|
||||
TZ=Europe/Moscow
|
||||
|
||||
# --- Gitea (for Claude Code / team workflow, not used by the app)
|
||||
@@ -29,3 +43,13 @@ GITEA_URL=https://gitea.24studbank.ru
|
||||
GITEA_REPO=MedITron/PTSRaiAgent
|
||||
GITEA_USER=
|
||||
GITEA_TOKEN=
|
||||
# MAX notifications: keep disabled until the backend/channel PRs and a real bot are installed.
|
||||
MAX_ENABLED=false
|
||||
MAX_BOT_TOKEN=
|
||||
MAX_BOT_USERNAME=
|
||||
MAX_WEBHOOK_SECRET=
|
||||
MAX_WEBHOOK_URL=
|
||||
MAX_SITE_URL=
|
||||
# Optional path to a trusted PEM CA bundle; never disable TLS verification.
|
||||
MAX_CA_BUNDLE=
|
||||
MAX_LINK_TTL_SECONDS=600
|
||||
|
||||
@@ -0,0 +1,2 @@
|
||||
# Shell scripts run inside Linux containers: never check them out with CRLF (bash fails on the carriage return).
|
||||
*.sh text eol=lf
|
||||
@@ -0,0 +1,52 @@
|
||||
name: CD
|
||||
|
||||
# Every merge into dev → lint + tests → deploy to the shared server (dev.meditron.tenvex.ru / meditron.tenvex.ru).
|
||||
# Secrets: DEPLOY_SSH_KEY (private key of the `ptsr-deploy` user), DEPLOY_HOST (user@host).
|
||||
on:
|
||||
push:
|
||||
branches: [dev]
|
||||
workflow_dispatch:
|
||||
|
||||
concurrency:
|
||||
group: deploy-dev
|
||||
cancel-in-progress: false
|
||||
|
||||
jobs:
|
||||
test:
|
||||
name: ruff · pytest
|
||||
runs-on: ubuntu-latest
|
||||
steps:
|
||||
- uses: actions/checkout@v4
|
||||
- uses: astral-sh/setup-uv@v3
|
||||
with:
|
||||
version: "0.8.4"
|
||||
- run: uv sync --frozen
|
||||
- run: uv run ruff check .
|
||||
- run: uv run pytest -q
|
||||
|
||||
deploy:
|
||||
name: deploy dev
|
||||
needs: test
|
||||
runs-on: ubuntu-latest
|
||||
steps:
|
||||
- uses: actions/checkout@v4
|
||||
with:
|
||||
fetch-depth: 0
|
||||
- name: ssh key
|
||||
run: |
|
||||
install -d -m 700 ~/.ssh
|
||||
printf '%s\n' "${{ secrets.DEPLOY_SSH_KEY }}" > ~/.ssh/deploy_key
|
||||
chmod 600 ~/.ssh/deploy_key
|
||||
- name: deploy
|
||||
env:
|
||||
DEPLOY_HOST: ${{ secrets.DEPLOY_HOST }}
|
||||
DEPLOY_SSH_OPTS: "-i /root/.ssh/deploy_key -o IdentitiesOnly=yes -o StrictHostKeyChecking=accept-new -o ConnectTimeout=20"
|
||||
run: |
|
||||
export DEPLOY_SSH_OPTS="${DEPLOY_SSH_OPTS//\/root\/.ssh/$HOME/.ssh}"
|
||||
infra/deploy/deploy.sh HEAD
|
||||
- name: smoke
|
||||
run: |
|
||||
sleep 10
|
||||
for u in https://dev.meditron.tenvex.ru/ https://dev.meditron.tenvex.ru/api/v1/demo/personas https://dev.meditron.tenvex.ru/doctor/; do
|
||||
code=$(curl -s -o /dev/null -w '%{http_code}' -m 20 "$u"); echo "$u -> $code"; [ "$code" = 200 ]
|
||||
done
|
||||
@@ -0,0 +1,18 @@
|
||||
# Dashboard-only Streamlit settings (doctor dashboard + demo console).
|
||||
[theme]
|
||||
base = "light"
|
||||
primaryColor = "#285E4E"
|
||||
backgroundColor = "#F6F7F3"
|
||||
secondaryBackgroundColor = "#FFFFFF"
|
||||
textColor = "#213B38"
|
||||
borderColor = "#E1E7E3"
|
||||
baseRadius = "medium"
|
||||
# Falls back to the system sans-serif when offline (ADR-004).
|
||||
font = "sans-serif"
|
||||
headingFontWeights = 600
|
||||
|
||||
[client]
|
||||
toolbarMode = "minimal"
|
||||
|
||||
[browser]
|
||||
gatherUsageStats = false
|
||||
@@ -6,7 +6,7 @@ install:
|
||||
up:
|
||||
@test -f .env || cp .env.example .env
|
||||
docker compose up -d --build
|
||||
@echo "API: http://localhost:8000/docs Dashboard: http://localhost:8501"
|
||||
@echo "Patient app: http://localhost:8080 API: http://localhost:8000/docs Doctor/demo console: http://localhost:8501"
|
||||
|
||||
down:
|
||||
docker compose down
|
||||
|
||||
@@ -1,14 +1,117 @@
|
||||
# PTSRaiAgent — ИИ-помощник сопровождения при ПТСР и депрессии
|
||||
|
||||
> Хакатон MedITron · кейс SberMed AI «ИИ-помощник пациента». Прототип на **синтетических данных**.
|
||||
> Telegram используется только для прототипа на синтетических данных; прод-канал — MAX / Госуслуги.
|
||||
> Хакатон MedITron · кейс SberMed AI «ИИ-помощник пациента». Прототип работает **только на синтетических данных**.
|
||||
> Демо-стенд: **https://meditron.tenvex.ru** (кабинет врача: https://meditron.tenvex.ru/doctor/, API: https://meditron.tenvex.ru/docs).
|
||||
|
||||
🚧 README заполняется к сдаче (issue «README по требованиям оформления»). Разделы по требованиям жюри:
|
||||
---
|
||||
|
||||
1. Цели и задачи решения
|
||||
2. Что реализовано
|
||||
3. Развёртывание, запуск, использование
|
||||
4. Входные и выходные данные, API
|
||||
5. Ограничения и особенности медицинской тематики
|
||||
## 1. Цели и задачи
|
||||
|
||||
Пока смотрите [`CLAUDE.md`](CLAUDE.md) и [`docs/`](docs/).
|
||||
**Проблема.** Ветераны СВО и люди с депрессией до помощи доходят с трудом, а начав лечение, часто его бросают: в первые недели побочные эффекты уже есть, а эффекта ещё нет. Врач между визитами ничего не знает о пациенте.
|
||||
|
||||
**Решение.** Цифровой помощник сопровождает пациента между визитами к врачу. Из сценариев кейса закрыты два: **мониторинг после обращения** и **управление приёмом лекарств**.
|
||||
- Пациент общается с помощником в чате: веб-приложение или Telegram. В проде канал — MAX / Госуслуги.
|
||||
- Помощник собирает валидированные шкалы, ежедневный чек-ин и отметки о приёме препарата.
|
||||
- Он отвечает на вопросы о лечении по клиническим рекомендациям Минздрава, по инструкции ГРЛС и по карте пациента в ЕМИАС.
|
||||
- Врач видит «красные зоны» и получает сигналы при ухудшении.
|
||||
|
||||
**Принципы.**
|
||||
- ИИ не ставит диагнозы и не назначает лечение.
|
||||
- LLM только формулирует ответы и извлекает данные.
|
||||
- **Риск, алерты и скоринг считают детерминированные правила** по валидированным шкалам (PHQ-9, PCL-5, GAD-7, AUDIT-C, C-SSRS, DAR-5).
|
||||
- Клинические решения принимает врач.
|
||||
|
||||
## 2. Что реализовано
|
||||
|
||||
| Блок | Что есть |
|
||||
|---|---|
|
||||
| **Чат-агент** | LLM с инструментами только для чтения: поиск по базе клинических рекомендаций (RAG, депрессия 2024, ПТСР 2023), карта пациента из ЕМИАС (мок), инструкция ГРЛС, детерминированная проверка препарата под пациента (сопутствующие болезни, непереносимость вспомогательных веществ, взаимодействия). Ответ печатается в реальном времени (SSE), видны шаги агента. Провайдеры: GigaChat (функции), OpenRouter (временно, только синтетика), офлайн-mock. |
|
||||
| **Диалоговый движок** | Обезличивание → проверка безопасности → FSM. Согласие (152-ФЗ, отзыв в один шаг), проверка возраста, онбординг ветерана (PC-PTSD-5 → PCL-5 → PHQ-9 → AUDIT-C), опросник intake (C-SSRS, PHQ-2→9, TSQ→PCL-5, RUS-AUDIT-S), ежедневный чек-ин, напоминания о дозах, побочные эффекты. На вопросы отвечает в любом состоянии. |
|
||||
| **Безопасность** | Лексикон риска (100% recall на наборе кризисных фраз), фиксированный кризисный скрипт без LLM, алерт врачу и дежурному, план безопасности. В демо кризисное окно показывается в конце теста и не блокирует диалог (`CRISIS_BLOCKING`). |
|
||||
| **Правила мониторинга** | 17 правил в `config/rules.yaml`: п.9 PHQ-9, рост баллов, побочки 3 дня подряд, намерение бросить, пропуски 3 из 7, сон < 4 ч, алкоголь, молчание > 3 дней и другие. |
|
||||
| **Кабинет врача** | Список «красных зон» с индексом риска прерывания терапии, карточка (графики шкал, сон, настроение, дозы, алерты, план безопасности, ИИ-саммари), живые алерты, подключение пациента с кодом и QR, аудит доступа. |
|
||||
| **Веб-приложение пациента** | Вход через ЕМИАС (демо: код от врача), анонимный вход или демо-вход в один клик (у каждого посетителя своя копия пациента). Экраны: сегодня, лекарства, чат, врач, профиль. |
|
||||
| **Демо-консоль** | Виртуальные часы (13 дней терапии за 3 минуты), проигрывание сценария, сплит-экран, тумблер начального теста. |
|
||||
| **Инфраструктура** | Docker compose, CI (ruff + pytest, около 1060 тестов), CD: мерж в `dev` выкатывает стенд. |
|
||||
|
||||
## 3. Развёртывание и запуск
|
||||
|
||||
**Требования:** только Docker с Compose v2 — всё остальное собирается в контейнерах. Для разработки — Python 3.12 и [uv](https://docs.astral.sh/uv/), Node 20.
|
||||
|
||||
```bash
|
||||
cp .env.example .env # по умолчанию офлайн: LLM_PROVIDER=mock, агент выключен
|
||||
make up # postgres + API (:8000) + кабинет врача/демо-консоль (:8501) + приложение пациента (:8080)
|
||||
make seed # синтетический кабинет: врач, ветеран Андрей и 7 пациентов
|
||||
```
|
||||
|
||||
- API и Swagger: http://localhost:8000/docs
|
||||
- Кабинет врача и демо-консоль: http://localhost:8501
|
||||
- Веб-приложение пациента: http://localhost:8080 (собирается внутри Docker, Node на машине не нужен; для разработки — `cd web && npm run dev`, :5173)
|
||||
|
||||
**Включить чат-агента** в `.env`:
|
||||
- `CHAT_AGENT=gigachat` + `GIGACHAT_CREDENTIALS=…` — целевой вариант для РФ;
|
||||
- или `CHAT_AGENT=openrouter` + `OPENROUTER_API_KEY=…` (+ `OPENROUTER_PROXY_URL` с сервера в РФ) — только для прототипа;
|
||||
- проверить из терминала: `uv run python -m app.llm.agent "Можно мне ибупрофен?" --persona andrey`.
|
||||
|
||||
**Демо-переключатели:**
|
||||
- `SCREENING_ENABLED` — начальный тест (дублируется тумблером в демо-консоли);
|
||||
- `CRISIS_BLOCKING` — клинический протокол: кризис блокирует диалог до подтверждения врача;
|
||||
- `DEMO_CLOCK` — виртуальные часы;
|
||||
- `INTAKE_DEMO` — опросники intake на синтетике.
|
||||
|
||||
**Сервер:** `infra/deploy/` — override compose, nginx-vhost, `deploy.sh`. Выкатка на стенд — `.gitea/workflows/deploy.yml`.
|
||||
|
||||
**Разработка:** `uv sync`, `make lint test`.
|
||||
|
||||
## 4. Входные и выходные данные, API
|
||||
|
||||
**Входные данные:**
|
||||
- сообщения и ответы кнопками пациента;
|
||||
- назначения (мок МИС, `data/meds/mis_prescriptions.json`);
|
||||
- карта ЕМИАС (мок, `data/emias/records.yaml`);
|
||||
- выдержки ГРЛС (`data/meds/grls/`);
|
||||
- клинические рекомендации (`config/rag/corpus/`).
|
||||
|
||||
**Выходные данные:** ответы пациенту, баллы шкал, алерты врачу, карточка пациента, журнал аудита.
|
||||
|
||||
Все клинические конфиги (шкалы, пороги, правила, тексты, лексикон) лежат в `config/` и правятся без кода.
|
||||
|
||||
Основные эндпоинты (`/api/v1`, полная спецификация — `/docs`):
|
||||
|
||||
| Метод и путь | Назначение |
|
||||
|---|---|
|
||||
| `POST /dialog/{token}/events` | событие диалога: текст, кнопка, start → ответы помощника |
|
||||
| `POST /dialog/{token}/events/stream` | то же в виде SSE: шаги агента, текст по мере генерации, финальные ответы |
|
||||
| `GET /dialog/{token}/outbox` | системные сообщения: напоминания, чек-ины |
|
||||
| `POST /auth/emias`, `/auth/emias/demo`, `/auth/demo/fresh`, `/auth/anonymous` | входы веб-приложения |
|
||||
| `GET /me/{token}/today` | план на сегодня: дозы, отметки за неделю, визит |
|
||||
| `GET /doctors/{id}/patients` | список пациентов врача с цветом и индексом риска |
|
||||
| `GET /patients/{token}?doctor_id=` | карточка пациента (пишется в аудит) |
|
||||
| `GET /doctors/{id}/alerts`, `POST /alerts/{id}/ack` | алерты и их подтверждение |
|
||||
| `POST /patients/connect` | подключение пациента: назначение и одноразовый код |
|
||||
| `GET/POST /demo/clock…`, `/demo/reset`, `/demo/settings` | демо-управление |
|
||||
|
||||
## 5. Ограничения и особенности медицинской тематики
|
||||
|
||||
- **Только синтетические данные.** Персоны, карты ЕМИАС, назначения и выдержки ГРЛС вымышлены или пересказаны для прототипа и подлежат сверке.
|
||||
- **Не медицинское изделие в текущем виде.** Сервис не ставит диагнозы и не меняет терапию. Пороги шкал, тексты и лексикон — стартовые значения из литературы, их утверждает психиатр (`docs/clinical/`).
|
||||
- **152-ФЗ:** отдельное согласие на обработку данных о здоровье, две раздельные БД (identity и clinical) со связью через HMAC-токен, в LLM уходит только обезличенный текст, каждое обращение врача пишется в аудит.
|
||||
- **Зарубежные сервисы.** OpenRouter используется временно и только на синтетике. Для реальных пациентов нужен GigaChat в РФ-контуре.
|
||||
- **Безопасность.** Кризисный ответ фиксированный и выдаётся без LLM. Пропуск кризиса недопустим, ложные срабатывания допустимы. Демо-режим (кризис без блокировки) не равен клиническому протоколу: в проде `CRISIS_BLOCKING=true`.
|
||||
- **Ответы LLM** могут слегка различаться от раза к разу. Фактура берётся только из инструментов, а запрещённые формулировки (диагнозы, дозы, «отмените») фильтруются.
|
||||
|
||||
## Структура репозитория
|
||||
|
||||
```
|
||||
app/ бэкенд: core (privacy, safety, шкалы, правила, часы), dialog (движок и сценарии), llm (шлюз, RAG,
|
||||
чат-агент), db, api, scheduler, integrations (моки МИС/ЕМИАС/ГРЛС, уведомления), services
|
||||
dashboard/ кабинет врача и демо-консоль (Streamlit)
|
||||
web/ веб-приложение пациента (React + Vite)
|
||||
config/ клинические конфиги: шкалы, правила, модули, тексты, лексикон, RAG-корпус
|
||||
data/ синтетика: сценарий демо, карты ЕМИАС, назначения, выдержки ГРЛС
|
||||
infra/ postgres init, деплой на сервер
|
||||
tests/ pytest (около 1060 тестов)
|
||||
docs/ спецификация, ADR (DECISIONS.md), клинические материалы, концепция и CJM, регламент
|
||||
```
|
||||
|
||||
Подробнее: [`docs/info/SPEC.md`](docs/info/SPEC.md) · [`docs/DECISIONS.md`](docs/DECISIONS.md) · [`docs/info/CLINICAL_MODULES.md`](docs/info/CLINICAL_MODULES.md) · [`docs/source/`](docs/source/) (кейс, концепция, CJM).
|
||||
|
||||
@@ -0,0 +1,89 @@
|
||||
"""Demo-console helpers (#12, ADR-005): scripted personas, reset, connect links, outbox access.
|
||||
|
||||
Synthetic data only. Scenario files live in `data/synthetic/<slug>.jsonl` (#18); a patient is a scripted persona
|
||||
when the transliterated first word of the display name equals the slug ("Андрей С." → `andrey.jsonl`).
|
||||
"""
|
||||
|
||||
import inspect
|
||||
import logging
|
||||
from importlib import import_module, util
|
||||
from pathlib import Path
|
||||
|
||||
from app.config import get_settings
|
||||
from app.integrations.base import MemoryOutbox, Outbox, integrations
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
SEED_MODULE = "scripts.seed_demo"
|
||||
CONSOLE_PATH = "/console"
|
||||
|
||||
_TRANSLIT = {
|
||||
"а": "a", "б": "b", "в": "v", "г": "g", "д": "d", "е": "e", "ё": "e", "ж": "zh", "з": "z", "и": "i",
|
||||
"й": "y", "к": "k", "л": "l", "м": "m", "н": "n", "о": "o", "п": "p", "р": "r", "с": "s", "т": "t",
|
||||
"у": "u", "ф": "f", "х": "kh", "ц": "ts", "ч": "ch", "ш": "sh", "щ": "shch", "ъ": "", "ы": "y", "ь": "",
|
||||
"э": "e", "ю": "yu", "я": "ya",
|
||||
} # fmt: skip
|
||||
|
||||
|
||||
def persona_slug(display_name: str) -> str:
|
||||
first = (display_name.split() or [""])[0].lower()
|
||||
return "".join(_TRANSLIT.get(ch, ch if ch.isascii() and ch.isalnum() else "") for ch in first)
|
||||
|
||||
|
||||
def scenario_files(data_dir: Path | None = None) -> dict[str, str]:
|
||||
"""slug → scenario path relative to the project root, e.g. {"andrey": "data/synthetic/andrey.jsonl"}."""
|
||||
root = data_dir or get_settings().data_dir
|
||||
folder = root / "synthetic"
|
||||
if not folder.is_dir():
|
||||
return {}
|
||||
return {f.stem: f"data/synthetic/{f.name}" for f in sorted(folder.glob("*.jsonl"))}
|
||||
|
||||
|
||||
async def bot_username() -> str | None:
|
||||
"""Username of the running Telegram bot (deep links); None when the bot is not started (no TG_BOT_TOKEN)."""
|
||||
from app.channels import telegram
|
||||
|
||||
bot = getattr(telegram, "_bot", None)
|
||||
if bot is None:
|
||||
return None
|
||||
try:
|
||||
me = await bot.me() # aiogram caches getMe
|
||||
except Exception as exc: # noqa: BLE001 — network / auth errors: fall back to the web console link
|
||||
log.warning("bot username unavailable error=%s", type(exc).__name__)
|
||||
return None
|
||||
return me.username or None
|
||||
|
||||
|
||||
async def deep_link(code: str) -> str:
|
||||
username = await bot_username()
|
||||
return f"https://t.me/{username}?start={code}" if username else f"{CONSOLE_PATH}?code={code}"
|
||||
|
||||
|
||||
def memory_outbox() -> MemoryOutbox | None:
|
||||
"""The in-memory outbox polled by the web console, also when wrapped (Telegram keeps it as `fallback`)."""
|
||||
box: Outbox | None = integrations.outbox
|
||||
for _ in range(5):
|
||||
if isinstance(box, MemoryOutbox):
|
||||
return box
|
||||
box = getattr(box, "fallback", None)
|
||||
return None
|
||||
|
||||
|
||||
async def reset_demo() -> bool:
|
||||
"""Clock reset is done by the caller; re-seed via `scripts.seed_demo.reset()` (#18) when it exists."""
|
||||
box = memory_outbox()
|
||||
if box is not None:
|
||||
box._q.clear()
|
||||
try:
|
||||
spec = util.find_spec(SEED_MODULE)
|
||||
except ModuleNotFoundError: # no `scripts` package on the path (e.g. installed app without scripts/)
|
||||
spec = None
|
||||
if spec is None:
|
||||
return False
|
||||
reset = getattr(import_module(SEED_MODULE), "reset", None)
|
||||
if reset is None:
|
||||
return False
|
||||
result = reset()
|
||||
if inspect.isawaitable(result):
|
||||
await result
|
||||
return True
|
||||
@@ -0,0 +1,378 @@
|
||||
"""Doctor dashboard read models (#12): clinical DB rows → frozen API schemas (`app/api/schemas.py`).
|
||||
|
||||
Everything shown to the doctor is derived from stored structured data — no LLM decides colours, trends or the
|
||||
discontinuation risk (ADR-007). Time comes in as `now` (from `app.core.clock`, ADR-005).
|
||||
|
||||
Identity data (guardrail #5): the API is the doctor's display boundary, so it reads exactly two identity fields —
|
||||
`display_name` (minimal identification for the treating doctor) and `birth_year` (age). SNILS, phone and chat
|
||||
id are never selected into a response model.
|
||||
"""
|
||||
|
||||
from collections.abc import Iterable, Sequence
|
||||
from dataclasses import dataclass
|
||||
from datetime import date, datetime, timedelta
|
||||
from typing import Any, Literal, cast, get_args
|
||||
|
||||
from sqlalchemy import select
|
||||
from sqlalchemy.ext.asyncio import AsyncSession
|
||||
|
||||
from app.api.schemas import (
|
||||
AlertOut,
|
||||
Color,
|
||||
DiscontinuationRisk,
|
||||
DoseOut,
|
||||
LevelName,
|
||||
Metric,
|
||||
Module,
|
||||
PatientCard,
|
||||
PatientListItem,
|
||||
SeriesPoint,
|
||||
)
|
||||
from app.core.rules import color, patient_status
|
||||
from app.core.types import AlertLevel
|
||||
from app.db import repo
|
||||
from app.db.clinical import Alert, DailyCheckin, Dose, PatientProfile, Prescription, SafetyPlan, ScaleResult
|
||||
from app.db.identity import Patient
|
||||
from app.integrations.base import Prescription as PrescriptionOut
|
||||
from app.services.anonymous_care import display_name as anonymous_name
|
||||
|
||||
COLOR_ORDER: dict[str, int] = {"red": 0, "yellow": 1, "grey": 2, "green": 3}
|
||||
_MODULES = frozenset(get_args(Module))
|
||||
_METRICS = frozenset(get_args(Metric))
|
||||
_SCALE_LABELS = {"phq9": "PHQ-9", "pcl5": "PCL-5", "gad7": "GAD-7", "auditc": "AUDIT-C", "dar5": "DAR-5"}
|
||||
|
||||
# Daily check-in buckets → numbers for charts. Sleep: bucket midpoints in hours ("<4" plotted as 3, ">8" as 9).
|
||||
SLEEP_HOURS = {"<4": 3.0, "4-6": 5.0, "6-8": 7.0, ">8": 9.0}
|
||||
# Alcohol: 0 = none, 1 = 1–2 drinks, 2 = more (same coding as app/llm/summary.py expects).
|
||||
ALCOHOL_LEVEL = {"none": 0.0, "1-2": 1.0, "more": 2.0}
|
||||
|
||||
# Trend: the last two complete results of one scale. A change smaller than about half of the minimal clinically
|
||||
# important difference (PHQ-9: 5 points, PCL-5: 10 points) is reported as "flat" so noise does not flip arrows.
|
||||
TREND_MIN_CHANGE = {"phq9": 3, "pcl5": 5}
|
||||
|
||||
CARD_DAYS = 60 # how far back the card series / dose log reach
|
||||
|
||||
|
||||
# --------------------------------------------------------------------------- discontinuation risk index
|
||||
#
|
||||
# Rule-based index (NOT a trained model) of the risk that the patient drops the therapy, 0–100, for sorting the
|
||||
# list and for the "talk about adherence" hint. Each factor is a deterministic check over the clinical DB with a
|
||||
# fixed weight; the score is the capped sum. Weights reflect the known predictors of early antidepressant
|
||||
# discontinuation (non-adherence, side effects in the first weeks, expressed intent to stop, low mood, alcohol):
|
||||
#
|
||||
# factor weight label for the doctor
|
||||
# missed/skipped doses on >= 3 of the last 7 days 30 "пропуски приёма N/7 дн."
|
||||
# ... on 1–2 of the last 7 days 15 "пропуски приёма N/7 дн."
|
||||
# side effects reported >= 3 days in a row 20 "побочные эффекты N дн. подряд"
|
||||
# ... 1–2 days in a row 10 "побочные эффекты N дн. подряд"
|
||||
# intent to stop medication voiced in last 14 days 25 "хотел бросить (день N)"
|
||||
# open, unacknowledged quit_intent alert +15 "не разобран сигнал «хочет бросить»"
|
||||
# mood <= 3 for >= 3 days in a row 15 "настроение ≤ 3 N дн. подряд"
|
||||
# alcohol on >= 3 of the last 7 days 15 "алкоголь N дн. из 7"
|
||||
# ... on 1–2 of the last 7 days 5 "алкоголь N дн. из 7"
|
||||
#
|
||||
# Level: >= 60 high, >= 30 medium, otherwise low. "Day" = calendar day in the clinic time zone; streaks end today
|
||||
# if today's check-in exists, otherwise yesterday (same anchor as app.core.rules), and a day without a check-in
|
||||
# breaks a streak — we never assume a symptom the patient did not report.
|
||||
|
||||
RISK_WINDOW_DAYS = 7
|
||||
QUIT_WINDOW_DAYS = 14
|
||||
MOOD_LOW = 3
|
||||
W_MISSED_MANY, W_MISSED_SOME = 30, 15
|
||||
W_SIDE_EFFECTS_LONG, W_SIDE_EFFECTS_SHORT = 20, 10
|
||||
W_QUIT_INTENT, W_QUIT_ALERT_OPEN = 25, 15
|
||||
W_MOOD_LOW = 15
|
||||
W_ALCOHOL_MANY, W_ALCOHOL_SOME = 15, 5
|
||||
STREAK_DAYS = 3
|
||||
RISK_HIGH, RISK_MEDIUM = 60, 30
|
||||
|
||||
|
||||
@dataclass
|
||||
class PatientData:
|
||||
"""Everything the list item and the card are computed from (one patient, loaded once)."""
|
||||
|
||||
profile: PatientProfile
|
||||
checkins: Sequence[DailyCheckin]
|
||||
results: Sequence[ScaleResult]
|
||||
doses: Sequence[Dose]
|
||||
prescriptions: Sequence[Prescription]
|
||||
alerts: Sequence[Alert] # newest first
|
||||
contact_requested_at: datetime | None = None
|
||||
|
||||
|
||||
async def load_patient_data(session: AsyncSession, profile: PatientProfile) -> PatientData:
|
||||
token = profile.token
|
||||
doses = (await session.scalars(select(Dose).where(Dose.token == token).order_by(Dose.planned_at))).all()
|
||||
rx = (
|
||||
await session.scalars(select(Prescription).where(Prescription.token == token).order_by(Prescription.id))
|
||||
).all()
|
||||
dialog = await repo.get_dialog_state(session, token)
|
||||
requests = (dialog.data.get("contact_requests") or []) if dialog else []
|
||||
contact_at = datetime.fromisoformat(requests[-1]["ts"]) if requests else None
|
||||
return PatientData(
|
||||
profile=profile,
|
||||
checkins=await repo.list_checkins(session, token),
|
||||
results=await repo.list_scale_results(session, token),
|
||||
doses=doses,
|
||||
prescriptions=rx,
|
||||
alerts=await repo.list_alerts(session, token=token),
|
||||
contact_requested_at=contact_at,
|
||||
)
|
||||
|
||||
|
||||
def _local(ts: datetime, now: datetime) -> date:
|
||||
return ts.astimezone(now.tzinfo).date()
|
||||
|
||||
|
||||
def _streak_days(checkins: Iterable[DailyCheckin], today: date, pred: Any) -> int:
|
||||
"""Length of the run of consecutive check-in days satisfying `pred`, ending at the anchor day."""
|
||||
by_day = {c.day: c for c in checkins if c.day <= today}
|
||||
day = today if today in by_day else today - timedelta(days=1)
|
||||
n = 0
|
||||
while (c := by_day.get(day)) is not None and pred(c):
|
||||
n += 1
|
||||
day -= timedelta(days=1)
|
||||
return n
|
||||
|
||||
|
||||
def _therapy_day(profile: PatientProfile, day: date) -> int:
|
||||
return (day - profile.therapy_start).days if profile.therapy_start else 0
|
||||
|
||||
|
||||
def _missed_days(d: PatientData, now: datetime, first: date) -> set[date]:
|
||||
# Same sources as rule missed_doses_7d: dose records and the check-in answer "did not take".
|
||||
days = {_local(x.planned_at, now) for x in d.doses if x.status in ("missed", "skipped") and x.planned_at <= now}
|
||||
days |= {c.day for c in d.checkins if c.med_taken is False}
|
||||
return {x for x in days if first <= x <= now.date()}
|
||||
|
||||
|
||||
def discontinuation_risk(d: PatientData, now: datetime) -> DiscontinuationRisk:
|
||||
"""Deterministic discontinuation-risk index; see the weight table above."""
|
||||
today = now.date()
|
||||
first = today - timedelta(days=RISK_WINDOW_DAYS - 1)
|
||||
score = 0
|
||||
factors: list[str] = []
|
||||
|
||||
missed = len(_missed_days(d, now, first))
|
||||
if missed:
|
||||
score += W_MISSED_MANY if missed >= STREAK_DAYS else W_MISSED_SOME
|
||||
factors.append(f"пропуски приёма {missed}/{RISK_WINDOW_DAYS} дн.")
|
||||
|
||||
side = _streak_days(d.checkins, today, lambda c: bool(c.side_effects))
|
||||
if side:
|
||||
score += W_SIDE_EFFECTS_LONG if side >= STREAK_DAYS else W_SIDE_EFFECTS_SHORT
|
||||
factors.append(f"побочные эффекты {side} дн. подряд")
|
||||
|
||||
quit_since = today - timedelta(days=QUIT_WINDOW_DAYS - 1)
|
||||
quit_days = [c.day for c in d.checkins if c.quit_intent and quit_since <= c.day <= today]
|
||||
if quit_days:
|
||||
score += W_QUIT_INTENT
|
||||
factors.append(f"хотел бросить (день {_therapy_day(d.profile, max(quit_days))})")
|
||||
if any(a.code == "quit_intent" and a.acked_at is None for a in d.alerts):
|
||||
score += W_QUIT_ALERT_OPEN
|
||||
factors.append("не разобран сигнал «хочет бросить»")
|
||||
|
||||
low = _streak_days(d.checkins, today, lambda c: c.mood is not None and c.mood <= MOOD_LOW)
|
||||
if low >= STREAK_DAYS:
|
||||
score += W_MOOD_LOW
|
||||
factors.append(f"настроение ≤ {MOOD_LOW} {low} дн. подряд")
|
||||
|
||||
drinking = sum(1 for c in d.checkins if first <= c.day <= today and c.alcohol_bucket not in (None, "none"))
|
||||
if drinking:
|
||||
score += W_ALCOHOL_MANY if drinking >= STREAK_DAYS else W_ALCOHOL_SOME
|
||||
factors.append(f"алкоголь {drinking} дн. из {RISK_WINDOW_DAYS}")
|
||||
|
||||
score = min(score, 100)
|
||||
level: Literal["low", "medium", "high"] = (
|
||||
"high" if score >= RISK_HIGH else "medium" if score >= RISK_MEDIUM else "low"
|
||||
)
|
||||
return DiscontinuationRisk(score=score, level=level, factors=factors)
|
||||
|
||||
|
||||
# --------------------------------------------------------------------------- list item
|
||||
|
||||
|
||||
def _complete(d: PatientData, scale: str) -> list[ScaleResult]:
|
||||
return [r for r in d.results if r.scale == scale and r.complete] # repo returns them oldest first
|
||||
|
||||
|
||||
def trend(d: PatientData) -> Literal["up", "down", "flat", "unknown"]:
|
||||
"""Direction of symptom scores (up = worse) from the scale with the most recent pair of results."""
|
||||
pairs = [(s, rs[-2:]) for s in TREND_MIN_CHANGE if len(rs := _complete(d, s)) >= 2]
|
||||
if not pairs:
|
||||
return "unknown"
|
||||
scale, (prev, last) = max(pairs, key=lambda p: p[1][-1].ts)
|
||||
delta = last.total - prev.total
|
||||
if abs(delta) < TREND_MIN_CHANGE[scale]:
|
||||
return "flat"
|
||||
return "up" if delta > 0 else "down"
|
||||
|
||||
|
||||
def adherence_7d(d: PatientData, now: datetime) -> float | None:
|
||||
"""Taken / planned doses of the last 7 days; doses still `pending` (not resolved yet) are not counted."""
|
||||
since = now - timedelta(days=RISK_WINDOW_DAYS)
|
||||
resolved = [x for x in d.doses if since < x.planned_at <= now and x.status != "pending"]
|
||||
if not resolved:
|
||||
return None
|
||||
return round(sum(1 for x in resolved if x.status == "taken") / len(resolved), 2)
|
||||
|
||||
|
||||
def _drug_label(rx: Prescription) -> str:
|
||||
return f"{rx.drug} {rx.dose}".strip()
|
||||
|
||||
|
||||
def _active_rx(d: PatientData, today: date) -> Prescription | None:
|
||||
active = [
|
||||
r
|
||||
for r in d.prescriptions
|
||||
if (r.start_date is None or r.start_date <= today) and (r.end_date is None or r.end_date >= today)
|
||||
]
|
||||
return (active or list(d.prescriptions) or [None])[-1]
|
||||
|
||||
|
||||
def _last_event(d: PatientData, now: datetime) -> str:
|
||||
alert = d.alerts[0] if d.alerts else None
|
||||
scales = [r for r in d.results if r.complete and r.scale in _SCALE_LABELS]
|
||||
scale = scales[-1] if scales else None
|
||||
if d.contact_requested_at is not None and all(
|
||||
d.contact_requested_at >= ts for ts in [x.ts for x in (alert, scale) if x is not None]
|
||||
):
|
||||
return "Пациент просит врача связаться"
|
||||
if scale is not None and (alert is None or scale.ts > alert.ts):
|
||||
day = _therapy_day(d.profile, _local(scale.ts, now))
|
||||
return f"{_SCALE_LABELS[scale.scale]} = {scale.total} (день {day})"
|
||||
return alert.reason if alert is not None else ""
|
||||
|
||||
|
||||
def _age(patient: Patient | None, profile: PatientProfile, today: date) -> int:
|
||||
birth_year = (patient.birth_year if patient else None) or profile.birth_year
|
||||
return today.year - birth_year if birth_year else 0
|
||||
|
||||
|
||||
def list_item(d: PatientData, patient: Patient | None, now: datetime) -> PatientListItem:
|
||||
p = d.profile
|
||||
today = now.date()
|
||||
open_alerts = [a for a in d.alerts if a.acked_at is None]
|
||||
# ADR-006: the colour is derived from open alert levels (the source of truth), not from the cached column.
|
||||
status = patient_status(AlertLevel[a.level.upper()] for a in open_alerts)
|
||||
phq9, pcl5 = _complete(d, "phq9"), _complete(d, "pcl5")
|
||||
rx = _active_rx(d, today)
|
||||
return PatientListItem(
|
||||
token=p.token,
|
||||
display_name=patient.display_name if patient else anonymous_name(p.token),
|
||||
age=_age(patient, p, today),
|
||||
modules=[cast(Module, m) for m in p.modules or [] if m in _MODULES],
|
||||
drug=_drug_label(rx) if rx else None,
|
||||
therapy_day=_therapy_day(p, today),
|
||||
next_visit=p.next_visit,
|
||||
status_color=status.color,
|
||||
top_alert_level=cast(LevelName, status.top_level.name.lower()) if status.top_level is not None else None,
|
||||
open_alerts=len(open_alerts),
|
||||
phq9_last=phq9[-1].total if phq9 else None,
|
||||
pcl5_last=pcl5[-1].total if pcl5 else None,
|
||||
trend=trend(d),
|
||||
adherence_7d=adherence_7d(d, now),
|
||||
discontinuation_risk=discontinuation_risk(d, now),
|
||||
last_event=_last_event(d, now),
|
||||
)
|
||||
|
||||
|
||||
def sort_key(item: PatientListItem) -> tuple[int, int, str]:
|
||||
"""red → yellow → grey → green, then discontinuation risk (desc), then name for a stable order."""
|
||||
return (COLOR_ORDER[item.status_color], -item.discontinuation_risk.score, item.display_name)
|
||||
|
||||
|
||||
# --------------------------------------------------------------------------- card
|
||||
|
||||
|
||||
def alert_out(a: Alert, patient_name: str) -> AlertOut:
|
||||
level = cast(LevelName, a.level)
|
||||
return AlertOut(
|
||||
id=a.id,
|
||||
token=a.token,
|
||||
patient_name=patient_name,
|
||||
ts=a.ts,
|
||||
level=level,
|
||||
color=cast(Color, color([AlertLevel[a.level.upper()]])),
|
||||
code=a.code,
|
||||
reason=a.reason,
|
||||
acked_by=a.acked_by,
|
||||
acked_at=a.acked_at,
|
||||
)
|
||||
|
||||
|
||||
def series(d: PatientData, now: datetime) -> list[SeriesPoint]:
|
||||
since = now.date() - timedelta(days=CARD_DAYS)
|
||||
out: list[SeriesPoint] = []
|
||||
for c in d.checkins:
|
||||
if not since <= c.day <= now.date():
|
||||
continue
|
||||
if c.mood is not None:
|
||||
out.append(SeriesPoint(day=c.day, metric="mood", value=float(c.mood)))
|
||||
if c.sleep_bucket in SLEEP_HOURS:
|
||||
out.append(SeriesPoint(day=c.day, metric="sleep_hours", value=SLEEP_HOURS[c.sleep_bucket]))
|
||||
if c.alcohol_bucket in ALCOHOL_LEVEL:
|
||||
out.append(SeriesPoint(day=c.day, metric="alcohol", value=ALCOHOL_LEVEL[c.alcohol_bucket]))
|
||||
for r in d.results:
|
||||
day = _local(r.ts, now)
|
||||
if r.complete and r.scale in _METRICS and since <= day and r.ts <= now:
|
||||
out.append(SeriesPoint(day=day, metric=cast(Metric, r.scale), value=float(r.total), scheduled=r.scheduled))
|
||||
return sorted(out, key=lambda p: (p.day, p.metric))
|
||||
|
||||
|
||||
def doses(d: PatientData, now: datetime) -> list[DoseOut]:
|
||||
labels = {r.id: _drug_label(r) for r in d.prescriptions}
|
||||
since = now - timedelta(days=CARD_DAYS)
|
||||
return [
|
||||
DoseOut(planned_at=x.planned_at, drug=labels.get(x.prescription_id, ""), status=x.status) # type: ignore[arg-type]
|
||||
for x in d.doses
|
||||
if since <= x.planned_at <= now + timedelta(days=1)
|
||||
]
|
||||
|
||||
|
||||
def prescriptions(d: PatientData) -> list[PrescriptionOut]:
|
||||
out = []
|
||||
for r in d.prescriptions:
|
||||
schedule = dict(r.schedule or {})
|
||||
out.append(
|
||||
PrescriptionOut(
|
||||
drug=r.drug,
|
||||
dose=r.dose,
|
||||
schedule={"times": [str(t) for t in schedule.get("times", [])]},
|
||||
instructions=" ".join(str(t) for t in _as_list(schedule.get("instructions"))),
|
||||
start_date=r.start_date,
|
||||
end_date=r.end_date,
|
||||
)
|
||||
)
|
||||
return out
|
||||
|
||||
|
||||
def _as_list(value: Any) -> list[Any]:
|
||||
if value is None:
|
||||
return []
|
||||
return list(value) if isinstance(value, list) else [value]
|
||||
|
||||
|
||||
def _plan_line(step: Any) -> str:
|
||||
# Same rendering as the dialog's safety-plan reply (app/dialog/actions.py).
|
||||
if isinstance(step, dict):
|
||||
return ": ".join(str(v) for v in step.values() if v)
|
||||
return str(step)
|
||||
|
||||
|
||||
async def safety_plan(session: AsyncSession, token: str) -> list[str] | None:
|
||||
row = await session.get(SafetyPlan, token)
|
||||
return [_plan_line(s) for s in row.steps] if row is not None and row.steps else None
|
||||
|
||||
|
||||
async def build_card(session: AsyncSession, d: PatientData, patient: Patient | None, now: datetime) -> PatientCard:
|
||||
"""Card without the summary (the caller adds it: the LLM call must not hold the DB session)."""
|
||||
item = list_item(d, patient, now)
|
||||
return PatientCard(
|
||||
patient=item,
|
||||
prescriptions=prescriptions(d),
|
||||
series=series(d, now),
|
||||
doses=doses(d, now),
|
||||
alerts=[alert_out(a, item.display_name) for a in d.alerts],
|
||||
safety_plan=await safety_plan(session, d.profile.token),
|
||||
)
|
||||
+9
-1
@@ -9,18 +9,26 @@ from zoneinfo import ZoneInfo
|
||||
|
||||
from app.api.schemas import (
|
||||
AlertOut,
|
||||
DemoPersona,
|
||||
DiscontinuationRisk,
|
||||
DoseOut,
|
||||
PatientCard,
|
||||
PatientListItem,
|
||||
SeriesPoint,
|
||||
)
|
||||
from app.core.safety import fill_phones
|
||||
from app.integrations.base import Prescription
|
||||
|
||||
TZ = ZoneInfo("Europe/Moscow")
|
||||
TODAY = date(2026, 10, 3)
|
||||
DOCTOR_ID = "doc-smirnova"
|
||||
|
||||
# Synthetic personas for the demo console and the demo ЕМИАС sign-in of the patient web app.
|
||||
DEMO_PERSONAS: list[DemoPersona] = [
|
||||
# ЕМИАС demo sign-in shows this persona as «Никита В.» (the one-click demo on the welcome screen is «Андрей С.»).
|
||||
DemoPersona(token="tok-andrey", display_name="Никита В.", therapy_day=13, scenario="data/synthetic/andrey.jsonl"),
|
||||
]
|
||||
|
||||
|
||||
def _risk(score: int, factors: list[str]) -> DiscontinuationRisk:
|
||||
level = "high" if score >= 60 else "medium" if score >= 30 else "low"
|
||||
@@ -256,7 +264,7 @@ def andrey_card() -> PatientCard:
|
||||
"Что помогает: прогулка с собакой, душ",
|
||||
"Люди и места: брат Олег, спортзал",
|
||||
"Кому звонить: жена, сослуживец Миша",
|
||||
"Специалисты: д-р Смирнова, 8-800-2000-122, 112",
|
||||
fill_phones("Специалисты: д-р Смирнова, {phone:helpline}, 112"),
|
||||
"Безопасная среда: ружьё хранится у брата",
|
||||
],
|
||||
summary="За 13 дней: приверженность 12/13, эпизод намерения бросить на 5-й день (снят после звонка врача). "
|
||||
|
||||
@@ -0,0 +1,115 @@
|
||||
"""Server API for a future MAX connect UI; webhook processing is supplied by the channel adapter."""
|
||||
|
||||
import hmac
|
||||
import json
|
||||
import re
|
||||
from datetime import datetime
|
||||
from typing import Annotated, Literal
|
||||
|
||||
from fastapi import APIRouter, Depends, HTTPException, Request
|
||||
from fastapi.security import HTTPAuthorizationCredentials, HTTPBearer
|
||||
from pydantic import BaseModel, ConfigDict
|
||||
from sqlalchemy import select
|
||||
from sqlalchemy.exc import SQLAlchemyError
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core import clock
|
||||
from app.db import repo
|
||||
from app.db.max_notifications import MaxBinding, MaxDelivery
|
||||
from app.db.session import get_clinical_session, get_identity_session
|
||||
from app.integrations import max_store
|
||||
|
||||
router = APIRouter(tags=["max-notifications"])
|
||||
bearer = HTTPBearer(auto_error=False)
|
||||
|
||||
|
||||
async def patient_token(auth: Annotated[HTTPAuthorizationCredentials | None, Depends(bearer)]) -> str:
|
||||
if auth is None or auth.scheme.lower() != "bearer" or not re.fullmatch(r"[A-Za-z0-9_-]{1,64}", auth.credentials):
|
||||
raise HTTPException(401, "patient authentication required", headers={"WWW-Authenticate": "Bearer"})
|
||||
async with get_clinical_session() as session:
|
||||
if await repo.get_profile(session, auth.credentials) is None:
|
||||
raise HTTPException(401, "patient authentication required")
|
||||
return auth.credentials
|
||||
|
||||
|
||||
PatientToken = Annotated[str, Depends(patient_token)]
|
||||
|
||||
|
||||
class MaxStatus(BaseModel):
|
||||
available: bool
|
||||
connected: bool
|
||||
last_delivery: str | None = None
|
||||
|
||||
|
||||
class LinkConsent(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid")
|
||||
consent: Literal[True]
|
||||
|
||||
|
||||
class MaxLink(BaseModel):
|
||||
url: str
|
||||
expires_at: datetime
|
||||
|
||||
|
||||
@router.get("/me/notifications/max", response_model=MaxStatus)
|
||||
async def status(token: PatientToken) -> MaxStatus:
|
||||
async with get_identity_session() as session:
|
||||
binding = await session.get(MaxBinding, token)
|
||||
last = await session.scalar(
|
||||
select(MaxDelivery.state)
|
||||
.where(MaxDelivery.token == token)
|
||||
.order_by(MaxDelivery.created_at.desc(), MaxDelivery.id.desc())
|
||||
.limit(1)
|
||||
)
|
||||
return MaxStatus(
|
||||
available=get_settings().max_enabled, connected=bool(binding and binding.enabled), last_delivery=last
|
||||
)
|
||||
|
||||
|
||||
@router.post("/me/notifications/max/link", response_model=MaxLink)
|
||||
async def link(body: LinkConsent, token: PatientToken) -> MaxLink:
|
||||
settings = get_settings()
|
||||
if not settings.max_enabled:
|
||||
raise HTTPException(503, "MAX is not configured")
|
||||
if not await max_store.active_patient(token):
|
||||
raise HTTPException(403, "active consent and adult confirmation required")
|
||||
async with get_identity_session() as session:
|
||||
raw, expires = await max_store.issue_code(session, token, clock.now(), settings.max_link_ttl_seconds)
|
||||
return MaxLink(url=f"https://max.ru/{settings.max_bot_username}?start={raw}", expires_at=expires)
|
||||
|
||||
|
||||
@router.delete("/me/notifications/max", response_model=MaxStatus)
|
||||
async def unlink(token: PatientToken) -> MaxStatus:
|
||||
async with get_identity_session() as session:
|
||||
await max_store.disconnect(session, token)
|
||||
return MaxStatus(available=get_settings().max_enabled, connected=False)
|
||||
|
||||
|
||||
@router.post("/webhooks/max")
|
||||
async def webhook(request: Request) -> dict[str, bool]:
|
||||
settings = get_settings()
|
||||
if not settings.max_enabled:
|
||||
raise HTTPException(503, "MAX is not configured")
|
||||
expected = settings.max_webhook_secret.get_secret_value().encode()
|
||||
supplied = request.headers.get("X-Max-Bot-Api-Secret", "").encode()
|
||||
if not expected or not hmac.compare_digest(supplied, expected):
|
||||
raise HTTPException(403, "invalid webhook secret")
|
||||
raw = bytearray()
|
||||
async for chunk in request.stream():
|
||||
raw.extend(chunk)
|
||||
if len(raw) > 65536:
|
||||
raise HTTPException(413, "event is too large")
|
||||
try:
|
||||
event = json.loads(raw)
|
||||
except (ValueError, UnicodeError) as exc:
|
||||
raise HTTPException(400, "invalid JSON") from exc
|
||||
if not isinstance(event, dict):
|
||||
raise HTTPException(422, "event must be an object")
|
||||
from app.channels.max_bot import handle_update
|
||||
|
||||
try:
|
||||
await handle_update(event)
|
||||
except SQLAlchemyError:
|
||||
# Let MAX retry; do not log DB exception parameters containing identity data.
|
||||
raise HTTPException(503, "notification storage unavailable") from None
|
||||
return {"success": True}
|
||||
@@ -0,0 +1,540 @@
|
||||
"""Patient web app: sign-in, the patient's own plan and public reference data (`/api/v1/auth/*`, `/me/*`,
|
||||
`/crisis/resources`, `/instruments/catalog`, `/meds/reference`).
|
||||
|
||||
The web app is one more channel of the same dialog engine: after sign-in it talks to `/dialog/{token}/...`
|
||||
exactly like the web console, and consent, onboarding, scales and check-ins come from the engine.
|
||||
|
||||
Two ways in:
|
||||
- **ЕМИАС** (demo): the doctor's one-time connect code via `EmiasMock`, or a synthetic demo persona. The
|
||||
patient is linked to the attending doctor, who sees the data on the dashboard.
|
||||
- **Anonymous**: a random pseudonymous token, no identity record, and access to the prototype care team.
|
||||
Clinical answers are stored on the server and visible to the assigned doctor under a pseudonym.
|
||||
Consent is kept in the dialog state. Existing doctor-less profiles require explicit care opt-in.
|
||||
|
||||
The token returned here is the session credential of the prototype. Production needs short-lived sessions
|
||||
issued by the server instead of handing out the pseudonymous token itself.
|
||||
"""
|
||||
|
||||
import logging
|
||||
import secrets
|
||||
import time as monotonic_time
|
||||
from collections import defaultdict
|
||||
from datetime import date, datetime, time, timedelta
|
||||
from typing import Any, Literal
|
||||
from zoneinfo import ZoneInfo
|
||||
|
||||
from fastapi import APIRouter, HTTPException, Request
|
||||
from pydantic import BaseModel, ConfigDict, Field
|
||||
from sqlalchemy import select
|
||||
|
||||
from app.api import fixtures
|
||||
from app.api.schemas import DemoPersona
|
||||
from app.config import get_settings
|
||||
from app.core import clock
|
||||
from app.core.instrument_catalog import Catalog, catalog
|
||||
from app.core.intake_questions import DIARY_KINDS
|
||||
from app.core.intake_runtime import intake_enabled, load_runtime
|
||||
from app.core.interpretation import texts as results_texts
|
||||
from app.core.meds_reference import find_drug, indication_for, load_reference
|
||||
from app.core.safety import CrisisResource, crisis_reply
|
||||
from app.db import identity_repo, repo
|
||||
from app.db.audit import audit
|
||||
from app.db.clinical import DailyCheckin, Dose, Prescription
|
||||
from app.db.identity import TOKEN_LEN
|
||||
from app.db.intake import QuestionnaireRecord
|
||||
from app.db.session import get_clinical_session, get_identity_session
|
||||
from app.integrations.emias_mock import CODE_MAX_LEN, EmiasMock
|
||||
from app.llm.stt import InvalidAudio, SttError, SttNoSpeech, get_stt, wav_seconds
|
||||
from app.services import anonymous_care
|
||||
from app.services.garden import Garden, garden_for
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
router = APIRouter(tags=["patient-web"])
|
||||
_emias = EmiasMock()
|
||||
|
||||
|
||||
class AuthOut(BaseModel):
|
||||
token: str
|
||||
mode: Literal["emias", "anonymous"]
|
||||
display_name: str | None = None # only for ЕМИАС sign-in; anonymous has none by design
|
||||
|
||||
|
||||
class EmiasCodeIn(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid", str_strip_whitespace=True)
|
||||
code: str = Field(min_length=1, max_length=CODE_MAX_LEN)
|
||||
|
||||
|
||||
class AnonymousIn(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid")
|
||||
focus: Literal["depression", "ptsd"] | None = None # what the person suspects; picks the module
|
||||
|
||||
|
||||
# Self-selected focus of an anonymous person → clinical module (PTSD is the veteran module, ADR-010).
|
||||
_FOCUS_MODULE = {"depression": "depression", "ptsd": "veteran"}
|
||||
|
||||
|
||||
class EmiasDemoIn(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid")
|
||||
persona_token: str = Field(min_length=1, max_length=64)
|
||||
|
||||
|
||||
async def _attach_doctor(token: str, doctor_id: str) -> None:
|
||||
async with get_clinical_session() as s:
|
||||
if await repo.get_profile(s, token) is None:
|
||||
await repo.upsert_profile(s, token=token, doctor_id=doctor_id)
|
||||
|
||||
|
||||
async def _seed_demo_persona(token: str, source: str | None = None) -> None:
|
||||
"""Synthetic clinical start for a demo persona (no `make seed` yet): profile, prescription, today's doses.
|
||||
|
||||
Idempotent: only missing pieces are created. Data mirror the dashboard fixtures, so the patient app and the
|
||||
doctor's card tell the same story.
|
||||
"""
|
||||
card = fixtures.card(source or token)
|
||||
item = next((p for p in fixtures.PATIENTS if p.token == (source or token)), None)
|
||||
if card is None or item is None:
|
||||
return
|
||||
now = clock.now()
|
||||
today = now.date()
|
||||
async with get_clinical_session() as s:
|
||||
if await repo.get_profile(s, token) is None:
|
||||
await repo.upsert_profile(
|
||||
s,
|
||||
token=token,
|
||||
doctor_id=fixtures.DOCTOR_ID,
|
||||
modules=list(item.modules),
|
||||
therapy_start=min((p.start_date for p in card.prescriptions if p.start_date), default=today),
|
||||
next_visit=today + timedelta(days=15),
|
||||
)
|
||||
if await s.scalar(select(Prescription.id).where(Prescription.token == token)) is not None:
|
||||
return
|
||||
for p in card.prescriptions:
|
||||
rx = Prescription(
|
||||
token=token, drug=p.drug, dose=p.dose, schedule=p.schedule, start_date=p.start_date or today
|
||||
)
|
||||
s.add(rx)
|
||||
await s.flush()
|
||||
# The dose history of the dashboard story (days before today), so the week marks match the doctor's card.
|
||||
for d in card.doses:
|
||||
if d.drug == p.drug and d.planned_at.astimezone(now.tzinfo).date() < today:
|
||||
s.add(Dose(token=token, prescription_id=rx.id, planned_at=d.planned_at, status=d.status))
|
||||
for t in p.schedule.get("times", []):
|
||||
hh, mm = (int(x) for x in t.split(":"))
|
||||
s.add(
|
||||
Dose(
|
||||
token=token, prescription_id=rx.id, planned_at=datetime.combine(today, time(hh, mm), now.tzinfo)
|
||||
)
|
||||
)
|
||||
|
||||
|
||||
@router.post("/auth/emias", response_model=AuthOut)
|
||||
async def auth_emias(body: EmiasCodeIn) -> AuthOut:
|
||||
"""Sign-in through ЕМИАС (demo: one-time connect code from the doctor)."""
|
||||
person = await _emias.verify(body.code)
|
||||
if person is None:
|
||||
log.info("web auth: emias code rejected")
|
||||
raise HTTPException(401, "code not accepted")
|
||||
await _attach_doctor(person.token, person.doctor_id)
|
||||
log.info("web auth: emias tok=%s", person.token[:6])
|
||||
return AuthOut(token=person.token, mode="emias")
|
||||
|
||||
|
||||
@router.get("/patient/demo-personas", response_model=list[DemoPersona])
|
||||
async def patient_demo_personas() -> list[DemoPersona]:
|
||||
"""Synthetic ЕМИАС accounts for the patient app sign-in (the demo console has its own `/demo/personas`)."""
|
||||
return fixtures.DEMO_PERSONAS
|
||||
|
||||
|
||||
@router.post("/auth/emias/demo", response_model=AuthOut)
|
||||
async def auth_emias_demo(body: EmiasDemoIn) -> AuthOut:
|
||||
"""Demo ЕМИАС account: signs in as one of the synthetic personas (`/patient/demo-personas`)."""
|
||||
persona = next((p for p in fixtures.DEMO_PERSONAS if p.token == body.persona_token), None)
|
||||
if persona is None:
|
||||
raise HTTPException(404, "persona not found")
|
||||
if persona.token == DEMO_SOURCE:
|
||||
# Every visitor gets a private copy (never the shared account); this entry starts from consent and the
|
||||
# initial questionnaires (subject to the screening switch), unlike the one-click chat demo.
|
||||
return await _fresh_demo_copy(start_in_chat=False)
|
||||
await _seed_demo_persona(persona.token)
|
||||
log.info("web auth: emias demo tok=%s", persona.token[:6])
|
||||
return AuthOut(token=persona.token, mode="emias", display_name=persona.display_name)
|
||||
|
||||
|
||||
DEMO_SOURCE = "tok-andrey"
|
||||
ONE_CLICK_NAME = "Андрей С." # «Демо: войти как Андрей»; the ЕМИАС demo persona is named in fixtures (Никита)
|
||||
|
||||
|
||||
@router.post("/auth/demo/fresh", response_model=AuthOut)
|
||||
async def auth_demo_fresh() -> AuthOut:
|
||||
return await _fresh_demo_copy(start_in_chat=True)
|
||||
|
||||
|
||||
async def _fresh_demo_copy(*, start_in_chat: bool) -> AuthOut:
|
||||
"""Presentation entry: a fresh private copy of veteran Andrey for every sign-in — consent given, prescription
|
||||
and ЕМИАС record in place, dialog resting in the chat. Nobody's crisis or half-done questionnaire leaks into
|
||||
another viewer's demo. Synthetic data only."""
|
||||
token = f"{DEMO_SOURCE}-{secrets.token_hex(4)}"
|
||||
now = clock.now()
|
||||
persona = next(p for p in fixtures.DEMO_PERSONAS if p.token == DEMO_SOURCE)
|
||||
name = persona.display_name if not start_in_chat else ONE_CLICK_NAME
|
||||
snils = f"000-{secrets.randbelow(10**3):03d}-{secrets.randbelow(10**3):03d} {secrets.randbelow(100):02d}"
|
||||
async with get_identity_session() as s:
|
||||
await identity_repo.create_patient(
|
||||
s,
|
||||
token=token,
|
||||
display_name=f"{name} (демо)",
|
||||
snils=snils,
|
||||
clinic_id="demo",
|
||||
doctor_id=fixtures.DOCTOR_ID,
|
||||
now=now,
|
||||
birth_year=now.year - 34,
|
||||
sex="m",
|
||||
)
|
||||
if start_in_chat:
|
||||
await identity_repo.record_consent(s, token=token, version="demo", now=now)
|
||||
await _seed_demo_persona(token, source=DEMO_SOURCE)
|
||||
async with get_clinical_session() as s:
|
||||
await repo.upsert_profile(s, token=token, sex="m", birth_year=now.year - 34)
|
||||
if start_in_chat:
|
||||
consent = {"consent": True, "consent_ver": "demo", "consent_at": now.isoformat(), "revoked_at": None}
|
||||
await repo.set_dialog_state(s, token=token, state="idle", data={**consent, "adult": True}, now=now)
|
||||
log.info("web auth: demo fresh tok=%s", token[:14])
|
||||
return AuthOut(token=token, mode="emias", display_name=name)
|
||||
|
||||
|
||||
@router.post("/auth/anonymous", response_model=AuthOut)
|
||||
async def auth_anonymous(body: AnonymousIn | None = None) -> AuthOut:
|
||||
"""Anonymous sign-in: a fresh random token; care without an identity record.
|
||||
|
||||
The clinical side gets a pseudonymous profile assigned to the prototype care team. It holds
|
||||
no identity fields. Legacy clients may supply `focus`; the common stage 1 screening sets modules itself.
|
||||
"""
|
||||
token = secrets.token_hex(TOKEN_LEN // 2)
|
||||
focus = body.focus if body is not None else None
|
||||
async with get_clinical_session() as s:
|
||||
await repo.upsert_profile(
|
||||
s, token=token, doctor_id=anonymous_care.doctor_id(), modules=[_FOCUS_MODULE[focus]] if focus else []
|
||||
)
|
||||
log.info("web auth: anonymous tok=%s", token[:6])
|
||||
return AuthOut(token=token, mode="anonymous")
|
||||
|
||||
|
||||
@router.get("/patient/capabilities")
|
||||
async def patient_capabilities() -> dict[str, bool]:
|
||||
"""Expose availability without leaking clinical policy or server configuration."""
|
||||
return {"primary_screening": intake_enabled(), "voice_input": get_stt(get_settings()) is not None}
|
||||
|
||||
|
||||
class SttOut(BaseModel):
|
||||
text: str
|
||||
provider: str
|
||||
|
||||
|
||||
# 16 kHz mono 16-bit PCM = 32 000 bytes/s, + header slack.
|
||||
_WAV_BYTES_PER_SECOND = 32_000
|
||||
|
||||
|
||||
@router.post("/me/{token}/stt", response_model=SttOut)
|
||||
async def transcribe_voice(token: str, request: Request) -> SttOut:
|
||||
"""Voice → text for the patient to check and edit (#116). Body: raw `audio/wav`, 16 kHz mono.
|
||||
|
||||
Only transcribes: nothing is written to the dialog and the agent is not called — the patient sends the
|
||||
checked text as an ordinary message, where safety and `scrub()` apply. The audio is neither stored nor logged.
|
||||
"""
|
||||
settings = get_settings()
|
||||
stt = get_stt(settings)
|
||||
if stt is None:
|
||||
raise HTTPException(404, "voice input is off")
|
||||
async with get_clinical_session() as s:
|
||||
if await repo.get_profile(s, token) is None:
|
||||
raise HTTPException(404, "patient not found")
|
||||
max_bytes = (settings.stt_max_seconds + 2) * _WAV_BYTES_PER_SECOND + 4096
|
||||
declared = request.headers.get("content-length")
|
||||
if declared and declared.isdigit() and int(declared) > max_bytes:
|
||||
raise HTTPException(413, "recording too long")
|
||||
audio = await request.body()
|
||||
if len(audio) > max_bytes:
|
||||
raise HTTPException(413, "recording too long")
|
||||
try:
|
||||
seconds = wav_seconds(audio)
|
||||
except InvalidAudio as exc:
|
||||
raise HTTPException(415, "expected audio/wav") from exc
|
||||
if seconds > settings.stt_max_seconds + 1:
|
||||
raise HTTPException(413, "recording too long")
|
||||
started = monotonic_time.monotonic() # latency only, not domain time (that is app.core.clock)
|
||||
try:
|
||||
text = await stt.transcribe(audio, "wav")
|
||||
except SttNoSpeech as exc:
|
||||
raise HTTPException(422, "no speech recognised") from exc
|
||||
except SttError as exc:
|
||||
log.warning("stt failed tok=%s provider=%s: %s", token[:6], stt.name, exc)
|
||||
raise HTTPException(503, "speech recognition unavailable") from exc
|
||||
ms = int((monotonic_time.monotonic() - started) * 1000)
|
||||
log.info("stt tok=%s provider=%s secs=%.1f ms=%d chars=%d", token[:6], stt.name, seconds, ms, len(text))
|
||||
return SttOut(text=text, provider=stt.name)
|
||||
|
||||
|
||||
@router.post("/me/{token}/doctor/connect")
|
||||
async def connect_anonymous_doctor(token: str) -> dict[str, bool]:
|
||||
"""Explicit opt-in for old doctor-less profiles; never reassign an existing doctor."""
|
||||
async with get_clinical_session() as s:
|
||||
profile = await repo.get_profile(s, token)
|
||||
if profile is None:
|
||||
raise HTTPException(404, "patient not found")
|
||||
if not profile.doctor_id:
|
||||
profile.doctor_id = anonymous_care.doctor_id()
|
||||
await audit(s, actor=token, action="anonymous_care_opt_in", token=token, ts=clock.now())
|
||||
return {"has_doctor": True}
|
||||
|
||||
|
||||
class DoseItem(BaseModel):
|
||||
id: int
|
||||
drug: str
|
||||
dose: str
|
||||
time: str # HH:MM, patient's local time
|
||||
status: Literal["taken", "missed", "skipped", "pending"]
|
||||
|
||||
|
||||
class WeekDay(BaseModel):
|
||||
day: date
|
||||
status: Literal["taken", "missed", "pending", "none"]
|
||||
|
||||
|
||||
class PrescriptionItem(BaseModel):
|
||||
drug: str
|
||||
dose: str
|
||||
times: list[str]
|
||||
week: list[WeekDay] # Mon..Sun of the current week
|
||||
ref_id: str | None = None # entry of /meds/reference, if the drug is covered
|
||||
indication: Literal["depression", "ptsd"] | None = None
|
||||
start_date: date | None = None
|
||||
therapy_day: int | None = None # 1 on the start date (spec: M5, «ожидаемый эффект» cards on days 1/7/14)
|
||||
|
||||
|
||||
class Questionnaires(BaseModel):
|
||||
"""Questionnaire state for the home screen. Answers and scores are not exposed here."""
|
||||
|
||||
enabled: bool
|
||||
intake: Literal["none", "active", "paused", "complete", "review"]
|
||||
diary_done: bool # both parts of today's diary
|
||||
diary_next: Literal["morning", "evening"] | None = None # the part still open today
|
||||
|
||||
|
||||
class TodayOut(BaseModel):
|
||||
today: date
|
||||
now: str # HH:MM on the (demo) clock — the client never uses its own clock
|
||||
has_doctor: bool
|
||||
checkin_done: bool
|
||||
next_visit: date | None
|
||||
doses: list[DoseItem]
|
||||
prescriptions: list[PrescriptionItem]
|
||||
questionnaires: Questionnaires
|
||||
|
||||
|
||||
def _intake_state(records: list[QuestionnaireRecord]) -> Literal["none", "active", "paused", "complete", "review"]:
|
||||
intake = [r for r in records if r.kind == "intake"]
|
||||
if any(r.status == "complete" for r in intake):
|
||||
return "complete"
|
||||
if not intake:
|
||||
return "none"
|
||||
last = max(intake, key=lambda r: r.started_at).status
|
||||
if last in ("active", "paused"):
|
||||
return last
|
||||
return "review" if last in ("review_required", "interrupted") else "none"
|
||||
|
||||
|
||||
def _day_status(statuses: list[str]) -> Literal["taken", "missed", "pending", "none"]:
|
||||
if not statuses:
|
||||
return "none"
|
||||
if any(s in ("missed", "skipped") for s in statuses):
|
||||
return "missed"
|
||||
return "taken" if all(s == "taken" for s in statuses) else "pending"
|
||||
|
||||
|
||||
@router.get("/me/{token}/today", response_model=TodayOut)
|
||||
async def my_today(token: str) -> TodayOut:
|
||||
"""The patient's own plan for today (home screen) and this week's dose marks (medication screen).
|
||||
|
||||
Only the patient's own prescription data; no scores, no alerts. Anonymous tokens have no profile → empty plan.
|
||||
"""
|
||||
now = clock.now()
|
||||
today = now.date()
|
||||
week_start = today - timedelta(days=today.weekday())
|
||||
async with get_clinical_session() as s:
|
||||
profile = await repo.get_profile(s, token)
|
||||
prescriptions = (await s.scalars(select(Prescription).where(Prescription.token == token))).all()
|
||||
doses = (
|
||||
await s.scalars(
|
||||
select(Dose)
|
||||
.where(Dose.token == token, Dose.planned_at >= datetime.combine(week_start, time.min, now.tzinfo))
|
||||
.order_by(Dose.planned_at)
|
||||
)
|
||||
).all()
|
||||
checkin = await s.scalar(select(DailyCheckin).where(DailyCheckin.token == token, DailyCheckin.day == today))
|
||||
records = list((await s.scalars(select(QuestionnaireRecord).where(QuestionnaireRecord.token == token))).all())
|
||||
|
||||
by_rx: dict[int, Prescription] = {p.id: p for p in prescriptions}
|
||||
today_doses: list[DoseItem] = []
|
||||
marks: dict[tuple[int, date], list[str]] = defaultdict(list)
|
||||
for d in doses:
|
||||
local = d.planned_at.astimezone(now.tzinfo)
|
||||
marks[(d.prescription_id, local.date())].append(d.status)
|
||||
rx = by_rx.get(d.prescription_id)
|
||||
if local.date() == today and rx is not None:
|
||||
today_doses.append(
|
||||
DoseItem(id=d.id, drug=rx.drug, dose=rx.dose, time=local.strftime("%H:%M"), status=d.status)
|
||||
)
|
||||
week = [week_start + timedelta(days=i) for i in range(7)]
|
||||
modules = list(profile.modules or []) if profile else []
|
||||
diary_day = now.astimezone(ZoneInfo(load_runtime().timezone)).date()
|
||||
done_parts = {r.kind for r in records if r.day == diary_day and r.status == "complete"}
|
||||
open_parts = [k.removeprefix("diary_") for k in DIARY_KINDS if k not in done_parts]
|
||||
diary_done = not open_parts
|
||||
|
||||
def item(p: Prescription) -> PrescriptionItem:
|
||||
ref = find_drug(p.drug)
|
||||
return PrescriptionItem(
|
||||
drug=p.drug,
|
||||
dose=p.dose,
|
||||
times=list((p.schedule or {}).get("times", [])),
|
||||
week=[WeekDay(day=d, status=_day_status(marks[(p.id, d)])) for d in week],
|
||||
ref_id=ref["id"] if ref else None,
|
||||
indication=indication_for(modules, ref) if ref else None,
|
||||
start_date=p.start_date,
|
||||
therapy_day=(today - p.start_date).days + 1 if p.start_date else None,
|
||||
)
|
||||
|
||||
return TodayOut(
|
||||
today=today,
|
||||
now=now.strftime("%H:%M"),
|
||||
has_doctor=profile is not None and bool(profile.doctor_id),
|
||||
checkin_done=(checkin is not None and checkin.mood is not None) or diary_done,
|
||||
next_visit=profile.next_visit if profile else None,
|
||||
doses=today_doses,
|
||||
prescriptions=[
|
||||
item(p)
|
||||
for p in prescriptions
|
||||
if (p.end_date is None or p.end_date >= today) and (p.start_date is None or p.start_date <= today)
|
||||
],
|
||||
questionnaires=Questionnaires(
|
||||
# Stage 1 needs no profile: the screening creates it (anonymous people have none before it).
|
||||
enabled=intake_enabled(),
|
||||
intake=_intake_state(records),
|
||||
diary_done=diary_done,
|
||||
diary_next=open_parts[0] if open_parts else None,
|
||||
),
|
||||
)
|
||||
|
||||
|
||||
@router.get("/me/{token}/garden", response_model=Garden)
|
||||
async def my_garden(token: str) -> Garden:
|
||||
"""The patient's garden (#118): grows from medication marks, check-ins/diary and finished questionnaires.
|
||||
|
||||
Never shrinks and never depends on answers. Seen only by the patient — not on the dashboard, not in summaries.
|
||||
"""
|
||||
async with get_clinical_session() as s:
|
||||
if await repo.get_profile(s, token) is None:
|
||||
raise HTTPException(404, "patient not found")
|
||||
return await garden_for(s, token)
|
||||
|
||||
|
||||
class ResultFinding(BaseModel):
|
||||
code: str
|
||||
title: str
|
||||
|
||||
|
||||
class Conclusion(BaseModel):
|
||||
"""Preliminary conclusion of stage 1 — a screening result, not a diagnosis."""
|
||||
|
||||
day: date
|
||||
title: str
|
||||
lines: list[str]
|
||||
findings: list[ResultFinding]
|
||||
modules: list[str]
|
||||
disclaimer: str
|
||||
|
||||
|
||||
class HistoryItem(BaseModel):
|
||||
id: str
|
||||
kind: str
|
||||
kind_title: str
|
||||
status: str
|
||||
status_title: str
|
||||
day: date
|
||||
started_at: datetime
|
||||
completed_at: datetime | None
|
||||
title: str | None # interpretation shown to the patient when the form was finished
|
||||
lines: list[str]
|
||||
|
||||
|
||||
class ResultsOut(BaseModel):
|
||||
conclusion: Conclusion | None
|
||||
history: list[HistoryItem]
|
||||
|
||||
|
||||
@router.get("/me/{token}/results", response_model=ResultsOut)
|
||||
async def my_results(token: str) -> ResultsOut:
|
||||
"""The patient's own questionnaire log: every administration with its date, status and the interpretation that
|
||||
was shown when it was finished (stored with the record, so it never changes afterwards). No raw answers."""
|
||||
async with get_clinical_session() as s:
|
||||
records = list(
|
||||
(
|
||||
await s.scalars(
|
||||
select(QuestionnaireRecord)
|
||||
.where(QuestionnaireRecord.token == token)
|
||||
.order_by(QuestionnaireRecord.started_at.desc(), QuestionnaireRecord.id)
|
||||
)
|
||||
).all()
|
||||
)
|
||||
t = results_texts()
|
||||
intake = next((r for r in records if r.kind == "intake" and r.status == "complete"), None)
|
||||
conclusion = None
|
||||
if intake and intake.details.get("interpretation"):
|
||||
i = intake.details["interpretation"]
|
||||
conclusion = Conclusion(
|
||||
day=intake.day,
|
||||
title=i["title"],
|
||||
lines=i["lines"],
|
||||
findings=[ResultFinding(**f) for f in i.get("findings", [])],
|
||||
modules=i.get("modules", []),
|
||||
disclaimer=i.get("disclaimer", t["disclaimer"]),
|
||||
)
|
||||
history = [
|
||||
HistoryItem(
|
||||
id=r.id,
|
||||
kind=r.kind,
|
||||
kind_title=t["kinds"].get(r.kind, r.kind),
|
||||
status=r.status,
|
||||
status_title=t["status"].get(r.status, r.status),
|
||||
day=r.day,
|
||||
started_at=r.started_at,
|
||||
completed_at=r.completed_at,
|
||||
title=(r.details.get("interpretation") or {}).get("title"),
|
||||
lines=(r.details.get("interpretation") or {}).get("lines", []),
|
||||
)
|
||||
for r in records
|
||||
]
|
||||
return ResultsOut(conclusion=conclusion, history=history)
|
||||
|
||||
|
||||
@router.get("/crisis/resources", response_model=list[CrisisResource])
|
||||
async def crisis_resources() -> list[CrisisResource]:
|
||||
"""Help lines for the always-visible «help now» button — the same list as the fixed crisis script."""
|
||||
return crisis_reply([], "patient").resources
|
||||
|
||||
|
||||
@router.get("/instruments/catalog", response_model=Catalog)
|
||||
async def instruments_catalog() -> Catalog:
|
||||
"""Form, position and recall period of every questionnaire item, for the question screen header."""
|
||||
return catalog()
|
||||
|
||||
|
||||
@router.get("/meds/reference")
|
||||
async def meds_reference() -> dict[str, Any]:
|
||||
"""Patient drug reference (draft from the Minzdrav guidelines): expected effect, course, side effects, red flags.
|
||||
|
||||
The internal rule parameters stay on the server.
|
||||
"""
|
||||
ref = load_reference()
|
||||
return {k: v for k, v in ref.items() if k != "rules"}
|
||||
+269
-29
@@ -1,12 +1,27 @@
|
||||
"""API routes `/api/v1` (#34 stubs → #12 implementation).
|
||||
"""API routes `/api/v1` (#34 contract → #12 implementation).
|
||||
|
||||
Stubs return deterministic fixtures (`app/api/fixtures.py`) so the dashboard can be built immediately.
|
||||
Lane B replaces bodies in #12 without changing paths or schemas (those are the frozen contract).
|
||||
Paths and schemas are the frozen contract (`app/api/schemas.py`); bodies read the identity and clinical DBs.
|
||||
Read models live in `app/api/doctor_views.py`, demo-console helpers in `app/api/demo.py`.
|
||||
Every doctor access to patient data is written to `audit_log` (guardrail #6): `view_patient_list`,
|
||||
`view_patient` (also a denied attempt: `view_patient_denied`), `view_alerts` (only when new alerts are
|
||||
disclosed — the dashboard polls every 2–3 s), `ack_alert` (in `repo.ack_alert`), `connect_patient`.
|
||||
`app/api/fixtures.py` is kept for tests and as the demo cabinet reference (doctor id).
|
||||
"""
|
||||
|
||||
from fastapi import APIRouter, HTTPException
|
||||
import asyncio
|
||||
import json
|
||||
import logging
|
||||
import secrets
|
||||
from typing import Any
|
||||
|
||||
from app.api import fixtures
|
||||
from fastapi import APIRouter, HTTPException
|
||||
from fastapi.responses import StreamingResponse
|
||||
from sqlalchemy import select
|
||||
|
||||
from app.api import demo as console
|
||||
from app.api import doctor_views as views
|
||||
from app.api import fixtures, max_notifications
|
||||
from app.api.patient_web import router as patient_web_router
|
||||
from app.api.questionnaire import router as questionnaire_router
|
||||
from app.api.schemas import (
|
||||
AckIn,
|
||||
@@ -23,68 +38,251 @@ from app.api.schemas import (
|
||||
PatientListItem,
|
||||
)
|
||||
from app.core import clock
|
||||
from app.dialog.contracts import get_engine
|
||||
from app.integrations.base import MemoryOutbox, integrations
|
||||
from app.core.privacy import pseudo_id
|
||||
from app.db import identity_repo, repo
|
||||
from app.db.audit import audit
|
||||
from app.db.clinical import Alert, Message, PatientProfile
|
||||
from app.db.clinical import Prescription as PrescriptionRow
|
||||
from app.db.identity import Patient
|
||||
from app.db.session import get_clinical_session, get_identity_session
|
||||
from app.dialog.contracts import Event, get_engine
|
||||
from app.integrations.base import integrations
|
||||
from app.llm.agent import stream as agent_stream
|
||||
from app.scheduler import jobs as scheduler
|
||||
from app.services.anonymous_care import display_name as anonymous_name
|
||||
from app.services.monitoring import refresh_status
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
router = APIRouter(prefix="/api/v1")
|
||||
router.include_router(max_notifications.router)
|
||||
router.include_router(questionnaire_router)
|
||||
router.include_router(patient_web_router)
|
||||
|
||||
DEFAULT_CLINIC = "clinic-demo"
|
||||
CODE_ALPHABET = "ABCDEFGHJKLMNPQRSTUVWXYZ23456789" # no 0/O/1/I: the code may be typed by hand
|
||||
CODE_LEN = 8
|
||||
|
||||
|
||||
async def _patients(tokens: list[str]) -> dict[str, Patient]:
|
||||
"""Identity rows for display name / age only (never put SNILS or phone into a response)."""
|
||||
if not tokens:
|
||||
return {}
|
||||
async with get_identity_session() as s:
|
||||
rows = (await s.scalars(select(Patient).where(Patient.token.in_(tokens)))).all()
|
||||
return {p.token: p for p in rows}
|
||||
|
||||
|
||||
def _name(patients: dict[str, Patient], token: str) -> str:
|
||||
p = patients.get(token)
|
||||
return p.display_name if p else anonymous_name(token)
|
||||
|
||||
|
||||
# ------------------------------------------------------------------ doctor dashboard
|
||||
@router.get("/doctors/{doctor_id}/patients", response_model=list[PatientListItem], tags=["doctor"])
|
||||
async def list_patients(doctor_id: str) -> list[PatientListItem]:
|
||||
"""Doctor's patients sorted red → yellow → grey → green, then by discontinuation risk."""
|
||||
order = {"red": 0, "yellow": 1, "grey": 2, "green": 3}
|
||||
return sorted(fixtures.PATIENTS, key=lambda p: (order[p.status_color], -p.discontinuation_risk.score))
|
||||
now = clock.now()
|
||||
async with get_clinical_session() as s:
|
||||
profiles = await repo.patients_of_doctor(s, doctor_id)
|
||||
data = [await views.load_patient_data(s, p) for p in profiles]
|
||||
await audit(s, actor=doctor_id, action="view_patient_list", token=None, details={"count": len(data)}, ts=now)
|
||||
patients = await _patients([p.token for p in profiles])
|
||||
items = [views.list_item(d, patients.get(d.profile.token), now) for d in data]
|
||||
return sorted(items, key=views.sort_key)
|
||||
|
||||
|
||||
@router.get("/patients/{token}", response_model=PatientCard, tags=["doctor"])
|
||||
async def patient_card(token: str, doctor_id: str) -> PatientCard:
|
||||
"""Patient card. Every call is written to audit_log as `view_patient` (#12)."""
|
||||
card = fixtures.card(token)
|
||||
if card is None:
|
||||
raise HTTPException(404, "patient not found")
|
||||
"""Patient card. Every call is written to audit_log as `view_patient`; only the attending doctor may read it."""
|
||||
now = clock.now()
|
||||
patient = (await _patients([token])).get(token)
|
||||
async with get_clinical_session() as s:
|
||||
profile = await repo.get_profile(s, token)
|
||||
if profile is None:
|
||||
raise HTTPException(404, "patient not found")
|
||||
if profile.doctor_id != doctor_id:
|
||||
await audit(s, actor=doctor_id, action="view_patient_denied", token=token, ts=now)
|
||||
await s.commit()
|
||||
raise HTTPException(403, "not your patient")
|
||||
data = await views.load_patient_data(s, profile)
|
||||
card = await views.build_card(s, data, patient, now)
|
||||
await audit(s, actor=doctor_id, action="view_patient", token=token, ts=now)
|
||||
# Summary after the commit: the (possibly slow) LLM call must not hold the DB transaction.
|
||||
from app.llm.summary import build_summary # summary imports app.api.schemas; avoid an import cycle
|
||||
|
||||
card.summary = await build_summary(card, today=now.date())
|
||||
return card
|
||||
|
||||
|
||||
@router.get("/doctors/{doctor_id}/alerts", response_model=list[AlertOut], tags=["doctor"])
|
||||
async def list_alerts(doctor_id: str, since_id: int = -1, open_only: bool = False) -> list[AlertOut]:
|
||||
"""Polled every 2–3 s by the dashboard: alerts with id > since_id, newest first."""
|
||||
alerts = [a for a in fixtures.all_alerts() if a.id > since_id]
|
||||
return [a for a in alerts if a.acked_at is None] if open_only else alerts
|
||||
async with get_clinical_session() as s:
|
||||
tokens = list(await s.scalars(select(PatientProfile.token).where(PatientProfile.doctor_id == doctor_id)))
|
||||
stmt = select(Alert).where(Alert.token.in_(tokens), Alert.id > since_id)
|
||||
if open_only:
|
||||
stmt = stmt.where(Alert.acked_at.is_(None))
|
||||
alerts = (await s.scalars(stmt.order_by(Alert.ts.desc(), Alert.id.desc()))).all()
|
||||
if alerts:
|
||||
await audit(
|
||||
s,
|
||||
actor=doctor_id,
|
||||
action="view_alerts",
|
||||
token=None,
|
||||
details={"alert_ids": [a.id for a in alerts][:50], "count": len(alerts)},
|
||||
ts=clock.now(),
|
||||
)
|
||||
patients = await _patients(sorted({a.token for a in alerts}))
|
||||
return [views.alert_out(a, _name(patients, a.token)) for a in alerts]
|
||||
|
||||
|
||||
@router.post("/alerts/{alert_id}/ack", response_model=AlertOut, tags=["doctor"])
|
||||
async def ack_alert(alert_id: int, body: AckIn) -> AlertOut:
|
||||
"""Doctor acknowledges an alert (written to audit_log). Acking an acute alert lets the patient leave crisis."""
|
||||
alert = next((a for a in fixtures.all_alerts() if a.id == alert_id), None)
|
||||
if alert is None:
|
||||
raise HTTPException(404, "alert not found")
|
||||
return alert.model_copy(update={"acked_by": body.doctor_id, "acked_at": clock.now()})
|
||||
now = clock.now()
|
||||
async with get_clinical_session() as s:
|
||||
alert = await s.get(Alert, alert_id)
|
||||
if alert is None:
|
||||
raise HTTPException(404, "alert not found")
|
||||
profile = await repo.get_profile(s, alert.token)
|
||||
if profile is None or profile.doctor_id != body.doctor_id:
|
||||
raise HTTPException(403, "not your patient")
|
||||
await repo.ack_alert(s, alert_id=alert_id, doctor_id=body.doctor_id, ts=now)
|
||||
await refresh_status(s, alert.token)
|
||||
open_acute = [a for a in await repo.list_alerts(s, token=alert.token, open_only=True) if a.level == "acute"]
|
||||
out = views.alert_out(alert, "")
|
||||
# The crisis ends only when no acute alert is left open (another acute signal keeps the patient in crisis).
|
||||
if alert.level == "acute" and not open_acute:
|
||||
replies = await get_engine().handle(alert.token, Event(type="system", system="doctor_ack"))
|
||||
if replies:
|
||||
await integrations.outbox.push(alert.token, replies)
|
||||
return out.model_copy(update={"patient_name": _name(await _patients([alert.token]), alert.token)})
|
||||
|
||||
|
||||
@router.post("/patients/connect", response_model=ConnectPatientOut, tags=["doctor"])
|
||||
async def connect_patient(body: ConnectPatientIn) -> ConnectPatientOut:
|
||||
"""Doctor connects a patient after the in-person visit (323-FZ art. 36.2): prescription → МИС mock, code/QR."""
|
||||
return ConnectPatientOut(token="tok-new", code="DEMO-0001", deep_link="https://t.me/ptsr_demo_bot?start=DEMO-0001")
|
||||
now = clock.now()
|
||||
try:
|
||||
token = pseudo_id(body.snils)
|
||||
except ValueError as exc:
|
||||
raise HTTPException(422, "SNILS must contain 11 digits") from exc
|
||||
code = "".join(secrets.choice(CODE_ALPHABET) for _ in range(CODE_LEN))
|
||||
async with get_identity_session() as ids:
|
||||
if await identity_repo.get_patient(ids, token) is not None:
|
||||
raise HTTPException(409, "patient already connected")
|
||||
doctor = await identity_repo.get_doctor(ids, body.doctor_id)
|
||||
await identity_repo.create_patient(
|
||||
ids,
|
||||
token=token,
|
||||
display_name=body.display_name,
|
||||
snils=body.snils,
|
||||
clinic_id=doctor.clinic_id if doctor else DEFAULT_CLINIC,
|
||||
doctor_id=body.doctor_id,
|
||||
now=now,
|
||||
birth_year=body.birth_year,
|
||||
sex=body.sex,
|
||||
)
|
||||
await identity_repo.create_connect_code(ids, code=code, token=token, doctor_id=body.doctor_id, now=now)
|
||||
# Clinical writes nested inside the identity unit of work: if they fail, the identity row rolls back too.
|
||||
async with get_clinical_session() as s:
|
||||
await repo.upsert_profile(
|
||||
s,
|
||||
token=token,
|
||||
doctor_id=body.doctor_id,
|
||||
modules=list(body.modules),
|
||||
therapy_start=now.date(),
|
||||
next_visit=body.next_visit,
|
||||
birth_year=body.birth_year,
|
||||
sex=body.sex,
|
||||
)
|
||||
schedule: dict[str, list[str]] = {"times": list(body.times)}
|
||||
if body.instructions:
|
||||
schedule["instructions"] = [body.instructions]
|
||||
s.add(
|
||||
PrescriptionRow(token=token, drug=body.drug, dose=body.dose, schedule=schedule, start_date=now.date())
|
||||
)
|
||||
await audit(
|
||||
s,
|
||||
actor=body.doctor_id,
|
||||
action="connect_patient",
|
||||
token=token,
|
||||
details={"modules": list(body.modules), "drug": body.drug},
|
||||
ts=now,
|
||||
)
|
||||
return ConnectPatientOut(token=token, code=code, deep_link=await console.deep_link(code))
|
||||
|
||||
|
||||
# ------------------------------------------------------------------ patient dialog (web console / any channel)
|
||||
async def _require_patient(token: str) -> None:
|
||||
async with get_clinical_session() as s:
|
||||
if await repo.get_profile(s, token) is None:
|
||||
raise HTTPException(404, "patient not found")
|
||||
|
||||
|
||||
@router.post("/dialog/{token}/events", response_model=DialogOut, tags=["dialog"])
|
||||
async def dialog_event(token: str, body: DialogIn) -> DialogOut:
|
||||
await _require_patient(token)
|
||||
return DialogOut(replies=await get_engine().handle(token, body))
|
||||
|
||||
|
||||
@router.post("/dialog/{token}/events/stream", tags=["dialog"])
|
||||
async def dialog_event_stream(token: str, body: DialogIn) -> StreamingResponse:
|
||||
"""Same as /events, as Server-Sent Events: `status` (agent steps), `delta` (answer as it is written),
|
||||
`reset`, then `done` with the final replies (identical to /events). `error` if the engine failed."""
|
||||
await _require_patient(token)
|
||||
queue: asyncio.Queue[tuple[str, Any]] = asyncio.Queue()
|
||||
marker = agent_stream.STREAM.set(queue) # copied into the task's context below
|
||||
try:
|
||||
|
||||
async def run() -> None:
|
||||
try:
|
||||
replies = await get_engine().handle(token, body)
|
||||
queue.put_nowait(("done", [r.model_dump() for r in replies]))
|
||||
except Exception: # noqa: BLE001 — reported to the client, which falls back to /events
|
||||
log.exception("dialog stream failed")
|
||||
queue.put_nowait(("error", None))
|
||||
|
||||
task = asyncio.create_task(run())
|
||||
finally:
|
||||
agent_stream.STREAM.reset(marker)
|
||||
|
||||
async def events():
|
||||
try:
|
||||
while True:
|
||||
try:
|
||||
kind, payload = await asyncio.wait_for(queue.get(), timeout=15)
|
||||
except TimeoutError:
|
||||
yield ": keepalive\n\n"
|
||||
continue
|
||||
yield f"event: {kind}\ndata: {json.dumps(payload, ensure_ascii=False)}\n\n"
|
||||
if kind in ("done", "error"):
|
||||
return
|
||||
finally:
|
||||
if not task.done():
|
||||
await task
|
||||
|
||||
return StreamingResponse(
|
||||
events(),
|
||||
media_type="text/event-stream",
|
||||
headers={"Cache-Control": "no-cache", "X-Accel-Buffering": "no"}, # nginx: do not buffer SSE
|
||||
)
|
||||
|
||||
|
||||
@router.get("/dialog/{token}/outbox", response_model=DialogOut, tags=["dialog"])
|
||||
async def dialog_outbox(token: str) -> DialogOut:
|
||||
"""System-initiated replies (reminders, check-ins) waiting for the web console."""
|
||||
box = integrations.outbox
|
||||
return DialogOut(replies=box.drain(token) if isinstance(box, MemoryOutbox) else [])
|
||||
box = console.memory_outbox()
|
||||
return DialogOut(replies=box.drain(token) if box is not None else [])
|
||||
|
||||
|
||||
@router.get("/dialog/{token}/history", response_model=list[MessageOut], tags=["dialog"])
|
||||
async def dialog_history(token: str, limit: int = 100) -> list[MessageOut]:
|
||||
return []
|
||||
"""Stored dialog (texts are scrubbed before storage, ADR-003), oldest first, the last `limit` messages."""
|
||||
async with get_clinical_session() as s:
|
||||
stmt = select(Message).where(Message.token == token).order_by(Message.ts.desc(), Message.id.desc())
|
||||
rows = (await s.scalars(stmt.limit(max(1, min(limit, 1000))))).all()
|
||||
return [MessageOut(ts=m.ts, direction=m.direction, text=m.text_scrubbed) for m in reversed(rows)] # type: ignore[arg-type]
|
||||
|
||||
|
||||
# ------------------------------------------------------------------ demo controls (ADR-005)
|
||||
@@ -99,21 +297,63 @@ async def get_clock() -> ClockOut:
|
||||
|
||||
@router.post("/demo/clock/advance", response_model=ClockOut, tags=["demo"])
|
||||
async def advance_clock(body: ClockAdvanceIn) -> ClockOut:
|
||||
"""Moves the virtual clock; #13 makes the scheduler replay all events up to the new time."""
|
||||
"""Moves the virtual clock and replays the scheduler up to the new time (#13)."""
|
||||
clock.advance(days=body.days, hours=body.hours)
|
||||
await scheduler.run_until_now()
|
||||
return _clock_out()
|
||||
|
||||
|
||||
@router.post("/demo/reset", tags=["demo"])
|
||||
async def demo_reset() -> dict[str, str]:
|
||||
"""Clock back to the wall clock, console outbox emptied, demo data re-seeded by `scripts.seed_demo` (#18)."""
|
||||
clock.reset()
|
||||
return {"status": "ok"}
|
||||
seeded = await console.reset_demo()
|
||||
return {"status": "ok", "seed": "reset" if seeded else "skipped"}
|
||||
|
||||
|
||||
@router.get("/demo/personas", response_model=list[DemoPersona], tags=["demo"])
|
||||
async def demo_personas() -> list[DemoPersona]:
|
||||
return [
|
||||
DemoPersona(
|
||||
token="tok-andrey", display_name="Андрей С.", therapy_day=13, scenario="data/synthetic/andrey.jsonl"
|
||||
"""Patients with a scripted scenario `data/synthetic/<slug>.jsonl`; the demo cabinet's doctor first."""
|
||||
scenarios = console.scenario_files()
|
||||
if not scenarios:
|
||||
return []
|
||||
async with get_identity_session() as ids:
|
||||
patients = (await ids.scalars(select(Patient))).all()
|
||||
scripted = [(p, scenarios[slug]) for p in patients if (slug := console.persona_slug(p.display_name)) in scenarios]
|
||||
if not scripted:
|
||||
return []
|
||||
today = clock.today()
|
||||
async with get_clinical_session() as s:
|
||||
profiles = {p.token: await repo.get_profile(s, p.token) for p, _ in scripted}
|
||||
out = []
|
||||
for p, path in sorted(scripted, key=lambda x: (x[0].doctor_id != fixtures.DOCTOR_ID, x[0].display_name)):
|
||||
profile = profiles.get(p.token)
|
||||
start = profile.therapy_start if profile else None
|
||||
out.append(
|
||||
DemoPersona(
|
||||
token=p.token,
|
||||
display_name=p.display_name,
|
||||
therapy_day=(today - start).days if start else 0,
|
||||
scenario=path,
|
||||
)
|
||||
)
|
||||
]
|
||||
return out
|
||||
|
||||
|
||||
@router.get("/demo/settings", tags=["demo"])
|
||||
async def get_demo_settings() -> dict[str, bool]:
|
||||
"""Presentation switches: `screening_enabled` — initial questionnaires after consent (off → straight to chat)."""
|
||||
from app.core import demo_settings
|
||||
|
||||
async with get_clinical_session() as s:
|
||||
return await demo_settings.get_all(s)
|
||||
|
||||
|
||||
@router.post("/demo/settings", tags=["demo"])
|
||||
async def set_demo_settings(body: dict[str, bool]) -> dict[str, bool]:
|
||||
from app.core import demo_settings
|
||||
|
||||
async with get_clinical_session() as s:
|
||||
if demo_settings.SCREENING in body:
|
||||
await demo_settings.set_screening(s, bool(body[demo_settings.SCREENING]))
|
||||
return await demo_settings.get_all(s)
|
||||
|
||||
@@ -0,0 +1,150 @@
|
||||
# Подключение будущего бота MAX
|
||||
|
||||
Серверная часть готова к подключению. Сам бот ещё не создан, секреты не заполнены,
|
||||
реальная отправка не включена. Изменений интерфейса сайта в этой поставке нет.
|
||||
Интеграция уведомляет **самого пациента**; врачебные оповещения остаются в существующем канале проекта.
|
||||
|
||||
## Что реализовано
|
||||
|
||||
- Одноразовая ссылка для привязки аккаунта MAX к текущему пациенту сайта, срок по умолчанию 10 минут.
|
||||
- Подтверждение подключения, `/help`, `/stop`, отключение при остановке или удалении бота в MAX.
|
||||
- Нейтральные напоминания из существующего планировщика сайта: тесты, дневник, приём лекарств и другие события outbox.
|
||||
- Уведомление о завершении теста: сервер каждые примерно 30 секунд находит новые завершённые
|
||||
`QuestionnaireRecord` и `ScaleResult`, начиная с момента подключения MAX. Незавершённые и старые тесты не отправляются.
|
||||
- Постоянная очередь, восстановление после перезапуска, ограниченные повторы при сетевых ошибках и ответах 429/5xx.
|
||||
- В сообщении только короткий текст и кнопка на сайт. Ответы, оценки, диагнозы, назначения и ключ входа на сайт
|
||||
в MAX не передаются. Переписка с ботом не сохраняется и не отправляется в LLM.
|
||||
|
||||
## 1. Создать бота — будущему владельцу
|
||||
|
||||
1. Открыть [MAX для партнёров](https://business.max.ru/) и пройти регистрацию/проверку профиля.
|
||||
Условия допуска зависят от типа владельца; актуальный порядок — в
|
||||
[официальной инструкции подключения](https://dev.max.ru/help/platform_connection).
|
||||
2. Создать чат-бота, оформить описание и пройти требуемую MAX модерацию.
|
||||
3. В настройках бота получить токен и скопировать имя из его публичной ссылки `https://max.ru/ИМЯ`.
|
||||
4. Передать администратору сервера имя бота, а токен — через защищённое хранилище секретов.
|
||||
Токен не нужен в переписке, MR или репозитории.
|
||||
|
||||
## 2. Заполнить настройки сервера
|
||||
|
||||
Нужны доступная identity/clinical БД проекта, публичный HTTPS-адрес сайта и HTTPS-адрес API на порту 443.
|
||||
Входящие POST от MAX должны доходить до API без браузерной CAPTCHA или страницы авторизации.
|
||||
Прокси должен передавать заголовок `X-Max-Bot-Api-Secret` и не журналировать тело webhook/Authorization.
|
||||
Дополнительные таблицы identity создаются существующим `init_db()` при запуске приложения.
|
||||
|
||||
В `.env` сервера (вне Git) заполнить:
|
||||
|
||||
```dotenv
|
||||
MAX_ENABLED=false
|
||||
MAX_BOT_TOKEN=
|
||||
MAX_BOT_USERNAME=
|
||||
MAX_WEBHOOK_SECRET=
|
||||
MAX_WEBHOOK_URL=https://api.example.org/api/v1/webhooks/max
|
||||
MAX_SITE_URL=https://patient.example.org/
|
||||
MAX_LINK_TTL_SECONDS=600
|
||||
# При необходимости — PEM-файл доверенного CA, доступный внутри контейнера:
|
||||
MAX_CA_BUNDLE=
|
||||
DEMO_CLOCK=false
|
||||
```
|
||||
|
||||
- `MAX_BOT_USERNAME` — только имя, без `@`, домена или параметров ссылки.
|
||||
- `MAX_WEBHOOK_SECRET` — отдельная случайная строка, не токен бота: 32–256 символов из `A–Z a–z 0–9 _ -`.
|
||||
Сгенерировать локально, например `python -c 'import secrets; print(secrets.token_urlsafe(32))'`, сохранить в секреты.
|
||||
- `MAX_SITE_URL` ведёт в обычный личный кабинет; не добавлять в адрес ключи доступа или данные пациента.
|
||||
- Исходящие запросы идут на `https://platform-api2.max.ru`, токен передаётся заголовком `Authorization`.
|
||||
Верификация TLS всегда включена. Если системе нужен корневой сертификат Минцифры, установить его по
|
||||
официальной инструкции MAX и указать PEM-путь в `MAX_CA_BUNDLE`; не отключать проверку TLS.
|
||||
- Переменные должны попасть именно в окружение API-контейнера/процесса, а не только панели сайта.
|
||||
В текущем Compose сервис `app` уже получает `.env` через `env_file`.
|
||||
После изменения окружения пересоздать процесс/контейнер API. Новые зависимости не требуются.
|
||||
|
||||
## 3. Проверить и включить
|
||||
|
||||
В каталоге проекта, в том же окружении, где работает API:
|
||||
|
||||
```sh
|
||||
uv run python -m app.channels.max_setup check
|
||||
```
|
||||
|
||||
Команда проверит токен и совпадение имени бота. Сообщений пользователям она не отправляет.
|
||||
Затем установить `MAX_ENABLED=true`, перезапустить API и выполнить:
|
||||
|
||||
```sh
|
||||
uv run python -m app.channels.max_setup subscribe
|
||||
uv run python -m app.channels.max_setup status
|
||||
```
|
||||
|
||||
`subscribe` регистрирует только заданный webhook с секретом и событиями
|
||||
`bot_started`, `message_created`, `bot_stopped`, `dialog_removed`. Старые чужие подписки автоматически
|
||||
не удаляются: при переносе сервера владелец должен проверить их отдельно через MAX API.
|
||||
`status` проверяет регистрацию адреса; это ещё не проверка доступности сервера из MAX.
|
||||
Команды не печатают токены, секрет webhook или сырые ответы платформы.
|
||||
|
||||
При запуске через Compose вместо `uv run python ...` использовать
|
||||
`docker compose exec app python -m app.channels.max_setup check` (также `subscribe` и `status`).
|
||||
После изменения `.env` пересоздать API: `docker compose up -d --build --force-recreate app`.
|
||||
|
||||
Запускать один процесс API с MAX на один токен бота: его worker отправляет до одного сообщения в секунду.
|
||||
БД защищает очередь от параллельного захвата, но общий лимит скорости нескольких процессов не координируется.
|
||||
Планировщик и MAX worker запускаются вместе с FastAPI, отдельный процесс бота не нужен.
|
||||
При `MAX_ENABLED=false` сетевых вызовов MAX и фонового worker нет; сайт продолжает обычную работу.
|
||||
|
||||
## API для разработчика сайта
|
||||
|
||||
В проекте используется ключ текущего пациента, полученный при входе. Для этих ручек передавать его
|
||||
как `Authorization: Bearer <patient_token>`; это существующая авторизация прототипа, не новая система SSO.
|
||||
Не брать token другого пациента и не публиковать демонстрационные учётные записи для реального использования.
|
||||
|
||||
| Метод и путь | Запрос | Ответ |
|
||||
|---|---|---|
|
||||
| `GET /api/v1/me/notifications/max` | Authorization | `available`, `connected`, `last_delivery` |
|
||||
| `POST /api/v1/me/notifications/max/link` | Authorization; JSON `{"consent": true}` | `url`, `expires_at` |
|
||||
| `DELETE /api/v1/me/notifications/max` | Authorization | состояние с `connected: false` |
|
||||
| `POST /api/v1/webhooks/max` | MAX JSON + `X-Max-Bot-Api-Secret` | `{"success": true}` после записи события |
|
||||
|
||||
Поток подключения: пациент явно соглашается на уведомления → сайт получает `url` → открывает ссылку MAX →
|
||||
пользователь запускает бота → webhook подтверждает привязку → повторный GET показывает `connected: true`.
|
||||
Ссылка одноразовая; новая ссылка отменяет предыдущую. Изначальный ключ пациента не входит в URL MAX.
|
||||
Для привязки и доставки дополнительно нужны действующее согласие и подтверждение совершеннолетия в состоянии пациента.
|
||||
Активную привязку нельзя молча переназначить другому аккаунту: сначала отключить её.
|
||||
|
||||
Коды ошибок: 401 — неизвестный/отсутствующий ключ пациента; 403 — нет согласия или неверный секрет webhook;
|
||||
422 — неверный запрос; 413 — webhook больше 64 КиБ; 503 — MAX выключен или хранилище события недоступно.
|
||||
Повтор webhook с тем же идентификатором события не создаёт новых отправок. Групповые чаты игнорируются.
|
||||
|
||||
`last_delivery`: `queued`, `sending`, `sent`, `failed`, `cancelled` или `null`.
|
||||
`sent` означает принятие сообщения API MAX, а не прочтение человеком.
|
||||
|
||||
## Пробное подключение после создания бота
|
||||
|
||||
1. Войти на сайте синтетическим пациентом и дать необходимые согласия.
|
||||
2. Получить ссылку через POST выше (Swagger `/docs` или будущий интерфейс сайта), перейти в MAX и запустить бота.
|
||||
3. Убедиться, что GET показывает `connected: true` и приходит подтверждение.
|
||||
4. Завершить тест на сайте; примерно через 30 секунд плюс очередь должно прийти сообщение без результатов.
|
||||
5. Дождаться события планировщика и проверить нейтральное напоминание с кнопкой на сайт.
|
||||
6. Отправить `/stop`: GET должен показать `connected: false`, ожидающие уведомления отменяются.
|
||||
7. Повторить подключение новой ссылкой, проверить DELETE через API и остановку бота через интерфейс MAX.
|
||||
|
||||
При недоставке проверить настройки и подписку, доступность HTTPS, состояние очереди и коды ошибок в логах.
|
||||
`http_401`/`http_403` требуют проверки токена/прав; `http_429` — ожидания; `transport` — сети/TLS;
|
||||
`failed` после шести попыток требует вмешательства администратора. Детали ответов и идентификаторы в логи не выводятся.
|
||||
Отключение отменяет очередь; уже принятый MAX запрос отозвать невозможно.
|
||||
|
||||
## Гарантии и ограничения
|
||||
|
||||
Очередь и подтверждения событий сохраняются в identity БД. Клинические записи остаются в clinical БД.
|
||||
Для событий завершения тестов БД повторно просматривается после перезапуска; ключи уведомлений предотвращают
|
||||
повторную постановку. Напоминания используют существующий механизм outbox/повторов планировщика.
|
||||
При временных ошибках — до 6 попыток с увеличением задержки и учётом `Retry-After`; зависшая отправка получает
|
||||
новую аренду через 60 секунд. Потеря процесса между принятием сообщения MAX и записью успеха в БД может
|
||||
привести к повторному сообщению: MAX не предоставляет ключ идемпотентности отправки.
|
||||
Не удалять строки дедупликации/очереди без согласованной политики хранения. При большом количестве пациентов
|
||||
нужны пакетное сканирование завершённых тестов и общий ограничитель скорости; текущая реализация рассчитана на MVP.
|
||||
|
||||
Проверки разработчика: `make lint test`; тесты MAX работают с синтетикой и подменённым HTTP-транспортом.
|
||||
Реальную доставку подтвердит только пробное подключение после выдачи токена и настройки публичного сервера.
|
||||
|
||||
Официальные контракты: [отправка сообщений](https://dev.max.ru/docs-api/methods/POST/messages),
|
||||
[подписка webhook](https://dev.max.ru/docs-api/methods/POST/subscriptions),
|
||||
[события](https://dev.max.ru/docs-api/objects/Update),
|
||||
[ссылки запуска бота](https://dev.max.ru/docs/chatbots/bots-coding/prepare).
|
||||
@@ -0,0 +1,224 @@
|
||||
"""Notifications-only MAX adapter; no patient text enters the dialog engine or an LLM.
|
||||
|
||||
Webhook transactions persist receipts and replies together, then return immediately.
|
||||
The worker delivers from identity DB with leases and bounded retries. MAX has no send
|
||||
idempotency key: a crash after API acceptance and before commit can duplicate a message.
|
||||
"""
|
||||
|
||||
import asyncio
|
||||
import contextlib
|
||||
import json
|
||||
import logging
|
||||
from functools import lru_cache
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, Field
|
||||
from sqlalchemy import select
|
||||
from sqlalchemy.exc import IntegrityError
|
||||
|
||||
from app.channels.max_client import MaxApiError, MaxClient
|
||||
from app.config import get_settings
|
||||
from app.core import clock
|
||||
from app.db.max_notifications import MaxBinding, MaxReceipt
|
||||
from app.db.session import get_identity_session
|
||||
from app.dialog.contracts import Reply
|
||||
from app.integrations import max_store as store
|
||||
from app.integrations.base import Outbox, integrations
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
|
||||
class Texts(BaseModel):
|
||||
connected: str = Field(max_length=4000)
|
||||
not_connected: str = Field(max_length=4000)
|
||||
invalid: str = Field(max_length=4000)
|
||||
stopped: str = Field(max_length=4000)
|
||||
help: str = Field(max_length=4000)
|
||||
notification: str = Field(max_length=4000)
|
||||
completed: str = Field(max_length=4000)
|
||||
open_site: str = Field(max_length=128)
|
||||
|
||||
|
||||
@lru_cache
|
||||
def texts() -> Texts:
|
||||
path = get_settings().config_dir / "texts" / "max.yaml"
|
||||
return Texts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
def _event(event: dict) -> tuple[str, int, str, str] | None:
|
||||
"""Normalize only documented private-user events; unknown/malformed events are ignored."""
|
||||
kind = event.get("update_type")
|
||||
stamp = event.get("timestamp")
|
||||
if type(stamp) is not int or stamp < 0:
|
||||
return None
|
||||
message_id = ""
|
||||
if kind == "message_created":
|
||||
message = event.get("message")
|
||||
if not isinstance(message, dict):
|
||||
return None
|
||||
recipient, body = message.get("recipient"), message.get("body")
|
||||
if not isinstance(recipient, dict) or recipient.get("chat_type") != "dialog" or not isinstance(body, dict):
|
||||
return None
|
||||
user, text, message_id = message.get("sender"), body.get("text"), body.get("mid")
|
||||
if not isinstance(message_id, str) or not message_id or not isinstance(text, str):
|
||||
return None
|
||||
elif kind in ("bot_started", "bot_stopped", "dialog_removed"):
|
||||
user, text = event.get("user"), event.get("payload") or ""
|
||||
else:
|
||||
return None
|
||||
if not isinstance(user, dict) or user.get("is_bot") is not False:
|
||||
return None
|
||||
uid = user.get("user_id")
|
||||
if type(uid) is not int or not 0 < uid < 2**63 or not isinstance(text, str) or len(text) > 4000:
|
||||
return None
|
||||
# Names, profile details and raw text are neither persisted nor logged.
|
||||
receipt = store.digest(f"{kind}:{uid}:{message_id or stamp}")
|
||||
return kind, uid, text.strip(), receipt
|
||||
|
||||
|
||||
async def handle_update(event: dict) -> None:
|
||||
if not get_settings().max_enabled or (parsed := _event(event)) is None:
|
||||
return
|
||||
kind, user_id, text, receipt = parsed
|
||||
now = clock.now()
|
||||
try:
|
||||
async with get_identity_session() as session:
|
||||
if await session.get(MaxReceipt, receipt):
|
||||
return
|
||||
session.add(MaxReceipt(digest=receipt, received_at=now))
|
||||
await session.flush()
|
||||
binding = await session.scalar(select(MaxBinding).where(MaxBinding.user_id == user_id))
|
||||
reply_token = None
|
||||
command, _, payload = text.partition(" ")
|
||||
if kind in ("bot_stopped", "dialog_removed") or command.lower() == "/stop":
|
||||
if binding:
|
||||
await store.disconnect(session, binding.token)
|
||||
# When MAX itself stops/deletes the bot, do not attempt a reply.
|
||||
if kind != "message_created":
|
||||
return
|
||||
reply = "stopped"
|
||||
elif kind == "bot_started" or command.lower() == "/start":
|
||||
code = text if kind == "bot_started" else payload.strip()
|
||||
if code:
|
||||
token = await store.code_token(session, code, now) if len(code) <= 128 else None
|
||||
linked = (
|
||||
token and await store.active_patient(token) and await store.bind(session, code, user_id, now)
|
||||
)
|
||||
reply = "connected" if linked else "invalid"
|
||||
reply_token = token if linked else None
|
||||
else:
|
||||
reply = "connected" if binding and binding.enabled else "not_connected"
|
||||
reply_token = binding.token if binding and binding.enabled else None
|
||||
else:
|
||||
reply = "help"
|
||||
await store.enqueue(session, key=receipt, user_id=user_id, token=reply_token, kind=reply, now=now)
|
||||
except IntegrityError:
|
||||
# A concurrent delivery of the same webhook can race on its receipt primary key.
|
||||
async with get_identity_session() as session:
|
||||
if await session.get(MaxReceipt, receipt) is None:
|
||||
raise
|
||||
|
||||
|
||||
class MaxOutbox:
|
||||
def __init__(self, fallback: Outbox):
|
||||
self.fallback = fallback
|
||||
|
||||
async def push(self, token: str, replies: list[Reply]) -> None:
|
||||
if replies and get_settings().max_enabled and await store.active_patient(token):
|
||||
async with get_identity_session() as session:
|
||||
binding = await session.get(MaxBinding, token)
|
||||
if binding and binding.enabled:
|
||||
# Hash the event for retry deduplication; never store/transmit its clinical text.
|
||||
event = json.dumps([r.model_dump() for r in replies], sort_keys=True, ensure_ascii=False)
|
||||
key = store.digest(f"{token}:{binding.connected_at.isoformat()}:{clock.today()}:{event}")
|
||||
await store.enqueue(
|
||||
session, key=key, user_id=binding.user_id, token=token, kind="notification", now=clock.now()
|
||||
)
|
||||
await self.fallback.push(token, replies)
|
||||
|
||||
|
||||
async def deliver_one(client: MaxClient) -> bool:
|
||||
async with get_identity_session() as session:
|
||||
row = await store.claim(session, clock.now())
|
||||
if row is None:
|
||||
return False
|
||||
if row.token is not None:
|
||||
async with get_identity_session() as session:
|
||||
binding = await session.get(MaxBinding, row.token)
|
||||
valid = (
|
||||
binding
|
||||
and binding.enabled
|
||||
and binding.user_id == row.user_id
|
||||
and binding.connected_at <= row.created_at
|
||||
)
|
||||
if not valid or not await store.active_patient(row.token):
|
||||
async with get_identity_session() as session:
|
||||
await store.finish(session, row, state="cancelled", now=clock.now())
|
||||
return True
|
||||
settings, messages = get_settings(), texts()
|
||||
try:
|
||||
await client.send(
|
||||
row.user_id, getattr(messages, row.kind), site_url=settings.max_site_url, button=messages.open_site
|
||||
)
|
||||
except MaxApiError as exc:
|
||||
retry = exc.retryable and row.attempts < store.MAX_ATTEMPTS
|
||||
delay = max(exc.retry_after, min(300, 5 * 2 ** (row.attempts - 1)))
|
||||
async with get_identity_session() as session:
|
||||
await store.finish(
|
||||
session,
|
||||
row,
|
||||
state="queued" if retry else "failed",
|
||||
now=clock.now(),
|
||||
error=exc.code,
|
||||
retry_seconds=delay if retry else 0,
|
||||
)
|
||||
log.warning("MAX delivery deferred=%s code=%s", retry, exc.code)
|
||||
else:
|
||||
async with get_identity_session() as session:
|
||||
await store.finish(session, row, state="sent", now=clock.now())
|
||||
return True
|
||||
|
||||
|
||||
async def _run(client: MaxClient) -> None:
|
||||
tick = 0
|
||||
while True:
|
||||
try:
|
||||
if tick % 30 == 0:
|
||||
async with get_identity_session() as session:
|
||||
await store.collect_completed(session, clock.now())
|
||||
await deliver_one(client)
|
||||
except Exception as exc:
|
||||
# No exception text: SQL/HTTP errors may contain identifiers or parameters.
|
||||
log.error("MAX worker failed type=%s", type(exc).__name__)
|
||||
tick += 1
|
||||
# One send per second per process, below MAX's two-per-second per-dialog limit.
|
||||
await asyncio.sleep(1)
|
||||
|
||||
|
||||
_client: MaxClient | None = None
|
||||
_task: asyncio.Task | None = None
|
||||
_wrapper: MaxOutbox | None = None
|
||||
|
||||
|
||||
async def start() -> None:
|
||||
global _client, _task, _wrapper
|
||||
if not get_settings().max_enabled or _task is not None:
|
||||
return
|
||||
texts() # Validate templates before replacing a working outbox.
|
||||
_client = MaxClient(get_settings())
|
||||
_wrapper = MaxOutbox(integrations.outbox)
|
||||
integrations.outbox = _wrapper
|
||||
_task = asyncio.create_task(_run(_client), name="max-notifications")
|
||||
|
||||
|
||||
async def stop() -> None:
|
||||
global _client, _task, _wrapper
|
||||
if _task:
|
||||
_task.cancel()
|
||||
with contextlib.suppress(asyncio.CancelledError):
|
||||
await _task
|
||||
if _wrapper and integrations.outbox is _wrapper:
|
||||
integrations.outbox = _wrapper.fallback
|
||||
if _client:
|
||||
await _client.close()
|
||||
_client = _task = _wrapper = None
|
||||
@@ -0,0 +1,101 @@
|
||||
"""Small MAX Bot API client. Secrets stay in headers; failures never expose response bodies."""
|
||||
|
||||
import logging
|
||||
import ssl
|
||||
|
||||
import httpx
|
||||
|
||||
from app.config import Settings
|
||||
|
||||
API_URL = "https://platform-api2.max.ru"
|
||||
UPDATE_TYPES = ["bot_started", "message_created", "bot_stopped", "dialog_removed"]
|
||||
|
||||
|
||||
class _HideRecipient(logging.Filter):
|
||||
def filter(self, record: logging.LogRecord) -> bool:
|
||||
# httpx INFO normally logs query strings, which include a MAX user_id.
|
||||
return "platform-api2.max.ru" not in record.getMessage()
|
||||
|
||||
|
||||
logging.getLogger("httpx").addFilter(_HideRecipient())
|
||||
|
||||
|
||||
class MaxApiError(Exception):
|
||||
def __init__(self, code: str, *, retryable: bool = False, retry_after: float = 0):
|
||||
self.code, self.retryable, self.retry_after = code, retryable, retry_after
|
||||
super().__init__(code)
|
||||
|
||||
|
||||
class MaxClient:
|
||||
def __init__(self, settings: Settings, *, transport: httpx.AsyncBaseTransport | None = None):
|
||||
context = ssl.create_default_context()
|
||||
if settings.max_ca_bundle:
|
||||
context.load_verify_locations(cafile=str(settings.max_ca_bundle))
|
||||
self.http = httpx.AsyncClient(
|
||||
base_url=API_URL,
|
||||
headers={"Authorization": settings.max_bot_token.get_secret_value()},
|
||||
timeout=httpx.Timeout(5),
|
||||
verify=context,
|
||||
follow_redirects=False,
|
||||
transport=transport,
|
||||
)
|
||||
|
||||
async def close(self) -> None:
|
||||
await self.http.aclose()
|
||||
|
||||
async def request(self, method: str, path: str, **kwargs) -> dict:
|
||||
try:
|
||||
response = await self.http.request(method, path, **kwargs)
|
||||
except httpx.RequestError:
|
||||
raise MaxApiError("transport", retryable=True) from None
|
||||
if not response.is_success:
|
||||
try:
|
||||
delay = min(3600, max(0, float(response.headers.get("Retry-After", "0"))))
|
||||
except ValueError:
|
||||
delay = 0
|
||||
raise MaxApiError(
|
||||
f"http_{response.status_code}",
|
||||
retryable=response.status_code in (408, 429) or response.status_code >= 500,
|
||||
retry_after=delay,
|
||||
)
|
||||
try:
|
||||
data = response.json()
|
||||
except ValueError:
|
||||
raise MaxApiError("invalid_response", retryable=True) from None
|
||||
if not isinstance(data, dict):
|
||||
raise MaxApiError("invalid_response", retryable=True)
|
||||
if data.get("success") is False:
|
||||
raise MaxApiError("rejected")
|
||||
return data
|
||||
|
||||
async def send(self, user_id: int, text: str, *, site_url: str, button: str) -> None:
|
||||
data = await self.request(
|
||||
"POST",
|
||||
"/messages",
|
||||
params={"user_id": user_id, "disable_link_preview": "true"},
|
||||
json={
|
||||
"text": text,
|
||||
"notify": True,
|
||||
"attachments": [
|
||||
{
|
||||
"type": "inline_keyboard",
|
||||
"payload": {"buttons": [[{"type": "link", "text": button, "url": site_url}]]},
|
||||
}
|
||||
],
|
||||
},
|
||||
)
|
||||
if not isinstance(data.get("message"), dict):
|
||||
raise MaxApiError("missing_message", retryable=True)
|
||||
|
||||
async def subscribe(self, settings: Settings) -> None:
|
||||
data = await self.request(
|
||||
"POST",
|
||||
"/subscriptions",
|
||||
json={
|
||||
"url": settings.max_webhook_url,
|
||||
"update_types": UPDATE_TYPES,
|
||||
"secret": settings.max_webhook_secret.get_secret_value(),
|
||||
},
|
||||
)
|
||||
if data.get("success") is not True:
|
||||
raise MaxApiError("subscription_not_confirmed")
|
||||
@@ -0,0 +1,56 @@
|
||||
"""Operator commands for a future bot owner. Never runs as part of application startup."""
|
||||
|
||||
import argparse
|
||||
import asyncio
|
||||
import sys
|
||||
|
||||
from pydantic import ValidationError
|
||||
|
||||
from app.channels.max_client import MaxApiError, MaxClient
|
||||
from app.config import Settings
|
||||
|
||||
|
||||
async def run(command: str) -> None:
|
||||
# Validate the same configuration even while the deployed app is still disabled.
|
||||
settings = Settings(max_enabled=True)
|
||||
client = MaxClient(settings)
|
||||
try:
|
||||
bot = await client.request("GET", "/me")
|
||||
if bot.get("is_bot") is not True:
|
||||
raise MaxApiError("not_a_bot")
|
||||
if bot.get("username") != settings.max_bot_username:
|
||||
raise MaxApiError("bot_username_mismatch")
|
||||
if command == "subscribe":
|
||||
await client.subscribe(settings)
|
||||
print("Webhook MAX зарегистрирован. Проверьте командой status, затем выполните пробное подключение.")
|
||||
elif command == "status":
|
||||
result = await client.request("GET", "/subscriptions")
|
||||
subscriptions = result.get("subscriptions", [])
|
||||
configured = any(isinstance(s, dict) and s.get("url") == settings.max_webhook_url for s in subscriptions)
|
||||
print("Нужный webhook зарегистрирован." if configured else "Нужный webhook не найден.")
|
||||
if not configured:
|
||||
raise MaxApiError("webhook_missing")
|
||||
else:
|
||||
print("Токен принят MAX, имя бота совпадает с настройкой. Подписка не изменялась.")
|
||||
finally:
|
||||
await client.close()
|
||||
|
||||
|
||||
def main() -> int:
|
||||
parser = argparse.ArgumentParser(description="Подготовка MAX: параметры берутся только из .env/окружения.")
|
||||
parser.add_argument("command", choices=("check", "subscribe", "status"))
|
||||
args = parser.parse_args()
|
||||
try:
|
||||
asyncio.run(run(args.command))
|
||||
except ValidationError:
|
||||
print("Проверьте параметры MAX в .env по app/channels/MAX_SETUP.md.", file=sys.stderr)
|
||||
return 1
|
||||
except (MaxApiError, OSError) as exc:
|
||||
code = exc.code if isinstance(exc, MaxApiError) else "tls_or_file_error"
|
||||
print(f"Не удалось выполнить настройку MAX: {code}. Секреты и ответ сервера скрыты.", file=sys.stderr)
|
||||
return 1
|
||||
return 0
|
||||
|
||||
|
||||
if __name__ == "__main__":
|
||||
raise SystemExit(main())
|
||||
@@ -19,6 +19,7 @@ from typing import Protocol
|
||||
|
||||
import yaml
|
||||
from aiogram import Bot, Dispatcher, F, Router
|
||||
from aiogram.client.session.aiohttp import AiohttpSession
|
||||
from aiogram.filters import CommandObject, CommandStart
|
||||
from aiogram.types import CallbackQuery, InlineKeyboardButton, InlineKeyboardMarkup, Message
|
||||
from pydantic import BaseModel
|
||||
@@ -193,11 +194,28 @@ class TelegramChannel:
|
||||
await self._dispatch(chat_id, person.token, Event(type="start", params={"code": code}))
|
||||
return
|
||||
token = await self.directory.token_for(chat_id)
|
||||
if token is None and get_settings().demo_clock:
|
||||
token = await self._demo_copy(chat_id)
|
||||
if token is None:
|
||||
await self._say(chat_id, texts.not_connected)
|
||||
return
|
||||
await self._dispatch(chat_id, token, Event(type="start"))
|
||||
|
||||
async def _demo_copy(self, chat_id: int) -> str | None:
|
||||
"""Demo stand (DEMO_CLOCK): `/start` without a code gets a private copy of veteran Andrey (synthetic),
|
||||
starting from consent and the intake — the same entry as the ЕМИАС demo button of the web app."""
|
||||
from app.api.patient_web import _fresh_demo_copy
|
||||
|
||||
try:
|
||||
token = (await _fresh_demo_copy(start_in_chat=False)).token
|
||||
except Exception:
|
||||
log.exception("start: demo copy failed")
|
||||
return None
|
||||
if not await self.directory.bind(chat_id, token):
|
||||
return None
|
||||
log.info("start: demo copy bound tok=%s", _short(token))
|
||||
return token
|
||||
|
||||
async def on_text(self, chat_id: int, text: str | None) -> None:
|
||||
texts = load_texts()
|
||||
token = await self.directory.token_for(chat_id)
|
||||
@@ -272,6 +290,12 @@ _task: asyncio.Task[None] | None = None
|
||||
_prev_outbox: Outbox | None = None
|
||||
|
||||
|
||||
def make_bot(token: str) -> Bot:
|
||||
"""aiogram `Bot`, through `TG_PROXY_URL` when it is set."""
|
||||
proxy = get_settings().tg_proxy_url
|
||||
return Bot(token, session=AiohttpSession(proxy=proxy)) if proxy else Bot(token)
|
||||
|
||||
|
||||
async def start() -> None:
|
||||
"""Start polling if TG_BOT_TOKEN is set; no-op otherwise."""
|
||||
global _bot, _dp, _task, _prev_outbox
|
||||
@@ -280,7 +304,7 @@ async def start() -> None:
|
||||
if not token:
|
||||
log.info("telegram disabled: TG_BOT_TOKEN is empty")
|
||||
return
|
||||
bot = Bot(token)
|
||||
bot = make_bot(token)
|
||||
channel = TelegramChannel(bot)
|
||||
dp = Dispatcher()
|
||||
dp.include_router(build_router(channel))
|
||||
|
||||
+60
-2
@@ -1,10 +1,12 @@
|
||||
"""Typed application settings. The only place that reads environment variables."""
|
||||
|
||||
import re
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
from typing import Literal
|
||||
from urllib.parse import urlsplit
|
||||
|
||||
from pydantic import Field
|
||||
from pydantic import Field, SecretStr, model_validator
|
||||
from pydantic_settings import BaseSettings, SettingsConfigDict
|
||||
|
||||
ROOT_DIR = Path(__file__).resolve().parent.parent
|
||||
@@ -12,7 +14,7 @@ ROOT_DIR = Path(__file__).resolve().parent.parent
|
||||
|
||||
class Settings(BaseSettings):
|
||||
# Empty values in .env (e.g. `TG_BOT_TOKEN=`) fall back to defaults instead of failing validation.
|
||||
model_config = SettingsConfigDict(env_file=".env", extra="ignore", env_ignore_empty=True)
|
||||
model_config = SettingsConfigDict(env_file=".env", extra="ignore", env_ignore_empty=True, hide_input_in_errors=True)
|
||||
|
||||
# Two separate databases (ADR-003): identity holds direct identifiers, clinical holds pseudonymised data.
|
||||
identity_db_url: str = "postgresql+asyncpg://identity_app:identity_app@localhost:5432/identity"
|
||||
@@ -28,12 +30,68 @@ class Settings(BaseSettings):
|
||||
gigachat_model: str = "GigaChat"
|
||||
gigachat_verify_ssl: bool = False
|
||||
|
||||
# Chat agent (tool-using LLM over RAG + patient record). `auto` = OpenRouter if a key is set, else off
|
||||
# (extractive RAG / instruction answers stay). OpenRouter is a TEMPORARY prototype provider on synthetic
|
||||
# data only — prod must use GigaChat (152-FZ, foreign services are forbidden for real PII).
|
||||
chat_agent: Literal["auto", "off", "mock", "openrouter", "gigachat"] = "auto"
|
||||
openrouter_api_key: str = ""
|
||||
openrouter_model: str = "google/gemini-2.5-flash-lite"
|
||||
openrouter_base_url: str = "https://openrouter.ai/api/v1"
|
||||
openrouter_proxy_url: str = "" # OpenRouter blocks RF IPs: the server goes through an HTTP proxy (as vobot does)
|
||||
gigachat_agent_model: str = "GigaChat-2-Pro" # function calling quality matters more than price here
|
||||
chat_agent_timeout_s: float = 25.0
|
||||
chat_agent_max_steps: int = 5
|
||||
|
||||
# Voice input (#116): speech-to-text for the patient's messages. `auto` = OpenRouter if a key is set, else mock.
|
||||
# OpenRouter STT is synthetic data only (ADR-014): the audio leaves the RF and cannot be scrubbed.
|
||||
stt_provider: Literal["auto", "off", "mock", "openrouter"] = "auto"
|
||||
stt_model: str = "google/gemini-2.5-flash" # needs audio input
|
||||
stt_timeout_s: float = 30.0
|
||||
stt_max_seconds: int = Field(default=60, ge=5, le=300)
|
||||
|
||||
# Telegram is used only for the prototype on synthetic data; prod channel is MAX / Gosuslugi.
|
||||
tg_bot_token: str = ""
|
||||
# The RF server reaches api.telegram.org over IPv6 only; docker has IPv4 only → go through a proxy (http/socks).
|
||||
tg_proxy_url: str = ""
|
||||
doctor_notify_chat_id: int | None = None
|
||||
|
||||
# MAX is opt-in. Its adapter is delivered in the related backend/channel changes.
|
||||
max_enabled: bool = False
|
||||
max_bot_token: SecretStr = SecretStr("")
|
||||
max_bot_username: str = ""
|
||||
max_webhook_secret: SecretStr = SecretStr("")
|
||||
max_webhook_url: str = ""
|
||||
max_site_url: str = ""
|
||||
max_ca_bundle: Path | None = None
|
||||
max_link_ttl_seconds: int = Field(default=600, ge=60, le=1800)
|
||||
|
||||
@model_validator(mode="after")
|
||||
def validate_max(self) -> "Settings":
|
||||
if not self.max_enabled:
|
||||
return self
|
||||
if not self.max_bot_token.get_secret_value().strip():
|
||||
raise ValueError("MAX_BOT_TOKEN is required when MAX_ENABLED=true")
|
||||
if not re.fullmatch(r"[A-Za-z0-9_]{1,128}", self.max_bot_username):
|
||||
raise ValueError("MAX_BOT_USERNAME must be the bot nickname without @ or a URL")
|
||||
if not re.fullmatch(r"[A-Za-z0-9_-]{32,256}", self.max_webhook_secret.get_secret_value()):
|
||||
raise ValueError("MAX_WEBHOOK_SECRET must contain 32..256 URL-safe characters")
|
||||
for name, value in (("MAX_SITE_URL", self.max_site_url), ("MAX_WEBHOOK_URL", self.max_webhook_url)):
|
||||
url = urlsplit(value)
|
||||
if url.scheme != "https" or not url.hostname or url.username or url.password or url.port not in (None, 443):
|
||||
raise ValueError(f"{name} must use HTTPS on port 443 without credentials")
|
||||
if url.query or (name == "MAX_WEBHOOK_URL" and url.fragment):
|
||||
raise ValueError(f"{name} must not contain a query string (or a fragment for webhook)")
|
||||
if self.max_ca_bundle is not None and not self.max_ca_bundle.is_file():
|
||||
raise ValueError("MAX_CA_BUNDLE must point to an existing trusted CA bundle")
|
||||
return self
|
||||
|
||||
# Virtual clock for the demo (ADR-005).
|
||||
demo_clock: bool = True
|
||||
# Initial screening (onboarding questionnaires) on/off — the default; the demo console can flip it at runtime.
|
||||
screening_enabled: bool = True
|
||||
# Crisis blocks the dialog until the doctor's ack (clinical protocol) — off for the demo: the crisis message
|
||||
# and the doctor's alert still happen, the patient keeps using everything.
|
||||
crisis_blocking: bool = False
|
||||
tz: str = "Europe/Moscow"
|
||||
|
||||
api_base_url: str = "http://localhost:8000"
|
||||
|
||||
@@ -0,0 +1,34 @@
|
||||
"""Presentation switches (demo): stored in `demo_settings`, default from settings/env.
|
||||
|
||||
SCREENING_ENABLED=false # env default
|
||||
POST /api/v1/demo/settings {"screening_enabled": false} # one button in the demo console
|
||||
|
||||
Screening off: after consent the patient goes straight to the chat — no onboarding questionnaires.
|
||||
"""
|
||||
|
||||
from typing import Any
|
||||
|
||||
from sqlalchemy.ext.asyncio import AsyncSession
|
||||
|
||||
from app.config import get_settings
|
||||
from app.db.clinical import DemoSetting
|
||||
|
||||
SCREENING = "screening_enabled"
|
||||
|
||||
|
||||
async def get_all(session: AsyncSession) -> dict[str, Any]:
|
||||
row = await session.get(DemoSetting, SCREENING)
|
||||
return {SCREENING: bool(row.value) if row is not None else get_settings().screening_enabled}
|
||||
|
||||
|
||||
async def screening_enabled(session: AsyncSession) -> bool:
|
||||
return (await get_all(session))[SCREENING]
|
||||
|
||||
|
||||
async def set_screening(session: AsyncSession, enabled: bool) -> None:
|
||||
row = await session.get(DemoSetting, SCREENING)
|
||||
if row is None:
|
||||
session.add(DemoSetting(key=SCREENING, value=enabled))
|
||||
else:
|
||||
row.value = enabled
|
||||
await session.flush()
|
||||
@@ -0,0 +1,142 @@
|
||||
"""Read-only catalog of questionnaire items for patient clients (web app).
|
||||
|
||||
The dialog engine sends a questionnaire question as plain text plus buttons; the button payload carries the item id
|
||||
(`iq:<nonce>:<item>:<i>`, `scale:<scale>:<item>:<v>`). A client looks the item up here to show which form it belongs
|
||||
to, its position and recall period. Nothing here changes what is asked or how it is scored — the texts stay those of
|
||||
the versioned sources in config/.
|
||||
"""
|
||||
|
||||
from functools import lru_cache
|
||||
from typing import Any, Literal
|
||||
|
||||
from pydantic import BaseModel
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.cssrs_content import load_cssrs_russian
|
||||
from app.core.intake_questions import DIARY_PARTS, content, diary_config, red_flags, texts
|
||||
from app.core.scales import load_scale
|
||||
|
||||
Section = Literal["safety", "mood", "trauma", "alcohol", "about", "diary", "scale"]
|
||||
|
||||
# Forms whose item order depends on earlier answers: a client shows the position without «из N».
|
||||
ADAPTIVE = {"cssrs", "rus_audit", "diary", "context"}
|
||||
|
||||
|
||||
class FormInfo(BaseModel):
|
||||
id: str
|
||||
title: str
|
||||
section: Section
|
||||
recall_period: str | None = None
|
||||
instruction: str | None = None
|
||||
|
||||
|
||||
class ItemInfo(BaseModel):
|
||||
form: str
|
||||
index: int # 1-based position in the form
|
||||
total: int
|
||||
adaptive: bool
|
||||
optional: bool = False
|
||||
numeric: bool = False
|
||||
|
||||
|
||||
class DrinksTable(BaseModel):
|
||||
"""RUS-AUDIT item 2 standard-drink table, exactly as in config/texts/intake.yaml (the approved form)."""
|
||||
|
||||
title: str
|
||||
header: list[str]
|
||||
rows: list[tuple[str, list[str]]]
|
||||
note: str
|
||||
|
||||
|
||||
class Catalog(BaseModel):
|
||||
forms: dict[str, FormInfo]
|
||||
items: dict[str, ItemInfo]
|
||||
standard_drinks: DrinksTable | None
|
||||
|
||||
|
||||
def _drinks() -> DrinksTable | None:
|
||||
raw = texts().get("standard_drinks")
|
||||
if not raw:
|
||||
return None
|
||||
lines = [line.strip() for line in raw.splitlines() if line.strip()]
|
||||
title, header_line, *rest = lines
|
||||
rows = [line for line in rest if ":" in line]
|
||||
note = " ".join(line for line in rest if ":" not in line)
|
||||
return DrinksTable(
|
||||
title=title,
|
||||
header=[h.strip() for h in header_line.split("·")],
|
||||
rows=[
|
||||
(label.strip(), [c.strip() for c in cells.split("·")]) for label, cells in (r.split(":", 1) for r in rows)
|
||||
],
|
||||
note=note,
|
||||
)
|
||||
|
||||
|
||||
@lru_cache(maxsize=1)
|
||||
def catalog() -> Catalog:
|
||||
forms: dict[str, FormInfo] = {}
|
||||
items: dict[str, ItemInfo] = {}
|
||||
|
||||
def add(form: FormInfo, ids: list[str], *, optional: set[str] = frozenset(), numeric: set[str] = frozenset()):
|
||||
forms[form.id] = form
|
||||
for i, item in enumerate(ids, 1):
|
||||
items.setdefault(
|
||||
item,
|
||||
ItemInfo(
|
||||
form=form.id,
|
||||
index=i,
|
||||
total=len(ids),
|
||||
adaptive=form.id in ADAPTIVE,
|
||||
optional=item in optional,
|
||||
numeric=item in numeric,
|
||||
),
|
||||
)
|
||||
|
||||
flags = red_flags()
|
||||
add(FormInfo(id="red_flags", title="Вопросы о безопасности", section="safety"), [i["id"] for i in flags["items"]])
|
||||
|
||||
cssrs = load_cssrs_russian()
|
||||
add(FormInfo(id="cssrs", title=cssrs.title, section="safety"), ["cssrs_" + i.id for i in cssrs.items])
|
||||
|
||||
intake_forms: dict[str, Any] = content()["forms"]
|
||||
for sid, section in (("phq9", "mood"), ("tsq", "trauma"), ("pcl5", "trauma"), ("rus_audit", "alcohol")):
|
||||
raw = intake_forms.get(sid) or {}
|
||||
scale = load_scale(sid)
|
||||
add(
|
||||
FormInfo(
|
||||
id=sid,
|
||||
title=raw.get("title") or scale.title,
|
||||
section=section,
|
||||
recall_period=raw.get("recall_period") or scale.recall_period,
|
||||
instruction=raw.get("instruction") or scale.instruction,
|
||||
),
|
||||
list(scale.item_ids),
|
||||
)
|
||||
add(FormInfo(id="trauma", title="Травматическое событие", section="trauma"), ["trauma", "recent_trauma"])
|
||||
add(FormInfo(id="context", title="Общие вопросы", section="about"), ["sex", "tbi", "psychotropics"])
|
||||
|
||||
diary = diary_config()
|
||||
core = [item for part in DIARY_PARTS for item in diary[part]]
|
||||
depression = [f"dphq_{i['id'].rsplit('_', 1)[1]}" for i in intake_forms[diary["depression"]["form"]]["items"]]
|
||||
ptsd = [f"dpcl_{i.rsplit('_', 1)[1]}" for i in diary["ptsd"]["items"]]
|
||||
add(
|
||||
FormInfo(id="diary", title="Дневник самочувствия", section="diary"),
|
||||
[i["id"] for i in core] + depression + ptsd,
|
||||
optional={i["id"] for i in core if i.get("optional")},
|
||||
numeric={i["id"] for i in core if i.get("numeric")},
|
||||
)
|
||||
|
||||
# Scales of the onboarding / scheduled sessions (`scale:<id>:...` buttons): the form header only.
|
||||
for path in sorted((get_settings().config_dir / "scales").glob("*.yaml")):
|
||||
scale = load_scale(path.stem)
|
||||
forms.setdefault(
|
||||
scale.id,
|
||||
FormInfo(
|
||||
id=scale.id,
|
||||
title=scale.title,
|
||||
section="scale",
|
||||
recall_period=scale.recall_period,
|
||||
instruction=scale.instruction,
|
||||
),
|
||||
)
|
||||
return Catalog(forms=forms, items=items, standard_drinks=_drinks())
|
||||
+109
-41
@@ -18,6 +18,7 @@ class Question:
|
||||
period: str = "context"
|
||||
numeric: bool = False
|
||||
optional: bool = False
|
||||
maximum: float = 24
|
||||
|
||||
|
||||
def content() -> dict:
|
||||
@@ -52,19 +53,30 @@ def cssrs_answers(answers: dict) -> dict[str, int]:
|
||||
return {k.removeprefix("cssrs_"): v for k, v in answers.items() if k.startswith("cssrs_")}
|
||||
|
||||
|
||||
def red_flags() -> dict:
|
||||
return yaml.safe_load((get_settings().config_dir / "instruments/red_flags.yaml").read_text(encoding="utf-8"))
|
||||
|
||||
|
||||
def red_flag_category(item_id: str) -> str | None:
|
||||
return next((i["category"] for i in red_flags()["items"] if i["id"] == item_id), None)
|
||||
|
||||
|
||||
def red_flag_triggers(item_id: str) -> bool:
|
||||
"""False for questions that are asked and stored but never stop/alert (rf_weapons, team decision 2026-10-04)."""
|
||||
return next((i.get("trigger", True) for i in red_flags()["items"] if i["id"] == item_id), True)
|
||||
|
||||
|
||||
def next_intake(answers: dict, policy: IntakePolicy, sex: str | None) -> Question | None:
|
||||
c = score_cssrs_recent(cssrs_answers(answers))
|
||||
if c.missing:
|
||||
form = load_cssrs_russian()
|
||||
item = next(i for i in form.items if i.id == c.missing[0])
|
||||
period = texts()["periods"][item.recall_period]
|
||||
# Guidance is interviewer-facing; retained in the source and record version.
|
||||
return Question(
|
||||
"cssrs_" + item.id,
|
||||
period + "\n\n" + item.text,
|
||||
tuple((o.value, o.label) for o in form.options),
|
||||
item.recall_period,
|
||||
)
|
||||
"""Stage 1: the red-flag block first (config/instruments/red_flags.yaml), then the fixed order of «Опросники
|
||||
для MVP»: PHQ-2, trauma filter → TSQ, RUS-AUDIT-S, C-SSRS screener, the context questions; stage 2 (rest of
|
||||
PHQ-9, PCL-5, full RUS-AUDIT) only where stage 1 is positive. Items inside a scale keep the order of the source.
|
||||
The risk stop rules run after every answer (flows/intake.py), so a positive answer interrupts the questionnaire
|
||||
wherever it comes."""
|
||||
flags = red_flags()
|
||||
for n, item in enumerate(flags["items"]):
|
||||
if item["id"] not in answers:
|
||||
text = (flags["intro"] + "\n\n" if n == 0 else "") + item["text"]
|
||||
return Question(item["id"], text, tuple((o["value"], o["label"]) for o in flags["options"]), "now")
|
||||
for item in ("phq9_1", "phq9_2"):
|
||||
if item not in answers:
|
||||
return scale_question("phq9", item)
|
||||
@@ -81,6 +93,18 @@ def next_intake(answers: dict, policy: IntakePolicy, sex: str | None) -> Questio
|
||||
for item in load_scale("rus_audit_s").item_ids:
|
||||
if item not in answers:
|
||||
return scale_question("rus_audit_s", item)
|
||||
c = score_cssrs_recent(cssrs_answers(answers))
|
||||
if c.missing:
|
||||
form = load_cssrs_russian()
|
||||
item = next(i for i in form.items if i.id == c.missing[0])
|
||||
period = texts()["periods"][item.recall_period]
|
||||
# Guidance is interviewer-facing; retained in the source and record version.
|
||||
return Question(
|
||||
"cssrs_" + item.id,
|
||||
period + "\n\n" + item.text,
|
||||
tuple((o.value, o.label) for o in form.options),
|
||||
item.recall_period,
|
||||
)
|
||||
if sex is None and "sex" not in answers:
|
||||
return Question("sex", texts()["sex"], (("f", "Женский"), ("m", "Мужской"), ("unknown", "Не указывать")))
|
||||
for key in ("tbi", "psychotropics"):
|
||||
@@ -108,34 +132,78 @@ def next_intake(answers: dict, policy: IntakePolicy, sex: str | None) -> Questio
|
||||
return None
|
||||
|
||||
|
||||
def diary_questions(
|
||||
modules: list[str], *, suicide_monitoring: bool, weekday: int, day_index: int | None = None
|
||||
) -> tuple[Question, ...]:
|
||||
config = yaml.safe_load((get_settings().config_dir / "instruments/diary.yaml").read_text())
|
||||
selected = ["core"]
|
||||
detailed = [name for name in ("veteran", "depression") if name in modules]
|
||||
if len(detailed) == 2:
|
||||
detailed = [detailed[(day_index if day_index is not None else weekday) % 2]]
|
||||
if "veteran" in detailed:
|
||||
selected.append("ptsd")
|
||||
if "depression" in detailed:
|
||||
selected.append("depression")
|
||||
if suicide_monitoring or "depression" in modules:
|
||||
selected.append("suicide")
|
||||
questions = []
|
||||
for section in selected:
|
||||
for item in config[section]:
|
||||
if item.get("weekly") and weekday != 0:
|
||||
continue
|
||||
questions.append(
|
||||
Question(
|
||||
item["id"],
|
||||
item["text"],
|
||||
tuple((o["value"], o["label"]) for o in item.get("options", [])),
|
||||
"past_week" if item.get("weekly") else "past_day",
|
||||
item.get("numeric", False),
|
||||
item.get("optional", False),
|
||||
def cssrs_since_contact_question(answers: dict) -> Question | None:
|
||||
"""Daily suicide-risk module of stage 2: the C-SSRS screener asked «since the last contact».
|
||||
|
||||
The official Russian Since Last Contact form is not in the repository yet (docs/clinical/README.md, C06), so the
|
||||
items of the Recent form are asked verbatim under the since-last-contact period. Behaviour since the last contact
|
||||
is recent by definition: the answer to q6 also fills q6_recent (derived), so the recent triage applies.
|
||||
"""
|
||||
c = score_cssrs_recent(cssrs_answers(answers))
|
||||
missing = [k for k in c.missing if k != "q6_recent"]
|
||||
if not missing:
|
||||
return None
|
||||
form = load_cssrs_russian()
|
||||
item = next(i for i in form.items if i.id == missing[0])
|
||||
return Question(
|
||||
"cssrs_" + item.id,
|
||||
texts()["periods"]["since_last_contact"] + "\n\n" + item.text,
|
||||
tuple((o.value, o.label) for o in form.options),
|
||||
"since_last_contact",
|
||||
)
|
||||
|
||||
|
||||
DIARY_PARTS = ("morning", "evening")
|
||||
DIARY_KINDS = ("diary_morning", "diary_evening")
|
||||
|
||||
|
||||
def diary_config() -> dict:
|
||||
return yaml.safe_load((get_settings().config_dir / "instruments/diary.yaml").read_text(encoding="utf-8"))
|
||||
|
||||
|
||||
def diary_questions(part: str, modules: list[str], *, day_index: int = 0) -> tuple[Question, ...]:
|
||||
"""Stage 2 diary of one part of the day: the core block plus, in the evening, the modules of the profile.
|
||||
|
||||
PTSD («veteran») and depression run side by side when both are present. The depression module asks three
|
||||
PHQ-9 items a day in rotation by `day_index` (days since the first diary). Ids are prefixed (`dphq_`, `dpcl_`)
|
||||
so diary answers never mix with the full scales.
|
||||
"""
|
||||
if part not in DIARY_PARTS:
|
||||
raise ValueError("unknown diary part")
|
||||
config = diary_config()
|
||||
questions = [
|
||||
Question(
|
||||
item["id"],
|
||||
item["text"],
|
||||
tuple((o["value"], o["label"]) for o in item.get("options", [])),
|
||||
"past_day",
|
||||
item.get("numeric", False),
|
||||
item.get("optional", False),
|
||||
item.get("max", 24),
|
||||
)
|
||||
for item in config[part]
|
||||
]
|
||||
if part == "evening":
|
||||
forms = content()["forms"]
|
||||
if "depression" in modules:
|
||||
module = config["depression"]
|
||||
items = forms[module["form"]]["items"]
|
||||
per_day = module["items_per_day"]
|
||||
start = (day_index % (len(items) // per_day)) * per_day
|
||||
options = tuple((o["value"], o["label"]) for o in module["options"])
|
||||
for item in items[start : start + per_day]:
|
||||
number = item["id"].rsplit("_", 1)[1]
|
||||
questions.append(
|
||||
Question(f"dphq_{number}", module["question"] + "\n\n" + item["text"], options, "today")
|
||||
)
|
||||
if "veteran" in modules:
|
||||
module = config["ptsd"]
|
||||
form = forms[module["form"]]
|
||||
by_id = {i["id"]: i["text"] for i in form["items"]}
|
||||
options = tuple((o["value"], o["label"]) for o in form["options"])
|
||||
for item_id in module["items"]:
|
||||
number = item_id.rsplit("_", 1)[1]
|
||||
questions.append(
|
||||
Question(f"dpcl_{number}", module["question"] + "\n\n" + by_id[item_id], options, "today")
|
||||
)
|
||||
)
|
||||
questions.sort(key=lambda q: q.id != "death_thoughts")
|
||||
return tuple(questions)
|
||||
|
||||
+82
-30
@@ -10,7 +10,7 @@ import yaml
|
||||
from pydantic import BaseModel, ConfigDict, Field, model_validator
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.questionnaire import Approval, load_policy
|
||||
from app.core.questionnaire import Approval, demo_mode, load_policy
|
||||
|
||||
|
||||
class RuntimePolicy(BaseModel):
|
||||
@@ -21,13 +21,20 @@ class RuntimePolicy(BaseModel):
|
||||
content_review: Approval | None = None
|
||||
contact_review: Approval | None = None
|
||||
timezone: str
|
||||
daily_hour: int = Field(ge=0, le=23)
|
||||
mood_baseline_days: int = Field(ge=2)
|
||||
mood_bad_days: int = Field(ge=1)
|
||||
mood_drop: int = Field(ge=1, le=10)
|
||||
morning_hour: int = Field(ge=0, le=23)
|
||||
evening_hour: int = Field(ge=0, le=23)
|
||||
norm_days: int = Field(ge=2)
|
||||
week_days: int = Field(ge=2)
|
||||
min_norm_values: int = Field(ge=1)
|
||||
min_week_values: int = Field(ge=1)
|
||||
mood_drop: float = Field(gt=0, le=10)
|
||||
depression_item_rise: float = Field(gt=0, le=3)
|
||||
ptsd_sum_rise: float = Field(gt=0, le=16)
|
||||
sleep_bad_days: int = Field(ge=1)
|
||||
sleep_hours_below: float = Field(gt=0, le=24)
|
||||
nightmares_at: int = Field(ge=0, le=4)
|
||||
alcohol_heavy_portions: float = Field(gt=0)
|
||||
alcohol_heavy_days: int = Field(ge=1)
|
||||
adherence_below: float = Field(gt=0, le=1)
|
||||
missed_medication_days: int = Field(ge=1)
|
||||
high_risk_silence_days: int = Field(ge=1)
|
||||
medication_days: tuple[int, ...]
|
||||
@@ -44,6 +51,8 @@ class RuntimePolicy(BaseModel):
|
||||
set(row) != {"phq9", "pcl5"} for row in self.route_intervals.values()
|
||||
):
|
||||
raise ValueError("all route and scale intervals must be defined")
|
||||
if self.morning_hour >= self.evening_hour:
|
||||
raise ValueError("the morning diary must come before the evening one")
|
||||
if not self.medication_days or tuple(sorted(set(self.medication_days))) != self.medication_days:
|
||||
raise ValueError("medication days must be nonempty and strictly increasing")
|
||||
if self.medication_days[0] < 1 or any(v < 1 for row in self.route_intervals.values() for v in row.values()):
|
||||
@@ -64,8 +73,17 @@ def load_runtime(path: Path | None = None) -> RuntimePolicy:
|
||||
return RuntimePolicy.model_validate(yaml.safe_load(path.read_text()))
|
||||
|
||||
|
||||
def demo_intake() -> bool:
|
||||
"""Demo-only switch (INTAKE_DEMO=1 with the virtual clock): shows the questionnaires on synthetic data.
|
||||
|
||||
It never touches the clinical release gate in config/intake_runtime.yaml; production runs keep the forms off
|
||||
until the approvals are recorded there.
|
||||
"""
|
||||
return demo_mode()
|
||||
|
||||
|
||||
def intake_enabled() -> bool:
|
||||
return load_runtime().released and load_policy().approval is not None
|
||||
return (load_runtime().released and load_policy().approval is not None) or demo_intake()
|
||||
|
||||
|
||||
def month_before(day: date, months: int = 1) -> date:
|
||||
@@ -115,39 +133,73 @@ def due_scales(
|
||||
return tuple(sorted(due))
|
||||
|
||||
|
||||
def diary_flags(history: dict[date, dict], today: date, policy: RuntimePolicy | None = None) -> tuple[str, ...]:
|
||||
"""Consecutive calendar dates; missing data never become zero or missed doses.
|
||||
def _mean(values: list[float]) -> float:
|
||||
return sum(values) / len(values)
|
||||
|
||||
Baseline is the seven dates BEFORE the three-day deterioration window;
|
||||
every baseline value is required. Nightmares OR short sleep must hold on
|
||||
each of three nights. These candidate definitions require signed review.
|
||||
|
||||
def diary_flags(
|
||||
history: dict[date, dict],
|
||||
today: date,
|
||||
policy: RuntimePolicy | None = None,
|
||||
*,
|
||||
medication_active: bool = False,
|
||||
) -> tuple[str, ...]:
|
||||
"""Stage 2 diary flags («Этап 2», p.4): weekly means against the personal norm, never single days.
|
||||
|
||||
`history` holds the merged morning + evening answers per date. The norm is the first `norm_days` of
|
||||
observation; trends are checked only after it. Missing data never become zero or missed doses.
|
||||
"""
|
||||
p = policy or load_runtime()
|
||||
flags = []
|
||||
flags: list[str] = []
|
||||
current = history.get(today, {})
|
||||
if current.get("death_thoughts") == 1:
|
||||
flags.append("suicide_assessment_now")
|
||||
recent = [history.get(today - timedelta(days=i), {}) for i in range(p.mood_bad_days)]
|
||||
baseline = [
|
||||
history.get(today - timedelta(days=i), {}).get("mood")
|
||||
for i in range(p.mood_bad_days, p.mood_bad_days + p.mood_baseline_days)
|
||||
]
|
||||
if all(x is not None for x in baseline) and all(x.get("mood") is not None for x in recent):
|
||||
mean = sum(baseline) / len(baseline)
|
||||
if all(mean - x["mood"] >= p.mood_drop for x in recent):
|
||||
flags.append("phq9_due_mood")
|
||||
start = min(history) if history else today
|
||||
norm = [history[d] for d in sorted(history) if (d - start).days < p.norm_days]
|
||||
week_start = today - timedelta(days=p.week_days - 1)
|
||||
week = [history[d] for d in sorted(history) if week_start <= d <= today]
|
||||
trend = (week_start - start).days >= p.norm_days
|
||||
|
||||
def values(rows: list[dict], key) -> list[float]:
|
||||
return [v for r in rows if (v := key(r)) is not None]
|
||||
|
||||
def risen(key, by: float, *, min_norm: int, min_week: int, drop: bool = False) -> bool:
|
||||
before, now = values(norm, key), values(week, key)
|
||||
if not trend or len(before) < min_norm or len(now) < min_week:
|
||||
return False
|
||||
change = _mean(before) - _mean(now) if drop else _mean(now) - _mean(before)
|
||||
return change >= by
|
||||
|
||||
if risen(lambda r: r.get("mood"), p.mood_drop, min_norm=p.min_norm_values, min_week=p.min_week_values, drop=True):
|
||||
flags.append("phq9_due_mood")
|
||||
# Depression module: each PHQ-9 item comes every third day, so a weekly mean has ~2 values per item.
|
||||
for item in range(1, 10):
|
||||
if risen(lambda r, i=item: r.get(f"dphq_{i}"), p.depression_item_rise, min_norm=2, min_week=2):
|
||||
flags.append("phq9_due_depression")
|
||||
break
|
||||
# PTSD module: only the sum of the four items is interpreted, never single clusters.
|
||||
ptsd_items = ("dpcl_1", "dpcl_7", "dpcl_10", "dpcl_18")
|
||||
|
||||
def ptsd_sum(r):
|
||||
return sum(r[k] for k in ptsd_items) if all(k in r for k in ptsd_items) else None
|
||||
|
||||
if risen(ptsd_sum, p.ptsd_sum_rise, min_norm=p.min_norm_values, min_week=p.min_week_values):
|
||||
flags.append("pcl5_due_ptsd")
|
||||
nights = [history.get(today - timedelta(days=i), {}) for i in range(p.sleep_bad_days)]
|
||||
if all(
|
||||
(r.get("nightmares") is not None and r["nightmares"] >= p.nightmares_at)
|
||||
or (r.get("sleep_hours") is not None and r["sleep_hours"] < p.sleep_hours_below)
|
||||
(r.get("sleep_hours") is not None and r["sleep_hours"] < p.sleep_hours_below) or r.get("sleep_quality") == 0
|
||||
for r in nights
|
||||
):
|
||||
flags.append("sleep_review")
|
||||
heavy = [r for r in week if (r.get("alcohol_portions") or 0) >= p.alcohol_heavy_portions]
|
||||
if medication_active and (current.get("alcohol_portions") or 0) >= p.alcohol_heavy_portions:
|
||||
flags.append("alcohol_on_medication")
|
||||
if len(heavy) >= p.alcohol_heavy_days:
|
||||
flags.append("rus_audit_due_alcohol")
|
||||
doses = [history.get(today - timedelta(days=i), {}) for i in range(p.missed_medication_days)]
|
||||
if all(r.get("medication") == "none" for r in doses):
|
||||
if all(r.get("medication") == "no" for r in doses):
|
||||
flags.append("medication_contact")
|
||||
if current.get("side_effects") == 1:
|
||||
taken = [r["medication"] for r in week if r.get("medication") in ("yes", "no")]
|
||||
if len(taken) >= p.min_week_values and taken.count("yes") / len(taken) < p.adherence_below:
|
||||
flags.append("adherence_review")
|
||||
if current.get("medication_reason") == "side_effects":
|
||||
flags.append("side_effects_review")
|
||||
if current.get("medication") == "partial":
|
||||
flags.append("partial_medication_review")
|
||||
return tuple(flags)
|
||||
|
||||
@@ -0,0 +1,166 @@
|
||||
"""Patient-facing interpretation of questionnaire results: deterministic rules, texts from config/texts/results.yaml.
|
||||
|
||||
Stage 1 («Опросники для MVP»): screening levels per scale → a preliminary conclusion and the diary modules of stage 2.
|
||||
Stage 2 («Этап 2»): full scales on schedule (level + change: response, remission, worsening) and diary flags.
|
||||
Nothing here diagnoses: the conclusion is a screening result, the diagnosis is the doctor's (ADR-007, guardrail 3).
|
||||
"""
|
||||
|
||||
from typing import Any
|
||||
|
||||
import yaml
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.intake_questions import content
|
||||
from app.core.questionnaire import IntakeDecision, IntakePolicy
|
||||
from app.core.safety import fill_phones
|
||||
|
||||
# Stage 1 finding → diary module of stage 2 (PTSD is the «veteran» module of the profile).
|
||||
FINDING_MODULE = {"depression_suspected": "depression", "ptsd_suspected": "veteran"}
|
||||
# Remission and improvement cut-offs of the full scales («Этап 2», p.5: Kroenke 2001; Marx et al., 2022).
|
||||
PHQ9_REMISSION_BELOW = 5
|
||||
PHQ9_IMPROVED_BY = 5
|
||||
PCL5_RESPONSE_BY = 10
|
||||
PCL5_IMPROVED_BELOW = 28
|
||||
|
||||
|
||||
def texts() -> dict[str, Any]:
|
||||
return yaml.safe_load(fill_phones((get_settings().config_dir / "texts/results.yaml").read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
def render(interpretation: dict[str, Any]) -> str:
|
||||
"""Plain text of an interpretation for the dialog reply (title, lines, then the disclaimer if any)."""
|
||||
parts = [interpretation["title"], *interpretation.get("lines", [])]
|
||||
if interpretation.get("disclaimer"):
|
||||
parts.append(interpretation["disclaimer"])
|
||||
return "\n\n".join(p for p in parts if p)
|
||||
|
||||
|
||||
def _alcohol_zone(totals: dict) -> int | None:
|
||||
full, short = totals.get("rus_audit") or {}, totals.get("rus_audit_s") or {}
|
||||
return full.get("zone") if full.get("complete") else short.get("zone")
|
||||
|
||||
|
||||
def intake_findings(totals: dict, answers: dict, policy: IntakePolicy) -> list[str]:
|
||||
"""Screening findings of stage 1, in the order they are shown."""
|
||||
found = []
|
||||
phq = totals.get("phq9") or {}
|
||||
if phq.get("complete"):
|
||||
if phq["total"] >= policy.phq9_specialist_at:
|
||||
found.append("depression_suspected")
|
||||
elif phq["total"] >= policy.phq9_psychologist_at:
|
||||
found.append("depression_mild")
|
||||
pcl, tsq = totals.get("pcl5") or {}, totals.get("tsq") or {}
|
||||
if pcl.get("complete") and pcl["total"] >= policy.pcl5_specialist_at:
|
||||
found.append("ptsd_suspected")
|
||||
elif answers.get("trauma") == 1 and tsq.get("complete") and tsq["total"] >= policy.tsq_expand_at:
|
||||
found.append("ptsd_signs")
|
||||
zone = _alcohol_zone(totals)
|
||||
if zone == 4:
|
||||
found.append("alcohol_high")
|
||||
elif zone in (2, 3):
|
||||
found.append("alcohol_risky")
|
||||
if (totals.get("cssrs_recent") or {}).get("risk") == "low":
|
||||
found.append("suicide_low")
|
||||
if answers.get("tbi") == 1:
|
||||
found.append("tbi")
|
||||
return found
|
||||
|
||||
|
||||
def intake_interpretation(totals: dict, answers: dict, decision: IntakeDecision, policy: IntakePolicy) -> dict:
|
||||
t = texts()
|
||||
found = intake_findings(totals, answers, policy)
|
||||
modules = [FINDING_MODULE[f] for f in found if f in FINDING_MODULE]
|
||||
head = t["intake"]["attention" if found else "ok"]
|
||||
lines = [head["text"]]
|
||||
lines += [f"{t['findings'][f]['title']}. {t['findings'][f]['text']}" for f in found]
|
||||
if decision.primary_route in t["routes"]:
|
||||
lines.append(t["routes"][decision.primary_route])
|
||||
names = ", ".join(t["modules"]["names"][m] for m in modules)
|
||||
lines.append(t["modules"]["diary"].format(modules=t["modules"]["with"].format(names=names) if names else ""))
|
||||
return {
|
||||
"kind": "intake",
|
||||
"title": head["title"],
|
||||
"lines": lines,
|
||||
"codes": found or ["ok"],
|
||||
"findings": [{"code": f, "title": t["findings"][f]["title"]} for f in found],
|
||||
"route": decision.primary_route,
|
||||
"modules": modules,
|
||||
"disclaimer": t["disclaimer"],
|
||||
}
|
||||
|
||||
|
||||
def _phq9_level(total: int) -> str:
|
||||
band = next(b for b in content()["forms"]["phq9"]["severity"] if b["min"] <= total <= b["max"])
|
||||
return band["code"]
|
||||
|
||||
|
||||
def scale_interpretation(
|
||||
kind: str,
|
||||
totals: dict,
|
||||
*,
|
||||
baseline: int | None,
|
||||
previous: int | None,
|
||||
policy: IntakePolicy,
|
||||
retriage_delta: int,
|
||||
) -> dict:
|
||||
"""A scheduled full scale: level, then the change against the start of observation and the last measurement."""
|
||||
t = texts()["scales"]
|
||||
if kind == "rus_audit_s":
|
||||
zone = _alcohol_zone(totals)
|
||||
result = totals.get("rus_audit") if (totals.get("rus_audit") or {}).get("complete") else totals["rus_audit_s"]
|
||||
level = t[kind]["levels"][f"zone_{zone}" if zone else "unknown"]
|
||||
line = t["score"].format(title=t[kind]["title"], total=result.get("total"), level=level)
|
||||
return {
|
||||
"kind": kind,
|
||||
"title": t[kind]["title"],
|
||||
"lines": [line],
|
||||
"codes": [f"zone_{zone}" if zone else "unknown"],
|
||||
}
|
||||
total = totals[kind]["total"]
|
||||
pcl5_level = "probable" if total >= policy.pcl5_specialist_at else "below"
|
||||
code = _phq9_level(total) if kind == "phq9" else pcl5_level
|
||||
lines = [t["score"].format(title=t[kind]["title"], total=total, level=t[kind]["levels"][code])]
|
||||
change = None
|
||||
if previous is not None and total - previous >= retriage_delta:
|
||||
change = "worse"
|
||||
elif baseline is not None:
|
||||
if kind == "phq9":
|
||||
if total < PHQ9_REMISSION_BELOW:
|
||||
change = "remission"
|
||||
elif baseline > 0 and total <= baseline / 2:
|
||||
change = "response"
|
||||
elif baseline - total >= PHQ9_IMPROVED_BY:
|
||||
change = "improved"
|
||||
else:
|
||||
change = "stable"
|
||||
else:
|
||||
if baseline - total >= PCL5_RESPONSE_BY:
|
||||
change = "response"
|
||||
elif total < PCL5_IMPROVED_BELOW <= baseline:
|
||||
change = "improved"
|
||||
else:
|
||||
change = "stable"
|
||||
if change:
|
||||
lines.append(t["change"][change])
|
||||
return {"kind": kind, "title": t[kind]["title"], "lines": lines, "codes": [code, *([change] if change else [])]}
|
||||
|
||||
|
||||
def diary_interpretation(part: str, flags: tuple[str, ...] | list[str]) -> dict:
|
||||
t = texts()["diary"]
|
||||
shown = [f for f in flags if f in t["flags"]]
|
||||
return {
|
||||
"kind": f"diary_{part}",
|
||||
"title": t["saved"].format(part=t["parts"][part]),
|
||||
"lines": [t["flags"][f] for f in shown],
|
||||
"codes": list(flags),
|
||||
}
|
||||
|
||||
|
||||
def cssrs_interpretation(risk: str | None) -> dict:
|
||||
t = texts()["cssrs"]
|
||||
return {
|
||||
"kind": "cssrs_since_contact",
|
||||
"title": t["low" if risk == "low" else "none"],
|
||||
"lines": [],
|
||||
"codes": [risk or "none"],
|
||||
}
|
||||
@@ -0,0 +1,35 @@
|
||||
"""Drug reference of the medication module (data/meds/meds_reference.json, built by scripts/build_meds_reference.py).
|
||||
|
||||
Read-only patient information collected from the Minzdrav clinical guidelines: when to expect the effect, how long
|
||||
the course lasts, common side effects, red flags. It never suggests a drug or a dose — the app only follows the
|
||||
doctor's prescription. Draft until reviewed by a psychiatrist (`status` in the file).
|
||||
"""
|
||||
|
||||
import json
|
||||
from functools import lru_cache
|
||||
from typing import Any, Literal
|
||||
|
||||
from app.config import get_settings
|
||||
|
||||
Indication = Literal["depression", "ptsd"]
|
||||
|
||||
|
||||
@lru_cache(maxsize=1)
|
||||
def load_reference() -> dict[str, Any]:
|
||||
path = get_settings().data_dir / "meds" / "meds_reference.json"
|
||||
return json.loads(path.read_text(encoding="utf-8"))
|
||||
|
||||
|
||||
def find_drug(name: str) -> dict[str, Any] | None:
|
||||
"""Reference entry for a prescription's drug (INN in Russian or the latin id), or None if it is not covered."""
|
||||
key = name.strip().split()[0].casefold() if name.strip() else ""
|
||||
for drug in load_reference()["drugs"]:
|
||||
if key in (drug["id"], drug["name_ru"].casefold()):
|
||||
return drug
|
||||
return None
|
||||
|
||||
|
||||
def indication_for(modules: list[str], drug: dict[str, Any]) -> Indication | None:
|
||||
"""The indication the patient is followed for, among those the drug has in the guidelines."""
|
||||
preferred: list[Indication] = ["ptsd", "depression"] if "veteran" in modules else ["depression", "ptsd"]
|
||||
return next((i for i in preferred if i in drug["indications"]), None)
|
||||
@@ -8,6 +8,7 @@ the returned status. Pending clinical policy never authorizes routine continuati
|
||||
|
||||
from __future__ import annotations
|
||||
|
||||
import os
|
||||
from dataclasses import dataclass
|
||||
from datetime import datetime
|
||||
from pathlib import Path
|
||||
@@ -49,7 +50,6 @@ class IntakePolicy(BaseModel):
|
||||
phq9_specialist_at: int = Field(ge=0, le=27, strict=True)
|
||||
phq9_priority_at: int = Field(ge=0, le=27, strict=True)
|
||||
pcl5_specialist_at: int = Field(ge=0, le=80, strict=True)
|
||||
pcl5_priority_at: int = Field(ge=0, le=80, strict=True)
|
||||
pcl5_behavior_flag_at: int = Field(ge=0, le=4, strict=True)
|
||||
|
||||
@model_validator(mode="after")
|
||||
@@ -64,13 +64,20 @@ class IntakePolicy(BaseModel):
|
||||
raise ValueError("choose a total threshold OR a zone for alcohol expansion")
|
||||
if not self.phq9_psychologist_at < self.phq9_specialist_at < self.phq9_priority_at:
|
||||
raise ValueError("PHQ-9 thresholds must be ordered")
|
||||
if self.pcl5_specialist_at >= self.pcl5_priority_at:
|
||||
raise ValueError("PCL-5 thresholds must be ordered")
|
||||
return self
|
||||
|
||||
|
||||
def demo_mode() -> bool:
|
||||
"""Demo-only switch (INTAKE_DEMO=1 with the virtual clock): questionnaires on synthetic data.
|
||||
|
||||
It selects `config/questionnaire_demo.yaml` (marked as NOT a clinical approval) instead of the real policy; the
|
||||
real policy and the release gate in config/intake_runtime.yaml are never touched.
|
||||
"""
|
||||
return os.environ.get("INTAKE_DEMO", "").lower() in ("1", "true", "yes") and get_settings().demo_clock
|
||||
|
||||
|
||||
def load_policy(path: Path | None = None) -> IntakePolicy:
|
||||
path = path or get_settings().config_dir / "questionnaire.yaml"
|
||||
path = path or get_settings().config_dir / ("questionnaire_demo.yaml" if demo_mode() else "questionnaire.yaml")
|
||||
return IntakePolicy.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
@@ -266,7 +273,9 @@ def evaluate_intake(
|
||||
if c.positive:
|
||||
flags.append("cssrs_positive")
|
||||
flags.extend(c.conflicts)
|
||||
if item9_positive or c.risk_lower_bound == "high":
|
||||
# One crisis rule (ADR-013): a high C-SSRS risk. Item 9 alone is a crisis only while the screener is not complete;
|
||||
# with a negative / low screener it is the «discrepancy» flag of the routing table, not the crisis screen.
|
||||
if c.risk_lower_bound == "high" or (item9_positive and not c.complete):
|
||||
return IntakeDecision(policy.version, "crisis", "crisis", (), tuple(flags), c.missing)
|
||||
if c.positive and policy.approval and policy.cssrs_positive_policy == "stop_any":
|
||||
return IntakeDecision(policy.version, "crisis", "crisis", (), tuple(flags), c.missing)
|
||||
@@ -317,9 +326,11 @@ def evaluate_intake(
|
||||
# PHQ-2-negative does not invent a PHQ-9 total; it simply does not trigger expansion.
|
||||
phq_total = phq.total if phq.complete else 0
|
||||
pcl_total = pcl.total if pcl.complete else 0
|
||||
# Risk and flags first, scales second (clinical review 2026-10-04). A high PCL-5 alone is not a reason for a
|
||||
# priority appointment: it goes to the planned specialist route.
|
||||
if c.risk == "moderate":
|
||||
primary = "urgent_psychiatrist"
|
||||
elif phq_total >= policy.phq9_priority_at or pcl_total >= policy.pcl5_priority_at:
|
||||
elif phq_total >= policy.phq9_priority_at:
|
||||
primary = "priority_psychiatrist"
|
||||
elif phq_total >= policy.phq9_specialist_at or pcl_total >= policy.pcl5_specialist_at:
|
||||
primary = "psychiatrist_or_psychotherapist"
|
||||
|
||||
@@ -395,6 +395,25 @@ def _crisis_cfg(path: Path = CRISIS_PATH) -> _CrisisCfg:
|
||||
return _CrisisCfg.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
_PHONE_REF = re.compile(r"\{phone:([a-z_]+)\}")
|
||||
|
||||
|
||||
def fill_phones(text: str, path: Path = CRISIS_PATH) -> str:
|
||||
"""Replace `{phone:<resource>}` with the number from the single table in config/texts/crisis.yaml.
|
||||
|
||||
Every patient text and prompt refers to the table instead of repeating a number, so a number is changed in one
|
||||
place. An unknown resource fails loudly: a wrong number on the crisis screen must never pass silently.
|
||||
"""
|
||||
resources = _crisis_cfg(path).resources
|
||||
|
||||
def number(m: re.Match[str]) -> str:
|
||||
if m.group(1) not in resources:
|
||||
raise ValueError(f"unknown crisis resource {m.group(1)!r}")
|
||||
return resources[m.group(1)].phone
|
||||
|
||||
return _PHONE_REF.sub(number, text)
|
||||
|
||||
|
||||
def _render(body: str, resources: list[CrisisResource], doctor_notified: str, grounding: str) -> str:
|
||||
lines = [body.strip(), ""]
|
||||
for r in resources:
|
||||
|
||||
@@ -5,6 +5,8 @@ The only module (besides registration code) that touches both schemas — and on
|
||||
|
||||
from app.db import audit as _audit # noqa: F401 (registers audit_log in clinical metadata)
|
||||
from app.db import intake as _intake # noqa: F401
|
||||
from app.db import max_notifications as _max_notifications # noqa: F401
|
||||
from app.db import scheduler as _scheduler # noqa: F401
|
||||
from app.db.clinical import ClinicalBase
|
||||
from app.db.identity import IdentityBase
|
||||
from app.db.session import clinical_engine, identity_engine
|
||||
|
||||
@@ -192,3 +192,12 @@ class ClockState(ClinicalBase):
|
||||
|
||||
id: Mapped[int] = mapped_column(Integer, primary_key=True)
|
||||
offset_seconds: Mapped[float] = mapped_column(Float, default=0.0)
|
||||
|
||||
|
||||
class DemoSetting(ClinicalBase):
|
||||
"""Presentation switches changed at runtime from the demo console (e.g. the initial screening on/off)."""
|
||||
|
||||
__tablename__ = "demo_settings"
|
||||
|
||||
key: Mapped[str] = mapped_column(String(64), primary_key=True)
|
||||
value: Mapped[Any] = mapped_column(JSONType)
|
||||
|
||||
@@ -0,0 +1,50 @@
|
||||
"""MAX identifiers and delivery metadata live only in the identity DB; no medical message bodies."""
|
||||
|
||||
from datetime import datetime
|
||||
|
||||
from sqlalchemy import BigInteger, Boolean, Integer, String
|
||||
from sqlalchemy.orm import Mapped, mapped_column
|
||||
|
||||
from app.db.identity import IdentityBase
|
||||
from app.db.types import TZDateTime
|
||||
|
||||
|
||||
class MaxBinding(IdentityBase):
|
||||
__tablename__ = "max_bindings"
|
||||
|
||||
# No FK: anonymous web profiles intentionally have no patients row in identity.
|
||||
token: Mapped[str] = mapped_column(String(64), primary_key=True)
|
||||
user_id: Mapped[int] = mapped_column(BigInteger, unique=True)
|
||||
enabled: Mapped[bool] = mapped_column(Boolean, default=True)
|
||||
connected_at: Mapped[datetime] = mapped_column(TZDateTime)
|
||||
|
||||
|
||||
class MaxLinkCode(IdentityBase):
|
||||
__tablename__ = "max_link_codes"
|
||||
|
||||
digest: Mapped[str] = mapped_column(String(64), primary_key=True)
|
||||
token: Mapped[str] = mapped_column(String(64), unique=True)
|
||||
expires_at: Mapped[datetime] = mapped_column(TZDateTime, index=True)
|
||||
used_at: Mapped[datetime | None] = mapped_column(TZDateTime)
|
||||
|
||||
|
||||
class MaxReceipt(IdentityBase):
|
||||
__tablename__ = "max_webhook_receipts"
|
||||
|
||||
digest: Mapped[str] = mapped_column(String(64), primary_key=True)
|
||||
received_at: Mapped[datetime] = mapped_column(TZDateTime, index=True)
|
||||
|
||||
|
||||
class MaxDelivery(IdentityBase):
|
||||
__tablename__ = "max_deliveries"
|
||||
|
||||
id: Mapped[str] = mapped_column(String(64), primary_key=True)
|
||||
token: Mapped[str | None] = mapped_column(String(64), index=True)
|
||||
user_id: Mapped[int] = mapped_column(BigInteger)
|
||||
kind: Mapped[str] = mapped_column(String(24))
|
||||
state: Mapped[str] = mapped_column(String(16), default="queued", index=True)
|
||||
attempts: Mapped[int] = mapped_column(Integer, default=0)
|
||||
created_at: Mapped[datetime] = mapped_column(TZDateTime)
|
||||
next_attempt_at: Mapped[datetime] = mapped_column(TZDateTime, index=True)
|
||||
lease: Mapped[str | None] = mapped_column(String(32))
|
||||
error_code: Mapped[str | None] = mapped_column(String(32))
|
||||
@@ -0,0 +1,24 @@
|
||||
"""Delivery log of the demo scheduler (#13): one row per delivered event, the unique key makes runs idempotent.
|
||||
|
||||
Clinical DB, keyed by token only (guardrail #5). Created by `init_db` (`app.db.bootstrap`).
|
||||
"""
|
||||
|
||||
from datetime import datetime
|
||||
|
||||
from sqlalchemy import String, UniqueConstraint
|
||||
from sqlalchemy.orm import Mapped, mapped_column
|
||||
|
||||
from app.db.clinical import TOKEN_LEN, BigId, ClinicalBase
|
||||
from app.db.types import TZDateTime
|
||||
|
||||
|
||||
class SchedulerEvent(ClinicalBase):
|
||||
__tablename__ = "scheduler_events"
|
||||
__table_args__ = (UniqueConstraint("token", "key", name="uq_scheduler_events_token_key"),)
|
||||
|
||||
id: Mapped[int] = mapped_column(BigId, primary_key=True, autoincrement=True)
|
||||
token: Mapped[str] = mapped_column(String(TOKEN_LEN))
|
||||
key: Mapped[str] = mapped_column(String(96)) # e.g. "dose:3:2026-10-06T08:00", "checkin:2026-10-06"
|
||||
kind: Mapped[str] = mapped_column(String(32)) # med_reminder | missed | daily_checkin | scale_due | evaluation
|
||||
due_at: Mapped[datetime] = mapped_column(TZDateTime)
|
||||
done_at: Mapped[datetime] = mapped_column(TZDateTime)
|
||||
+16
-4
@@ -6,7 +6,7 @@ are ignored here. While a crisis is open only crisis-relevant actions (crisis, s
|
||||
the patient: no medication tips or visit offers in the middle of a crisis.
|
||||
"""
|
||||
|
||||
from collections.abc import Iterable
|
||||
from collections.abc import Awaitable, Callable, Iterable
|
||||
from typing import Any
|
||||
|
||||
from app.core.rules import Action
|
||||
@@ -20,6 +20,16 @@ from app.dialog.scale_session import active_scale, add_pending
|
||||
_MED_INFO_INTENTS = {"delayed_effect": "quit_intent", "alcohol_interaction": "alcohol_info", "nausea": "nausea_info"}
|
||||
_CRISIS_SAFE = {"crisis", "show_safety_plan", "schedule_scale"}
|
||||
|
||||
# Optional `med_info` answerer registered by a flow (`flows/meds.py`, #37): answers from the drug instruction
|
||||
# (med_qa). Returning None falls back to the phrase template below.
|
||||
MedInfoHandler = Callable[[Ctx, Action], Awaitable[Reply | None]]
|
||||
_med_info_handler: MedInfoHandler | None = None
|
||||
|
||||
|
||||
def register_med_info_handler(handler: MedInfoHandler | None) -> None:
|
||||
global _med_info_handler
|
||||
_med_info_handler = handler
|
||||
|
||||
|
||||
def _plan_line(step: Any) -> str:
|
||||
if isinstance(step, dict):
|
||||
@@ -57,9 +67,11 @@ async def execute(ctx: Ctx, actions: Iterable[Action]) -> Step:
|
||||
pending = add_pending(data, scale_id, bool(action.params.get("scheduled", False)))
|
||||
step = step.then(Step(data={"pending_scales": pending}))
|
||||
elif action.type == "med_info":
|
||||
intent = _MED_INFO_INTENTS.get(str(action.params.get("topic")), "default")
|
||||
text = await ctx.gateway.phrase(intent, {})
|
||||
step = step.then(Step(replies=[Reply(text=text, kind="info")]))
|
||||
reply = await _med_info_handler(ctx, action) if _med_info_handler is not None else None
|
||||
if reply is None:
|
||||
intent = _MED_INFO_INTENTS.get(str(action.params.get("topic")), "default")
|
||||
reply = Reply(text=await ctx.gateway.phrase(intent, {}), kind="info")
|
||||
step = step.then(Step(replies=[reply]))
|
||||
elif action.type == "suggest_visit":
|
||||
text = await ctx.gateway.phrase("book_visit_offer", {})
|
||||
button = Button(label=ctx.texts.visit.button, data="menu:visit")
|
||||
|
||||
@@ -14,6 +14,7 @@ Decisions:
|
||||
|
||||
from typing import Any
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.safety import CrisisResource, CrisisScript, crisis_reply
|
||||
from app.dialog.contracts import Reply
|
||||
from app.dialog.fsm import Ctx, Step
|
||||
@@ -37,6 +38,9 @@ def open_crisis(ctx: Ctx, categories: list[str], source: str) -> Step:
|
||||
text = "\n".join([ctx.texts.crisis.repeat, *_resource_lines(script.resources)])
|
||||
return Step(replies=[Reply(text=text, kind="crisis")])
|
||||
crisis = {"open": True, "opened_at": ctx.now.isoformat(), "source": source, "variant": script.variant}
|
||||
if not get_settings().crisis_blocking:
|
||||
# Non-blocking (demo default): the script is shown, the doctor is alerted, the patient keeps going.
|
||||
return Step(replies=[Reply(text=script.text, kind="crisis")], data={"crisis": crisis})
|
||||
return Step(
|
||||
replies=[Reply(text=script.text, kind="crisis")],
|
||||
next_state="crisis",
|
||||
@@ -44,6 +48,10 @@ def open_crisis(ctx: Ctx, categories: list[str], source: str) -> Step:
|
||||
)
|
||||
|
||||
|
||||
def crisis_resource_lines(resources: list[CrisisResource]) -> list[str]:
|
||||
return _resource_lines(resources)
|
||||
|
||||
|
||||
def no_consent_crisis_text(script: CrisisScript) -> str:
|
||||
"""Crisis script without the "doctor notified" line — for people we may not (or did not) notify about."""
|
||||
return "\n".join([script.body, "", *_resource_lines(script.resources), "", script.grounding])
|
||||
|
||||
+123
-4
@@ -2,6 +2,10 @@
|
||||
|
||||
Pipeline for one incoming event (SPEC §3, guardrails #1, #2, #3):
|
||||
|
||||
0. abandoned step the FSM sits in a question step (check-in, scale) the patient left more than
|
||||
`settings.abandon_after_hours` ago → back to idle first (stored answers stay; never in
|
||||
crisis, never in an onboarding chain), then the event is handled as usual.
|
||||
|
||||
text event
|
||||
1. scrub() raw text → ScrubbedText. Raw text is never stored, logged or sent anywhere.
|
||||
2. consent gate no valid consent → no LLM, nothing stored; only the local crisis lexicon runs
|
||||
@@ -24,14 +28,16 @@ Logs carry only the token, states and event codes (guardrail #8).
|
||||
|
||||
import asyncio
|
||||
import logging
|
||||
import re
|
||||
from dataclasses import dataclass, field
|
||||
from datetime import datetime
|
||||
from datetime import datetime, timedelta
|
||||
from typing import Any
|
||||
from weakref import WeakValueDictionary
|
||||
|
||||
from sqlalchemy.exc import InterfaceError, OperationalError
|
||||
from sqlalchemy.ext.asyncio import AsyncSession
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core import clock, safety
|
||||
from app.core.intake_runtime import intake_enabled
|
||||
from app.core.privacy import scrub
|
||||
@@ -42,10 +48,19 @@ from app.db.session import get_clinical_session
|
||||
from app.dialog import scale_session
|
||||
from app.dialog.actions import execute
|
||||
from app.dialog.contracts import Event, Reply, register_engine
|
||||
from app.dialog.crisis import crisis_open, no_consent_crisis_text, open_crisis
|
||||
from app.dialog.crisis import crisis_open, crisis_resource_lines, no_consent_crisis_text, open_crisis
|
||||
from app.dialog.flows import load_flows
|
||||
from app.dialog.flows.core import close_crisis, revoke
|
||||
from app.dialog.fsm import NO_CONSENT_STATES, RESTING_STATES, Ctx, Step, apply_data, enter_hook_for, handler_for
|
||||
from app.dialog.fsm import (
|
||||
NO_CONSENT_STATES,
|
||||
RESTING_STATES,
|
||||
Ctx,
|
||||
Step,
|
||||
apply_data,
|
||||
enter_hook_for,
|
||||
handler_for,
|
||||
is_abandonable,
|
||||
)
|
||||
from app.dialog.texts import DialogTexts, load_dialog_texts
|
||||
from app.llm.gateway import LLMGateway, get_gateway
|
||||
from app.services import questionnaire as intake_service
|
||||
@@ -53,11 +68,23 @@ from app.services.contracts import MonitoringService, get_monitoring
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
LAST_PROMPT = "last_prompt"
|
||||
DEFERRED_CRISIS = "deferred_crisis"
|
||||
QUESTIONNAIRE_PREFIXES = ("scale.", "veteran.onboarding.", "intake.")
|
||||
DEFERRABLE_KINDS = frozenset({"crisis", "safety_plan"})
|
||||
MEDICINE_WORDS = re.compile(
|
||||
r"(лекарств|таблет|препарат|сертралин|пароксетин|флуоксетин|эсциталопрам|антидепрессант|побочк)", re.I
|
||||
)
|
||||
# States with their own free-text handling (idle → flows' `text:idle`; explicit question states).
|
||||
SIDE_ANSWER_SKIP = frozenset({"idle", "kb.question", "meds.question"})
|
||||
FREE_TEXT_PREFIXES = ("daily.", "meds.", "kb.") # steps that expect free text (check-in, side effects, questions)
|
||||
# Enter hooks may chain (scale done → next onboarding state → next scale); a cycle must not hang a request.
|
||||
MAX_ENTER_CHAIN = 8
|
||||
_patient_locks = WeakValueDictionary()
|
||||
# DB unreachable: answer safely instead of failing the channel (connectivity errors only — bugs must surface).
|
||||
_DB_DOWN = (OSError, OperationalError, InterfaceError)
|
||||
# dialog_state.data key: when the patient last acted in (or the FSM entered) the current step — abandon timeout.
|
||||
STEP_AT = "step_at"
|
||||
|
||||
|
||||
@dataclass
|
||||
@@ -109,6 +136,8 @@ class Engine:
|
||||
state_before = ctx.state
|
||||
run = _Run()
|
||||
|
||||
if self._abandoned(ctx):
|
||||
await self._apply(ctx, self._abandon(ctx), run)
|
||||
await self._apply(ctx, await self._route(ctx, event), run)
|
||||
|
||||
if run.notify:
|
||||
@@ -120,12 +149,21 @@ class Engine:
|
||||
|
||||
await self._apply(ctx, await self._start_pending(ctx), run)
|
||||
|
||||
self._defer_crisis_messages(ctx, event, run)
|
||||
|
||||
if _consented(ctx):
|
||||
for reply in run.replies:
|
||||
# Outgoing texts may quote the safety plan (names of relatives) — scrub before storing too.
|
||||
await repo.add_message(
|
||||
session, token=token, direction="out", text=scrub(reply.text), ts=ctx.now, fsm_state=ctx.state
|
||||
)
|
||||
prompt = next((r for r in reversed(run.replies) if r.buttons), None)
|
||||
if prompt is not None and ctx.state not in RESTING_STATES:
|
||||
# Re-shown after an off-script question so the patient (and the web screen) gets the buttons back.
|
||||
ctx.data[LAST_PROMPT] = prompt.model_dump()
|
||||
if event.type != "system" or ctx.state != state_before:
|
||||
# System events the step ignores (reminders inside a scale) do not count as the patient being there.
|
||||
ctx.data[STEP_AT] = ctx.now.isoformat()
|
||||
await self._save_state(ctx)
|
||||
task_id = event.params.get("questionnaire_task")
|
||||
if event.type == "system" and task_id and run.replies:
|
||||
@@ -145,6 +183,39 @@ class Engine:
|
||||
)
|
||||
return run.replies
|
||||
|
||||
def _defer_crisis_messages(self, ctx: Ctx, event: Event, run: _Run) -> None:
|
||||
"""Crisis messages triggered by test answers wait until the questionnaire is over (team decision
|
||||
2026-10-04: let the patient finish the test, then show the crisis message; it blocks nothing). The doctor's
|
||||
alert is not delayed — only the patient-facing message. A typed acute message is never deferred."""
|
||||
if get_settings().crisis_blocking:
|
||||
return # clinical protocol: the crisis takes over immediately
|
||||
if event.type == "button" and ctx.state.startswith(QUESTIONNAIRE_PREFIXES):
|
||||
held = [r for r in run.replies if r.kind in DEFERRABLE_KINDS]
|
||||
if held:
|
||||
run.replies[:] = [r for r in run.replies if r.kind not in DEFERRABLE_KINDS]
|
||||
ctx.data[DEFERRED_CRISIS] = [*(ctx.data.get(DEFERRED_CRISIS) or []), *(r.model_dump() for r in held)]
|
||||
return
|
||||
if ctx.data.get(DEFERRED_CRISIS) and not ctx.state.startswith(QUESTIONNAIRE_PREFIXES):
|
||||
run.replies.extend(Reply.model_validate(r) for r in ctx.data.pop(DEFERRED_CRISIS))
|
||||
|
||||
def _abandoned(self, ctx: Ctx) -> bool:
|
||||
"""The current question step was left unanswered longer than `abandon_after_hours` (app.core.clock)."""
|
||||
if intake_enabled() or not _consented(ctx) or ctx.state in RESTING_STATES or crisis_open(ctx.data):
|
||||
return False
|
||||
hours = ctx.texts.settings.abandon_after_hours
|
||||
last = ctx.data.get(STEP_AT)
|
||||
if not hours or not last or ctx.now - datetime.fromisoformat(last) < timedelta(hours=hours):
|
||||
return False
|
||||
return is_abandonable(ctx)
|
||||
|
||||
def _abandon(self, ctx: Ctx) -> Step:
|
||||
"""Drop the unfinished step's progress (answers already stored in item_responses / daily_checkins stay;
|
||||
an unfinished scale gets no scale_results row) and rest in idle so queued scales may start."""
|
||||
log.info("dialog step abandoned token=%s state=%s", ctx.token, ctx.state)
|
||||
scale_id = scale_session.active_scale(ctx.state)
|
||||
scales = {k: v for k, v in (ctx.data.get("scales") or {}).items() if k != scale_id}
|
||||
return Step(next_state="idle", data={"checkin": None, "scales": scales or None})
|
||||
|
||||
async def _route(self, ctx: Ctx, event: Event) -> Step:
|
||||
consented = _consented(ctx)
|
||||
if event.type == "text":
|
||||
@@ -251,8 +322,47 @@ class Engine:
|
||||
step.notify_monitoring = True
|
||||
return step
|
||||
|
||||
side = await self._side_answer(ctx)
|
||||
if side is not None:
|
||||
return side
|
||||
return await self._dispatch(ctx, event)
|
||||
|
||||
async def _side_answer(self, ctx: Ctx) -> Step | None:
|
||||
"""A question asked in the middle of a questionnaire, a check-in or a crisis is answered right away
|
||||
(agent → guidelines/instruction), then the pending question is shown again with its buttons — the
|
||||
chat never ignores a question. Idle and the explicit question states have their own handlers.
|
||||
In a crisis the answer always carries the emergency contacts; the crisis itself stays open until the
|
||||
doctor acknowledges it, and acute messages never get here (handled above)."""
|
||||
from app.dialog.flows.knowledge import knowledge_answer, looks_like_question
|
||||
|
||||
in_crisis = (crisis_open(ctx.data) or ctx.state == "crisis") and await ctx.monitoring.is_in_crisis(ctx.token)
|
||||
free_text_step = ctx.state in SIDE_ANSWER_SKIP or ctx.state.startswith(FREE_TEXT_PREFIXES)
|
||||
if ctx.text is None or (free_text_step and not in_crisis):
|
||||
return None # idle / check-in / question states parse free text themselves
|
||||
asks = looks_like_question(ctx.text) or bool(MEDICINE_WORDS.search(ctx.text))
|
||||
if asks:
|
||||
answer = await knowledge_answer(ctx, explicit=True)
|
||||
elif in_crisis:
|
||||
# Not a question, but in a crisis every message gets a human reply (with contacts below), never silence.
|
||||
answer = await ctx.gateway.phrase("support")
|
||||
else:
|
||||
return None # e.g. a free-text answer to the current scale item — the step handles it
|
||||
if not answer:
|
||||
return None
|
||||
log.info("dialog side answer token=%s state=%s crisis=%s", ctx.token, ctx.state, in_crisis)
|
||||
replies = [Reply(text=answer)]
|
||||
if in_crisis:
|
||||
script = crisis_reply([])
|
||||
replies.append(
|
||||
Reply(
|
||||
text="\n".join([ctx.texts.crisis.repeat, *crisis_resource_lines(script.resources)]), kind="crisis"
|
||||
)
|
||||
)
|
||||
elif ctx.data.get(LAST_PROMPT):
|
||||
last = Reply.model_validate(ctx.data[LAST_PROMPT])
|
||||
replies.append(last.model_copy(update={"text": f"{ctx.texts.side_answer_return}\n\n{last.text}"}))
|
||||
return Step(replies=replies)
|
||||
|
||||
def _can_screen(self, ctx: Ctx, screen: str) -> bool:
|
||||
if crisis_open(ctx.data) or scale_session.active_scale(ctx.state) == screen:
|
||||
return False
|
||||
@@ -307,10 +417,19 @@ class Engine:
|
||||
if not pending or ctx.state not in RESTING_STATES:
|
||||
return Step()
|
||||
screen = ctx.texts.settings.risk_screen_scale
|
||||
dropped: dict[str, Any] = {}
|
||||
if any(p["scale"] == screen for p in pending) and await scale_session.recent_risk_screen(ctx, screen):
|
||||
# Item 9 / rule phq9_item9 / scale_due asked for a C-SSRS the patient completed within the cooldown:
|
||||
# do not repeat the same suicide screen (#56). Crisis script and alerts are unaffected.
|
||||
log.info("dialog risk screen skipped (cooldown) token=%s", ctx.token)
|
||||
pending = [p for p in pending if p["scale"] != screen]
|
||||
dropped = {"pending_scales": pending or None}
|
||||
if not pending:
|
||||
return Step(data=dropped)
|
||||
if ctx.state == "crisis":
|
||||
pending_screen = [p for p in pending if p["scale"] == screen]
|
||||
if not pending_screen:
|
||||
return Step()
|
||||
return Step(data=dropped)
|
||||
item = pending_screen[0]
|
||||
else:
|
||||
item = pending[0]
|
||||
|
||||
@@ -39,6 +39,7 @@ def menu_reply(ctx: Ctx, text: str | None = None) -> Reply:
|
||||
buttons = [
|
||||
[Button(label=b.checkin, data="menu:checkin")],
|
||||
[Button(label=b.med_question, data="menu:med_question")],
|
||||
[Button(label=b.kb_question, data="menu:kb_question")],
|
||||
[Button(label=b.contact_doctor, data="menu:contact_doctor")],
|
||||
[Button(label=b.revoke, data="consent:revoke")],
|
||||
]
|
||||
@@ -65,11 +66,17 @@ def menu_reply(ctx: Ctx, text: str | None = None) -> Reply:
|
||||
async def onboarding_entry(ctx: Ctx, after: str | None = None) -> str:
|
||||
"""Entry state of the next module onboarding: `"{module}.onboarding.start"` for the first module of the
|
||||
profile (after `after`, if given) that has such a state registered; `"idle"` when none is left."""
|
||||
profile = await ctx.profile()
|
||||
modules = list(profile.modules) if profile is not None and profile.modules else []
|
||||
from app.core.demo_settings import screening_enabled
|
||||
from app.core.intake_runtime import intake_enabled
|
||||
|
||||
if after is None and intake_enabled() and any(m in modules for m in ("veteran", "depression")):
|
||||
if after is None and not await screening_enabled(ctx.session):
|
||||
return "idle" # demo switch: no initial questionnaires, straight to the chat
|
||||
profile = await ctx.profile()
|
||||
modules = list(profile.modules) if profile is not None and profile.modules else []
|
||||
|
||||
# Stage 1 is the same for everyone (ADR-012): it does not depend on modules, which it sets itself — an anonymous
|
||||
# person has no profile at all before it.
|
||||
if after is None and intake_enabled():
|
||||
return "intake.start"
|
||||
if after in modules:
|
||||
modules = modules[modules.index(after) + 1 :]
|
||||
|
||||
+238
-60
@@ -4,12 +4,19 @@ import math
|
||||
from dataclasses import asdict, replace
|
||||
from zoneinfo import ZoneInfo
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core import interpretation
|
||||
from app.core.intake_questions import (
|
||||
DIARY_KINDS,
|
||||
Question,
|
||||
content,
|
||||
cssrs_answers,
|
||||
cssrs_since_contact_question,
|
||||
diary_questions,
|
||||
group_answers,
|
||||
next_intake,
|
||||
red_flag_category,
|
||||
red_flag_triggers,
|
||||
scale_question,
|
||||
texts,
|
||||
)
|
||||
@@ -17,32 +24,36 @@ from app.core.intake_runtime import diary_flags, intake_enabled, load_runtime
|
||||
from app.core.questionnaire import alcohol_expansion, load_policy, score_alcohol, score_cssrs_recent
|
||||
from app.core.scales import load_scale
|
||||
from app.core.types import AlertLevel
|
||||
from app.db import repo
|
||||
from app.db.intake import QuestionnaireRecord, QuestionnaireTask
|
||||
from app.dialog.contracts import Button, Event, Reply
|
||||
from app.dialog.crisis import crisis_open, open_crisis
|
||||
from app.dialog.fsm import Step, on_enter, state, trigger
|
||||
from app.services import questionnaire as service
|
||||
from app.services.followup import schedule_post_crisis_call
|
||||
|
||||
|
||||
def allowed(ctx):
|
||||
return ctx.data.get("consent") is True and ctx.data.get("adult") is True and intake_enabled()
|
||||
|
||||
|
||||
def side_effects_question():
|
||||
"""FIBSER-style tolerability question added to the full scales while a medication is active («Этап 2», p.3)."""
|
||||
return Question("side_effects", texts()["side_effects"], ((1, "Да"), (0, "Нет")), "past_week")
|
||||
|
||||
|
||||
def next_question(row):
|
||||
a = row.answers
|
||||
if row.kind == "intake":
|
||||
return next_intake(a, load_policy(), row.details.get("sex"))
|
||||
if row.kind == "diary":
|
||||
for q in diary_questions(
|
||||
row.details["modules"], suicide_monitoring=row.details["suicide_monitoring"], weekday=row.day.weekday()
|
||||
):
|
||||
if row.kind == "cssrs_since_contact":
|
||||
return cssrs_since_contact_question(a)
|
||||
if row.kind in DIARY_KINDS:
|
||||
part = row.kind.removeprefix("diary_")
|
||||
for q in diary_questions(part, row.details["modules"], day_index=row.details.get("day_index", 0)):
|
||||
if q.id in a:
|
||||
continue
|
||||
if q.id == "medication_reason" and a.get("medication") not in ("partial", "none"):
|
||||
continue
|
||||
if q.id == "side_effects" and a.get("medication") == "not_prescribed":
|
||||
continue
|
||||
if q.id == "thought_intensity" and a.get("death_thoughts") != 1:
|
||||
if q.id == "medication_reason" and a.get("medication") != "no":
|
||||
continue
|
||||
return q
|
||||
return None
|
||||
@@ -63,11 +74,7 @@ def next_question(row):
|
||||
q = replace(q, text=q.text.replace("последний месяц", "последнюю неделю"), period="past_week")
|
||||
return q
|
||||
if row.details.get("medication_active") and "side_effects" not in a:
|
||||
return next(
|
||||
q
|
||||
for q in diary_questions([], suicide_monitoring=False, weekday=row.day.weekday())
|
||||
if q.id == "side_effects"
|
||||
)
|
||||
return side_effects_question()
|
||||
return None
|
||||
|
||||
|
||||
@@ -89,7 +96,7 @@ async def urgent(ctx, row=None, *, code="help_now", categories=None):
|
||||
if profile:
|
||||
profile.enhanced_monitoring = True
|
||||
flags = list(service.decision(row).flags) if row else []
|
||||
if row and (row.answers.get("death_thoughts") == 1 or row.answers.get("phq9_9", 0) > 0):
|
||||
if row and (row.answers.get("dphq_9", 0) > 0 or row.answers.get("phq9_9", 0) > 0):
|
||||
flags.append("cssrs_since_contact_required")
|
||||
if row:
|
||||
await service.finish(ctx, row, "interrupted", extra={"stop_reason": code, "flags": flags})
|
||||
@@ -102,6 +109,7 @@ async def urgent(ctx, row=None, *, code="help_now", categories=None):
|
||||
level=AlertLevel.ACUTE,
|
||||
params={"record_id": row.id if row else None, "flags": flags},
|
||||
)
|
||||
await schedule_post_crisis_call(ctx.session, ctx.token, ctx.now, source="questionnaire:" + code)
|
||||
step = open_crisis(ctx, categories or [], source="questionnaire:" + code)
|
||||
step.data["questionnaire_record"] = None
|
||||
step.data["intake_review_required"] = True
|
||||
@@ -110,6 +118,74 @@ async def urgent(ctx, row=None, *, code="help_now", categories=None):
|
||||
return step
|
||||
|
||||
|
||||
def _defer_urgent(row, code, categories=None):
|
||||
"""Remember the first crisis signal of this questionnaire; the questionnaire goes on (team decision
|
||||
2026-10-04: the crisis message comes at the end and blocks nothing)."""
|
||||
if not row.details.get("pending_urgent"):
|
||||
row.details = {**row.details, "pending_urgent": {"code": code, "categories": categories or []}}
|
||||
|
||||
|
||||
async def _flush_urgent(ctx, row, step):
|
||||
"""Questionnaire over: acute alert + callback for the doctor, then the (non-blocking) crisis message."""
|
||||
pending = (row.details or {}).get("pending_urgent")
|
||||
if not pending or step.next_state == "intake.collect":
|
||||
return step
|
||||
row.details = {**row.details, "pending_urgent": None}
|
||||
code, categories = pending["code"], pending.get("categories") or []
|
||||
profile = await ctx.profile()
|
||||
if profile:
|
||||
profile.enhanced_monitoring = True
|
||||
await service.alert(
|
||||
ctx.session,
|
||||
ctx.token,
|
||||
f"{row.id}:{code}",
|
||||
code,
|
||||
ctx.now,
|
||||
level=AlertLevel.ACUTE,
|
||||
params={"record_id": row.id, "deferred": True},
|
||||
)
|
||||
await schedule_post_crisis_call(ctx.session, ctx.token, ctx.now, source="questionnaire:" + code)
|
||||
crisis = open_crisis(ctx, categories, source="questionnaire:" + code)
|
||||
for reply in crisis.replies:
|
||||
reply.buttons.append([Button(label=ctx.texts.safety_plan.title.rstrip(":"), data="safety_plan")])
|
||||
return step.then(crisis)
|
||||
|
||||
|
||||
async def item9_discrepancy(ctx, row):
|
||||
profile = await ctx.profile()
|
||||
if profile:
|
||||
profile.enhanced_monitoring = True
|
||||
await service.alert(
|
||||
ctx.session,
|
||||
ctx.token,
|
||||
row.id + ":phq9_cssrs_discrepancy",
|
||||
"phq9_cssrs_discrepancy",
|
||||
ctx.now,
|
||||
level=AlertLevel.HIGH,
|
||||
params={"record_id": row.id},
|
||||
)
|
||||
row.details = {**row.details, "item9_flagged": True}
|
||||
|
||||
|
||||
async def item9_assessment(ctx, row):
|
||||
"""Thoughts of death in PHQ-9 item 9 → the C-SSRS screener at once; the screener's level decides (graded)."""
|
||||
await service.alert(
|
||||
ctx.session,
|
||||
ctx.token,
|
||||
row.id + ":item9_assessment",
|
||||
"phq9_item9_cssrs",
|
||||
ctx.now,
|
||||
level=AlertLevel.HIGH,
|
||||
params={"record_id": row.id},
|
||||
)
|
||||
await service.finish(ctx, row, "complete", extra={"stop_reason": "phq9_item9_cssrs"})
|
||||
profile = await ctx.profile()
|
||||
if profile:
|
||||
profile.enhanced_monitoring = True
|
||||
task = await service.queue_task(ctx.session, ctx.token, "cssrs_since_contact", row.id + ":cssrs", ctx.now)
|
||||
return await start(ctx, "cssrs_since_contact", task)
|
||||
|
||||
|
||||
async def manual_review(ctx, row, code):
|
||||
await service.finish(ctx, row, "review_required", extra={"stop_reason": code})
|
||||
await service.alert(
|
||||
@@ -129,11 +205,36 @@ async def manual_review(ctx, row, code):
|
||||
|
||||
|
||||
async def advance(ctx, row):
|
||||
return await _flush_urgent(ctx, row, await _advance(ctx, row))
|
||||
|
||||
|
||||
async def _advance(ctx, row):
|
||||
a = row.answers
|
||||
c = score_cssrs_recent(cssrs_answers(a))
|
||||
policy = load_policy()
|
||||
if a.get("phq9_9", 0) > 0 or a.get("death_thoughts") == 1 or c.risk_lower_bound == "high":
|
||||
return await urgent(ctx, row, code="suicide_signal")
|
||||
# Red flags (asked first): any «Да» stops the questionnaire with the help screen of its category.
|
||||
for item_id, value in a.items():
|
||||
if item_id.startswith("rf_") and value == 1 and red_flag_triggers(item_id):
|
||||
category = red_flag_category(item_id)
|
||||
if get_settings().crisis_blocking: # clinical protocol: stop at once
|
||||
return await urgent(ctx, row, code="red_flag_" + item_id[3:], categories=[category] if category else [])
|
||||
_defer_urgent(row, "red_flag_" + item_id[3:], [category] if category else [])
|
||||
break
|
||||
# One crisis rule for the whole app (ADR-013): the crisis screen opens at a HIGH C-SSRS risk only. Moderate →
|
||||
# stop + psychiatrist (about 24 h); low → flag, safety plan, continue.
|
||||
if c.risk_lower_bound == "high":
|
||||
if get_settings().crisis_blocking:
|
||||
return await urgent(ctx, row, code="suicide_signal")
|
||||
_defer_urgent(row, "suicide_signal")
|
||||
if a.get("dphq_9", 0) > 0 and row.kind in DIARY_KINDS:
|
||||
# Diary depression module, item 9 ≥1 → the C-SSRS right away («Этап 2»); its risk level decides.
|
||||
return await item9_assessment(ctx, row)
|
||||
if a.get("phq9_9", 0) > 0 and not c.complete:
|
||||
# Item 9 without a completed screener (only in a scheduled PHQ-9): assess the risk right away.
|
||||
return await item9_assessment(ctx, row)
|
||||
if a.get("phq9_9", 0) > 0 and not row.details.get("item9_flagged"):
|
||||
# Item 9 ≥1 with a negative / low C-SSRS = discrepancy (routing table): flag to the doctor, safety plan.
|
||||
await item9_discrepancy(ctx, row)
|
||||
if c.positive and policy.cssrs_positive_policy == "stop_any":
|
||||
return await urgent(ctx, row, code="cssrs_positive")
|
||||
if c.conflicts:
|
||||
@@ -153,9 +254,6 @@ async def advance(ctx, row):
|
||||
ctx.now,
|
||||
params={"record_id": row.id},
|
||||
)
|
||||
if row.kind == "cssrs_since_contact":
|
||||
# Recent and Since Last Contact are different instruments. No silent substitution.
|
||||
return await manual_review(ctx, row, "cssrs_since_contact_required")
|
||||
try:
|
||||
q = next_question(row)
|
||||
# Validate preserved short answers against a newly answered full-form item 1.
|
||||
@@ -164,7 +262,7 @@ async def advance(ctx, row):
|
||||
return await manual_review(ctx, row, "answer_conflict")
|
||||
if q:
|
||||
replies = [question_reply(row, q)]
|
||||
if c.complete and c.risk == "low" and not row.details.get("plan_shown"):
|
||||
if ((c.complete and c.risk == "low") or row.details.get("item9_flagged")) and not row.details.get("plan_shown"):
|
||||
from app.dialog.actions import safety_plan_reply
|
||||
|
||||
replies.insert(0, await safety_plan_reply(ctx))
|
||||
@@ -187,6 +285,8 @@ async def advance(ctx, row):
|
||||
extra = {"decision": asdict(result), "totals": service.summary(row)}
|
||||
if a.get("recent_trauma") == 1:
|
||||
extra["recent_trauma"] = True
|
||||
extra["interpretation"] = interpretation.intake_interpretation(extra["totals"], a, result, policy)
|
||||
await apply_modules(ctx, extra["interpretation"]["modules"])
|
||||
if result.primary_route != "self_help" or result.flags or result.parallel_routes or a.get("recent_trauma"):
|
||||
await service.alert(
|
||||
ctx.session,
|
||||
@@ -196,54 +296,71 @@ async def advance(ctx, row):
|
||||
ctx.now,
|
||||
params={"record_id": row.id, **extra},
|
||||
)
|
||||
elif row.kind == "diary":
|
||||
history = {
|
||||
r.day: r.answers
|
||||
for r in await service.records(ctx.session, ctx.token)
|
||||
if r.kind == "diary" and r.status == "complete"
|
||||
}
|
||||
history[row.day] = a
|
||||
flags = diary_flags(history, row.day)
|
||||
elif row.kind == "cssrs_since_contact":
|
||||
extra["totals"] = {"cssrs_recent": asdict(c)}
|
||||
extra["interpretation"] = interpretation.cssrs_interpretation(c.risk)
|
||||
elif row.kind in DIARY_KINDS:
|
||||
# Morning and evening answers of one date form one diary day.
|
||||
history: dict = {}
|
||||
for r in await service.records(ctx.session, ctx.token):
|
||||
if r.kind in DIARY_KINDS and r.status == "complete" and r.id != row.id:
|
||||
history.setdefault(r.day, {}).update(r.answers)
|
||||
history.setdefault(row.day, {}).update(a)
|
||||
flags = diary_flags(history, row.day, medication_active=row.details.get("medication_active", False))
|
||||
extra["flags"] = flags
|
||||
for flag in flags:
|
||||
await service.alert(
|
||||
ctx.session, ctx.token, row.id + ":" + flag, flag, ctx.now, params={"record_id": row.id}
|
||||
)
|
||||
if flag == "phq9_due_mood":
|
||||
await service.queue_task(ctx.session, ctx.token, "phq9", row.id + ":phq9", ctx.now)
|
||||
if flag in DIARY_SCALE_TASKS:
|
||||
sid = DIARY_SCALE_TASKS[flag]
|
||||
await service.queue_task(ctx.session, ctx.token, sid, row.id + ":" + sid, ctx.now)
|
||||
extra["interpretation"] = interpretation.diary_interpretation(row.kind.removeprefix("diary_"), flags)
|
||||
else:
|
||||
extra["totals"] = service.summary(row)
|
||||
runtime = load_runtime()
|
||||
if row.kind in ("phq9", "pcl5"):
|
||||
sid = row.kind
|
||||
total = extra["totals"][sid]["total"]
|
||||
priority = getattr(policy, sid + "_priority_at")
|
||||
# Only PHQ-9 has a priority threshold; PCL-5 alone never makes an appointment a priority.
|
||||
priority = getattr(policy, sid + "_priority_at", None)
|
||||
specialist = getattr(policy, sid + "_specialist_at")
|
||||
extra["route"] = (
|
||||
"priority_psychiatrist"
|
||||
if total >= priority
|
||||
if priority is not None and total >= priority
|
||||
else ("psychiatrist_or_psychotherapist" if total >= specialist else "review_with_treating_clinician")
|
||||
)
|
||||
prior = next(
|
||||
(
|
||||
r
|
||||
for r in reversed(await service.records(ctx.session, ctx.token))
|
||||
if r.id != row.id
|
||||
and r.status == "complete"
|
||||
and r.version == row.version
|
||||
and r.details.get("totals", {}).get(sid, {}).get("complete")
|
||||
and (sid != "pcl5" or r.details.get("weekly_pcl", False) == row.details.get("weekly_pcl", False))
|
||||
),
|
||||
None,
|
||||
)
|
||||
earlier = [
|
||||
r
|
||||
for r in await service.records(ctx.session, ctx.token)
|
||||
if r.id != row.id
|
||||
and r.status == "complete"
|
||||
and r.version == row.version
|
||||
and r.details.get("totals", {}).get(sid, {}).get("complete")
|
||||
and (sid != "pcl5" or r.details.get("weekly_pcl", False) == row.details.get("weekly_pcl", False))
|
||||
]
|
||||
prior = earlier[-1] if earlier else None
|
||||
if prior:
|
||||
change = total - prior.details["totals"][sid]["total"]
|
||||
extra["delta"] = {
|
||||
"baseline_record": prior.id,
|
||||
"value": change,
|
||||
"retriage": change >= getattr(load_runtime(), sid + "_retriage_delta"),
|
||||
"retriage": change >= getattr(runtime, sid + "_retriage_delta"),
|
||||
}
|
||||
extra["interpretation"] = interpretation.scale_interpretation(
|
||||
sid,
|
||||
extra["totals"],
|
||||
baseline=earlier[0].details["totals"][sid]["total"] if earlier else None,
|
||||
previous=prior.details["totals"][sid]["total"] if prior else None,
|
||||
policy=policy,
|
||||
retriage_delta=getattr(runtime, sid + "_retriage_delta"),
|
||||
)
|
||||
if row.kind == "rus_audit_s" and not row.details.get("sex"):
|
||||
return await manual_review(ctx, row, "alcohol_sex_unknown")
|
||||
if row.kind == "rus_audit_s":
|
||||
extra["interpretation"] = interpretation.scale_interpretation(
|
||||
"rus_audit_s", extra["totals"], baseline=None, previous=None, policy=policy, retriage_delta=0
|
||||
)
|
||||
if extra["totals"]["rus_audit"].get("zone") == 4:
|
||||
extra["parallel_routes"] = ["narcologist"]
|
||||
retriage = extra.get("delta", {}).get("retriage", False)
|
||||
@@ -257,15 +374,56 @@ async def advance(ctx, row):
|
||||
params={"record_id": row.id, **extra},
|
||||
)
|
||||
await service.finish(ctx, row, "complete", extra=extra)
|
||||
shown = interpretation.render(extra["interpretation"]) if extra.get("interpretation") else texts()["done"]
|
||||
if row.kind == "cssrs_since_contact" and not await done_today(ctx, "diary_evening"):
|
||||
# The risk questions open the evening diary; continue straight into it.
|
||||
step = await start(ctx, "diary_evening")
|
||||
step.replies.insert(0, Reply(text=shown, kind="info"))
|
||||
return step
|
||||
from app.dialog.flows.core import menu_reply
|
||||
|
||||
replies = [menu_reply(ctx, texts()["done"])]
|
||||
alcohol_total = extra.get("totals", {}).get("rus_audit", {})
|
||||
if alcohol_total.get("zone") in (2, 3):
|
||||
replies.insert(0, Reply(text=texts()["alcohol_advice"], kind="info"))
|
||||
replies = [menu_reply(ctx, shown)]
|
||||
if ((c.complete and c.risk == "low") or row.details.get("item9_flagged")) and not row.details.get("plan_shown"):
|
||||
# The safety plan is never skipped because the risk signal came with the last question.
|
||||
from app.dialog.actions import safety_plan_reply
|
||||
|
||||
replies.insert(0, await safety_plan_reply(ctx))
|
||||
return Step(replies=replies, next_state="idle", data={"questionnaire_record": None})
|
||||
|
||||
|
||||
# Diary flags that bring a full scale forward («Этап 2», p.4).
|
||||
DIARY_SCALE_TASKS = {
|
||||
"phq9_due_mood": "phq9",
|
||||
"phq9_due_depression": "phq9",
|
||||
"pcl5_due_ptsd": "pcl5",
|
||||
"rus_audit_due_alcohol": "rus_audit_s",
|
||||
}
|
||||
|
||||
|
||||
async def apply_modules(ctx, modules):
|
||||
"""Stage 1 result → diary modules of stage 2. Without a doctor the screening defines them; a doctor's modules
|
||||
(diagnosis from ЕМИАС) are kept and only extended."""
|
||||
profile = await ctx.profile()
|
||||
if profile is None:
|
||||
await repo.upsert_profile(ctx.session, token=ctx.token, doctor_id="", modules=list(modules))
|
||||
return
|
||||
current = list(profile.modules or [])
|
||||
merged = [*current, *(m for m in modules if m not in current)] if profile.doctor_id else list(modules)
|
||||
await repo.upsert_profile(ctx.session, token=ctx.token, modules=merged)
|
||||
|
||||
|
||||
def local_day(ctx):
|
||||
return ctx.now.astimezone(ZoneInfo(load_runtime().timezone)).date()
|
||||
|
||||
|
||||
async def done_today(ctx, kind):
|
||||
day = local_day(ctx)
|
||||
return any(
|
||||
r.kind == kind and r.day == day and r.status == "complete"
|
||||
for r in await service.records(ctx.session, ctx.token)
|
||||
)
|
||||
|
||||
|
||||
async def start(ctx, kind="intake", task=None):
|
||||
if not allowed(ctx) or crisis_open(ctx.data):
|
||||
if task:
|
||||
@@ -288,6 +446,8 @@ async def start(ctx, kind="intake", task=None):
|
||||
if task:
|
||||
return Step()
|
||||
return Step(replies=[Reply(text=texts()["review"], kind="info")])
|
||||
# A manual start takes over the scheduled task of the same form, so the task does not stay outstanding.
|
||||
task = task or await service.outstanding_task(ctx.session, ctx.token, kind)
|
||||
row = await service.create_record(ctx, kind, task=task)
|
||||
return await advance(ctx, row)
|
||||
|
||||
@@ -316,14 +476,28 @@ async def checkin(ctx, event):
|
||||
existing = await service.records(ctx.session, ctx.token)
|
||||
if not any(r.kind == "intake" and r.status == "complete" for r in existing):
|
||||
return await start(ctx)
|
||||
day = ctx.now.astimezone(ZoneInfo(load_runtime().timezone)).date()
|
||||
if any(r.kind == "diary" and r.day == day and r.status == "complete" for r in existing):
|
||||
return Step(replies=[Reply(text=texts()["done"], kind="info")])
|
||||
risk_task = await service.queue_task(ctx.session, ctx.token, "cssrs_since_contact", f"cssrs:{day}", ctx.now)
|
||||
if risk_task.status in ("pending", "active"):
|
||||
await service.queue_task(ctx.session, ctx.token, "diary", f"diary:{day}", ctx.now)
|
||||
return await start(ctx, "cssrs_since_contact", risk_task)
|
||||
return await start(ctx, "diary")
|
||||
return await next_diary(ctx)
|
||||
|
||||
|
||||
async def next_diary(ctx):
|
||||
"""The part of today's diary that is still open: morning first, then evening. The evening opens with the C-SSRS
|
||||
«since last contact» when the profile is under suicide-risk monitoring («Этап 2», module of suicide risk)."""
|
||||
day = local_day(ctx)
|
||||
done = {r.kind for r in await service.records(ctx.session, ctx.token) if r.day == day and r.status == "complete"}
|
||||
for kind in DIARY_KINDS:
|
||||
if kind in done:
|
||||
continue
|
||||
profile = await ctx.profile()
|
||||
if kind == "diary_evening" and profile and profile.enhanced_monitoring and "cssrs_since_contact" not in done:
|
||||
risk_task = await service.queue_task(ctx.session, ctx.token, "cssrs_since_contact", f"cssrs:{day}", ctx.now)
|
||||
return await start(ctx, "cssrs_since_contact", risk_task)
|
||||
return await start(ctx, kind)
|
||||
return Step(replies=[Reply(text=texts()["diary_done"], kind="info")])
|
||||
|
||||
|
||||
@trigger("button:diary:next")
|
||||
async def diary_button(ctx, event):
|
||||
return await next_diary(ctx)
|
||||
|
||||
|
||||
@state("intake")
|
||||
@@ -365,12 +539,16 @@ async def collect(ctx, event: Event):
|
||||
elif event.type == "text" and q.numeric:
|
||||
try:
|
||||
value = float(str(ctx.text).replace(",", "."))
|
||||
valid = math.isfinite(value) and 0 <= value <= 24
|
||||
valid = math.isfinite(value) and 0 <= value <= q.maximum
|
||||
except ValueError:
|
||||
pass
|
||||
elif event.type == "text" and q.optional:
|
||||
value, valid = str(ctx.text)[:2000], True
|
||||
if not valid:
|
||||
return Step(replies=[Reply(text=texts()["numeric" if q.numeric else "invalid"]), question_reply(row, q)])
|
||||
hint = "invalid" if not q.numeric else ("numeric_portions" if q.id == "alcohol_portions" else "numeric")
|
||||
return Step(replies=[Reply(text=texts()[hint]), question_reply(row, q)])
|
||||
service.save_answer(row, q, value, ctx.now)
|
||||
if row.kind == "cssrs_since_contact" and q.id == "cssrs_q6_lifetime":
|
||||
# Behaviour since the last contact is recent by definition (see cssrs_since_contact_question).
|
||||
service.save_answer(row, replace(q, id="cssrs_q6_recent"), value, ctx.now, derived=True)
|
||||
return await advance(ctx, row)
|
||||
|
||||
@@ -0,0 +1,107 @@
|
||||
"""Questions about the condition and its treatment → knowledge base of clinical guidelines (#64, RAG #60).
|
||||
|
||||
menu «Вопрос о лечении» ──▶ kb.question (free text) ──▶ rag.answer: KR quote + source, or «уточните у врача»
|
||||
free text in idle that looks like a question (veteran_daily `text:idle`, after the check-in signals and the
|
||||
drug question) ──▶ rag.answer, or the usual support phrase when the KB has no answer
|
||||
|
||||
The engine has already scrubbed the text, checked consent and run the safety check (ACUTE never gets here).
|
||||
Questions about the patient's own drug stay with `med_qa` (instruction only, SPEC §7 п.5); this flow answers
|
||||
general questions from the guidelines, extractively and without doses (`app.llm.rag.qa`). Logs carry codes only.
|
||||
"""
|
||||
|
||||
import logging
|
||||
import re
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, ConfigDict
|
||||
|
||||
from app.config import get_settings
|
||||
from app.dialog.contracts import Event, Reply
|
||||
from app.dialog.flows.core import menu_reply
|
||||
from app.dialog.fsm import Ctx, Step, abandonable, handler_for, state, trigger
|
||||
from app.llm import agent, rag
|
||||
from app.llm.med_qa import DOSE_QUESTION
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
QUESTION_STATE = "kb.question"
|
||||
# `scrub()` placeholders and the punctuation around them: "[NAME], что такое ПТСР?" starts with "что такое".
|
||||
_PLACEHOLDERS = re.compile(r"^(?:\s*\[[A-Z_]+\][\s,.:;!-]*)+")
|
||||
|
||||
|
||||
class KnowledgeTexts(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid", frozen=True)
|
||||
|
||||
prompt: str
|
||||
dose_redirect: str
|
||||
question_starts: list[str]
|
||||
small_talk: list[str]
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_knowledge_texts(path: Path | None = None) -> KnowledgeTexts:
|
||||
path = path or get_settings().config_dir / "texts" / "knowledge.yaml"
|
||||
return KnowledgeTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
@lru_cache
|
||||
def _question_start() -> re.Pattern[str]:
|
||||
starts = sorted(load_knowledge_texts().question_starts, key=len, reverse=True)
|
||||
return re.compile(r"^\s*(?:" + "|".join(re.escape(s) for s in starts) + r")\b", re.IGNORECASE)
|
||||
|
||||
|
||||
@lru_cache
|
||||
def _small_talk() -> re.Pattern[str]:
|
||||
return re.compile(r"\b(?:" + "|".join(re.escape(s) for s in load_knowledge_texts().small_talk) + r")\b", re.I)
|
||||
|
||||
|
||||
def looks_like_question(text: str) -> bool:
|
||||
"""A "?" anywhere or a question word at the start ("что такое флэшбек", "можно ли ..."); small talk
|
||||
("как дела?") is not a question for the knowledge base."""
|
||||
text = _PLACEHOLDERS.sub("", text)
|
||||
if _small_talk().search(text):
|
||||
return False
|
||||
return "?" in text or bool(_question_start().search(text))
|
||||
|
||||
|
||||
async def knowledge_answer(ctx: Ctx, *, explicit: bool) -> str | None:
|
||||
"""KB answer for `ctx.text`. No answer → «уточните у врача» if the patient asked via the menu (`explicit`),
|
||||
`None` otherwise (the caller keeps its own reply, e.g. the support phrase)."""
|
||||
if ctx.text is None:
|
||||
return None
|
||||
if DOSE_QUESTION.search(ctx.text.lower()):
|
||||
log.info("kb: dose question redirected to doctor")
|
||||
return load_knowledge_texts().dose_redirect
|
||||
# Tool-using agent first (RAG + ЕМИАС record + drug-safety check); disabled/failed → extractive RAG below.
|
||||
smart = await agent.answer_chat(ctx.token, ctx.text)
|
||||
if smart is not None:
|
||||
log.info("kb: agent answered provider=%s tools=%s", smart.provider, ",".join(smart.tools))
|
||||
return agent.render(smart)
|
||||
reply = await rag.answer(ctx.text, audience="patient")
|
||||
if reply is not None:
|
||||
log.info("kb: answered docs=%s", ",".join(c.doc for c in reply.citations))
|
||||
return reply.text
|
||||
log.info("kb: no answer explicit=%s", explicit)
|
||||
return rag.fallback_text("patient") if explicit else None
|
||||
|
||||
|
||||
@trigger("button:menu:kb_question")
|
||||
async def _menu_question(ctx: Ctx, event: Event) -> Step:
|
||||
return Step(replies=[Reply(text=load_knowledge_texts().prompt)], next_state=QUESTION_STATE)
|
||||
|
||||
|
||||
@state(QUESTION_STATE)
|
||||
async def _question(ctx: Ctx, event: Event) -> Step:
|
||||
if event.type != "text" or ctx.text is None:
|
||||
# A menu button or a reminder instead of the question: drop the question and let idle handle it.
|
||||
step = Step(next_state="idle")
|
||||
idle = handler_for("idle")
|
||||
return step.then(await idle(ctx, event)) if idle is not None else step
|
||||
text = await knowledge_answer(ctx, explicit=True)
|
||||
return Step(replies=[menu_reply(ctx, text)], next_state="idle")
|
||||
|
||||
|
||||
# A question asked yesterday must not swallow today's message.
|
||||
abandonable("kb")
|
||||
@@ -0,0 +1,477 @@
|
||||
"""Medication flow (#37, case scenario «управление приёмом лекарств»). Module-agnostic: every patient with a
|
||||
prescription gets it, whatever the clinical module.
|
||||
|
||||
system:med_reminder {dose_id, drug, dose}
|
||||
──▶ «Принял» → dose taken, check-in med_taken = true
|
||||
──▶ «Пропущу» → dose skipped, med_taken = false ──▶ reason:
|
||||
забыл / побочки (→ side effects) / решил бросить (quit_intent) / другое
|
||||
──▶ «Есть побочные эффекты» → code buttons (тошнота, бессонница, …) or «Другое» → free text
|
||||
→ check-in side_effects (+ dose.side_effects) → «А препарат сегодня приняли?»
|
||||
menu «Вопрос о лекарстве" ──▶ meds.question (free text) ──▶ med_qa (instruction excerpt) or «уточните у врача»
|
||||
rule action med_info (actions.py hook) ──▶ instruction excerpt for the rule topic + fixed notice
|
||||
|
||||
Everything the patient answers is written to the clinical DB (`doses`, `daily_checkins`) and the step asks the
|
||||
engine to run monitoring (`notify_monitoring`): the rules (lane B, ADR-007) decide alerts and further actions
|
||||
(quit intent → delayed-onset explanation, missed doses → caring contact). Nothing here decides risk.
|
||||
|
||||
Reminder buttons carry the dose they refer to (#56): "med:taken:<ref>", "med:skip:<ref>",
|
||||
"med:side_effects:<ref>" and the follow-up buttons likewise ("med:se:<code>:<ref>", "med:skip_reason:<r>:<ref>",
|
||||
"med:dose:yes:<ref>"), matched by prefix triggers. `<ref>` is the `doses.id` of the reminder or, when there is
|
||||
no dose row (prescription only known to the МИС), the reminder's ISO date. A button of an earlier day's dose is
|
||||
stale (friendly note, nothing recorded); so are the old payload-less buttons ("med:taken") of earlier releases.
|
||||
Check-in answers without a button (daily.med step, free text) go to today's planned dose, if any.
|
||||
"""
|
||||
|
||||
from datetime import date, timedelta
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
from typing import Any
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, ConfigDict
|
||||
from sqlalchemy import select
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.privacy import scrub
|
||||
from app.core.rules import Action
|
||||
from app.db import repo
|
||||
from app.db.clinical import DailyCheckin, Dose
|
||||
from app.db.clinical import Prescription as PrescriptionRow
|
||||
from app.dialog.actions import register_med_info_handler
|
||||
from app.dialog.contracts import Button, Event, Reply
|
||||
from app.dialog.flows.core import menu_reply
|
||||
from app.dialog.fsm import Ctx, Step, abandonable, get_trigger, handler_for, state, trigger, trigger_payload
|
||||
from app.integrations.base import integrations
|
||||
from app.llm import agent
|
||||
from app.llm.med_qa import DOSE_QUESTION, fallback_text, med_qa
|
||||
|
||||
QUESTION_STATE = "meds.question"
|
||||
SIDE_EFFECT_TEXT_STATE = "meds.side_effect_text"
|
||||
# A client sends this button when the person submits a free-text step without writing anything.
|
||||
NO_COMMENT = "text:skip"
|
||||
SIDE_EFFECT_CODES = ("nausea", "insomnia", "headache", "dizziness", "agitation", "other")
|
||||
SKIP_REASONS = ("forgot", "side_effects", "quit", "other")
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- texts
|
||||
|
||||
|
||||
class _Strict(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid", frozen=True)
|
||||
|
||||
|
||||
class ReminderTexts(_Strict):
|
||||
text: str
|
||||
text_no_drug: str
|
||||
taken: str
|
||||
skip: str
|
||||
side_effects: str
|
||||
|
||||
|
||||
class SkipTexts(_Strict):
|
||||
question: str
|
||||
reasons: dict[str, str]
|
||||
ack: dict[str, str]
|
||||
|
||||
|
||||
class SideEffectTexts(_Strict):
|
||||
question: str
|
||||
options: dict[str, str]
|
||||
questions: dict[str, str]
|
||||
describe: str
|
||||
ack: str
|
||||
repeat: str
|
||||
ask_dose: str
|
||||
dose_yes: str
|
||||
dose_no: str
|
||||
|
||||
|
||||
class CheckinMedTexts(_Strict):
|
||||
question: str
|
||||
question_no_drug: str
|
||||
yes: str
|
||||
no: str
|
||||
later: str
|
||||
|
||||
|
||||
class QuestionTexts(_Strict):
|
||||
prompt: str
|
||||
no_prescription: str
|
||||
|
||||
|
||||
class MedInfoTopic(_Strict):
|
||||
section: str # med_qa section code (side_effects | onset | alcohol | ...)
|
||||
question: str
|
||||
lead: str = ""
|
||||
fallback: str
|
||||
notice: str = ""
|
||||
|
||||
|
||||
class MedsTexts(_Strict):
|
||||
status: str
|
||||
reminder: ReminderTexts
|
||||
taken_ack: str
|
||||
stale: str
|
||||
skip: SkipTexts
|
||||
side_effects: SideEffectTexts
|
||||
checkin: CheckinMedTexts
|
||||
question: QuestionTexts
|
||||
med_info: dict[str, MedInfoTopic]
|
||||
|
||||
|
||||
def meds_texts_path() -> Path:
|
||||
return get_settings().config_dir / "texts" / "meds.yaml"
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_meds_texts(path: Path | None = None) -> MedsTexts:
|
||||
path = path or meds_texts_path()
|
||||
return MedsTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- data helpers
|
||||
|
||||
|
||||
class Rx(BaseModel):
|
||||
"""Active prescription as the dialog needs it (drug INN + dose exactly as the doctor wrote them)."""
|
||||
|
||||
id: int | None
|
||||
drug: str
|
||||
dose: str
|
||||
|
||||
|
||||
async def current_prescription(ctx: Ctx) -> Rx | None:
|
||||
"""Latest prescription active today: clinical DB first, then the МИС integration (demo: in-memory)."""
|
||||
today = ctx.now.date()
|
||||
rows = await ctx.session.scalars(
|
||||
select(PrescriptionRow).where(PrescriptionRow.token == ctx.token).order_by(PrescriptionRow.id.desc())
|
||||
)
|
||||
for row in rows:
|
||||
if (row.start_date is None or row.start_date <= today) and (row.end_date is None or row.end_date >= today):
|
||||
return Rx(id=row.id, drug=row.drug, dose=row.dose)
|
||||
for p in await integrations.prescriptions.get_prescriptions(ctx.token):
|
||||
if (p.start_date is None or p.start_date <= today) and (p.end_date is None or p.end_date >= today):
|
||||
return Rx(id=None, drug=p.drug, dose=p.dose)
|
||||
return None
|
||||
|
||||
|
||||
async def checkin_of(ctx: Ctx, day: date) -> DailyCheckin | None:
|
||||
return await ctx.session.scalar(
|
||||
select(DailyCheckin).where(DailyCheckin.token == ctx.token, DailyCheckin.day == day)
|
||||
)
|
||||
|
||||
|
||||
async def save_checkin(ctx: Ctx, **fields: Any) -> DailyCheckin:
|
||||
return await repo.upsert_checkin(ctx.session, token=ctx.token, day=ctx.now.date(), now=ctx.now, **fields)
|
||||
|
||||
|
||||
def dose_ref(dose_id: int | None, day: date) -> str:
|
||||
"""Button payload naming a dose: its row id, or the reminder day when there is no row."""
|
||||
return str(dose_id) if dose_id is not None else day.isoformat()
|
||||
|
||||
|
||||
async def todays_dose(ctx: Ctx) -> Dose | None:
|
||||
"""Latest dose row planned for today (local day of `ctx.now`) — target of answers given without a button."""
|
||||
rows = await ctx.session.scalars(select(Dose).where(Dose.token == ctx.token).order_by(Dose.id.desc()).limit(20))
|
||||
today = ctx.now.date()
|
||||
return next((r for r in rows if r.planned_at.astimezone(ctx.now.tzinfo).date() == today), None)
|
||||
|
||||
|
||||
async def resolve_ref(ctx: Ctx, ref: str | None) -> tuple[bool, Dose | None]:
|
||||
"""(fresh, dose row) for a button payload. Not fresh: missing/foreign/unknown ref or a dose of another day."""
|
||||
if not ref:
|
||||
return False, None
|
||||
if ref.isdigit():
|
||||
row = await ctx.session.get(Dose, int(ref))
|
||||
if row is None or row.token != ctx.token:
|
||||
return False, None
|
||||
return row.planned_at.astimezone(ctx.now.tzinfo).date() == ctx.now.date(), row
|
||||
try:
|
||||
return date.fromisoformat(ref) == ctx.now.date(), None
|
||||
except ValueError:
|
||||
return False, None
|
||||
|
||||
|
||||
async def _dose_row(ctx: Ctx, ref: str | None) -> Dose | None:
|
||||
if ref is None:
|
||||
return await todays_dose(ctx)
|
||||
return (await resolve_ref(ctx, ref))[1]
|
||||
|
||||
|
||||
async def record_dose(ctx: Ctx, taken: bool, *, status: str | None = None, ref: str | None = None) -> None:
|
||||
"""Dose answer → `doses` row (`ref` from the button, else today's) + `daily_checkins.med_taken` (rules read
|
||||
both)."""
|
||||
row = await _dose_row(ctx, ref)
|
||||
if row is not None:
|
||||
row.status = status or ("taken" if taken else "skipped")
|
||||
row.answered_at = ctx.now
|
||||
await save_checkin(ctx, med_taken=taken)
|
||||
|
||||
|
||||
async def record_side_effects(ctx: Ctx, codes: list[str], *, ref: str | None = None) -> None:
|
||||
"""Merge side-effect codes into today's check-in (rule `side_effect_3d` counts days with any code)."""
|
||||
today = await checkin_of(ctx, ctx.now.date())
|
||||
merged = list(dict.fromkeys([*(today.side_effects if today and today.side_effects else []), *codes]))
|
||||
await save_checkin(ctx, side_effects=merged)
|
||||
row = await _dose_row(ctx, ref)
|
||||
if row is not None:
|
||||
row.side_effects = ",".join(c for c in dict.fromkeys([*(row.side_effects or "").split(","), *codes]) if c)
|
||||
|
||||
|
||||
async def side_effect_reply(ctx: Ctx, codes: list[str]) -> Reply:
|
||||
"""Reaction to newly reported side effects.
|
||||
|
||||
Same effect as yesterday → short support (the instruction was already shown; persistence over 3 days is the
|
||||
rules' business). New effect with a known instruction question → the excerpt of the drug instruction
|
||||
(med_qa, section side_effects) — never generated advice. Otherwise a plain acknowledgement.
|
||||
"""
|
||||
t = load_meds_texts().side_effects
|
||||
yesterday = await checkin_of(ctx, ctx.now.date() - timedelta(days=1))
|
||||
if yesterday is not None and set(codes) & set(yesterday.side_effects or []):
|
||||
return Reply(text=t.repeat, kind="info")
|
||||
rx = await current_prescription(ctx)
|
||||
for code in codes:
|
||||
if code in t.questions and rx is not None:
|
||||
answer = await med_qa(rx.drug, scrub(t.questions[code]), topic="side_effects")
|
||||
if answer is not None:
|
||||
return Reply(text=answer.text, kind="info")
|
||||
return Reply(text=t.ack, kind="info")
|
||||
|
||||
|
||||
async def leave_to_idle(ctx: Ctx, event: Event, data: dict[str, Any] | None = None) -> Step:
|
||||
"""Abandon the current sub-flow and let the idle state handle the event (menu button, system event...)."""
|
||||
step = Step(next_state="idle", data=data or {})
|
||||
idle = handler_for("idle")
|
||||
return step.then(await idle(ctx, event)) if idle is not None else step
|
||||
|
||||
|
||||
async def run_trigger_inline(ctx: Ctx, key: str, event: Event) -> Step | None:
|
||||
"""Run an idle trigger from inside another flow (e.g. a reminder button pressed during the check-in)."""
|
||||
handler = get_trigger(key)
|
||||
return await handler(ctx, event) if handler is not None else None
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- reminder
|
||||
|
||||
|
||||
def _reminder_buttons(ref: str) -> list[list[Button]]:
|
||||
t = load_meds_texts().reminder
|
||||
return [
|
||||
[Button(label=t.taken, data=f"med:taken:{ref}")],
|
||||
[Button(label=t.skip, data=f"med:skip:{ref}")],
|
||||
[Button(label=t.side_effects, data=f"med:side_effects:{ref}")],
|
||||
]
|
||||
|
||||
|
||||
@trigger("system:med_reminder", replace=True)
|
||||
async def _med_reminder(ctx: Ctx, event: Event) -> Step:
|
||||
t = load_meds_texts().reminder
|
||||
rx = await current_prescription(ctx)
|
||||
drug = str(event.params.get("drug") or (rx.drug if rx else ""))
|
||||
dose = str(event.params.get("dose") or (rx.dose if rx else ""))
|
||||
try:
|
||||
dose_id: int | None = int(event.params["dose_id"]) # type: ignore[call-overload]
|
||||
except (KeyError, TypeError, ValueError):
|
||||
dose_id = None
|
||||
if dose_id is None and rx is not None and rx.id is not None:
|
||||
# No scheduler row (demo console without #13): create the planned dose so the answer has a record.
|
||||
row = Dose(token=ctx.token, prescription_id=rx.id, planned_at=ctx.now, status="pending")
|
||||
ctx.session.add(row)
|
||||
await ctx.session.flush()
|
||||
dose_id = row.id
|
||||
text = t.text.format(drug=drug, dose=dose).replace(" ", " ") if drug else t.text_no_drug
|
||||
reply = Reply(text=text, buttons=_reminder_buttons(dose_ref(dose_id, ctx.now.date())), kind="question")
|
||||
return Step(replies=[reply], data={"med_pending": None}) # key of earlier releases: the button carries it now
|
||||
|
||||
|
||||
def _stale_reply() -> Step:
|
||||
return Step(replies=[Reply(text=load_meds_texts().stale)])
|
||||
|
||||
|
||||
async def _legacy(ctx: Ctx, event: Event) -> Step:
|
||||
"""Payload-less medication button of an earlier release: the dose is unknown → treat as stale."""
|
||||
return _stale_reply()
|
||||
|
||||
|
||||
def _with_dose(fn: Any) -> Any:
|
||||
"""Prefix-trigger handler wrapper: resolve the dose payload, answer stale buttons without recording."""
|
||||
|
||||
async def handler(ctx: Ctx, event: Event) -> Step:
|
||||
ref = trigger_payload(event)
|
||||
fresh, _row = await resolve_ref(ctx, ref)
|
||||
if not fresh:
|
||||
return _stale_reply()
|
||||
return await fn(ctx, event, ref)
|
||||
|
||||
return handler
|
||||
|
||||
|
||||
def med_trigger(name: str) -> Any:
|
||||
"""Register `button:med:<name>:*` (with the dose payload) plus the legacy payload-less key as stale."""
|
||||
|
||||
def deco(fn: Any) -> Any:
|
||||
trigger(f"button:med:{name}:*")(_with_dose(fn))
|
||||
trigger(f"button:med:{name}")(_legacy)
|
||||
return fn
|
||||
|
||||
return deco
|
||||
|
||||
|
||||
@med_trigger("taken")
|
||||
async def _taken(ctx: Ctx, event: Event, ref: str) -> Step:
|
||||
await record_dose(ctx, True, ref=ref)
|
||||
return Step(replies=[Reply(text=load_meds_texts().taken_ack)], notify_monitoring=True)
|
||||
|
||||
|
||||
@med_trigger("skip")
|
||||
async def _skip(ctx: Ctx, event: Event, ref: str) -> Step:
|
||||
await record_dose(ctx, False, status="skipped", ref=ref)
|
||||
t = load_meds_texts().skip
|
||||
buttons = [[Button(label=t.reasons[r], data=f"med:skip_reason:{r}:{ref}")] for r in SKIP_REASONS]
|
||||
return Step(replies=[Reply(text=t.question, buttons=buttons, kind="question")], notify_monitoring=True)
|
||||
|
||||
|
||||
def _side_effect_question(ref: str) -> Reply:
|
||||
t = load_meds_texts().side_effects
|
||||
buttons = [[Button(label=t.options[c], data=f"med:se:{c}:{ref}")] for c in SIDE_EFFECT_CODES]
|
||||
return Reply(text=t.question, buttons=buttons, kind="question")
|
||||
|
||||
|
||||
def _skip_reason(reason: str) -> Any:
|
||||
async def handler(ctx: Ctx, event: Event, ref: str) -> Step:
|
||||
if reason == "side_effects":
|
||||
return Step(replies=[_side_effect_question(ref)])
|
||||
if reason == "quit":
|
||||
# «Решил бросить» is the same signal as "брошу" in free text: rule `quit_intent` reacts (alert +
|
||||
# delayed-onset explanation through the med_info action).
|
||||
await save_checkin(ctx, quit_intent=True)
|
||||
return Step(replies=[Reply(text=load_meds_texts().skip.ack["quit"])], notify_monitoring=True)
|
||||
return Step(replies=[Reply(text=load_meds_texts().skip.ack[reason])])
|
||||
|
||||
return handler
|
||||
|
||||
|
||||
for _reason in SKIP_REASONS:
|
||||
med_trigger(f"skip_reason:{_reason}")(_skip_reason(_reason))
|
||||
|
||||
|
||||
@med_trigger("side_effects")
|
||||
async def _side_effects(ctx: Ctx, event: Event, ref: str) -> Step:
|
||||
return Step(replies=[_side_effect_question(ref)])
|
||||
|
||||
|
||||
async def _after_side_effects(ctx: Ctx, codes: list[str], ref: str | None) -> Step:
|
||||
if ref is None:
|
||||
row = await todays_dose(ctx)
|
||||
ref = dose_ref(row.id if row is not None else None, ctx.now.date())
|
||||
await record_side_effects(ctx, codes, ref=ref)
|
||||
replies = [await side_effect_reply(ctx, codes)]
|
||||
today = await checkin_of(ctx, ctx.now.date())
|
||||
if (today is None or today.med_taken is None) and await current_prescription(ctx) is not None:
|
||||
t = load_meds_texts().side_effects
|
||||
buttons = [
|
||||
[Button(label=t.dose_yes, data=f"med:dose:yes:{ref}")],
|
||||
[Button(label=t.dose_no, data=f"med:dose:no:{ref}")],
|
||||
]
|
||||
replies.append(Reply(text=t.ask_dose, buttons=buttons, kind="question"))
|
||||
return Step(replies=replies, next_state="idle", data={"med_se_ref": None}, notify_monitoring=True)
|
||||
|
||||
|
||||
def _side_effect_code(code: str) -> Any:
|
||||
async def handler(ctx: Ctx, event: Event, ref: str) -> Step:
|
||||
if code == "other":
|
||||
return Step(
|
||||
# kind="question": the engine waits for free text here (clients show an input, optional).
|
||||
replies=[Reply(text=load_meds_texts().side_effects.describe, kind="question")],
|
||||
next_state=SIDE_EFFECT_TEXT_STATE,
|
||||
data={"med_se_ref": ref},
|
||||
)
|
||||
return await _after_side_effects(ctx, [code], ref)
|
||||
|
||||
return handler
|
||||
|
||||
|
||||
for _code in SIDE_EFFECT_CODES:
|
||||
med_trigger(f"se:{_code}")(_side_effect_code(_code))
|
||||
|
||||
|
||||
@state(SIDE_EFFECT_TEXT_STATE)
|
||||
async def _side_effect_text(ctx: Ctx, event: Event) -> Step:
|
||||
ref = ctx.data.get("med_se_ref")
|
||||
if event.type == "button" and event.button == NO_COMMENT:
|
||||
# The description is optional: «other» side effect without words.
|
||||
return await _after_side_effects(ctx, ["other"], str(ref) if ref else None)
|
||||
if event.type != "text" or ctx.text is None:
|
||||
return await leave_to_idle(ctx, event, {"med_se_ref": None})
|
||||
facts = await ctx.gateway.extract_checkin(ctx.text)
|
||||
# Store only normalised codes, never the description itself (it stays in the scrubbed message log).
|
||||
codes = [str(c) for c in facts.side_effects] if facts is not None and facts.side_effects else ["other"]
|
||||
return await _after_side_effects(ctx, codes, str(ref) if ref else None)
|
||||
|
||||
|
||||
def _dose_answer(taken: bool) -> Any:
|
||||
async def handler(ctx: Ctx, event: Event, ref: str) -> Step:
|
||||
await record_dose(ctx, taken, status=None if taken else "missed", ref=ref)
|
||||
return Step(
|
||||
replies=[Reply(text=load_meds_texts().taken_ack if taken else load_meds_texts().skip.ack["other"])],
|
||||
notify_monitoring=True,
|
||||
)
|
||||
|
||||
return handler
|
||||
|
||||
|
||||
med_trigger("dose:yes")(_dose_answer(True))
|
||||
med_trigger("dose:no")(_dose_answer(False))
|
||||
|
||||
# Free-text waiting states of this flow: a long-forgotten question must not swallow tomorrow's message.
|
||||
abandonable("meds")
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- question menu
|
||||
|
||||
|
||||
@trigger("button:menu:med_question", replace=True)
|
||||
async def _menu_question(ctx: Ctx, event: Event) -> Step:
|
||||
t = load_meds_texts().question
|
||||
if await current_prescription(ctx) is None:
|
||||
return Step(replies=[menu_reply(ctx, t.no_prescription)])
|
||||
return Step(replies=[Reply(text=t.prompt, kind="question")], next_state=QUESTION_STATE)
|
||||
|
||||
|
||||
async def answer_question(ctx: Ctx, rx: Rx | None) -> str:
|
||||
"""Answer from the instruction excerpt only (SPEC §7 п.5); dose questions and gaps → «уточните у врача»."""
|
||||
if rx is None or ctx.text is None:
|
||||
return load_meds_texts().question.no_prescription
|
||||
if DOSE_QUESTION.search(ctx.text.lower()) is None:
|
||||
# Agent: instruction + ЕМИАС record (other drugs, conditions, intolerances) + guidelines; else excerpt only.
|
||||
smart = await agent.answer_chat(ctx.token, ctx.text)
|
||||
if smart is not None:
|
||||
return agent.render(smart)
|
||||
answer = await med_qa(rx.drug, ctx.text)
|
||||
return answer.text if answer is not None else fallback_text()
|
||||
|
||||
|
||||
@state(QUESTION_STATE)
|
||||
async def _question(ctx: Ctx, event: Event) -> Step:
|
||||
if event.type != "text" or ctx.text is None:
|
||||
return await leave_to_idle(ctx, event)
|
||||
text = await answer_question(ctx, await current_prescription(ctx))
|
||||
return Step(replies=[menu_reply(ctx, text)], next_state="idle")
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- rule actions
|
||||
|
||||
|
||||
async def med_info_reply(ctx: Ctx, action: Action) -> Reply | None:
|
||||
"""`med_info` action of a rule (quit_intent → onset, alcohol_3d → alcohol): instruction excerpt framed by
|
||||
fixed texts. The rule already decided to say it; this only picks the words. None → engine template."""
|
||||
spec = load_meds_texts().med_info.get(str(action.params.get("topic")))
|
||||
if spec is None:
|
||||
return None
|
||||
rx = await current_prescription(ctx)
|
||||
answer = await med_qa(rx.drug, scrub(spec.question), topic=spec.section) if rx is not None else None
|
||||
body = answer.text if answer is not None else spec.fallback
|
||||
return Reply(text="\n\n".join(p for p in (spec.lead, body, spec.notice) if p), kind="info")
|
||||
|
||||
|
||||
register_med_info_handler(med_info_reply)
|
||||
@@ -0,0 +1,484 @@
|
||||
"""Daily check-in and scheduled-scale intros (#37, ADR-002, CLINICAL_MODULES §1–2, case «мониторинг после
|
||||
обращения»).
|
||||
|
||||
Check-in = core (mood 0–10, dose taken) + the module question (veteran: sleep hours + nightmares; alcohol for
|
||||
veterans and for anyone with a positive AUDIT-C) + free text:
|
||||
|
||||
system:daily_checkin / menu «Как я сегодня»
|
||||
──▶ daily.mood buttons 0–10 (a bare number is accepted too)
|
||||
──▶ daily.med only with a prescription and no dose answer today (the reminder may have got it)
|
||||
──▶ daily.sleep <4 / 4–6 / 6–8 / >8 h ┐ module veteran
|
||||
──▶ daily.nightmares yes / no ┘
|
||||
──▶ daily.alcohol none / 1–2 / more (veteran or AUDIT-C positive)
|
||||
──▶ daily.text «Как вы? Пару слов» (skip button) → extract_checkin on the SCRUBBED text
|
||||
──▶ [daily.alcohol_amount] alcohol mentioned in the text but not asked by button → amount buttons
|
||||
──▶ idle upsert done, `notify_monitoring` → rules (lane B) → dialog actions
|
||||
|
||||
Data algorithm (medical data, jury requirement):
|
||||
* Every button answer is written to `daily_checkins` immediately (`repo.upsert_checkin` merges non-None
|
||||
fields), so an interrupted check-in (crisis, the patient walking away) still leaves today's mood on record —
|
||||
the "mood ≤ 3 three days in a row" rule must not miss a day because the free text was never written.
|
||||
* Button answers are the patient's own and always win over the LLM: from the free text the LLM may only add
|
||||
side effects, the quit intent and fields that were not asked by buttons today.
|
||||
* The LLM never decides anything here: alerts and follow-ups (delayed-onset explanation, unscheduled PHQ-9,
|
||||
alcohol interaction, visit offer) come from the rules through `MonitoringService` (ADR-007).
|
||||
* A free-text message classified POSSIBLE by the safety layer is taken over by the engine (C-SSRS). When the
|
||||
screen returns to `daily.text` the message counts as the answer: the check-in is closed, not asked again.
|
||||
* A check-in left unfinished is dropped on the next event of a later day, or after
|
||||
`settings.abandon_after_hours` of silence (engine abandon timeout, #56) — answers given so far stay stored.
|
||||
|
||||
Also here: friendly intros for scheduled scales (pcl5, phq9, dar5, auditc), registered with
|
||||
`register_scale_intro` so the engine's `scale_due` / rule-triggered sessions show them.
|
||||
"""
|
||||
|
||||
import re
|
||||
from datetime import datetime
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
from typing import Any
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, ConfigDict
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.intake_runtime import intake_enabled
|
||||
from app.core.rules import load_rules
|
||||
from app.db import repo
|
||||
from app.dialog.contracts import Button, Event, Reply
|
||||
from app.dialog.flows import intake
|
||||
from app.dialog.flows.core import menu_reply
|
||||
from app.dialog.flows.knowledge import knowledge_answer, looks_like_question
|
||||
from app.dialog.flows.meds import (
|
||||
answer_question,
|
||||
checkin_of,
|
||||
current_prescription,
|
||||
leave_to_idle,
|
||||
load_meds_texts,
|
||||
record_dose,
|
||||
record_side_effects,
|
||||
run_trigger_inline,
|
||||
save_checkin,
|
||||
side_effect_reply,
|
||||
)
|
||||
from app.dialog.fsm import Ctx, Step, abandonable, on_enter, state, trigger
|
||||
from app.dialog.scale_session import register_scale_intro
|
||||
from app.llm import agent
|
||||
|
||||
PREFIX = "daily"
|
||||
STEPS = ("mood", "med", "sleep", "nightmares", "alcohol", "text")
|
||||
ALCOHOL_AMOUNT = "alcohol_amount"
|
||||
SLEEP_BUCKETS = ("<4", "4-6", "6-8", ">8")
|
||||
ALCOHOL_BUCKETS = ("none", "1-2", "more")
|
||||
_NUMBER = re.compile(r"^\s*(\d{1,2})\s*$")
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- texts
|
||||
|
||||
|
||||
class _Strict(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid", frozen=True)
|
||||
|
||||
|
||||
class DailySettings(_Strict):
|
||||
sleep_modules: list[str]
|
||||
alcohol_daily_modules: list[str]
|
||||
intro_scales: list[str]
|
||||
|
||||
|
||||
class Question(_Strict):
|
||||
question: str
|
||||
|
||||
|
||||
class OptionsQuestion(_Strict):
|
||||
question: str
|
||||
options: dict[str, str]
|
||||
|
||||
|
||||
class YesNoQuestion(_Strict):
|
||||
question: str
|
||||
yes: str
|
||||
no: str
|
||||
|
||||
|
||||
class AlcoholQuestion(_Strict):
|
||||
question: str
|
||||
clarify: str
|
||||
options: dict[str, str]
|
||||
|
||||
|
||||
class TextQuestion(_Strict):
|
||||
question: str
|
||||
skip: str
|
||||
|
||||
|
||||
class CheckinTexts(_Strict):
|
||||
start: str
|
||||
mood: Question
|
||||
sleep: OptionsQuestion
|
||||
nightmares: YesNoQuestion
|
||||
alcohol: AlcoholQuestion
|
||||
text: TextQuestion
|
||||
buttons_hint: str
|
||||
done: str
|
||||
already_done: str
|
||||
|
||||
|
||||
class VisitTexts(_Strict):
|
||||
requested: str
|
||||
|
||||
|
||||
class ScaleIntros(_Strict):
|
||||
scheduled: dict[str, str]
|
||||
unscheduled: dict[str, str]
|
||||
|
||||
|
||||
class DailyTexts(_Strict):
|
||||
status: str
|
||||
settings: DailySettings
|
||||
checkin: CheckinTexts
|
||||
visit: VisitTexts
|
||||
scale_intros: ScaleIntros
|
||||
|
||||
|
||||
def daily_texts_path() -> Path:
|
||||
return get_settings().config_dir / "texts" / "veteran_daily.yaml"
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_daily_texts(path: Path | None = None) -> DailyTexts:
|
||||
path = path or daily_texts_path()
|
||||
return DailyTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- step logic
|
||||
|
||||
|
||||
def _today(ctx: Ctx) -> str:
|
||||
return ctx.now.date().isoformat()
|
||||
|
||||
|
||||
def _ck(ctx: Ctx) -> dict[str, Any]:
|
||||
return dict(ctx.data.get("checkin") or {})
|
||||
|
||||
|
||||
async def _modules(ctx: Ctx) -> set[str]:
|
||||
profile = await ctx.profile()
|
||||
return set(profile.modules or []) if profile is not None else set()
|
||||
|
||||
|
||||
async def _auditc_positive(ctx: Ctx) -> bool:
|
||||
"""Latest AUDIT-C at or above the sex-specific cut-off of rule `auditc_positive` (one threshold, one place)."""
|
||||
results = await repo.list_scale_results(ctx.session, ctx.token, "auditc")
|
||||
if not results:
|
||||
return False
|
||||
rule = next((r for r in load_rules().rules if r.id == "auditc_positive"), None)
|
||||
if rule is None:
|
||||
return False
|
||||
profile = await ctx.profile()
|
||||
key = "threshold_f" if profile is not None and profile.sex == "f" else "threshold_m"
|
||||
return results[-1].total >= int(rule.params[key])
|
||||
|
||||
|
||||
async def _applicable(ctx: Ctx, step: str) -> bool:
|
||||
settings = load_daily_texts().settings
|
||||
if step in ("mood", "text"):
|
||||
return True
|
||||
if step == "med":
|
||||
today = await checkin_of(ctx, ctx.now.date())
|
||||
return (today is None or today.med_taken is None) and await current_prescription(ctx) is not None
|
||||
modules = await _modules(ctx)
|
||||
if step in ("sleep", "nightmares"):
|
||||
return bool(modules & set(settings.sleep_modules))
|
||||
if step == "alcohol":
|
||||
return bool(modules & set(settings.alcohol_daily_modules)) or await _auditc_positive(ctx)
|
||||
return False
|
||||
|
||||
|
||||
async def _next_step(ctx: Ctx, after: str | None) -> str:
|
||||
rest = STEPS if after is None else STEPS[STEPS.index(after) + 1 :]
|
||||
for step in rest:
|
||||
if await _applicable(ctx, step):
|
||||
return step
|
||||
return "text"
|
||||
|
||||
|
||||
def _buttons(step: str, options: list[tuple[str, str]]) -> list[list[Button]]:
|
||||
return [[Button(label=label, data=f"{PREFIX}:{step}:{value}")] for value, label in options]
|
||||
|
||||
|
||||
async def _question(ctx: Ctx, step: str, note: str = "") -> Reply:
|
||||
t = load_daily_texts().checkin
|
||||
buttons: list[list[Button]]
|
||||
if step == "mood":
|
||||
text = t.mood.question
|
||||
# Two rows (0–5, 6–10): 11 buttons in one column are hard to use on a phone.
|
||||
buttons = [
|
||||
[Button(label=str(v), data=f"{PREFIX}:mood:{v}") for v in range(6)],
|
||||
[Button(label=str(v), data=f"{PREFIX}:mood:{v}") for v in range(6, 11)],
|
||||
]
|
||||
elif step == "med":
|
||||
m = load_meds_texts().checkin
|
||||
rx = await current_prescription(ctx)
|
||||
text = m.question.format(drug=rx.drug) if rx is not None else m.question_no_drug
|
||||
buttons = _buttons(step, [("yes", m.yes), ("no", m.no), ("later", m.later)])
|
||||
elif step == "sleep":
|
||||
text = t.sleep.question
|
||||
buttons = _buttons(step, [(b, t.sleep.options[b]) for b in SLEEP_BUCKETS])
|
||||
elif step == "nightmares":
|
||||
text = t.nightmares.question
|
||||
buttons = _buttons(step, [("yes", t.nightmares.yes), ("no", t.nightmares.no)])
|
||||
elif step in ("alcohol", ALCOHOL_AMOUNT):
|
||||
text = t.alcohol.question if step == "alcohol" else t.alcohol.clarify
|
||||
buttons = _buttons(step, [(b, t.alcohol.options[b]) for b in ALCOHOL_BUCKETS])
|
||||
else:
|
||||
text = t.text.question
|
||||
buttons = _buttons("text", [("skip", t.text.skip)])
|
||||
return Reply(text="\n\n".join(p for p in (note, text) if p), buttons=buttons, kind="question")
|
||||
|
||||
|
||||
async def start_checkin(ctx: Ctx, *, from_menu: bool) -> Step:
|
||||
if ctx.data.get("checkin_done") == _today(ctx):
|
||||
# The scheduler may fire twice; the menu button gets a friendly note instead of a second check-in.
|
||||
return Step(replies=[menu_reply(ctx, load_daily_texts().checkin.already_done)]) if from_menu else Step()
|
||||
first = await _next_step(ctx, None)
|
||||
ck = {"day": _today(ctx), "answered": [], "started_at": ctx.now.isoformat()}
|
||||
return Step(
|
||||
replies=[Reply(text=load_daily_texts().checkin.start)],
|
||||
next_state=f"{PREFIX}.{first}",
|
||||
data={"checkin": ck},
|
||||
)
|
||||
|
||||
|
||||
def _finish(ctx: Ctx, replies: list[Reply] | None = None) -> Step:
|
||||
done = Reply(text=load_daily_texts().checkin.done)
|
||||
return Step(
|
||||
replies=[done, *(replies or [])],
|
||||
next_state="idle",
|
||||
data={"checkin": None, "checkin_done": _today(ctx)},
|
||||
notify_monitoring=True,
|
||||
)
|
||||
|
||||
|
||||
def _consumed_by_safety(ctx: Ctx, ck: dict[str, Any]) -> bool:
|
||||
"""The free-text answer was taken over by the safety layer (C-SSRS screen) after the question was asked."""
|
||||
asked = ck.get("text_asked_at")
|
||||
if not asked:
|
||||
return False
|
||||
for event in reversed(ctx.data.get("safety_events") or []):
|
||||
if event.get("state") == f"{PREFIX}.text" and datetime.fromisoformat(event["ts"]) >= datetime.fromisoformat(
|
||||
asked
|
||||
):
|
||||
return True
|
||||
return False
|
||||
|
||||
|
||||
@on_enter(PREFIX)
|
||||
async def _enter(ctx: Ctx) -> Step:
|
||||
step = ctx.state.split(".", 1)[1] if "." in ctx.state else ""
|
||||
ck = _ck(ctx)
|
||||
if not ck or ck.get("day") != _today(ctx):
|
||||
return Step(next_state="idle", data={"checkin": None})
|
||||
if step == "text":
|
||||
if _consumed_by_safety(ctx, ck):
|
||||
return _finish(ctx)
|
||||
return Step(
|
||||
replies=[await _question(ctx, step)], data={"checkin": {**ck, "text_asked_at": ctx.now.isoformat()}}
|
||||
)
|
||||
return Step(replies=[await _question(ctx, step)])
|
||||
|
||||
|
||||
async def _advance(ctx: Ctx, step: str, ck: dict[str, Any]) -> Step:
|
||||
ck = {**ck, "answered": [*ck.get("answered", []), step]}
|
||||
if step == ALCOHOL_AMOUNT:
|
||||
return _finish(ctx)
|
||||
nxt = await _next_step(ctx, step)
|
||||
return Step(next_state=f"{PREFIX}.{nxt}", data={"checkin": ck})
|
||||
|
||||
|
||||
async def _record_button(ctx: Ctx, step: str, value: str) -> bool:
|
||||
"""Store one button answer right away. False = value not valid for this step (stale/forged button)."""
|
||||
if step == "mood" and value.isdigit() and 0 <= int(value) <= 10:
|
||||
await save_checkin(ctx, mood=int(value))
|
||||
elif step == "med" and value in ("yes", "no", "later"):
|
||||
if value != "later": # «Ещё нет» is not a missed dose: nothing is recorded yet
|
||||
await record_dose(ctx, value == "yes", status=None if value == "yes" else "missed")
|
||||
elif step == "sleep" and value in SLEEP_BUCKETS:
|
||||
await save_checkin(ctx, sleep_bucket=value)
|
||||
elif step == "nightmares" and value in ("yes", "no"):
|
||||
await save_checkin(ctx, nightmares=value == "yes")
|
||||
elif step in ("alcohol", ALCOHOL_AMOUNT) and value in ALCOHOL_BUCKETS:
|
||||
await save_checkin(ctx, alcohol_bucket=value)
|
||||
else:
|
||||
return False
|
||||
return True
|
||||
|
||||
|
||||
async def _free_text(ctx: Ctx, ck: dict[str, Any]) -> Step:
|
||||
assert ctx.text is not None
|
||||
facts = await ctx.gateway.extract_checkin(ctx.text)
|
||||
answered = set(ck.get("answered", []))
|
||||
fields: dict[str, Any] = {"free_text_scrubbed": ctx.text}
|
||||
replies: list[Reply] = []
|
||||
clarify_alcohol = False
|
||||
if facts is not None:
|
||||
if facts.quit_intent:
|
||||
fields["quit_intent"] = True
|
||||
# Buttons win: the LLM only fills what was not asked today.
|
||||
if "med" not in answered and facts.med_taken is not None:
|
||||
today = await checkin_of(ctx, ctx.now.date())
|
||||
if today is None or today.med_taken is None:
|
||||
fields["med_taken"] = facts.med_taken
|
||||
if "sleep" not in answered and facts.sleep_hours_bucket is not None:
|
||||
fields["sleep_bucket"] = facts.sleep_hours_bucket
|
||||
if "nightmares" not in answered and facts.nightmares is not None:
|
||||
fields["nightmares"] = facts.nightmares
|
||||
if "alcohol" not in answered and facts.alcohol is not None:
|
||||
fields["alcohol_bucket"] = facts.alcohol # provisional; the amount buttons below refine it
|
||||
clarify_alcohol = facts.alcohol != "none"
|
||||
if facts.side_effects:
|
||||
await record_side_effects(ctx, [str(c) for c in facts.side_effects])
|
||||
# One topic per message: when the text also carries a quit intent or alcohol, the rules answer
|
||||
# those (delayed onset / interaction); the side-effect excerpt would only bury that message.
|
||||
if not facts.quit_intent and facts.alcohol in (None, "none"):
|
||||
replies.append(await side_effect_reply(ctx, [str(c) for c in facts.side_effects]))
|
||||
await save_checkin(ctx, **fields)
|
||||
if clarify_alcohol:
|
||||
return Step(replies=replies, next_state=f"{PREFIX}.{ALCOHOL_AMOUNT}", data={"checkin": ck})
|
||||
return _finish(ctx, replies)
|
||||
|
||||
|
||||
abandonable(PREFIX)
|
||||
|
||||
|
||||
@state(PREFIX)
|
||||
async def _handle(ctx: Ctx, event: Event) -> Step:
|
||||
step = ctx.state.split(".", 1)[1] if "." in ctx.state else ""
|
||||
ck = _ck(ctx)
|
||||
if not ck or ck.get("day") != _today(ctx):
|
||||
# Unfinished check-in from an earlier day: drop it and handle the event as idle would.
|
||||
return await leave_to_idle(ctx, event, {"checkin": None})
|
||||
|
||||
if event.type == "button" and event.button:
|
||||
parts = event.button.split(":")
|
||||
if len(parts) == 3 and parts[0] == PREFIX and parts[1] == step:
|
||||
if step == "text" and parts[2] == "skip":
|
||||
return _finish(ctx)
|
||||
if await _record_button(ctx, step, parts[2]):
|
||||
return await _advance(ctx, step, ck)
|
||||
if parts[0] == "med":
|
||||
# A reminder button pressed mid check-in: answer it, then repeat the current question.
|
||||
inline = await run_trigger_inline(ctx, f"button:{event.button}", event)
|
||||
if inline is not None:
|
||||
return inline if inline.next_state else inline.then(Step(replies=[await _question(ctx, step)]))
|
||||
if parts[0] in (PREFIX, "scale"):
|
||||
return Step(replies=[await _question(ctx, step)]) # stale button of an earlier question
|
||||
return await leave_to_idle(ctx, event, {"checkin": None})
|
||||
|
||||
if event.type == "system" and event.system:
|
||||
if event.system == "daily_checkin":
|
||||
return Step(replies=[await _question(ctx, step)])
|
||||
inline = await run_trigger_inline(ctx, f"system:{event.system}", event)
|
||||
if inline is None:
|
||||
return Step()
|
||||
return inline if inline.next_state else inline.then(Step(replies=[await _question(ctx, step)]))
|
||||
|
||||
if event.type == "text" and ctx.text is not None:
|
||||
if step == "text":
|
||||
return await _free_text(ctx, ck)
|
||||
number = _NUMBER.match(ctx.text)
|
||||
if step == "mood" and number and await _record_button(ctx, "mood", number.group(1)):
|
||||
return await _advance(ctx, step, ck)
|
||||
return Step(replies=[await _question(ctx, step, note=load_daily_texts().checkin.buttons_hint)])
|
||||
|
||||
return Step(replies=[await _question(ctx, step)])
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- idle triggers
|
||||
|
||||
|
||||
@trigger("system:daily_checkin", replace=True)
|
||||
async def _daily_checkin(ctx: Ctx, event: Event) -> Step:
|
||||
if intake_enabled(): # the intake diary (#53, feature flag) replaces this check-in when released
|
||||
return await intake.checkin(ctx, event)
|
||||
return await start_checkin(ctx, from_menu=False)
|
||||
|
||||
|
||||
@trigger("button:menu:checkin", replace=True)
|
||||
async def _menu_checkin(ctx: Ctx, event: Event) -> Step:
|
||||
if intake_enabled():
|
||||
return await intake.checkin(ctx, event)
|
||||
return await start_checkin(ctx, from_menu=True)
|
||||
|
||||
|
||||
@trigger("button:menu:visit", replace=True)
|
||||
async def _visit(ctx: Ctx, event: Event) -> Step:
|
||||
# «Записаться раньше» (rule action suggest_visit): no online booking yet — the request is a fact for lane B
|
||||
# (#38) and the dashboard, like `contact_requests`. No alert is created here (ADR-007).
|
||||
requests = [*(ctx.data.get("visit_requests") or []), {"ts": ctx.now.isoformat()}][-20:]
|
||||
return Step(
|
||||
replies=[Reply(text=load_daily_texts().visit.requested)],
|
||||
data={"visit_requests": requests},
|
||||
notify_monitoring=True,
|
||||
)
|
||||
|
||||
|
||||
@trigger("text:idle", replace=True)
|
||||
async def _idle_text(ctx: Ctx, event: Event) -> Step:
|
||||
"""Free text outside the check-in: drug question → instruction excerpt; side effects / quit intent / alcohol
|
||||
→ today's check-in (the rules react); another question → clinical guidelines (knowledge base); otherwise
|
||||
the neutral support phrase with the menu."""
|
||||
assert ctx.text is not None
|
||||
facts = await ctx.gateway.extract_checkin(ctx.text)
|
||||
if facts is None:
|
||||
smart = await agent.answer_chat(ctx.token, ctx.text)
|
||||
if smart is not None:
|
||||
return Step(replies=[menu_reply(ctx, agent.render(smart))])
|
||||
text = await knowledge_answer(ctx, explicit=False) if looks_like_question(ctx.text) else None
|
||||
return Step(replies=[menu_reply(ctx, text or await ctx.gateway.phrase("support"))])
|
||||
fields: dict[str, Any] = {}
|
||||
if facts.quit_intent:
|
||||
fields["quit_intent"] = True
|
||||
if facts.alcohol is not None and facts.alcohol != "none":
|
||||
today = await checkin_of(ctx, ctx.now.date())
|
||||
if today is None or today.alcohol_bucket in (None, "none"):
|
||||
fields["alcohol_bucket"] = facts.alcohol
|
||||
text: str | None = None
|
||||
if facts.side_effects:
|
||||
codes = [str(c) for c in facts.side_effects]
|
||||
await record_side_effects(ctx, codes)
|
||||
if not facts.quit_intent:
|
||||
text = (await side_effect_reply(ctx, codes)).text
|
||||
if fields:
|
||||
await save_checkin(ctx, **fields)
|
||||
if not facts.quit_intent:
|
||||
# Chat first: whatever the patient writes in idle gets the agent's answer; check-in signals above are
|
||||
# recorded silently for the doctor. Quit intent keeps its rule reaction (explanation + doctor notified).
|
||||
smart = await agent.answer_chat(ctx.token, ctx.text)
|
||||
if smart is not None:
|
||||
return Step(
|
||||
replies=[menu_reply(ctx, agent.render(smart))], notify_monitoring=bool(fields or facts.side_effects)
|
||||
)
|
||||
if text is None and facts.med_question and not facts.quit_intent:
|
||||
text = await answer_question(ctx, await current_prescription(ctx))
|
||||
# A question is answered even if it also mentioned alcohol/side effects (those are recorded above).
|
||||
# Quit intent gets the rule reaction (delayed-onset explanation + doctor notified) — no second answer.
|
||||
if text is None and not facts.quit_intent and looks_like_question(ctx.text):
|
||||
text = await knowledge_answer(ctx, explicit=False) # general question → clinical guidelines (#64)
|
||||
if text is None:
|
||||
text = await ctx.gateway.phrase("support")
|
||||
return Step(replies=[menu_reply(ctx, text)], notify_monitoring=bool(fields or facts.side_effects))
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- scale intros
|
||||
|
||||
|
||||
def _scale_intro(ctx: Ctx, scale_id: str, scheduled: bool, return_state: str) -> str | None:
|
||||
"""Friendly intro of a scheduled (or rule-triggered) scale. Onboarding sessions (#36) have their own texts."""
|
||||
if ".onboarding" in return_state:
|
||||
return None
|
||||
intros = load_daily_texts().scale_intros
|
||||
return (intros.scheduled if scheduled else intros.unscheduled).get(scale_id)
|
||||
|
||||
|
||||
for _scale_id in load_daily_texts().settings.intro_scales:
|
||||
register_scale_intro(_scale_id, _scale_intro)
|
||||
@@ -0,0 +1,458 @@
|
||||
"""Veteran start screening (issue #36, CLINICAL_MODULES §1, ADR-001/002/007/010).
|
||||
|
||||
Entered by the core flow after consent + age gate when the profile has module `veteran`:
|
||||
|
||||
veteran.onboarding.start intro «что нормально после возвращения» + FAQ ──«Начнём»──▶
|
||||
veteran.onboarding.exposure trauma exposure (yes / no / decline)
|
||||
yes ──▶ scale.pcptsd5 ──▶ ┐
|
||||
no / decline ───────────▶ ┤ (PC-PTSD-5 is not administered; nothing is stored for it)
|
||||
veteran.onboarding.pcl5 ─┘──▶ scale.pcl5
|
||||
veteran.onboarding.phq9 ──▶ scale.phq9 (item 9 buttons only; positive → engine crisis path)
|
||||
veteran.onboarding.auditc sex from profile, asked if unknown ──▶ scale.auditc
|
||||
veteran.onboarding.weapon weapon access (4 buttons) → facts; access + risk signal → safe-storage block
|
||||
veteran.onboarding.result plain-language summary, modules enabled in profile → finish_onboarding()
|
||||
|
||||
Clinical decisions encoded here:
|
||||
* PCL-5 is given to every veteran regardless of the exposure answer: the module's start set is PCL-5/PHQ-9/
|
||||
AUDIT-C (CLINICAL_MODULES §1); PC-PTSD-5 is only a short entry screen and, by its own instructions, is asked
|
||||
only after a "yes" to trauma exposure (`config/scales/pcptsd5.yaml: notes`).
|
||||
* Module `depression` is enabled when the PHQ-9 total meets `config/modules.yaml:
|
||||
veteran.enables_depression_if` (≥ 10). Scores and severity labels are never shown to the patient.
|
||||
* Safe-storage block (means restriction, one of the best-evidenced suicide-prevention measures) is shown when
|
||||
the patient reports access to a weapon AND there is a risk signal in this onboarding: a scale flag listed in
|
||||
`settings.weapon_risk_flags` (PHQ-9 item 9 ≥ 1, C-SSRS, AUDIT-C positive), a safety event (POSSIBLE/ACUTE)
|
||||
or a crisis opened since the onboarding began. Deterministic, no LLM (ADR-007).
|
||||
|
||||
Facts for lane B (`dialog_state.data["facts"]`, merged with whatever else is there):
|
||||
trauma_exposure True | False | None (declined)
|
||||
weapon_access True (self / others_or_safe) | False (none) | None (declined)
|
||||
weapon_access_choice "none" | "self" | "others_or_safe" | "declined"
|
||||
weapon_access_at ISO timestamp of the answer
|
||||
weapon_safety_block True when the safe-storage block was shown
|
||||
`PatientSnapshot.weapon_access` should be built from `facts["weapon_access"]`.
|
||||
|
||||
Crisis during onboarding: the engine moves to `crisis` and drops the running scale session. Progress is kept in
|
||||
`data["veteran_onboarding"]` (`stage`, `since_id`); when the FSM later enters `idle` (doctor acknowledged the
|
||||
crisis) the onboarding resumes at the stored stage, and scale stages whose result was already stored since the
|
||||
onboarding began are skipped (`since_id` = last scale_results id before the start).
|
||||
"""
|
||||
|
||||
from __future__ import annotations
|
||||
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
from typing import Any
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, ConfigDict, Field
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.modules import load_modules
|
||||
from app.db import repo
|
||||
from app.db.clinical import ScaleResult
|
||||
from app.dialog.contracts import Button, Event, Reply
|
||||
from app.dialog.crisis import crisis_open
|
||||
from app.dialog.flows.core import finish_onboarding, menu_reply
|
||||
from app.dialog.fsm import Ctx, Step, on_enter, state, trigger
|
||||
from app.dialog.scale_session import start_scale
|
||||
|
||||
MODULE = "veteran"
|
||||
PREFIX = "veteran.onboarding"
|
||||
START = f"{PREFIX}.start"
|
||||
EXPOSURE = f"{PREFIX}.exposure"
|
||||
PCL5 = f"{PREFIX}.pcl5"
|
||||
PHQ9 = f"{PREFIX}.phq9"
|
||||
AUDITC = f"{PREFIX}.auditc"
|
||||
WEAPON = f"{PREFIX}.weapon"
|
||||
RESULT = f"{PREFIX}.result"
|
||||
|
||||
BTN = "vonb" # button data namespace: "vonb:<question>:<choice>"
|
||||
FAQ_KEYS = ("who", "unit", "licences")
|
||||
|
||||
# choice code → value of facts["weapon_access"]: storage with others still means the patient owns a weapon.
|
||||
WEAPON_ACCESS: dict[str, bool | None] = {"none": False, "self": True, "others_or_safe": True, "declined": None}
|
||||
EXPOSURE_VALUE: dict[str, bool | None] = {"yes": True, "no": False, "declined": None}
|
||||
SEX_VALUE: dict[str, str | None] = {"m": "m", "f": "f", "declined": None}
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- texts
|
||||
|
||||
|
||||
class _Strict(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid", frozen=True)
|
||||
|
||||
|
||||
class OnbSettings(_Strict):
|
||||
weapon_risk_flags: list[str] = Field(default_factory=list)
|
||||
|
||||
|
||||
class IntroTexts(_Strict):
|
||||
text: str
|
||||
go: str
|
||||
repeat: str
|
||||
resume: str
|
||||
|
||||
|
||||
class ExposureTexts(_Strict):
|
||||
question: str
|
||||
answer_yes: str
|
||||
answer_no: str
|
||||
decline: str
|
||||
ack_yes: str
|
||||
ack_other: str
|
||||
|
||||
|
||||
class SexTexts(_Strict):
|
||||
question: str
|
||||
male: str
|
||||
female: str
|
||||
decline: str
|
||||
|
||||
|
||||
class WeaponTexts(_Strict):
|
||||
question: str
|
||||
no_access: str
|
||||
self: str
|
||||
others_or_safe: str
|
||||
decline: str
|
||||
ack: str
|
||||
safety_block_self: str
|
||||
safety_block_stored: str
|
||||
safety_block_unknown: str
|
||||
|
||||
|
||||
class ResultTexts(_Strict):
|
||||
intro: str
|
||||
calm: str
|
||||
load: str
|
||||
ptsd: str
|
||||
mood: str
|
||||
alcohol: str
|
||||
next: str
|
||||
|
||||
|
||||
class FaqEntry(_Strict):
|
||||
button: str
|
||||
text: str
|
||||
|
||||
|
||||
class FaqTexts(_Strict):
|
||||
who: FaqEntry
|
||||
unit: FaqEntry
|
||||
licences: FaqEntry
|
||||
|
||||
|
||||
class VeteranOnboardingTexts(_Strict):
|
||||
status: str
|
||||
settings: OnbSettings
|
||||
intro: IntroTexts
|
||||
buttons_hint: str
|
||||
exposure: ExposureTexts
|
||||
sex: SexTexts
|
||||
weapon: WeaponTexts
|
||||
result: ResultTexts
|
||||
faq: FaqTexts
|
||||
|
||||
|
||||
def texts_path() -> Path:
|
||||
return get_settings().config_dir / "texts" / "veteran_onboarding.yaml"
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_texts(path: Path | None = None) -> VeteranOnboardingTexts:
|
||||
path = path or texts_path()
|
||||
return VeteranOnboardingTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- helpers
|
||||
|
||||
|
||||
def _progress(ctx: Ctx) -> dict[str, Any]:
|
||||
return dict(ctx.data.get("veteran_onboarding") or {})
|
||||
|
||||
|
||||
def _at_stage(ctx: Ctx, stage: str) -> dict[str, Any]:
|
||||
"""Data update remembering the current stage (resume point after a crisis)."""
|
||||
return {"veteran_onboarding": {**_progress(ctx), "stage": stage}}
|
||||
|
||||
|
||||
def _facts(ctx: Ctx, **updates: Any) -> dict[str, Any]:
|
||||
return {"facts": {**(ctx.data.get("facts") or {}), **updates}}
|
||||
|
||||
|
||||
def _faq_buttons() -> list[list[Button]]:
|
||||
faq = load_texts().faq
|
||||
return [[Button(label=getattr(faq, key).button, data=f"{BTN}:faq:{key}")] for key in FAQ_KEYS]
|
||||
|
||||
|
||||
def _choice(event: Event, question: str, allowed: dict[str, Any]) -> str | None:
|
||||
if event.type != "button" or not event.button:
|
||||
return None
|
||||
parts = event.button.split(":")
|
||||
if len(parts) == 3 and parts[0] == BTN and parts[1] == question and parts[2] in allowed:
|
||||
return parts[2]
|
||||
return None
|
||||
|
||||
|
||||
def _faq_key(event: Event) -> str | None:
|
||||
if event.type == "button" and event.button and event.button.startswith(f"{BTN}:faq:"):
|
||||
key = event.button.rsplit(":", 1)[1]
|
||||
return key if key in FAQ_KEYS else None
|
||||
return None
|
||||
|
||||
|
||||
async def _results_since(ctx: Ctx) -> list[ScaleResult]:
|
||||
since_id = int(_progress(ctx).get("since_id") or 0)
|
||||
return [r for r in await repo.list_scale_results(ctx.session, ctx.token) if r.id > since_id]
|
||||
|
||||
|
||||
async def _latest(ctx: Ctx, scale: str) -> ScaleResult | None:
|
||||
rows = [r for r in await _results_since(ctx) if r.scale == scale]
|
||||
return rows[-1] if rows else None
|
||||
|
||||
|
||||
async def _risk_signals(ctx: Ctx) -> list[str]:
|
||||
"""Deterministic risk signals collected during this onboarding (see module docstring)."""
|
||||
risk_flags = set(load_texts().settings.weapon_risk_flags)
|
||||
signals = sorted({f for r in await _results_since(ctx) for f in (r.flags or {}) if f in risk_flags})
|
||||
started = str(_progress(ctx).get("started_at") or "")
|
||||
events = [
|
||||
e
|
||||
for e in ctx.data.get("safety_events") or []
|
||||
if str(e.get("ts", "")) >= started and e.get("level") in ("possible", "acute")
|
||||
]
|
||||
if events:
|
||||
signals.append("safety_event")
|
||||
opened_at = str((ctx.data.get("crisis") or {}).get("opened_at") or "")
|
||||
if crisis_open(ctx.data) or (opened_at and opened_at >= started):
|
||||
signals.append("crisis")
|
||||
return signals
|
||||
|
||||
|
||||
async def _scale_stage(ctx: Ctx, stage: str, scale: str, next_stage: str) -> Step:
|
||||
"""Start `scale` unless its result is already stored in this onboarding (resume after a crisis)."""
|
||||
if await _latest(ctx, scale) is not None:
|
||||
return Step(next_state=next_stage, data=_at_stage(ctx, next_stage))
|
||||
step = await start_scale(ctx, scale, return_state=next_stage, scheduled=True)
|
||||
step.data.update(_at_stage(ctx, stage))
|
||||
return step
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- start
|
||||
|
||||
|
||||
def _intro_reply(text: str) -> Reply:
|
||||
go = Button(label=load_texts().intro.go, data=f"{BTN}:go:yes")
|
||||
return Reply(text=text, buttons=[[go], *_faq_buttons()], kind="question")
|
||||
|
||||
|
||||
@on_enter(START)
|
||||
async def _start_enter(ctx: Ctx) -> Step:
|
||||
rows = await repo.list_scale_results(ctx.session, ctx.token)
|
||||
progress = {
|
||||
"stage": START,
|
||||
"since_id": max((r.id for r in rows), default=0),
|
||||
"started_at": ctx.now.isoformat(),
|
||||
}
|
||||
return Step(replies=[_intro_reply(load_texts().intro.text)], data={"veteran_onboarding": progress})
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- questions
|
||||
|
||||
|
||||
def _exposure_reply(note: str = "") -> Reply:
|
||||
t = load_texts().exposure
|
||||
buttons = [
|
||||
[Button(label=t.answer_yes, data=f"{BTN}:exposure:yes")],
|
||||
[Button(label=t.answer_no, data=f"{BTN}:exposure:no")],
|
||||
[Button(label=t.decline, data=f"{BTN}:exposure:declined")],
|
||||
]
|
||||
return Reply(text="\n\n".join(p for p in (note, t.question) if p), buttons=buttons, kind="question")
|
||||
|
||||
|
||||
def _sex_reply(note: str = "") -> Reply:
|
||||
t = load_texts().sex
|
||||
buttons = [
|
||||
[Button(label=t.male, data=f"{BTN}:sex:m")],
|
||||
[Button(label=t.female, data=f"{BTN}:sex:f")],
|
||||
[Button(label=t.decline, data=f"{BTN}:sex:declined")],
|
||||
]
|
||||
return Reply(text="\n\n".join(p for p in (note, t.question) if p), buttons=buttons, kind="question")
|
||||
|
||||
|
||||
def _weapon_reply(note: str = "") -> Reply:
|
||||
t = load_texts().weapon
|
||||
buttons = [
|
||||
[Button(label=t.no_access, data=f"{BTN}:weapon:none")],
|
||||
[Button(label=t.self, data=f"{BTN}:weapon:self")],
|
||||
[Button(label=t.others_or_safe, data=f"{BTN}:weapon:others_or_safe")],
|
||||
[Button(label=t.decline, data=f"{BTN}:weapon:declined")],
|
||||
]
|
||||
return Reply(text="\n\n".join(p for p in (note, t.question) if p), buttons=buttons, kind="question")
|
||||
|
||||
|
||||
def _current_question(ctx: Ctx, note: str = "") -> Reply:
|
||||
if ctx.state == EXPOSURE:
|
||||
return _exposure_reply(note)
|
||||
if ctx.state == AUDITC:
|
||||
return _sex_reply(note)
|
||||
if ctx.state == WEAPON:
|
||||
return _weapon_reply(note)
|
||||
t = load_texts().intro
|
||||
return _intro_reply("\n\n".join(p for p in (note, t.repeat) if p))
|
||||
|
||||
|
||||
@on_enter(EXPOSURE)
|
||||
async def _exposure_enter(ctx: Ctx) -> Step:
|
||||
return Step(replies=[_exposure_reply()], data=_at_stage(ctx, EXPOSURE))
|
||||
|
||||
|
||||
@on_enter(PCL5)
|
||||
async def _pcl5_enter(ctx: Ctx) -> Step:
|
||||
return await _scale_stage(ctx, PCL5, "pcl5", PHQ9)
|
||||
|
||||
|
||||
@on_enter(PHQ9)
|
||||
async def _phq9_enter(ctx: Ctx) -> Step:
|
||||
# Item 9 is buttons-only and a positive answer opens the crisis path inside the scale session (engine).
|
||||
return await _scale_stage(ctx, PHQ9, "phq9", AUDITC)
|
||||
|
||||
|
||||
@on_enter(AUDITC)
|
||||
async def _auditc_enter(ctx: Ctx) -> Step:
|
||||
if await _latest(ctx, "auditc") is not None:
|
||||
return Step(next_state=WEAPON, data=_at_stage(ctx, WEAPON))
|
||||
profile = await ctx.profile()
|
||||
known = profile is not None and profile.sex in ("m", "f")
|
||||
if known or _progress(ctx).get("sex_asked"):
|
||||
# Unknown sex after "не хочу отвечать": AUDIT-C uses the more sensitive default threshold.
|
||||
return await _scale_stage(ctx, AUDITC, "auditc", WEAPON)
|
||||
return Step(replies=[_sex_reply()], data=_at_stage(ctx, AUDITC))
|
||||
|
||||
|
||||
@on_enter(WEAPON)
|
||||
async def _weapon_enter(ctx: Ctx) -> Step:
|
||||
return Step(replies=[_weapon_reply()], data=_at_stage(ctx, WEAPON))
|
||||
|
||||
|
||||
@state(PREFIX)
|
||||
async def _handle(ctx: Ctx, event: Event) -> Step:
|
||||
"""Events in the onboarding's own question states (scales are handled by the scale session)."""
|
||||
t = load_texts()
|
||||
faq = _faq_key(event)
|
||||
if faq is not None:
|
||||
return Step(replies=[Reply(text=getattr(t.faq, faq).text), _current_question(ctx)])
|
||||
if event.type == "system":
|
||||
return Step() # reminders do not interrupt the screening
|
||||
|
||||
if ctx.state == START:
|
||||
if _choice(event, "go", {"yes": True}):
|
||||
return Step(next_state=EXPOSURE)
|
||||
return Step(replies=[_current_question(ctx)])
|
||||
|
||||
if ctx.state == EXPOSURE and (code := _choice(event, "exposure", EXPOSURE_VALUE)):
|
||||
exposed = EXPOSURE_VALUE[code]
|
||||
step = Step(data=_facts(ctx, trauma_exposure=exposed))
|
||||
if exposed:
|
||||
step.replies.append(Reply(text=t.exposure.ack_yes))
|
||||
nxt = await start_scale(ctx, "pcptsd5", return_state=PCL5, scheduled=True)
|
||||
nxt.data.update(_at_stage(ctx, EXPOSURE))
|
||||
return step.then(nxt)
|
||||
step.replies.append(Reply(text=t.exposure.ack_other))
|
||||
return step.then(Step(next_state=PCL5))
|
||||
|
||||
if ctx.state == AUDITC and (code := _choice(event, "sex", SEX_VALUE)):
|
||||
sex = SEX_VALUE[code]
|
||||
if sex is not None:
|
||||
await repo.upsert_profile(ctx.session, token=ctx.token, sex=sex)
|
||||
step = await _scale_stage(ctx, AUDITC, "auditc", WEAPON)
|
||||
step.data["veteran_onboarding"] = {**step.data["veteran_onboarding"], "sex_asked": True}
|
||||
return step
|
||||
|
||||
if ctx.state == WEAPON and (code := _choice(event, "weapon", WEAPON_ACCESS)):
|
||||
return await _weapon_answer(ctx, code)
|
||||
|
||||
return Step(replies=[_current_question(ctx, t.buttons_hint)])
|
||||
|
||||
|
||||
async def _weapon_answer(ctx: Ctx, code: str) -> Step:
|
||||
t = load_texts().weapon
|
||||
access = WEAPON_ACCESS[code]
|
||||
replies = [Reply(text=t.ack)]
|
||||
show_block = access is not False and bool(await _risk_signals(ctx))
|
||||
if show_block:
|
||||
block = {"self": t.safety_block_self, "others_or_safe": t.safety_block_stored}.get(code, t.safety_block_unknown)
|
||||
replies = [Reply(text=block, kind="safety_plan")]
|
||||
data = _facts(
|
||||
ctx,
|
||||
weapon_access=access,
|
||||
weapon_access_choice=code,
|
||||
weapon_access_at=ctx.now.isoformat(),
|
||||
weapon_safety_block=show_block,
|
||||
)
|
||||
# notify_monitoring: weapon access is a monitoring fact (lane B rule "доступ к оружию → блок безопасности").
|
||||
return Step(replies=replies, next_state=RESULT, data=data, notify_monitoring=True)
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- result
|
||||
|
||||
|
||||
def _meets(total: int, op: str, value: int) -> bool:
|
||||
return total >= value if op == ">=" else total > value
|
||||
|
||||
|
||||
@on_enter(RESULT)
|
||||
async def _result_enter(ctx: Ctx) -> Step:
|
||||
t = load_texts().result
|
||||
pcl5 = await _latest(ctx, "pcl5")
|
||||
auditc = await _latest(ctx, "auditc")
|
||||
|
||||
# Depression module: PHQ-9 total vs. the threshold from config/modules.yaml (veteran.enables_depression_if).
|
||||
rule = load_modules().modules[MODULE].enables_depression_if
|
||||
trigger_result = await _latest(ctx, rule.scale) if rule is not None else None
|
||||
depression = bool(rule and trigger_result and _meets(trigger_result.total, rule.op, rule.value))
|
||||
profile = await ctx.profile()
|
||||
modules = list(profile.modules or []) if profile is not None else []
|
||||
for module in (MODULE, "depression") if depression else (MODULE,):
|
||||
if module not in modules:
|
||||
modules.append(module)
|
||||
await repo.upsert_profile(ctx.session, token=ctx.token, modules=modules)
|
||||
|
||||
lines = []
|
||||
if pcl5 is not None and "pcl5_probable_ptsd" in (pcl5.flags or {}):
|
||||
lines.append(t.ptsd)
|
||||
if depression:
|
||||
lines.append(t.mood)
|
||||
if auditc is not None and "auditc_positive" in (auditc.flags or {}):
|
||||
lines.append(t.alcohol)
|
||||
body = [t.intro, t.load, *lines] if lines else [t.intro, t.calm]
|
||||
summary = Reply(text="\n".join([*body, "", t.next]), buttons=_faq_buttons())
|
||||
done = Step(
|
||||
replies=[summary],
|
||||
data={"veteran_onboarding": {**_progress(ctx), "stage": None, "done_at": ctx.now.isoformat()}},
|
||||
notify_monitoring=True,
|
||||
)
|
||||
return done.then(await finish_onboarding(ctx, module=MODULE))
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------- resume / FAQ
|
||||
|
||||
|
||||
@on_enter("idle")
|
||||
async def _resume_after_crisis(ctx: Ctx) -> Step:
|
||||
"""Back in idle with an unfinished veteran onboarding (it was interrupted by a crisis) → continue it."""
|
||||
stage = _progress(ctx).get("stage")
|
||||
if not stage or not str(stage).startswith(PREFIX) or crisis_open(ctx.data) or ctx.data.get("consent") is not True:
|
||||
return Step()
|
||||
stage = EXPOSURE if stage == START else str(stage)
|
||||
return Step(replies=[Reply(text=load_texts().intro.resume)], next_state=stage)
|
||||
|
||||
|
||||
def _faq_trigger(key: str) -> None:
|
||||
@trigger(f"button:{BTN}:faq:{key}")
|
||||
async def _faq(ctx: Ctx, event: Event) -> Step:
|
||||
return Step(replies=[menu_reply(ctx, getattr(load_texts().faq, key).text)])
|
||||
|
||||
|
||||
for _key in FAQ_KEYS:
|
||||
_faq_trigger(_key)
|
||||
+57
-4
@@ -22,6 +22,14 @@ Name resolution: an exact registration wins, otherwise the longest registered do
|
||||
`@trigger("system:daily_checkin")`, `@trigger("text:idle")`) let flows take over what the core `idle` state does
|
||||
with menu buttons, system events and free text; the core registers defaults, a flow overrides with
|
||||
`replace=True`.
|
||||
|
||||
Prefix triggers carry data in the button (#56): `@trigger("button:med:taken:*")` handles every button whose data
|
||||
starts with "med:taken:"; the rest of the data ("med:taken:42" → "42") reaches the handler as
|
||||
`trigger_payload(event)`. An exact key always wins over a prefix, a longer prefix over a shorter one.
|
||||
|
||||
Abandoned steps (#56): a flow marks its question states with `abandonable("daily")`; if the patient stays silent
|
||||
in such a state longer than `settings.abandon_after_hours`, the engine returns the FSM to `idle` before
|
||||
handling the next event (answers already stored stay stored).
|
||||
"""
|
||||
|
||||
from __future__ import annotations
|
||||
@@ -103,6 +111,11 @@ EnterHook = Callable[[Ctx], Awaitable[Step]]
|
||||
_handlers: dict[str, Handler] = {}
|
||||
_enter_hooks: dict[str, EnterHook] = {}
|
||||
_triggers: dict[str, Handler] = {}
|
||||
_prefix_triggers: dict[str, Handler] = {} # "button:med:taken:" → handler (registered as "button:med:taken:*")
|
||||
_abandonable: dict[str, Callable[[Ctx], bool] | None] = {}
|
||||
|
||||
PREFIX_WILDCARD = "*"
|
||||
PAYLOAD_PARAM = "trigger_payload"
|
||||
|
||||
|
||||
def state(name: str) -> Callable[[Handler], Handler]:
|
||||
@@ -133,18 +146,45 @@ def trigger(key: str, *, replace: bool = False) -> Callable[[Handler], Handler]:
|
||||
"""Register a handler for an idle-menu button / system event / idle free text.
|
||||
|
||||
Keys: "button:<Button.data>", "system:<SystemEventKind>", "text:idle". The core registers defaults;
|
||||
flows pass `replace=True` to take one over.
|
||||
flows pass `replace=True` to take one over. A key ending in ":*" is a prefix trigger (see module doc).
|
||||
"""
|
||||
table, name = _triggers, key
|
||||
if key.endswith(":" + PREFIX_WILDCARD):
|
||||
table, name = _prefix_triggers, key[: -len(PREFIX_WILDCARD)]
|
||||
|
||||
def deco(fn: Handler) -> Handler:
|
||||
if key in _triggers and not replace:
|
||||
if name in table and not replace:
|
||||
raise ValueError(f"trigger '{key}' already registered (use replace=True to override)")
|
||||
_triggers[key] = fn
|
||||
table[name] = fn
|
||||
return fn
|
||||
|
||||
return deco
|
||||
|
||||
|
||||
def trigger_payload(event: Event) -> str | None:
|
||||
"""Data after the matched prefix of a prefix trigger ("med:taken:42" → "42"); None for exact triggers."""
|
||||
value = event.params.get(PAYLOAD_PARAM)
|
||||
return str(value) if value is not None else None
|
||||
|
||||
|
||||
def abandonable(prefix: str, when: Callable[[Ctx], bool] | None = None) -> None:
|
||||
"""Mark states `prefix` / `prefix.*` as question steps the engine may abandon after a long silence.
|
||||
|
||||
`when(ctx)` may veto it for a particular situation (e.g. a scale that is part of an onboarding).
|
||||
"""
|
||||
if prefix in _abandonable:
|
||||
raise ValueError(f"abandonable '{prefix}' already registered")
|
||||
_abandonable[prefix] = when
|
||||
|
||||
|
||||
def is_abandonable(ctx: Ctx) -> bool:
|
||||
key = _resolve(ctx.state, _abandonable)
|
||||
if key is None:
|
||||
return False
|
||||
when = _abandonable[key]
|
||||
return when is None or when(ctx)
|
||||
|
||||
|
||||
def _resolve(name: str, table: dict[str, Any]) -> str | None:
|
||||
candidate = name
|
||||
while candidate:
|
||||
@@ -167,7 +207,20 @@ def enter_hook_for(name: str) -> EnterHook | None:
|
||||
|
||||
|
||||
def get_trigger(key: str) -> Handler | None:
|
||||
return _triggers.get(key)
|
||||
"""Exact trigger, else the longest matching prefix trigger (wrapped so it sees the payload)."""
|
||||
exact = _triggers.get(key)
|
||||
if exact is not None:
|
||||
return exact
|
||||
matches = [p for p in _prefix_triggers if key.startswith(p) and len(key) > len(p)]
|
||||
if not matches:
|
||||
return None
|
||||
prefix = max(matches, key=len)
|
||||
fn, payload = _prefix_triggers[prefix], key[len(prefix) :]
|
||||
|
||||
async def with_payload(ctx: Ctx, event: Event) -> Step:
|
||||
return await fn(ctx, event.model_copy(update={"params": {**event.params, PAYLOAD_PARAM: payload}}))
|
||||
|
||||
return with_payload
|
||||
|
||||
|
||||
def is_registered(name: str) -> bool:
|
||||
|
||||
@@ -15,24 +15,52 @@ Algorithm per item:
|
||||
4. Every answer is stored immediately (`item_responses`), so a session interrupted by a crisis keeps its data.
|
||||
5. After each answer the scale is scored deterministically (`app.core.scales.score`). If a crisis flag from
|
||||
`config/texts/dialog.yaml: settings.crisis_flags` fires (PHQ-9 item 9 ≥ 1, C-SSRS high) the session ends at
|
||||
once: partial result saved, fixed crisis script, C-SSRS queued (unless this *is* the C-SSRS). A positive
|
||||
item 9 is acted upon even in a half-finished questionnaire.
|
||||
once: partial result saved, fixed crisis script, C-SSRS queued (unless this *is* the C-SSRS, or a C-SSRS was
|
||||
completed less than `settings.cssrs_cooldown_hours` ago — the patient is not asked the same suicide screen
|
||||
twice in a day; the crisis script and the alert still happen). A positive item 9 is acted upon even in a
|
||||
half-finished questionnaire.
|
||||
6. On completion: `scale_results` row (total, severity, item 9, scheduled flag, flags) → the engine commits
|
||||
and calls `MonitoringService.after_data_change()` (rules decide alerts — ADR-007) → back to `return_state`.
|
||||
The patient never sees a score or a severity label: that would read as a diagnosis.
|
||||
|
||||
Intros (#56): `start_scale(intro=None)` looks the intro up in a registry filled by flows
|
||||
(`register_scale_intro("phq9", fn_or_text)`), so scales started by the engine (`scale_due`, rule actions) get
|
||||
the flow's friendly intro without the flow hooking `scale.<id>` itself.
|
||||
"""
|
||||
|
||||
from collections.abc import Callable
|
||||
from dataclasses import replace
|
||||
from datetime import timedelta
|
||||
from typing import Any
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.privacy import scrub
|
||||
from app.core.scales import Item, ScaleDef, ScaleResult, load_scale, score
|
||||
from app.db import repo
|
||||
from app.dialog.contracts import Button, Event, Reply
|
||||
from app.dialog.crisis import crisis_open, open_crisis
|
||||
from app.dialog.fsm import Ctx, Step, on_enter, state
|
||||
from app.dialog.fsm import RESTING_STATES, Ctx, Step, abandonable, is_abandonable, on_enter, state
|
||||
|
||||
PREFIX = "scale"
|
||||
|
||||
# (ctx, scale_id, scheduled, return_state) → intro text or None (no intro in this situation).
|
||||
IntroFn = Callable[[Ctx, str, bool, str], str | None]
|
||||
_intros: dict[str, str | IntroFn] = {}
|
||||
|
||||
|
||||
def register_scale_intro(scale_id: str, intro: str | IntroFn, *, replace: bool = False) -> None:
|
||||
"""Register the intro shown before `scale_id` when a session is started without an explicit `intro`."""
|
||||
if scale_id in _intros and not replace:
|
||||
raise ValueError(f"intro of scale '{scale_id}' already registered (use replace=True to override)")
|
||||
_intros[scale_id] = intro
|
||||
|
||||
|
||||
def scale_intro(ctx: Ctx, scale_id: str, *, scheduled: bool, return_state: str) -> str | None:
|
||||
intro = _intros.get(scale_id)
|
||||
if intro is None or isinstance(intro, str):
|
||||
return intro or None
|
||||
return intro(ctx, scale_id, scheduled, return_state) or None
|
||||
|
||||
|
||||
def scale_state(scale_id: str) -> str:
|
||||
return f"{PREFIX}.{scale_id}"
|
||||
@@ -56,9 +84,11 @@ async def start_scale(
|
||||
"""Begin a session of `scale_id`; returns a Step moving the FSM to `scale.<id>`.
|
||||
|
||||
`scheduled=False` marks an unscheduled administration (triggered by a rule or a safety signal).
|
||||
`intro` — optional extra text shown before the scale instruction.
|
||||
`intro` — optional extra text shown before the scale instruction; None → the registered intro, if any.
|
||||
"""
|
||||
scale = load_scale(scale_id) # fail fast on an unknown id
|
||||
if intro is None:
|
||||
intro = scale_intro(ctx, scale_id, scheduled=scheduled, return_state=return_state)
|
||||
sessions = dict(ctx.data.get("scales") or {})
|
||||
sessions[scale_id] = {
|
||||
"idx": 0,
|
||||
@@ -98,6 +128,28 @@ def _session(ctx: Ctx) -> tuple[ScaleDef, dict[str, Any]] | None:
|
||||
return load_scale(scale_id), session
|
||||
|
||||
|
||||
def _abandon_allowed(ctx: Ctx) -> bool:
|
||||
"""A silent scale session may be abandoned only if what it returns to may be (idle, a check-in step) —
|
||||
never an onboarding chain, which would otherwise be skipped."""
|
||||
found = _session(ctx)
|
||||
if found is None:
|
||||
return True
|
||||
back = str(found[1].get("return_state") or "idle")
|
||||
if back in RESTING_STATES:
|
||||
return True
|
||||
return back != ctx.state and is_abandonable(replace(ctx, state=back))
|
||||
|
||||
|
||||
abandonable(PREFIX, _abandon_allowed)
|
||||
|
||||
|
||||
async def recent_risk_screen(ctx: Ctx, screen: str) -> bool:
|
||||
"""A complete risk screen (C-SSRS) less than `cssrs_cooldown_hours` ago (scale_results, any trigger)."""
|
||||
since = ctx.now - timedelta(hours=ctx.texts.settings.cssrs_cooldown_hours)
|
||||
results = await repo.list_scale_results(ctx.session, ctx.token, screen)
|
||||
return any(r.complete and r.ts >= since for r in results)
|
||||
|
||||
|
||||
@on_enter(PREFIX)
|
||||
async def _enter(ctx: Ctx) -> Step:
|
||||
found = _session(ctx)
|
||||
@@ -186,7 +238,10 @@ async def _record(
|
||||
sex = profile.sex if profile is not None and profile.sex in ("m", "f") else None
|
||||
result = score(scale.id, answers, sex=sex) # type: ignore[arg-type]
|
||||
crisis_flags = [f for f in result.flags if f in ctx.texts.settings.crisis_flags]
|
||||
if crisis_flags or session["idx"] + 1 >= len(scale.items):
|
||||
# Clinical protocol (crisis_blocking): a crisis flag ends the scale at once. Demo default: the scale is finished
|
||||
# first and the crisis message comes at the end of the questionnaire (engine defers it), blocking nothing.
|
||||
stop_now = bool(crisis_flags) and get_settings().crisis_blocking
|
||||
if stop_now or session["idx"] + 1 >= len(scale.items):
|
||||
return await _finish(ctx, scale, session, answers, result, crisis_flags)
|
||||
updated = {**session, "answers": answers, "idx": session["idx"] + 1}
|
||||
sessions = {**(ctx.data.get("scales") or {}), scale.id: updated}
|
||||
@@ -227,10 +282,11 @@ async def _finish(
|
||||
# Crisis path decided by the scale's own flags (deterministic), not by the LLM.
|
||||
risk_screen = ctx.texts.settings.risk_screen_scale
|
||||
if crisis_open(ctx.data):
|
||||
crisis = Step(next_state="crisis")
|
||||
crisis = Step(next_state="crisis") if get_settings().crisis_blocking else Step()
|
||||
else:
|
||||
crisis = open_crisis(ctx, categories=[], source=f"scale:{scale.id}")
|
||||
step = done.then(crisis)
|
||||
if scale.id != risk_screen:
|
||||
# Same-day repeat guard: a C-SSRS completed within the cooldown already answered the screening question.
|
||||
if scale.id != risk_screen and not await recent_risk_screen(ctx, risk_screen):
|
||||
step.data["pending_scales"] = add_pending(ctx.data, risk_screen, scheduled=False)
|
||||
return step
|
||||
|
||||
+6
-1
@@ -7,6 +7,7 @@ import yaml
|
||||
from pydantic import BaseModel, ConfigDict, Field
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.safety import fill_phones
|
||||
|
||||
|
||||
class _Strict(BaseModel):
|
||||
@@ -19,6 +20,7 @@ class DialogSettings(_Strict):
|
||||
max_safety_events: int = 50
|
||||
crisis_flags: list[str] = Field(default_factory=list)
|
||||
risk_screen_scale: str = "cssrs_screen"
|
||||
abandon_after_hours: float = 6
|
||||
|
||||
|
||||
class Commands(_Strict):
|
||||
@@ -46,6 +48,7 @@ class AgeGateTexts(_Strict):
|
||||
class IdleButtons(_Strict):
|
||||
checkin: str
|
||||
med_question: str
|
||||
kb_question: str
|
||||
contact_doctor: str
|
||||
revoke: str
|
||||
|
||||
@@ -89,6 +92,7 @@ class ReachOutTexts(_Strict):
|
||||
silence: str
|
||||
missed_doses: str
|
||||
default: str
|
||||
after_crisis: str
|
||||
|
||||
|
||||
class VisitTexts(_Strict):
|
||||
@@ -109,6 +113,7 @@ class DialogTexts(_Strict):
|
||||
reach_out: ReachOutTexts
|
||||
visit: VisitTexts
|
||||
unavailable: str
|
||||
side_answer_return: str = "Вернёмся к вопросу:"
|
||||
|
||||
|
||||
def dialog_texts_path() -> Path:
|
||||
@@ -118,4 +123,4 @@ def dialog_texts_path() -> Path:
|
||||
@lru_cache
|
||||
def load_dialog_texts(path: Path | None = None) -> DialogTexts:
|
||||
path = path or dialog_texts_path()
|
||||
return DialogTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
return DialogTexts.model_validate(yaml.safe_load(fill_phones(path.read_text(encoding="utf-8"))))
|
||||
|
||||
@@ -0,0 +1,51 @@
|
||||
"""Demo adapters behind the frozen integration Protocols (SPEC §9, #14).
|
||||
|
||||
`setup()` runs when the package is first imported. Every consumer imports `app.integrations.base`, which
|
||||
initialises this package first, and `app/main.py` is a frozen contract — so the registry is wired before
|
||||
any request or job without a startup hook. Setup only constructs objects: data files and DB sessions are
|
||||
opened lazily on the first call, so importing the package never fails on I/O.
|
||||
|
||||
Registry after setup:
|
||||
- `prescriptions` — `MisMock`: clinical DB `prescriptions`, then `data/meds/mis_prescriptions.json`;
|
||||
- `identity` — `ConnectCodeIdentity`: one-time connect code from the doctor (ЕСИА stand-in);
|
||||
- `drug_info` — `GrlsExcerpts`: `data/meds/grls/*.yaml`;
|
||||
- `notifier` — `CompositeNotifier`: in-memory dashboard feed + optional Telegram doctor chat;
|
||||
- `outbox` — unchanged `MemoryOutbox` (the web console drains it; the Telegram channel wraps it at start).
|
||||
"""
|
||||
|
||||
from app.integrations.base import (
|
||||
EmptyPrescriptions,
|
||||
MemoryNotifier,
|
||||
NoDrugInfo,
|
||||
RejectIdentity,
|
||||
integrations,
|
||||
)
|
||||
from app.integrations.connect_code import ConnectCodeIdentity
|
||||
from app.integrations.grls import GrlsExcerpts
|
||||
from app.integrations.mis_mock import MisMock
|
||||
from app.integrations.notify import CompositeNotifier, NotificationFeed
|
||||
|
||||
__all__ = ["CompositeNotifier", "ConnectCodeIdentity", "GrlsExcerpts", "MisMock", "NotificationFeed", "setup"]
|
||||
|
||||
_done = False
|
||||
|
||||
|
||||
def setup(*, force: bool = False) -> None:
|
||||
"""Register the demo adapters. Idempotent; never replaces an adapter someone already swapped in
|
||||
(a test fake, the Telegram outbox), only the in-memory defaults from `base.py` — unless `force`."""
|
||||
global _done
|
||||
if _done and not force:
|
||||
return
|
||||
if force or isinstance(integrations.prescriptions, EmptyPrescriptions):
|
||||
integrations.prescriptions = MisMock()
|
||||
if force or isinstance(integrations.identity, RejectIdentity):
|
||||
integrations.identity = ConnectCodeIdentity()
|
||||
if force or isinstance(integrations.drug_info, NoDrugInfo):
|
||||
integrations.drug_info = GrlsExcerpts()
|
||||
# Exact type check: MemoryNotifier subclasses used as test sinks must stay in place.
|
||||
if force or type(integrations.notifier) is MemoryNotifier:
|
||||
integrations.notifier = CompositeNotifier()
|
||||
_done = True
|
||||
|
||||
|
||||
setup()
|
||||
|
||||
@@ -0,0 +1,58 @@
|
||||
"""ЕСИА stand-in: the patient proves identity with the one-time connect code issued by the doctor.
|
||||
|
||||
The doctor creates the code in «Подключить пациента» (identity DB `connect_codes`); the patient opens the
|
||||
QR deep link / enters the code. In prod this is ЕСИА OAuth; the `IdentityProvider` Protocol stays the same.
|
||||
"""
|
||||
|
||||
import logging
|
||||
from datetime import UTC, timedelta
|
||||
|
||||
from sqlalchemy.exc import SQLAlchemyError
|
||||
|
||||
from app.core import clock
|
||||
from app.integrations.base import VerifiedPerson
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
# One connect flow verifies the same code twice: the Telegram channel on `/start <code>` (to bind the chat)
|
||||
# and then the dialog engine's `new` state (to check the code belongs to this token). A short grace window
|
||||
# lets the second check pass; after it a used code is rejected like an unknown one.
|
||||
REDEEM_GRACE = timedelta(minutes=15)
|
||||
|
||||
|
||||
class ConnectCodeIdentity:
|
||||
"""`IdentityProvider` over identity-DB connect codes."""
|
||||
|
||||
def __init__(self, grace: timedelta = REDEEM_GRACE) -> None:
|
||||
self.grace = grace
|
||||
|
||||
async def verify(self, auth_code: str) -> VerifiedPerson | None:
|
||||
code = auth_code.strip()
|
||||
if not code:
|
||||
return None
|
||||
# Imported lazily: the integrations package is imported by clinical-side modules, which must not
|
||||
# pull the identity schema into their import graph (guardrail #5).
|
||||
from app.db import identity_repo
|
||||
from app.db.identity import ConnectCode
|
||||
from app.db.session import get_identity_session
|
||||
|
||||
now = clock.now()
|
||||
try:
|
||||
async with get_identity_session() as s:
|
||||
row = await s.get(ConnectCode, code)
|
||||
if row is None:
|
||||
log.info("connect code rejected: unknown")
|
||||
return None
|
||||
person = VerifiedPerson(token=row.token, doctor_id=row.doctor_id)
|
||||
if row.used_at is not None:
|
||||
used_at = row.used_at if row.used_at.tzinfo else row.used_at.replace(tzinfo=UTC)
|
||||
if now - used_at <= self.grace:
|
||||
return person
|
||||
log.info("connect code rejected: already used")
|
||||
return None
|
||||
if await identity_repo.redeem_connect_code(s, code=code, now=now) is None:
|
||||
return None
|
||||
return person
|
||||
except (OSError, SQLAlchemyError) as exc:
|
||||
log.warning("connect code check failed error=%s", type(exc).__name__)
|
||||
return None
|
||||
@@ -0,0 +1,35 @@
|
||||
"""ЕМИАС sign-in mock for the patient web app (SPEC §9 `esia_mock`: registration by the doctor's code).
|
||||
|
||||
Real ЕМИАС / ЕСИА OAuth needs a registered information system, so the prototype accepts the one-time connect
|
||||
code the doctor hands out after the visit (323-FZ art. 36.2): code → patient token + attending doctor. The
|
||||
class implements `IdentityProvider`, so the real OAuth client replaces it without touching the web channel.
|
||||
|
||||
It is deliberately NOT installed into `integrations.identity`: the Telegram channel verifies a code twice
|
||||
(on `/start` and in the core flow), which a one-time redeeming provider would break. Lane B wires the
|
||||
production provider for all channels (#14).
|
||||
|
||||
This module may use the identity DB: it is the registration boundary (guardrail #5).
|
||||
"""
|
||||
|
||||
from app.core import clock
|
||||
from app.db import identity_repo
|
||||
from app.db.identity import ConnectCode
|
||||
from app.db.session import get_identity_session
|
||||
from app.integrations.base import VerifiedPerson
|
||||
|
||||
CODE_MAX_LEN = 32
|
||||
|
||||
|
||||
class EmiasMock:
|
||||
async def verify(self, auth_code: str) -> VerifiedPerson | None:
|
||||
code = auth_code.strip().upper()
|
||||
if not code or len(code) > CODE_MAX_LEN:
|
||||
return None
|
||||
async with get_identity_session() as s:
|
||||
row = await s.get(ConnectCode, code)
|
||||
if row is None:
|
||||
return None
|
||||
token = await identity_repo.redeem_connect_code(s, code=code, now=clock.now())
|
||||
if token is None:
|
||||
return None
|
||||
return VerifiedPerson(token=token, doctor_id=row.doctor_id)
|
||||
@@ -0,0 +1,102 @@
|
||||
"""ЕМИАС medical record mock: diagnoses, comorbidities, allergies and other specialists' prescriptions.
|
||||
|
||||
Prod: the regional МИС / ЕГИСЗ adapter replaces `EmiasRecordSource` (same `get(token)` contract). Demo: synthetic
|
||||
records from `data/emias/records.yaml` keyed by synthetic SNILS, converted to tokens with `pseudo_id()` at load
|
||||
time — so the record handed to the chat agent carries no SNILS, name or phone (guardrail #1). The current
|
||||
psychiatric prescription comes from the МИС mock (`integrations.prescriptions`).
|
||||
"""
|
||||
|
||||
import logging
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, Field
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.privacy import pseudo_id
|
||||
from app.integrations.base import integrations
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
|
||||
class Diagnosis(BaseModel):
|
||||
code: str
|
||||
name: str
|
||||
|
||||
|
||||
class Condition(BaseModel):
|
||||
name: str
|
||||
tags: list[str] = Field(default_factory=list)
|
||||
|
||||
|
||||
class OtherMedication(BaseModel):
|
||||
drug: str
|
||||
how: str = ""
|
||||
prescribed_by: str = ""
|
||||
classes: list[str] = Field(default_factory=list)
|
||||
|
||||
|
||||
class CurrentPrescription(BaseModel):
|
||||
drug: str
|
||||
dose: str
|
||||
instructions: str = ""
|
||||
|
||||
|
||||
class PatientRecord(BaseModel):
|
||||
"""Clinical-only view of the record (no identifiers): what the chat agent may see."""
|
||||
|
||||
diagnoses: list[Diagnosis] = Field(default_factory=list)
|
||||
conditions: list[Condition] = Field(default_factory=list)
|
||||
allergies: list[Condition] = Field(default_factory=list)
|
||||
other_medications: list[OtherMedication] = Field(default_factory=list)
|
||||
pregnancy: dict[str, str] | None = None
|
||||
current_prescriptions: list[CurrentPrescription] = Field(default_factory=list)
|
||||
|
||||
|
||||
def default_records_path() -> Path:
|
||||
return get_settings().data_dir / "emias" / "records.yaml"
|
||||
|
||||
|
||||
@lru_cache
|
||||
def _load(path: Path) -> dict[str, PatientRecord]:
|
||||
raw = yaml.safe_load(path.read_text(encoding="utf-8")) or {}
|
||||
out: dict[str, PatientRecord] = {}
|
||||
for snils, rec in (raw.get("records") or {}).items():
|
||||
aliases = rec.pop("tokens", []) if isinstance(rec, dict) else []
|
||||
record = PatientRecord.model_validate(rec)
|
||||
out[pseudo_id(snils)] = record
|
||||
for token in aliases: # demo tokens used by the patient web app (e.g. tok-andrey) share the record
|
||||
out[token] = record
|
||||
return out
|
||||
|
||||
|
||||
class EmiasRecordSource:
|
||||
def __init__(self, path: Path | None = None) -> None:
|
||||
self._path = path
|
||||
|
||||
async def get(self, token: str) -> PatientRecord | None:
|
||||
try:
|
||||
records = _load(self._path or default_records_path())
|
||||
base = records.get(token)
|
||||
if base is None and "-" in token:
|
||||
# Fresh demo copies (POST /auth/demo/fresh): "tok-andrey-1a2b3c4d" → the "tok-andrey" record.
|
||||
base = records.get(token.rsplit("-", 1)[0])
|
||||
except (OSError, yaml.YAMLError, ValueError) as exc:
|
||||
log.error("emias records unavailable: %s", type(exc).__name__)
|
||||
base = None
|
||||
record = base.model_copy(deep=True) if base is not None else PatientRecord()
|
||||
try:
|
||||
rx = await integrations.prescriptions.get_prescriptions(token)
|
||||
except Exception as exc: # noqa: BLE001 — the МИС being down must not break the chat
|
||||
log.error("prescriptions unavailable: %s", type(exc).__name__)
|
||||
rx = []
|
||||
record.current_prescriptions = [
|
||||
CurrentPrescription(drug=p.drug, dose=p.dose, instructions=p.instructions) for p in rx
|
||||
]
|
||||
if base is None and not rx:
|
||||
return None
|
||||
return record
|
||||
|
||||
|
||||
emias_records = EmiasRecordSource()
|
||||
@@ -0,0 +1,80 @@
|
||||
"""ГРЛС stand-in: short excerpts of the official drug instruction, per section (SPEC §9, SPEC §7 п.5).
|
||||
|
||||
Each `data/meds/grls/<name>.yaml` holds one drug:
|
||||
|
||||
inn: сертралин
|
||||
aliases: [sertraline]
|
||||
sections:
|
||||
side_effects: {text: "...", source: "ГРЛС, инструкция по медицинскому применению, раздел «...»"}
|
||||
|
||||
Section codes are the ones `app/llm/med_qa.py` understands (side_effects, onset, alcohol, discontinuation,
|
||||
administration, interactions, overdose). The bot answers drug questions ONLY from these texts, so they are
|
||||
the single place to verify against the current ГРЛС instruction (see the header of each file).
|
||||
"""
|
||||
|
||||
import logging
|
||||
from pathlib import Path
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, Field, ValidationError
|
||||
|
||||
from app.config import get_settings
|
||||
from app.integrations.base import DrugSection
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
|
||||
class _SectionFile(BaseModel):
|
||||
text: str
|
||||
source: str
|
||||
|
||||
|
||||
class _DrugFile(BaseModel):
|
||||
inn: str
|
||||
aliases: list[str] = Field(default_factory=list)
|
||||
sections: dict[str, _SectionFile]
|
||||
|
||||
|
||||
def default_grls_dir() -> Path:
|
||||
return get_settings().data_dir / "meds" / "grls"
|
||||
|
||||
|
||||
def normalize_inn(name: str) -> str:
|
||||
"""Lookup key: «Сертралин 50 мг», «сертралин», «Sertraline» -> first word, lower case, ё -> е."""
|
||||
words = name.strip().lower().replace("ё", "е").split()
|
||||
return words[0] if words else ""
|
||||
|
||||
|
||||
class GrlsExcerpts:
|
||||
"""`DrugInfo` over local YAML excerpts. Files are read lazily on the first lookup and cached."""
|
||||
|
||||
def __init__(self, directory: Path | None = None) -> None:
|
||||
self._dir = directory
|
||||
self._index: dict[str, list[DrugSection]] | None = None
|
||||
|
||||
def _load(self) -> dict[str, list[DrugSection]]:
|
||||
if self._index is not None:
|
||||
return self._index
|
||||
directory = self._dir or default_grls_dir()
|
||||
index: dict[str, list[DrugSection]] = {}
|
||||
for path in sorted(directory.glob("*.yaml")):
|
||||
try:
|
||||
drug = _DrugFile.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
except (OSError, yaml.YAMLError, ValidationError) as exc:
|
||||
log.warning("grls file skipped file=%s error=%s", path.name, type(exc).__name__)
|
||||
continue
|
||||
sections = [
|
||||
DrugSection(inn=drug.inn, section=code, text=" ".join(s.text.split()), source=s.source)
|
||||
for code, s in drug.sections.items()
|
||||
]
|
||||
for key in (drug.inn, *drug.aliases):
|
||||
index[normalize_inn(key)] = sections
|
||||
self._index = index
|
||||
return index
|
||||
|
||||
def known(self) -> list[str]:
|
||||
"""INNs with excerpts (for the dashboard / tests)."""
|
||||
return sorted({s[0].inn for s in self._load().values() if s})
|
||||
|
||||
async def sections(self, inn: str) -> list[DrugSection]:
|
||||
return [s.model_copy() for s in self._load().get(normalize_inn(inn), [])]
|
||||
@@ -0,0 +1,201 @@
|
||||
"""Registration boundary and durable MAX queue. Callers own the identity transaction.
|
||||
|
||||
Only this boundary joins a pseudonymous profile to a MAX recipient. Clinical modules never import it.
|
||||
Queue rows contain a template name, never replies, scores, prescriptions or patient-auth tokens in URLs.
|
||||
"""
|
||||
|
||||
import hashlib
|
||||
import secrets
|
||||
from datetime import datetime, timedelta
|
||||
|
||||
from sqlalchemy import delete, select, update
|
||||
from sqlalchemy.exc import IntegrityError
|
||||
from sqlalchemy.ext.asyncio import AsyncSession
|
||||
|
||||
from app.db import repo
|
||||
from app.db.clinical import ScaleResult
|
||||
from app.db.intake import QuestionnaireRecord
|
||||
from app.db.max_notifications import MaxBinding, MaxDelivery, MaxLinkCode
|
||||
from app.db.session import get_clinical_session
|
||||
|
||||
MAX_ATTEMPTS = 6
|
||||
LEASE_SECONDS = 60
|
||||
|
||||
|
||||
def digest(value: str) -> str:
|
||||
return hashlib.sha256(value.encode()).hexdigest()
|
||||
|
||||
|
||||
async def active_patient(token: str) -> bool:
|
||||
"""Same consent/adult gate used by the scheduler, checked again at delivery time."""
|
||||
async with get_clinical_session() as session:
|
||||
state = await repo.get_dialog_state(session, token)
|
||||
return bool(
|
||||
await repo.get_profile(session, token)
|
||||
and state
|
||||
and state.data.get("consent") is True
|
||||
and state.data.get("adult") is True
|
||||
)
|
||||
|
||||
|
||||
async def issue_code(session: AsyncSession, token: str, now: datetime, ttl: int) -> tuple[str, datetime]:
|
||||
raw = secrets.token_urlsafe(32)
|
||||
expires = now + timedelta(seconds=ttl)
|
||||
await session.execute(delete(MaxLinkCode).where(MaxLinkCode.token == token))
|
||||
session.add(MaxLinkCode(digest=digest(raw), token=token, expires_at=expires))
|
||||
await session.flush()
|
||||
return raw, expires
|
||||
|
||||
|
||||
async def code_token(session: AsyncSession, raw: str, now: datetime) -> str | None:
|
||||
row = await session.get(MaxLinkCode, digest(raw))
|
||||
return row.token if row and row.used_at is None and row.expires_at > now else None
|
||||
|
||||
|
||||
async def bind(session: AsyncSession, raw: str, user_id: int, now: datetime) -> str | None:
|
||||
"""Atomically consume a code. Existing active identities cannot be silently reassigned."""
|
||||
token = await code_token(session, raw, now)
|
||||
if token is None:
|
||||
return None
|
||||
owner = await session.scalar(select(MaxBinding).where(MaxBinding.user_id == user_id))
|
||||
binding = await session.get(MaxBinding, token)
|
||||
if owner and owner.token != token and owner.enabled:
|
||||
return None
|
||||
if binding and binding.user_id != user_id and binding.enabled:
|
||||
return None
|
||||
used = await session.execute(
|
||||
update(MaxLinkCode)
|
||||
.where(MaxLinkCode.digest == digest(raw), MaxLinkCode.used_at.is_(None), MaxLinkCode.expires_at > now)
|
||||
.values(used_at=now)
|
||||
.returning(MaxLinkCode.token)
|
||||
)
|
||||
if used.scalar_one_or_none() is None:
|
||||
return None
|
||||
if owner and owner.token != token:
|
||||
await session.delete(owner)
|
||||
await session.flush()
|
||||
if binding is None:
|
||||
binding = MaxBinding(token=token, user_id=user_id, connected_at=now)
|
||||
session.add(binding)
|
||||
# Cancel stale deliveries even when the same account reconnects later.
|
||||
await cancel_pending(session, token)
|
||||
binding.user_id, binding.enabled, binding.connected_at = user_id, True, now
|
||||
await session.flush()
|
||||
return token
|
||||
|
||||
|
||||
async def cancel_pending(session: AsyncSession, token: str) -> None:
|
||||
await session.execute(
|
||||
update(MaxDelivery)
|
||||
.where(MaxDelivery.token == token, MaxDelivery.state.in_(("queued", "sending")))
|
||||
.values(state="cancelled", lease=None)
|
||||
)
|
||||
|
||||
|
||||
async def disconnect(session: AsyncSession, token: str) -> None:
|
||||
binding = await session.get(MaxBinding, token)
|
||||
if binding:
|
||||
binding.enabled = False
|
||||
await session.execute(delete(MaxLinkCode).where(MaxLinkCode.token == token))
|
||||
await cancel_pending(session, token)
|
||||
|
||||
|
||||
async def enqueue(
|
||||
session: AsyncSession, *, key: str, user_id: int, kind: str, now: datetime, token: str | None = None
|
||||
) -> None:
|
||||
if await session.get(MaxDelivery, key) is not None:
|
||||
return
|
||||
try:
|
||||
async with session.begin_nested():
|
||||
session.add(
|
||||
MaxDelivery(id=key, user_id=user_id, token=token, kind=kind, created_at=now, next_attempt_at=now)
|
||||
)
|
||||
await session.flush()
|
||||
except IntegrityError:
|
||||
# Another worker may enqueue the same event between SELECT and INSERT.
|
||||
if await session.get(MaxDelivery, key) is None:
|
||||
raise
|
||||
|
||||
|
||||
async def collect_completed(session: AsyncSession, now: datetime) -> None:
|
||||
"""Recover completion events from committed clinical records, including after a restart.
|
||||
|
||||
No clinical hooks depend on identity. Read only IDs/dates, then enqueue a generic template.
|
||||
A binding's activation time bounds history; repeated scans are idempotent.
|
||||
"""
|
||||
bindings = (await session.scalars(select(MaxBinding).where(MaxBinding.enabled.is_(True)))).all()
|
||||
for binding in bindings:
|
||||
if not await active_patient(binding.token):
|
||||
continue
|
||||
async with get_clinical_session() as clinical:
|
||||
forms = (
|
||||
await clinical.scalars(
|
||||
select(QuestionnaireRecord.id).where(
|
||||
QuestionnaireRecord.token == binding.token,
|
||||
QuestionnaireRecord.status == "complete",
|
||||
QuestionnaireRecord.completed_at >= binding.connected_at,
|
||||
)
|
||||
)
|
||||
).all()
|
||||
scales = (
|
||||
await clinical.scalars(
|
||||
select(ScaleResult.id).where(
|
||||
ScaleResult.token == binding.token,
|
||||
ScaleResult.complete.is_(True),
|
||||
ScaleResult.ts >= binding.connected_at,
|
||||
)
|
||||
)
|
||||
).all()
|
||||
for source, ids in (("form", forms), ("scale", scales)):
|
||||
for record_id in ids:
|
||||
key = digest(f"completed:{binding.token}:{binding.connected_at.isoformat()}:{source}:{record_id}")
|
||||
await enqueue(session, key=key, token=binding.token, user_id=binding.user_id, kind="completed", now=now)
|
||||
|
||||
|
||||
async def claim(session: AsyncSession, now: datetime) -> MaxDelivery | None:
|
||||
"""One lease per row; recovery after a worker crash is bounded by the lease deadline."""
|
||||
ready = (MaxDelivery.state.in_(("queued", "sending"))) & (MaxDelivery.next_attempt_at <= now)
|
||||
row = await session.scalar(
|
||||
select(MaxDelivery)
|
||||
.where(ready)
|
||||
.order_by(MaxDelivery.created_at, MaxDelivery.id)
|
||||
.with_for_update(skip_locked=True)
|
||||
.limit(1)
|
||||
)
|
||||
if row is None:
|
||||
return None
|
||||
if row.attempts >= MAX_ATTEMPTS:
|
||||
row.state, row.error_code, row.lease = "failed", "attempt_limit", None
|
||||
return None
|
||||
lease = secrets.token_hex(16)
|
||||
result = await session.execute(
|
||||
update(MaxDelivery)
|
||||
.where(MaxDelivery.id == row.id, ready)
|
||||
.values(
|
||||
state="sending",
|
||||
attempts=MaxDelivery.attempts + 1,
|
||||
lease=lease,
|
||||
next_attempt_at=now + timedelta(seconds=LEASE_SECONDS),
|
||||
)
|
||||
.returning(MaxDelivery.id)
|
||||
)
|
||||
if result.scalar_one_or_none() is None:
|
||||
return None
|
||||
await session.refresh(row)
|
||||
return row
|
||||
|
||||
|
||||
async def finish(
|
||||
session: AsyncSession,
|
||||
row: MaxDelivery,
|
||||
*,
|
||||
state: str,
|
||||
now: datetime,
|
||||
error: str | None = None,
|
||||
retry_seconds: float = 0,
|
||||
) -> None:
|
||||
await session.execute(
|
||||
update(MaxDelivery)
|
||||
.where(MaxDelivery.id == row.id, MaxDelivery.lease == row.lease, MaxDelivery.state == "sending")
|
||||
.values(state=state, lease=None, error_code=error, next_attempt_at=now + timedelta(seconds=retry_seconds))
|
||||
)
|
||||
@@ -0,0 +1,97 @@
|
||||
"""МИС / ЕГИСЗ stand-in: the patient's prescriptions (SPEC §9).
|
||||
|
||||
Source order: the clinical DB table `prescriptions` (written when the doctor connects a patient or by the
|
||||
demo seed), then the synthetic catalogue `data/meds/mis_prescriptions.json` keyed by token. In prod this is
|
||||
a regional МИС query; the Protocol stays the same.
|
||||
"""
|
||||
|
||||
import json
|
||||
import logging
|
||||
from datetime import date
|
||||
from pathlib import Path
|
||||
from typing import Any
|
||||
|
||||
from pydantic import BaseModel, Field, ValidationError
|
||||
from sqlalchemy import select
|
||||
from sqlalchemy.exc import SQLAlchemyError
|
||||
|
||||
from app.config import get_settings
|
||||
from app.integrations.base import Prescription
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
|
||||
class _CatalogPatient(BaseModel):
|
||||
persona: str
|
||||
tokens: list[str] = Field(default_factory=list)
|
||||
prescriptions: list[Prescription]
|
||||
|
||||
|
||||
class _Catalog(BaseModel):
|
||||
patients: list[_CatalogPatient]
|
||||
|
||||
|
||||
def _from_row(drug: str, dose: str, schedule: dict[str, Any], start: date | None, end: date | None) -> Prescription:
|
||||
# The table has no instructions column; the doctor's note («утром после еды») may ride in the schedule JSON.
|
||||
times = {k: [str(x) for x in v] for k, v in schedule.items() if isinstance(v, list)}
|
||||
return Prescription(
|
||||
drug=drug,
|
||||
dose=dose,
|
||||
schedule=times or {"times": ["08:00"]},
|
||||
instructions=str(schedule.get("instructions") or ""),
|
||||
start_date=start,
|
||||
end_date=end,
|
||||
)
|
||||
|
||||
|
||||
def default_catalog_path() -> Path:
|
||||
return get_settings().data_dir / "meds" / "mis_prescriptions.json"
|
||||
|
||||
|
||||
class MisMock:
|
||||
"""`PrescriptionSource`: clinical DB first, synthetic JSON catalogue as the fallback."""
|
||||
|
||||
def __init__(self, catalog_path: Path | None = None, *, use_db: bool = True) -> None:
|
||||
self._path = catalog_path
|
||||
self._use_db = use_db
|
||||
self._by_token: dict[str, list[Prescription]] | None = None
|
||||
|
||||
def _catalog(self) -> dict[str, list[Prescription]]:
|
||||
# Lazy: the package is imported before startup, a missing/broken file must not break the import.
|
||||
if self._by_token is None:
|
||||
path = self._path or default_catalog_path()
|
||||
index: dict[str, list[Prescription]] = {}
|
||||
try:
|
||||
catalog = _Catalog.model_validate(json.loads(path.read_text(encoding="utf-8")))
|
||||
except (OSError, ValueError, ValidationError) as exc:
|
||||
log.warning("mis_mock catalogue not loaded error=%s", type(exc).__name__)
|
||||
catalog = _Catalog(patients=[])
|
||||
for patient in catalog.patients:
|
||||
for token in patient.tokens:
|
||||
index[token] = patient.prescriptions
|
||||
self._by_token = index
|
||||
return self._by_token
|
||||
|
||||
async def _from_db(self, token: str) -> list[Prescription]:
|
||||
from app.db.clinical import Prescription as PrescriptionRow
|
||||
from app.db.session import get_clinical_session
|
||||
|
||||
async with get_clinical_session() as s:
|
||||
rows = (
|
||||
await s.scalars(
|
||||
select(PrescriptionRow).where(PrescriptionRow.token == token).order_by(PrescriptionRow.id)
|
||||
)
|
||||
).all()
|
||||
return [_from_row(r.drug, r.dose, r.schedule or {}, r.start_date, r.end_date) for r in rows]
|
||||
|
||||
async def get_prescriptions(self, token: str) -> list[Prescription]:
|
||||
if self._use_db:
|
||||
try:
|
||||
found = await self._from_db(token)
|
||||
except (OSError, SQLAlchemyError) as exc:
|
||||
# DB down or not migrated: the demo still shows the catalogue prescription.
|
||||
log.warning("mis_mock db lookup failed error=%s", type(exc).__name__)
|
||||
found = []
|
||||
if found:
|
||||
return found
|
||||
return [p.model_copy(deep=True) for p in self._catalog().get(token, [])]
|
||||
@@ -0,0 +1,141 @@
|
||||
"""Doctor notifications (SPEC §9): in-memory feed for the dashboard + optional Telegram doctor chat.
|
||||
|
||||
The alert itself is already committed to the clinical DB before `send()` is called (the dashboard reads
|
||||
alerts from there via the API), so every channel here is best effort: failures are logged, never raised.
|
||||
Messages carry only the level, the rule reason/code and a short pseudonymous patient id — no PII
|
||||
(guardrail #8); the reason texts come from `config/rules.yaml`, not from patient messages.
|
||||
"""
|
||||
|
||||
import asyncio
|
||||
import itertools
|
||||
import logging
|
||||
from collections import deque
|
||||
from collections.abc import Awaitable, Callable
|
||||
from datetime import datetime
|
||||
from typing import Any
|
||||
|
||||
from pydantic import BaseModel
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core import clock
|
||||
from app.integrations.base import AlertLevelName
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
FEED_SIZE = 500
|
||||
SHORT_ID_LEN = 6
|
||||
MAX_REASON_CHARS = 200
|
||||
TELEGRAM_TIMEOUT_S = 5.0
|
||||
# Doctor-facing labels (not patient texts); acute alerts are visually distinct in the chat.
|
||||
LEVEL_LABELS: dict[str, str] = {
|
||||
"acute": "КРИТИЧНО",
|
||||
"high": "Высокий",
|
||||
"moderate": "Умеренный",
|
||||
"info": "Инфо",
|
||||
}
|
||||
|
||||
ChatSender = Callable[[int, str], Awaitable[Any]]
|
||||
|
||||
|
||||
def short_id(token: str | None) -> str:
|
||||
return token[:SHORT_ID_LEN] if token else "—"
|
||||
|
||||
|
||||
def format_message(level: str, text: str, token: str | None) -> str:
|
||||
reason = " ".join(text.split())
|
||||
if len(reason) > MAX_REASON_CHARS:
|
||||
reason = reason[: MAX_REASON_CHARS - 1] + "…"
|
||||
return f"[{LEVEL_LABELS.get(level, level)}] {reason}\nПациент #{short_id(token)}"
|
||||
|
||||
|
||||
class Notification(BaseModel):
|
||||
id: int
|
||||
ts: datetime
|
||||
doctor_id: str
|
||||
level: str
|
||||
text: str
|
||||
token: str | None = None
|
||||
|
||||
|
||||
class NotificationFeed:
|
||||
"""Bounded in-memory feed; ids increase monotonically so a poller asks only for `recent(since_id)`."""
|
||||
|
||||
def __init__(self, size: int = FEED_SIZE) -> None:
|
||||
self._items: deque[Notification] = deque(maxlen=size)
|
||||
self._ids = itertools.count(1)
|
||||
|
||||
def add(self, doctor_id: str, level: str, text: str, token: str | None, ts: datetime) -> Notification:
|
||||
item = Notification(id=next(self._ids), ts=ts, doctor_id=doctor_id, level=level, text=text, token=token)
|
||||
self._items.append(item)
|
||||
return item
|
||||
|
||||
def recent(self, since_id: int = 0, doctor_id: str | None = None) -> list[Notification]:
|
||||
return [n for n in self._items if n.id > since_id and (doctor_id is None or n.doctor_id == doctor_id)]
|
||||
|
||||
|
||||
class TelegramDoctorChat:
|
||||
"""Sends to the doctor chat `DOCTOR_NOTIFY_CHAT_ID` through the bot `TG_BOT_TOKEN`.
|
||||
|
||||
The aiogram `Bot` is created on the first message only; with either setting empty the channel is off.
|
||||
"""
|
||||
|
||||
def __init__(self, chat_id: int | None = None, bot_token: str | None = None, sender: ChatSender | None = None):
|
||||
settings = get_settings()
|
||||
self.chat_id = chat_id if chat_id is not None else settings.doctor_notify_chat_id
|
||||
self._bot_token = bot_token if bot_token is not None else settings.tg_bot_token
|
||||
self._sender = sender
|
||||
self._bot: Any = None
|
||||
|
||||
@property
|
||||
def enabled(self) -> bool:
|
||||
return self.chat_id is not None and (self._sender is not None or bool(self._bot_token))
|
||||
|
||||
def _get_sender(self) -> ChatSender:
|
||||
if self._sender is None:
|
||||
from app.channels.telegram import make_bot
|
||||
|
||||
self._bot = make_bot(self._bot_token)
|
||||
self._sender = self._bot.send_message
|
||||
return self._sender
|
||||
|
||||
async def send(self, level: str, text: str, token: str | None) -> None:
|
||||
if not self.enabled or self.chat_id is None:
|
||||
return
|
||||
try:
|
||||
await asyncio.wait_for(
|
||||
self._get_sender()(self.chat_id, format_message(level, text, token)), timeout=TELEGRAM_TIMEOUT_S
|
||||
)
|
||||
except Exception as exc: # noqa: BLE001 — any channel error; the alert is already in the DB
|
||||
err = type(exc).__name__
|
||||
log.warning("doctor chat notify failed level=%s tok=%s error=%s", level, short_id(token), err)
|
||||
|
||||
async def aclose(self) -> None:
|
||||
if self._bot is not None:
|
||||
await self._bot.session.close()
|
||||
self._bot = None
|
||||
self._sender = None
|
||||
|
||||
|
||||
class CompositeNotifier:
|
||||
"""`Notifier`: dashboard feed + Telegram doctor chat (when configured)."""
|
||||
|
||||
def __init__(self, feed: NotificationFeed | None = None, chat: TelegramDoctorChat | None = None) -> None:
|
||||
self.feed = feed or NotificationFeed()
|
||||
self._chat = chat
|
||||
|
||||
@property
|
||||
def chat(self) -> TelegramDoctorChat:
|
||||
# Lazy: settings are read on the first notification, not when the package is imported.
|
||||
if self._chat is None:
|
||||
self._chat = TelegramDoctorChat()
|
||||
return self._chat
|
||||
|
||||
def recent(self, since_id: int = 0, doctor_id: str | None = None) -> list[Notification]:
|
||||
return self.feed.recent(since_id, doctor_id)
|
||||
|
||||
async def send(self, doctor_id: str, level: AlertLevelName, text: str, token: str | None = None) -> None:
|
||||
try:
|
||||
self.feed.add(doctor_id, level, text, token, clock.now())
|
||||
except Exception as exc: # noqa: BLE001 — never break the caller
|
||||
log.warning("notify feed failed error=%s", type(exc).__name__)
|
||||
await self.chat.send(level, text, token)
|
||||
@@ -0,0 +1,200 @@
|
||||
"""Chat agent: tool-using LLM over the knowledge base (RAG), the ЕМИАС record and the drug-safety reference.
|
||||
|
||||
from app.llm.agent import answer_chat
|
||||
reply = await answer_chat(token, scrubbed_question) # None → caller falls back to extractive RAG / med_qa
|
||||
|
||||
Guarantees (on top of what the dialog engine already did — scrub, consent, safety check; ACUTE never gets here):
|
||||
* only scrubbed text goes to the provider (`assert_scrubbed`), tool results carry no identifiers;
|
||||
* tools are bound to the current token server-side; read-only;
|
||||
* the final text passes the gateway's forbidden-output filter (diagnoses, dose/drug advice); a violation or any
|
||||
provider error → None, so the patient gets the safe extractive answer instead;
|
||||
* logs carry tool names and counts only.
|
||||
"""
|
||||
|
||||
import asyncio
|
||||
import json
|
||||
import logging
|
||||
import re
|
||||
from typing import Any
|
||||
|
||||
from pydantic import BaseModel
|
||||
|
||||
from app.config import Settings, get_settings
|
||||
from app.core.types import ScrubbedText
|
||||
from app.llm.agent import stream
|
||||
from app.llm.agent.prompts import SYSTEM_PROMPT
|
||||
from app.llm.agent.providers import (
|
||||
GigaChatToolProvider,
|
||||
MockAgentProvider,
|
||||
OpenRouterProvider,
|
||||
ProviderError,
|
||||
ToolChatProvider,
|
||||
)
|
||||
from app.llm.agent.tools import TOOL_SPECS, ToolContext, run_tool
|
||||
from app.llm.gateway import is_forbidden
|
||||
from app.llm.guard import assert_scrubbed
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
MAX_ANSWER_CHARS = 1200
|
||||
MAX_TOOL_CALLS_PER_TURN = 4 # seen live: one «как дела?» turn issued 23 parallel guideline searches
|
||||
# Greetings / small talk: answered without the LLM (instant, free, never drags medical findings into «привет»).
|
||||
SMALL_TALK = re.compile(
|
||||
r"^\W*(прив\w*|здравств\w*|здаров\w*|добр(ый|ое|ого)\s+\w+|хай|hello|hi|ку)\b"
|
||||
r"|\b(как\s+(дела|ты|вы|жизнь|поживаешь)|что\s+делаешь|чем\s+занят\w*|спишь|кто\s+ты|ты\s+(бот|робот|кто))\b",
|
||||
re.I,
|
||||
)
|
||||
SMALL_TALK_MAX_WORDS = 8
|
||||
SMALL_TALK_REPLY = (
|
||||
"Здравствуйте! Я на связи. Могу рассказать о вашем лечении: как действует препарат и когда ждать эффекта, "
|
||||
"какие бывают побочные эффекты, что можно и нельзя сочетать с вашими таблетками, что в составе. "
|
||||
"Спросите — отвечу по вашей карте, инструкции и клиническим рекомендациям."
|
||||
)
|
||||
NUDGE = "Сформулируй ответ пациенту по результатам инструментов выше (3–6 предложений)."
|
||||
_ALLOWED_MSG_KEYS = {"role", "content", "tool_calls", "tool_call_id"}
|
||||
|
||||
|
||||
class AgentAnswer(BaseModel):
|
||||
text: str
|
||||
sources: list[str]
|
||||
tools: list[str]
|
||||
provider: str
|
||||
|
||||
|
||||
def build_provider(settings: Settings | None = None) -> ToolChatProvider | None:
|
||||
s = settings or get_settings()
|
||||
mode = s.chat_agent
|
||||
if mode == "auto":
|
||||
mode = "gigachat" if s.gigachat_credentials else "openrouter" if s.openrouter_api_key else "off"
|
||||
if mode == "openrouter":
|
||||
if not s.openrouter_api_key:
|
||||
log.warning("chat agent: openrouter selected without OPENROUTER_API_KEY — disabled")
|
||||
return None
|
||||
return OpenRouterProvider(s)
|
||||
if mode == "mock":
|
||||
return MockAgentProvider()
|
||||
if mode == "gigachat":
|
||||
if not s.gigachat_credentials:
|
||||
log.warning("chat agent: gigachat selected without GIGACHAT_CREDENTIALS — disabled")
|
||||
return None
|
||||
return GigaChatToolProvider(s)
|
||||
return None
|
||||
|
||||
|
||||
def is_small_talk(text: str) -> bool:
|
||||
"""Short greeting / chit-chat without a medical question in it."""
|
||||
words = re.findall(r"\w+", text)
|
||||
medical = r"(лекарств|таблет|препарат|побоч|доз|лечени|можно|ибупрофен|нурофен|алкогол|пив|сертралин|сон|сплю)"
|
||||
if len(words) > SMALL_TALK_MAX_WORDS or re.search(medical, text, re.I):
|
||||
return False
|
||||
return bool(SMALL_TALK.search(text))
|
||||
|
||||
|
||||
async def _chat_with_retry(provider: ToolChatProvider, messages: list[dict[str, Any]]):
|
||||
"""One retry: OpenRouter occasionally fails a single call (seen live as intermittent ProviderError)."""
|
||||
wire = _wire(messages) if provider.name == "openrouter" else messages # gigachat needs the tool `name`
|
||||
try:
|
||||
return await provider.chat(wire, TOOL_SPECS)
|
||||
except ProviderError as exc:
|
||||
log.warning("chat agent provider=%s retry after %s", provider.name, exc)
|
||||
return await provider.chat(wire, TOOL_SPECS)
|
||||
|
||||
|
||||
async def _patient_brief(ctx: ToolContext) -> str:
|
||||
"""One line of context so the model knows what «мои таблетки» means (drug names only, no identifiers)."""
|
||||
rec = await ctx.record()
|
||||
if rec is None or not rec.current_prescriptions:
|
||||
return "\n\nТекущее назначение психиатра: нет данных."
|
||||
drugs = ", ".join(p.drug for p in rec.current_prescriptions)
|
||||
return f"\n\nТекущее назначение психиатра: {drugs}. «Мои таблетки» = это назначение."
|
||||
|
||||
|
||||
def _wire(messages: list[dict[str, Any]]) -> list[dict[str, Any]]:
|
||||
"""Strip internal keys (tool `name`) before sending."""
|
||||
return [{k: v for k, v in m.items() if k in _ALLOWED_MSG_KEYS} for m in messages]
|
||||
|
||||
|
||||
async def answer_chat(
|
||||
token: str, question: ScrubbedText, *, provider: ToolChatProvider | None = None, settings: Settings | None = None
|
||||
) -> AgentAnswer | None:
|
||||
s = settings or get_settings()
|
||||
provider = provider or build_provider(s)
|
||||
if provider is None:
|
||||
return None
|
||||
try:
|
||||
assert_scrubbed(question)
|
||||
except ValueError:
|
||||
log.warning("chat agent: unscrubbed input rejected")
|
||||
return None
|
||||
if is_small_talk(question):
|
||||
return AgentAnswer(text=SMALL_TALK_REPLY, sources=[], tools=[], provider="small_talk")
|
||||
stream.emit("status", "Думаю над вопросом…")
|
||||
ctx = ToolContext(token=token)
|
||||
messages: list[dict[str, Any]] = [
|
||||
{"role": "system", "content": SYSTEM_PROMPT + await _patient_brief(ctx)},
|
||||
{"role": "user", "content": str(question)},
|
||||
]
|
||||
nudged = False
|
||||
try:
|
||||
async with asyncio.timeout(s.chat_agent_timeout_s * 2):
|
||||
for _ in range(s.chat_agent_max_steps):
|
||||
turn = await _chat_with_retry(provider, messages)
|
||||
if not turn.tool_calls:
|
||||
if not (turn.content or "").strip() and not nudged:
|
||||
# Some models (Gemini Flash) occasionally end with an empty message after tool results.
|
||||
nudged = True
|
||||
messages.append({"role": "user", "content": NUDGE})
|
||||
continue
|
||||
return _finish(turn.content or "", ctx, provider.name)
|
||||
messages.append(
|
||||
{
|
||||
"role": "assistant",
|
||||
"content": turn.content,
|
||||
"tool_calls": [ # the calls we actually run (capped) — history must match the results
|
||||
{
|
||||
"id": c.id,
|
||||
"type": "function",
|
||||
"function": {"name": c.name, "arguments": json.dumps(c.arguments, ensure_ascii=False)},
|
||||
}
|
||||
for c in turn.tool_calls[:MAX_TOOL_CALLS_PER_TURN]
|
||||
],
|
||||
}
|
||||
)
|
||||
for c in turn.tool_calls[:MAX_TOOL_CALLS_PER_TURN]:
|
||||
stream.emit("status", stream.TOOL_STATUS.get(c.name, "Проверяю данные…"))
|
||||
result = await run_tool(ctx, c.name, c.arguments)
|
||||
messages.append({"role": "tool", "tool_call_id": c.id, "name": c.name, "content": result})
|
||||
log.warning("chat agent: step limit reached tools=%s", ",".join(ctx.used))
|
||||
return None
|
||||
except (ProviderError, TimeoutError) as exc:
|
||||
log.error("chat agent provider=%s failed: %s %s", provider.name, type(exc).__name__, exc)
|
||||
return None
|
||||
except Exception: # noqa: BLE001 — the agent is optional: any bug must degrade to the extractive answer, not a 500
|
||||
log.exception("chat agent provider=%s crashed", provider.name)
|
||||
return None
|
||||
|
||||
|
||||
def _finish(text: str, ctx: ToolContext, provider: str) -> AgentAnswer | None:
|
||||
text = text.strip()
|
||||
if not text:
|
||||
return None
|
||||
if is_forbidden(text):
|
||||
log.warning("chat agent: forbidden output filtered provider=%s", provider)
|
||||
return None
|
||||
if len(text) > MAX_ANSWER_CHARS:
|
||||
text = text[:MAX_ANSWER_CHARS].rsplit(" ", 1)[0] + "…"
|
||||
log.info("chat agent ok provider=%s tools=%s sources=%d", provider, ",".join(ctx.used), len(ctx.sources))
|
||||
return AgentAnswer(text=text, sources=ctx.sources[:4], tools=ctx.used, provider=provider)
|
||||
|
||||
|
||||
_MD_BULLET = re.compile(r"^\s*[*-]\s+", re.M)
|
||||
_MD_MARKS = re.compile(r"\*\*|__|^#+\s*", re.M)
|
||||
SOURCES_MIN_CHARS = 160 # short replies (greetings, small talk) go without the sources footer
|
||||
|
||||
|
||||
def render(answer: AgentAnswer) -> str:
|
||||
"""Patient-facing text: answer (markdown stripped to plain text with «•» bullets) + short sources footer."""
|
||||
text = _MD_MARKS.sub("", _MD_BULLET.sub("• ", answer.text)).strip()
|
||||
if not answer.sources or len(text) < SOURCES_MIN_CHARS:
|
||||
return text
|
||||
return f"{text}\n\nИсточники: " + "; ".join(answer.sources)
|
||||
@@ -0,0 +1,59 @@
|
||||
"""Try the chat agent from the shell (synthetic personas only):
|
||||
|
||||
uv run python -m app.llm.agent "Можно мне ибупрофен вместе с моими таблетками?" --persona andrey
|
||||
CHAT_AGENT=mock uv run python -m app.llm.agent "Есть ли лактоза в сертралине?"
|
||||
|
||||
Prescriptions come from the МИС mock (DB if reachable, else data/meds/mis_prescriptions.json); the question is
|
||||
scrubbed before it reaches any provider.
|
||||
"""
|
||||
|
||||
import argparse
|
||||
import asyncio
|
||||
import logging
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.privacy import pseudo_id, scrub
|
||||
from app.integrations.base import Prescription, integrations
|
||||
from app.llm.agent import answer_chat, build_provider, render
|
||||
|
||||
PERSONAS = { # synthetic SNILS from scripts/seed_demo.py → current psychiatric prescription
|
||||
"andrey": ("900-000-013 34", "сертралин"),
|
||||
"dmitry": ("900-000-041 01", "сертралин"),
|
||||
"sergey": ("900-000-037 02", "пароксетин"),
|
||||
"nikolay": ("900-000-052 03", "сертралин"),
|
||||
"anna": ("900-000-023 04", "флуоксетин"),
|
||||
"pavel": ("900-000-045 07", "эсциталопрам"),
|
||||
}
|
||||
|
||||
|
||||
class _FixedRx:
|
||||
def __init__(self, drug: str) -> None:
|
||||
self.drug = drug
|
||||
|
||||
async def get_prescriptions(self, token: str) -> list[Prescription]:
|
||||
return [Prescription(drug=self.drug, dose="по назначению врача")]
|
||||
|
||||
|
||||
async def main() -> None:
|
||||
p = argparse.ArgumentParser()
|
||||
p.add_argument("question")
|
||||
p.add_argument("--persona", default="andrey", choices=sorted(PERSONAS))
|
||||
p.add_argument("-v", "--verbose", action="store_true")
|
||||
a = p.parse_args()
|
||||
logging.basicConfig(level=logging.INFO if a.verbose else logging.WARNING)
|
||||
snils, drug = PERSONAS[a.persona]
|
||||
integrations.prescriptions = _FixedRx(drug) # CLI runs without the DB
|
||||
provider = build_provider()
|
||||
if provider is None:
|
||||
raise SystemExit(
|
||||
f"agent disabled (CHAT_AGENT={get_settings().chat_agent}); set OPENROUTER_API_KEY or CHAT_AGENT=mock"
|
||||
)
|
||||
ans = await answer_chat(pseudo_id(snils), scrub(a.question), provider=provider)
|
||||
if ans is None:
|
||||
raise SystemExit("no answer (provider error, filtered output or nothing found) — chat falls back to RAG")
|
||||
print(render(ans))
|
||||
print(f"\n[provider={ans.provider} tools={', '.join(ans.tools)}]")
|
||||
|
||||
|
||||
if __name__ == "__main__":
|
||||
asyncio.run(main())
|
||||
@@ -0,0 +1,147 @@
|
||||
"""Deterministic drug-safety lookup: composition, contraindications, interactions, patient-specific findings.
|
||||
|
||||
The LLM never decides whether a drug is safe for the patient (ADR-007 spirit): it calls `check_patient` and
|
||||
retells the findings. Matching is by tags shared with the ЕМИАС record (`data/emias/records.yaml`):
|
||||
condition tags → `cautions[].when_condition`, allergy tags → `composition.excipient_tags`, other medication
|
||||
classes → `interactions[].with_class`. Source data: `data/meds/drug_safety.yaml` (prototype retelling of ГРЛС).
|
||||
"""
|
||||
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
from typing import Literal
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, Field
|
||||
|
||||
from app.config import get_settings
|
||||
from app.integrations.emias_record import PatientRecord
|
||||
|
||||
Severity = Literal["high", "medium", "low"]
|
||||
|
||||
|
||||
class Caution(BaseModel):
|
||||
when_condition: str
|
||||
severity: Severity
|
||||
text: str
|
||||
|
||||
|
||||
class Interaction(BaseModel):
|
||||
with_class: str
|
||||
severity: Severity
|
||||
text: str
|
||||
|
||||
|
||||
class Composition(BaseModel):
|
||||
form: str
|
||||
active: str
|
||||
excipients: list[str] = Field(default_factory=list)
|
||||
excipient_tags: list[str] = Field(default_factory=list)
|
||||
note: str = ""
|
||||
|
||||
|
||||
class DrugEntry(BaseModel):
|
||||
inn: str
|
||||
aliases: list[str] = Field(default_factory=list)
|
||||
drug_class: str = ""
|
||||
classes: list[str] = Field(default_factory=list) # classes this drug belongs to (e.g. nsaid, ssri)
|
||||
contraindications: list[str] = Field(default_factory=list)
|
||||
cautions: list[Caution] = Field(default_factory=list)
|
||||
interactions: list[Interaction] = Field(default_factory=list)
|
||||
composition: Composition | None = None
|
||||
pregnancy: str = ""
|
||||
source: str = ""
|
||||
|
||||
|
||||
class Finding(BaseModel):
|
||||
severity: Severity
|
||||
kind: Literal["condition", "allergy", "interaction", "pregnancy", "contraindication"]
|
||||
text: str
|
||||
|
||||
|
||||
class SafetyDb(BaseModel):
|
||||
drugs: dict[str, DrugEntry]
|
||||
allergy_labels: dict[str, str] = Field(default_factory=dict)
|
||||
|
||||
|
||||
def _path() -> Path:
|
||||
return get_settings().data_dir / "meds" / "drug_safety.yaml"
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_db(path: Path | None = None) -> SafetyDb:
|
||||
raw = yaml.safe_load((path or _path()).read_text(encoding="utf-8"))
|
||||
classes_of: dict[str, list[str]] = {}
|
||||
for cls, members in (raw.get("drug_classes") or {}).items():
|
||||
for m in members:
|
||||
classes_of.setdefault(m, []).append(cls)
|
||||
drugs: dict[str, DrugEntry] = {}
|
||||
for inn, d in (raw.get("drugs") or {}).items():
|
||||
entry = DrugEntry(
|
||||
inn=inn,
|
||||
aliases=d.get("aliases", []),
|
||||
drug_class=d.get("class", ""),
|
||||
classes=sorted(set(d.get("classes", [])) | set(classes_of.get(inn, []))),
|
||||
contraindications=d.get("contraindications", []),
|
||||
cautions=d.get("cautions", []),
|
||||
interactions=d.get("interactions", []),
|
||||
composition=d.get("composition"),
|
||||
pregnancy=d.get("pregnancy", ""),
|
||||
source=d.get("source", ""),
|
||||
)
|
||||
drugs[inn] = entry
|
||||
return SafetyDb(drugs=drugs, allergy_labels=raw.get("allergy_labels") or {})
|
||||
|
||||
|
||||
def find_drug(name: str, db: SafetyDb | None = None) -> DrugEntry | None:
|
||||
"""By INN or alias, case-insensitive; "сертралин 50 мг" → сертралин."""
|
||||
db = db or load_db()
|
||||
words = [w.strip(".,!?;:«»()") for w in name.lower().replace("ё", "е").split()]
|
||||
for entry in db.drugs.values():
|
||||
names = {entry.inn, *(a.lower() for a in entry.aliases)}
|
||||
# Russian case endings: "сертралине", "ибупрофена" — match on the stem (name minus the last letter).
|
||||
if any(w in names or any(len(n) > 4 and w.startswith(n[:-1]) for n in names) for w in words):
|
||||
return entry
|
||||
return None
|
||||
|
||||
|
||||
def check_patient(drug: DrugEntry, record: PatientRecord, db: SafetyDb | None = None) -> list[Finding]:
|
||||
"""Patient-specific findings for `drug`, most severe first. Empty list = nothing found in the reference —
|
||||
which is NOT a statement that the drug is safe (the answer must say so)."""
|
||||
db = db or load_db()
|
||||
out: list[Finding] = []
|
||||
cond_tags = {t for c in record.conditions for t in c.tags}
|
||||
for c in drug.cautions:
|
||||
if c.when_condition in cond_tags:
|
||||
out.append(Finding(severity=c.severity, kind="condition", text=c.text))
|
||||
# Excipients vs allergies / intolerances.
|
||||
allergy_tags = {t for a in record.allergies for t in a.tags}
|
||||
if drug.composition is not None:
|
||||
for tag in sorted(allergy_tags & set(drug.composition.excipient_tags)):
|
||||
label = db.allergy_labels.get(tag, tag)
|
||||
out.append(
|
||||
Finding(
|
||||
severity="high", kind="allergy", text=f"В составе есть {label}, а в карте отмечена непереносимость."
|
||||
)
|
||||
)
|
||||
# Interactions with the patient's other medicines and with the current psychiatric prescription.
|
||||
other_classes: dict[str, str] = {}
|
||||
for m in record.other_medications:
|
||||
for cls in m.classes:
|
||||
other_classes[cls] = m.drug
|
||||
for rx in record.current_prescriptions:
|
||||
entry = find_drug(rx.drug, db)
|
||||
if entry is not None and entry.inn != drug.inn:
|
||||
for cls in entry.classes:
|
||||
other_classes.setdefault(cls, rx.drug)
|
||||
for i in drug.interactions:
|
||||
if i.with_class in other_classes:
|
||||
out.append(
|
||||
Finding(
|
||||
severity=i.severity, kind="interaction", text=f"{i.text} (в карте: {other_classes[i.with_class]})."
|
||||
)
|
||||
)
|
||||
if record.pregnancy and drug.pregnancy:
|
||||
out.append(Finding(severity="medium", kind="pregnancy", text=drug.pregnancy))
|
||||
order = {"high": 0, "medium": 1, "low": 2}
|
||||
out.sort(key=lambda f: order[f.severity])
|
||||
return out
|
||||
@@ -0,0 +1,48 @@
|
||||
"""System prompt of the chat agent (Russian). Prohibitions follow SPEC §7; grounding: answer only from tools."""
|
||||
|
||||
from app.core.safety import fill_phones
|
||||
|
||||
_SYSTEM_PROMPT = """Ты — помощник пациента в сервисе сопровождения лечения между визитами к врачу. Пациент лечится у
|
||||
психиатра; ты отвечаешь на его вопросы о состоянии, лечении и лекарствах.
|
||||
|
||||
Как работать:
|
||||
1. Сначала собери данные инструментами. Для вопросов о лекарствах, сочетаниях, составе, аллергиях всегда
|
||||
вызывай get_patient_record и check_drug_for_patient (для каждого упомянутого препарата и, если вопрос
|
||||
о «моих таблетках», для текущего назначения). Вопросы об алкоголе, еде, вождении, сочетании с другими
|
||||
средствами, составе и непереносимостях — тоже вопросы о лекарстве: проверь текущее назначение через
|
||||
check_drug_for_patient (там есть состав, сравнение с непереносимостями и все взаимодействия).
|
||||
Вопросы «когда подействует», «что будет, если бросить», «как принимать», побочные эффекты — смотри поле
|
||||
instruction в check_drug_for_patient (инструкция ГРЛС) и дополняй search_guidelines.
|
||||
Для общих вопросов о лечении вызывай search_guidelines.
|
||||
2. Отвечай ТОЛЬКО на основе результатов инструментов. Если в них нет ответа — честно скажи, что в
|
||||
рекомендациях и инструкции этого нет, и предложи уточнить у лечащего врача. Ничего не додумывай.
|
||||
3. Если check_drug_for_patient вернул findings — назови КАЖДУЮ находку (сначала severity=high) простыми
|
||||
словами и посоветуй обсудить с врачом до приёма. Пустой список не значит «безопасно».
|
||||
Находки (findings) упоминай, когда вопрос о приёме, сочетании или безопасности препарата; на вопросы о
|
||||
сроках действия, отмене, побочных эффектах отвечай по существу, без посторонних находок.
|
||||
Про состав и непереносимости (intolerance_check) говори, только если о них спросили.
|
||||
Про алкоголь бери текст из general_interactions.
|
||||
4. Ссылайся на источник в тексте коротко: «по клиническим рекомендациям», «по инструкции к препарату»,
|
||||
«в вашей карте указано».
|
||||
|
||||
Запрещено:
|
||||
- ставить или называть диагнозы («у вас депрессия»), даже если они есть в карте;
|
||||
- назначать, отменять препараты, менять дозы, советовать «примите/не принимайте» — решение всегда за врачом;
|
||||
- называть дозировки в миллиграммах;
|
||||
- проводить психотерапию; обещать конфиденциальность сверх реальной;
|
||||
- выдумывать факты, которых нет в результатах инструментов.
|
||||
|
||||
На приветствия и болтовню («привет», «как дела?», «спишь?») отвечай 1–2 фразами, тепло, от лица помощника
|
||||
сервиса (не называй себя «языковой моделью» или «ИИ-моделью») и предложи, с чем можешь помочь: вопросы о
|
||||
лечении, лекарствах, побочных эффектах, самочувствии. Находки из карты в ответ на болтовню не упоминай.
|
||||
Никогда не переспрашивай, о каком препарате речь, если вопрос о «моём лекарстве»: это текущее назначение.
|
||||
Про аналоги и замену: назови группу текущего препарата по инструкции (например, «антидепрессант группы СИОЗС»),
|
||||
скажи, что в группе есть и другие препараты, а подбор и замену делает только лечащий врач.
|
||||
|
||||
Стиль: по-русски, на «вы», спокойно и по-человечески, 3–6 коротких предложений. Без markdown: никаких «*», «#»,
|
||||
«**»; если нужен список — короткие строки с «•».
|
||||
Если в вопросе есть признаки угрозы жизни — коротко скажи, что важно сразу позвонить 112 или на телефон
|
||||
доверия {phone:helpline}, и что врач будет уведомлён."""
|
||||
|
||||
# Numbers come from the single table config/texts/crisis.yaml.
|
||||
SYSTEM_PROMPT = fill_phones(_SYSTEM_PROMPT)
|
||||
@@ -0,0 +1,344 @@
|
||||
"""Tool-calling chat providers for the agent.
|
||||
|
||||
* `OpenRouterProvider` — OpenAI-compatible `/chat/completions` with `tools`. TEMPORARY for the prototype on
|
||||
synthetic data: OpenRouter is a foreign service, forbidden for real PII (152-FZ art. 18 p. 5). Replace with
|
||||
GigaChat (function calling) before any real patient — same `ToolChatProvider` contract.
|
||||
* `MockAgentProvider` — offline, deterministic: plans tool calls from keywords and composes an answer from the
|
||||
tool results. Keeps the demo working without network (ADR-004).
|
||||
"""
|
||||
|
||||
import json
|
||||
import logging
|
||||
import re
|
||||
from typing import Any, Protocol
|
||||
|
||||
import httpx
|
||||
from pydantic import BaseModel, Field
|
||||
|
||||
from app.config import Settings
|
||||
from app.llm.agent import stream
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
|
||||
class ToolCall(BaseModel):
|
||||
id: str
|
||||
name: str
|
||||
arguments: dict[str, Any] = Field(default_factory=dict)
|
||||
|
||||
|
||||
class AssistantTurn(BaseModel):
|
||||
content: str | None = None
|
||||
tool_calls: list[ToolCall] = Field(default_factory=list)
|
||||
|
||||
|
||||
class ToolChatProvider(Protocol):
|
||||
name: str
|
||||
|
||||
async def chat(self, messages: list[dict[str, Any]], tools: list[dict[str, Any]]) -> AssistantTurn: ...
|
||||
|
||||
|
||||
class ProviderError(RuntimeError):
|
||||
pass
|
||||
|
||||
|
||||
class OpenRouterProvider:
|
||||
name = "openrouter"
|
||||
|
||||
def __init__(self, settings: Settings, client: httpx.AsyncClient | None = None) -> None:
|
||||
self._key = settings.openrouter_api_key
|
||||
self._model = settings.openrouter_model
|
||||
self._url = settings.openrouter_base_url.rstrip("/") + "/chat/completions"
|
||||
self._timeout = settings.chat_agent_timeout_s
|
||||
self._proxy = settings.openrouter_proxy_url or None
|
||||
self._client = client
|
||||
|
||||
async def chat(self, messages: list[dict[str, Any]], tools: list[dict[str, Any]]) -> AssistantTurn:
|
||||
if stream.active():
|
||||
return await self._chat_stream(messages, tools)
|
||||
body: dict[str, Any] = {"model": self._model, "messages": messages, "tools": tools, "temperature": 0.1}
|
||||
body["max_tokens"] = 900
|
||||
if not any(m["role"] == "tool" for m in messages):
|
||||
body["tool_choice"] = "required" # never answer from the model's own memory: ground first
|
||||
headers = {"Authorization": f"Bearer {self._key}", "X-Title": "PTSRaiAgent prototype (synthetic data)"}
|
||||
try:
|
||||
if self._client is not None:
|
||||
resp = await self._client.post(self._url, json=body, headers=headers, timeout=self._timeout)
|
||||
else:
|
||||
async with httpx.AsyncClient(timeout=self._timeout, proxy=self._proxy) as client:
|
||||
resp = await client.post(self._url, json=body, headers=headers)
|
||||
except httpx.HTTPError as exc:
|
||||
raise ProviderError(type(exc).__name__) from exc
|
||||
if resp.status_code != 200:
|
||||
# Provider error bodies are generic (no patient text) — log the message to make failures diagnosable.
|
||||
try:
|
||||
err = resp.json().get("error", "")
|
||||
detail = str(err.get("message", "") if isinstance(err, dict) else err)[:200]
|
||||
except (ValueError, AttributeError):
|
||||
detail = resp.text[:200]
|
||||
log.error("openrouter http %s: %s", resp.status_code, detail)
|
||||
raise ProviderError(f"http {resp.status_code}")
|
||||
try:
|
||||
msg = resp.json()["choices"][0]["message"]
|
||||
except (ValueError, KeyError, IndexError) as exc:
|
||||
raise ProviderError("bad response") from exc
|
||||
calls = []
|
||||
for c in msg.get("tool_calls") or []:
|
||||
fn = c.get("function") or {}
|
||||
try:
|
||||
args = json.loads(fn.get("arguments") or "{}")
|
||||
except json.JSONDecodeError:
|
||||
args = {}
|
||||
calls.append(ToolCall(id=c.get("id") or fn.get("name", "call"), name=fn.get("name", ""), arguments=args))
|
||||
usage = resp.json().get("usage") or {}
|
||||
log.info("openrouter ok calls=%d tokens=%s", len(calls), usage.get("total_tokens"))
|
||||
return AssistantTurn(content=msg.get("content"), tool_calls=calls)
|
||||
|
||||
|
||||
class GigaChatToolProvider:
|
||||
"""GigaChat function calling (RF provider, 152-FZ compliant). Converts the OpenAI-style history the agent keeps:
|
||||
assistant `tool_calls` → `function_call`, `tool` results → role `function` with the function name.
|
||||
GigaChat returns at most one function call per turn — the agent loop handles that naturally."""
|
||||
|
||||
name = "gigachat"
|
||||
|
||||
def __init__(self, settings: Settings, client: Any | None = None) -> None:
|
||||
self._settings = settings
|
||||
self._client = client
|
||||
|
||||
def _get_client(self) -> Any:
|
||||
if self._client is None:
|
||||
from gigachat import GigaChat
|
||||
|
||||
s = self._settings
|
||||
self._client = GigaChat(
|
||||
credentials=s.gigachat_credentials,
|
||||
scope=s.gigachat_scope,
|
||||
model=s.gigachat_agent_model,
|
||||
verify_ssl_certs=s.gigachat_verify_ssl,
|
||||
timeout=s.chat_agent_timeout_s,
|
||||
)
|
||||
return self._client
|
||||
|
||||
@staticmethod
|
||||
def to_messages(messages: list[dict[str, Any]]) -> list[Any]:
|
||||
from gigachat.models import FunctionCall, Messages, MessagesRole
|
||||
|
||||
out = []
|
||||
for m in messages:
|
||||
role = m["role"]
|
||||
if role == "system":
|
||||
out.append(Messages(role=MessagesRole.SYSTEM, content=m["content"]))
|
||||
elif role == "user":
|
||||
out.append(Messages(role=MessagesRole.USER, content=m["content"]))
|
||||
elif role == "assistant":
|
||||
calls = m.get("tool_calls") or []
|
||||
for c in calls or [None]:
|
||||
fc = None
|
||||
if c is not None:
|
||||
fc = FunctionCall(name=c["function"]["name"], arguments=json.loads(c["function"]["arguments"]))
|
||||
out.append(Messages(role=MessagesRole.ASSISTANT, content=m.get("content") or "", function_call=fc))
|
||||
elif role == "tool":
|
||||
out.append(Messages(role=MessagesRole.FUNCTION, name=m.get("name"), content=m["content"]))
|
||||
return out
|
||||
|
||||
@staticmethod
|
||||
def to_functions(tools: list[dict[str, Any]]) -> list[Any]:
|
||||
from gigachat.models import Function
|
||||
|
||||
return [Function.model_validate(t["function"]) for t in tools]
|
||||
|
||||
async def chat(self, messages: list[dict[str, Any]], tools: list[dict[str, Any]]) -> AssistantTurn:
|
||||
from gigachat.models import Chat
|
||||
|
||||
chat = Chat(
|
||||
messages=self.to_messages(messages),
|
||||
functions=self.to_functions(tools),
|
||||
function_call="auto",
|
||||
temperature=0.1,
|
||||
max_tokens=900,
|
||||
)
|
||||
try:
|
||||
resp = await self._get_client().achat(chat)
|
||||
except Exception as exc: # noqa: BLE001 — network/auth/HTTP errors of the SDK
|
||||
raise ProviderError(type(exc).__name__) from exc
|
||||
msg = resp.choices[0].message
|
||||
calls = []
|
||||
if msg.function_call is not None:
|
||||
args = msg.function_call.arguments or {}
|
||||
if isinstance(args, str):
|
||||
try:
|
||||
args = json.loads(args)
|
||||
except json.JSONDecodeError:
|
||||
args = {}
|
||||
calls.append(ToolCall(id=msg.function_call.name, name=msg.function_call.name, arguments=args))
|
||||
usage = getattr(resp, "usage", None)
|
||||
log.info("gigachat agent ok calls=%d tokens=%s", len(calls), getattr(usage, "total_tokens", None))
|
||||
return AssistantTurn(content=msg.content or None, tool_calls=calls)
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------------ streaming
|
||||
|
||||
|
||||
async def _iter_sse(resp: httpx.Response):
|
||||
async for line in resp.aiter_lines():
|
||||
if not line.startswith("data:"):
|
||||
continue # comments («: OPENROUTER PROCESSING») and blank lines
|
||||
data = line[5:].strip()
|
||||
if data == "[DONE]":
|
||||
return
|
||||
try:
|
||||
yield json.loads(data)
|
||||
except json.JSONDecodeError:
|
||||
continue
|
||||
|
||||
|
||||
async def _openrouter_stream(self: "OpenRouterProvider", messages: list[dict[str, Any]], tools: list[dict[str, Any]]):
|
||||
"""Same request with `stream: true`: content deltas go to the live channel, tool calls are assembled."""
|
||||
body: dict[str, Any] = {
|
||||
"model": self._model,
|
||||
"messages": messages,
|
||||
"tools": tools,
|
||||
"temperature": 0.1,
|
||||
"max_tokens": 900,
|
||||
"stream": True,
|
||||
}
|
||||
if not any(m["role"] == "tool" for m in messages):
|
||||
body["tool_choice"] = "required"
|
||||
headers = {"Authorization": f"Bearer {self._key}", "X-Title": "PTSRaiAgent prototype (synthetic data)"}
|
||||
content: list[str] = []
|
||||
calls: dict[int, dict[str, Any]] = {}
|
||||
try:
|
||||
client = self._client or httpx.AsyncClient(timeout=self._timeout, proxy=self._proxy)
|
||||
try:
|
||||
async with client.stream("POST", self._url, json=body, headers=headers, timeout=self._timeout) as resp:
|
||||
if resp.status_code != 200:
|
||||
await resp.aread()
|
||||
raise ProviderError(f"http {resp.status_code}")
|
||||
async for chunk in _iter_sse(resp):
|
||||
choice = (chunk.get("choices") or [{}])[0]
|
||||
delta = choice.get("delta") or {}
|
||||
if delta.get("content"):
|
||||
content.append(delta["content"])
|
||||
stream.emit("delta", delta["content"])
|
||||
for tc in delta.get("tool_calls") or []:
|
||||
slot = calls.setdefault(tc.get("index", 0), {"id": "", "name": "", "args": ""})
|
||||
slot["id"] = tc.get("id") or slot["id"]
|
||||
fn = tc.get("function") or {}
|
||||
slot["name"] += fn.get("name") or ""
|
||||
slot["args"] += fn.get("arguments") or ""
|
||||
finally:
|
||||
if self._client is None:
|
||||
await client.aclose()
|
||||
except httpx.HTTPError as exc:
|
||||
raise ProviderError(type(exc).__name__) from exc
|
||||
out = []
|
||||
for i in sorted(calls):
|
||||
c = calls[i]
|
||||
try:
|
||||
args = json.loads(c["args"] or "{}")
|
||||
except json.JSONDecodeError:
|
||||
args = {}
|
||||
out.append(ToolCall(id=c["id"] or c["name"] or f"call{i}", name=c["name"], arguments=args))
|
||||
if out and content:
|
||||
stream.emit("reset", None) # a preface before tool calls is not the answer
|
||||
log.info("openrouter stream ok calls=%d chars=%d", len(out), sum(map(len, content)))
|
||||
return AssistantTurn(content="".join(content) or None, tool_calls=out)
|
||||
|
||||
|
||||
OpenRouterProvider._chat_stream = _openrouter_stream # type: ignore[attr-defined]
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------------ offline mock
|
||||
|
||||
_DRUG_WORDS = re.compile(
|
||||
r"\b(сертралин\w*|пароксетин\w*|эсциталопрам\w*|флуоксетин\w*|ибупрофен\w*|нурофен\w*|золофт\w*)", re.I
|
||||
)
|
||||
_MED_HINT = re.compile(r"(таблет|лекарств|препарат|состав|можно ли|совмест|вместе|противопоказ|аллерг|лактоз)", re.I)
|
||||
|
||||
|
||||
class MockAgentProvider:
|
||||
"""Plans: record → (drug check for each mentioned drug, or the current prescription for medicine questions)
|
||||
→ guidelines search; then writes a short answer strictly from the tool results."""
|
||||
|
||||
name = "mock"
|
||||
|
||||
async def chat(self, messages: list[dict[str, Any]], tools: list[dict[str, Any]]) -> AssistantTurn:
|
||||
question = next(m["content"] for m in reversed(messages) if m["role"] == "user")
|
||||
done = [m for m in messages if m["role"] == "tool"]
|
||||
if not done:
|
||||
drugs = [m.group(1).lower() for m in _DRUG_WORDS.finditer(question)]
|
||||
calls = [ToolCall(id="c0", name="get_patient_record")]
|
||||
calls += [
|
||||
ToolCall(id=f"d{i}", name="check_drug_for_patient", arguments={"drug": d}) for i, d in enumerate(drugs)
|
||||
]
|
||||
if drugs and re.search(r"состав|лактоз|желатин|аллерг|непереносим", question, re.I):
|
||||
calls += [
|
||||
ToolCall(id=f"i{i}", name="get_drug_info", arguments={"drug": d}) for i, d in enumerate(drugs)
|
||||
]
|
||||
calls.append(ToolCall(id="s0", name="search_guidelines", arguments={"query": question}))
|
||||
return AssistantTurn(tool_calls=calls)
|
||||
mine = re.search(r"мо(и|ими|их|ей|я|ё) (таблет|лекарств|препарат)", question, re.I)
|
||||
checked = [m for m in done if m.get("name") == "check_drug_for_patient"]
|
||||
if (not checked or mine) and len(checked) < 3 and _MED_HINT.search(question):
|
||||
record = _tool_json(done, "get_patient_record")
|
||||
rx = (record or {}).get("current_prescriptions") or []
|
||||
checked_args = {str(json.loads(m["content"]).get("inn", "")) for m in checked}
|
||||
rx = [r for r in rx if not any(r["drug"].lower().startswith(c[:-1]) for c in checked_args if c)]
|
||||
if rx:
|
||||
return AssistantTurn(
|
||||
tool_calls=[ToolCall(id="d9", name="check_drug_for_patient", arguments={"drug": rx[0]["drug"]})]
|
||||
)
|
||||
return AssistantTurn(content=_compose(done))
|
||||
|
||||
|
||||
def _tool_json(done: list[dict[str, Any]], name: str) -> dict[str, Any] | None:
|
||||
for m in done:
|
||||
if m.get("name") == name:
|
||||
try:
|
||||
return json.loads(m["content"])
|
||||
except json.JSONDecodeError:
|
||||
return None
|
||||
return None
|
||||
|
||||
|
||||
def _compose(done: list[dict[str, Any]]) -> str:
|
||||
parts: list[str] = []
|
||||
seen: set[str] = set()
|
||||
for m in done:
|
||||
if m.get("name") != "check_drug_for_patient":
|
||||
continue
|
||||
data = json.loads(m["content"])
|
||||
if not data.get("found") or data["inn"] in seen:
|
||||
continue
|
||||
seen.add(data["inn"])
|
||||
findings = data.get("findings") or []
|
||||
if findings:
|
||||
parts.append(f"По вашей карте и инструкции к препарату «{data['inn']}» есть важное:")
|
||||
parts += [f"• {f['text']}" for f in findings[:3]]
|
||||
else:
|
||||
parts.append(f"В справочнике не нашлось особых ограничений по «{data['inn']}» с учётом вашей карты.")
|
||||
for m in done:
|
||||
if m.get("name") != "get_drug_info":
|
||||
continue
|
||||
data = json.loads(m["content"])
|
||||
comp = data.get("composition") if data.get("found") else None
|
||||
if comp:
|
||||
record = _tool_json(done, "get_patient_record") or {}
|
||||
allergies = record.get("allergies") or []
|
||||
if allergies:
|
||||
names = ", ".join(a["name"] for a in allergies)
|
||||
hit = {t for a in allergies for t in a.get("tags", [])} & set(comp.get("excipient_tags", []))
|
||||
verdict = "это вещество есть" if hit else "этого вещества нет, но состав зависит от производителя"
|
||||
parts.append(f"В вашей карте: {names}. В примере состава «{data['inn']}» {verdict}.")
|
||||
excipients = ", ".join(comp["excipients"])
|
||||
parts.append(f"Состав ({comp['form']}): {comp['active']}; вспомогательные: {excipients}. {comp['note']}")
|
||||
search = _tool_json(done, "search_guidelines") or {}
|
||||
results = search.get("results") or []
|
||||
if results and not parts: # medicine findings already answer the question; a KR quote would dilute it
|
||||
text = results[0]["text"].strip()
|
||||
parts.append(f"В клинических рекомендациях: «{text[:400]}{'…' if len(text) > 400 else ''}»")
|
||||
if not parts:
|
||||
return ""
|
||||
parts.append("Любые изменения в лечении обсуждайте с вашим врачом.")
|
||||
return "\n".join(parts)
|
||||
@@ -0,0 +1,32 @@
|
||||
"""Live progress of the chat agent for streaming channels (web SSE).
|
||||
|
||||
The SSE endpoint sets a queue in the context; the agent pushes events while it works:
|
||||
status — a tool step in plain Russian («Смотрю вашу карту ЕМИАС…»)
|
||||
delta — a chunk of the answer as the model writes it
|
||||
reset — the streamed text so far was a preface before tool calls: clear it
|
||||
Channels without a queue (Telegram, tests) are unaffected. Deltas are the raw model text: the final reply
|
||||
(forbidden-output filter, sources footer) always comes in the closing `done` event and replaces it.
|
||||
"""
|
||||
|
||||
import asyncio
|
||||
from contextvars import ContextVar
|
||||
from typing import Any
|
||||
|
||||
STREAM: ContextVar[asyncio.Queue[tuple[str, Any]] | None] = ContextVar("agent_stream", default=None)
|
||||
|
||||
TOOL_STATUS = {
|
||||
"get_patient_record": "Смотрю вашу карту ЕМИАС…",
|
||||
"check_drug_for_patient": "Проверяю препарат по вашей карте: болезни, непереносимости, другие лекарства…",
|
||||
"get_drug_info": "Открываю инструкцию к препарату (ГРЛС)…",
|
||||
"search_guidelines": "Ищу в клинических рекомендациях Минздрава…",
|
||||
}
|
||||
|
||||
|
||||
def active() -> bool:
|
||||
return STREAM.get() is not None
|
||||
|
||||
|
||||
def emit(kind: str, payload: Any) -> None:
|
||||
q = STREAM.get()
|
||||
if q is not None:
|
||||
q.put_nowait((kind, payload))
|
||||
@@ -0,0 +1,219 @@
|
||||
"""Read-only tools of the chat agent. Every tool is bound to the current patient's token on the server side:
|
||||
the model never passes a token, so it cannot read another patient's data (medical secrecy, 323-FZ art. 13).
|
||||
|
||||
Tool results contain clinical data only (no name, SNILS, phone) — they are sent to the LLM provider.
|
||||
"""
|
||||
|
||||
import json
|
||||
import logging
|
||||
import re
|
||||
from dataclasses import dataclass, field
|
||||
from typing import Any
|
||||
|
||||
from app.integrations.base import integrations
|
||||
from app.integrations.emias_record import PatientRecord, emias_records
|
||||
from app.llm.agent.drug_safety import check_patient, find_drug, load_db
|
||||
from app.llm.rag import retrieve
|
||||
from app.llm.rag.index import sentences
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
RAG_TOP_K = 4
|
||||
PASSAGE_CHARS = 700
|
||||
# Patients never get dosages (SPEC §7): sentences with doses are dropped before the text reaches the LLM.
|
||||
_DOSE = re.compile(r"\d\s*(?:-|–)?\s*\d*\s*(?:мг|mg|мкг|г/сут|таблетк)|\bдоз(?:а|у|ы|е|ой|ировк)", re.I)
|
||||
|
||||
TOOL_SPECS: list[dict[str, Any]] = [
|
||||
{
|
||||
"type": "function",
|
||||
"function": {
|
||||
"name": "search_guidelines",
|
||||
"description": (
|
||||
"Поиск по базе знаний: клинические рекомендации Минздрава РФ (депрессия 2024, ПТСР 2023). "
|
||||
"Возвращает фрагменты с источником и страницей. Используй для любых общих вопросов о состоянии, "
|
||||
"лечении, сроках действия терапии, побочных эффектах, отмене, образе жизни."
|
||||
),
|
||||
"parameters": {
|
||||
"type": "object",
|
||||
"properties": {"query": {"type": "string", "description": "Поисковый запрос на русском"}},
|
||||
"required": ["query"],
|
||||
},
|
||||
},
|
||||
},
|
||||
{
|
||||
"type": "function",
|
||||
"function": {
|
||||
"name": "get_patient_record",
|
||||
"description": (
|
||||
"Медицинская карта текущего пациента из ЕМИАС: диагнозы (МКБ-10), сопутствующие заболевания, "
|
||||
"аллергии и непереносимости, назначения других врачей и текущее назначение психиатра. "
|
||||
"Вызывай, когда ответ зависит от особенностей пациента или его лекарств."
|
||||
),
|
||||
"parameters": {"type": "object", "properties": {}},
|
||||
},
|
||||
},
|
||||
{
|
||||
"type": "function",
|
||||
"function": {
|
||||
"name": "get_drug_info",
|
||||
"description": (
|
||||
"Справка о препарате по инструкции ГРЛС: состав (действующее и вспомогательные вещества), "
|
||||
"противопоказания, взаимодействия, беременность. Аргумент — название препарата (МНН или торговое)."
|
||||
),
|
||||
"parameters": {
|
||||
"type": "object",
|
||||
"properties": {"drug": {"type": "string"}},
|
||||
"required": ["drug"],
|
||||
},
|
||||
},
|
||||
},
|
||||
{
|
||||
"type": "function",
|
||||
"function": {
|
||||
"name": "check_drug_for_patient",
|
||||
"description": (
|
||||
"Детерминированная проверка препарата для текущего пациента: сопутствующие заболевания, "
|
||||
"непереносимости по составу, взаимодействия с другими его лекарствами. Используй перед любым "
|
||||
"ответом о том, подходит ли пациенту препарат или сочетание препаратов."
|
||||
),
|
||||
"parameters": {
|
||||
"type": "object",
|
||||
"properties": {
|
||||
"drug": {"type": "string", "description": "Название препарата; пусто — текущее назначение пациента"}
|
||||
},
|
||||
},
|
||||
},
|
||||
},
|
||||
]
|
||||
|
||||
|
||||
@dataclass
|
||||
class ToolContext:
|
||||
token: str
|
||||
sources: list[str] = field(default_factory=list) # citations collected for the answer footer
|
||||
used: list[str] = field(default_factory=list)
|
||||
_record: PatientRecord | None = None
|
||||
_record_loaded: bool = False
|
||||
|
||||
async def record(self) -> PatientRecord | None:
|
||||
if not self._record_loaded:
|
||||
self._record = await emias_records.get(self.token)
|
||||
self._record_loaded = True
|
||||
return self._record
|
||||
|
||||
def cite(self, label: str) -> None:
|
||||
if label and label not in self.sources:
|
||||
self.sources.append(label)
|
||||
|
||||
|
||||
async def run_tool(ctx: ToolContext, name: str, args: dict[str, Any]) -> str:
|
||||
"""Execute a tool; always returns a JSON string (errors included) so the model can recover."""
|
||||
ctx.used.append(name)
|
||||
log.info("agent tool=%s", name) # no arguments: they may echo patient text
|
||||
try:
|
||||
if name == "search_guidelines":
|
||||
return _json(_search(ctx, str(args.get("query", ""))))
|
||||
if name == "get_patient_record":
|
||||
rec = await ctx.record()
|
||||
if rec is None:
|
||||
return _json({"found": False})
|
||||
ctx.cite("ЕМИАС: медицинская карта")
|
||||
return _json({"found": True, **rec.model_dump()})
|
||||
if name == "get_drug_info":
|
||||
return _json(_drug_info(ctx, str(args.get("drug", ""))))
|
||||
if name == "check_drug_for_patient":
|
||||
return _json(await _check(ctx, str(args.get("drug", ""))))
|
||||
return _json({"error": f"unknown tool {name}"})
|
||||
except Exception as exc: # noqa: BLE001 — a tool failure must not crash the chat
|
||||
log.error("agent tool=%s failed: %s", name, type(exc).__name__)
|
||||
return _json({"error": "tool failed"})
|
||||
|
||||
|
||||
def _search(ctx: ToolContext, query: str) -> dict[str, Any]:
|
||||
hits = retrieve(query, audience="patient", top_k=RAG_TOP_K) if query.strip() else []
|
||||
out = []
|
||||
for h in hits:
|
||||
label = h.chunk.citation.strip("[]")
|
||||
ctx.cite(label)
|
||||
text = " ".join(x for x in sentences(h.passage) if not _DOSE.search(x))[:PASSAGE_CHARS]
|
||||
if text:
|
||||
out.append({"source": label, "section": h.chunk.section, "text": text})
|
||||
return {"results": out, "found": bool(out)}
|
||||
|
||||
|
||||
def _drug_info(ctx: ToolContext, name: str) -> dict[str, Any]:
|
||||
entry = find_drug(name)
|
||||
if entry is None:
|
||||
return {"found": False, "drug": name}
|
||||
ctx.cite(entry.source)
|
||||
return {
|
||||
"found": True,
|
||||
"inn": entry.inn,
|
||||
"class": entry.drug_class,
|
||||
"composition": entry.composition.model_dump() if entry.composition else None,
|
||||
"contraindications": entry.contraindications,
|
||||
"interactions": [i.text for i in entry.interactions],
|
||||
"pregnancy": entry.pregnancy,
|
||||
"source": entry.source,
|
||||
}
|
||||
|
||||
|
||||
async def _check(ctx: ToolContext, name: str) -> dict[str, Any]:
|
||||
entry = find_drug(name) if name.strip() else None
|
||||
if entry is None:
|
||||
# "мои таблетки" / no name → the current psychiatric prescription from the record.
|
||||
rec = await ctx.record()
|
||||
current = [find_drug(p.drug) for p in (rec.current_prescriptions if rec else [])]
|
||||
entry = next((e for e in current if e is not None), None) if not find_drug(name) else None
|
||||
if entry is None:
|
||||
return {"found": False, "drug": name, "note": "Препарата нет в справочнике — отвечать «уточните у врача»."}
|
||||
rec = await ctx.record()
|
||||
if rec is None:
|
||||
return {"found": True, "inn": entry.inn, "record": False, "findings": []}
|
||||
ctx.cite(entry.source)
|
||||
ctx.cite("ЕМИАС: медицинская карта")
|
||||
db = load_db()
|
||||
findings = check_patient(entry, rec, db)
|
||||
comp = entry.composition
|
||||
intolerances = [a.name for a in rec.allergies]
|
||||
intolerance_check = None
|
||||
if comp is not None and intolerances:
|
||||
hit = {t for a in rec.allergies for t in a.tags} & set(comp.excipient_tags)
|
||||
intolerance_check = f"Непереносимость из карты ({', '.join(intolerances)}): " + (
|
||||
"вещество ЕСТЬ в составе."
|
||||
if hit
|
||||
else "в примере состава этого вещества нет; состав зависит от производителя."
|
||||
)
|
||||
instruction = await _instruction(ctx, entry.inn)
|
||||
return {
|
||||
"found": True,
|
||||
"inn": entry.inn,
|
||||
"record": True,
|
||||
"instruction": instruction, # ГРЛС excerpts: onset, side effects, discontinuation, administration
|
||||
"findings": [f.model_dump() for f in findings],
|
||||
"intolerance_check": intolerance_check,
|
||||
"composition": comp.model_dump(exclude={"excipient_tags"}) if comp else None,
|
||||
"general_interactions": [i.text for i in entry.interactions], # incl. alcohol — for questions about it
|
||||
"contraindications": entry.contraindications,
|
||||
"note": "Пустой findings не означает, что препарат безопасен: решение о приёме принимает врач.",
|
||||
}
|
||||
|
||||
|
||||
INSTRUCTION_SECTIONS = ("onset", "side_effects", "discontinuation", "administration", "alcohol")
|
||||
|
||||
|
||||
async def _instruction(ctx: ToolContext, inn: str) -> dict[str, str]:
|
||||
"""ГРЛС excerpts for the drug (no doses in mg — see data/meds/grls)."""
|
||||
try:
|
||||
sections = await integrations.drug_info.sections(inn)
|
||||
except Exception as exc: # noqa: BLE001
|
||||
log.error("drug_info unavailable: %s", type(exc).__name__)
|
||||
return {}
|
||||
out = {s.section: s.text for s in sections if s.section in INSTRUCTION_SECTIONS}
|
||||
if out:
|
||||
ctx.cite(sections[0].source.split(",")[0] + ": инструкция к препарату")
|
||||
return out
|
||||
|
||||
|
||||
def _json(data: Any) -> str:
|
||||
return json.dumps(data, ensure_ascii=False)
|
||||
+3
-1
@@ -43,7 +43,9 @@ FORBIDDEN_OUTPUT: tuple[re.Pattern[str], ...] = tuple(
|
||||
for p in (
|
||||
r"диагноз",
|
||||
r"у (вас|тебя) (\w+ )?(депресси|птср|тревожн\w* расстройств|расстройств|биполяр|шизофрен)",
|
||||
r"(это|похоже на|признаки) (\w+ )?(депресси|птср|посттравматическ|расстройств)",
|
||||
# Diagnosis-like statements about the patient. A plain definition («ПТСР — это расстройство, которое…»)
|
||||
# is education, not a diagnosis, so bare «это …» is no longer blocked.
|
||||
r"(похоже на|признаки|скорее всего,? у вас|у вас,? похоже) (\w+ )?(депресси|птср|посттравматическ|расстройств)",
|
||||
r"(увеличьте|уменьшите|снизьте|повысьте|удвойте|измените|увеличь|уменьши|снизь) (\w+ )?доз",
|
||||
r"(?<!не )отмен(ите|и) ",
|
||||
r"(?<!не )(прекратите|перестаньте|бросьте) (\w+ )?(приём|прием|принимать|пить)",
|
||||
|
||||
@@ -0,0 +1,24 @@
|
||||
"""Knowledge base (RAG, #60): clinical guidelines -> citable chunks -> BM25 retrieval -> grounded answers.
|
||||
|
||||
from app.llm.rag import answer, retrieve
|
||||
hits = retrieve("синдром отмены антидепрессантов", audience="doctor")
|
||||
reply = await answer(scrub(text), audience="patient") # None -> rag.fallback_text()
|
||||
|
||||
Corpus and parameters: `config/rag/sources.yaml`; PDF sources and the converter: `docs/source/rag/`.
|
||||
"""
|
||||
|
||||
from app.llm.rag.corpus import Chunk, load_chunks
|
||||
from app.llm.rag.index import Hit, get_index, retrieve
|
||||
from app.llm.rag.qa import Citation, RagAnswer, answer, fallback_text
|
||||
|
||||
__all__ = [
|
||||
"Chunk",
|
||||
"Citation",
|
||||
"Hit",
|
||||
"RagAnswer",
|
||||
"answer",
|
||||
"fallback_text",
|
||||
"get_index",
|
||||
"load_chunks",
|
||||
"retrieve",
|
||||
]
|
||||
@@ -0,0 +1,52 @@
|
||||
"""Manual check of the knowledge base on synthetic questions.
|
||||
|
||||
python -m app.llm.rag "через сколько начинают действовать антидепрессанты"
|
||||
python -m app.llm.rag --audience doctor "синдром отмены антидепрессантов"
|
||||
python -m app.llm.rag --search "ДПДГ при ПТСР" # raw retrieval: chunks, scores, passages
|
||||
python -m app.llm.rag --stats # corpus summary
|
||||
|
||||
The question always goes through `privacy.scrub()` first; the CLI never bypasses it.
|
||||
"""
|
||||
|
||||
import argparse
|
||||
import asyncio
|
||||
from collections import Counter
|
||||
|
||||
from app.core import privacy
|
||||
from app.llm.gateway import get_gateway
|
||||
from app.llm.rag.index import get_index
|
||||
from app.llm.rag.qa import answer, fallback_text
|
||||
|
||||
|
||||
def main(argv: list[str] | None = None) -> int:
|
||||
parser = argparse.ArgumentParser(prog="python -m app.llm.rag")
|
||||
parser.add_argument("question", nargs="?")
|
||||
parser.add_argument("--audience", choices=["patient", "doctor", "team"], default="patient")
|
||||
parser.add_argument("--search", action="store_true", help="show retrieved chunks instead of an answer")
|
||||
parser.add_argument("--top", type=int, default=5)
|
||||
parser.add_argument("--stats", action="store_true")
|
||||
args = parser.parse_args(argv)
|
||||
|
||||
index = get_index()
|
||||
if args.stats:
|
||||
by_doc = Counter(c.doc.short for c in index.chunks)
|
||||
print(f"chunks={len(index.chunks)}", ", ".join(f"{d}: {n}" for d, n in by_doc.items()))
|
||||
return 0
|
||||
if not args.question:
|
||||
parser.error("question is required")
|
||||
question = privacy.scrub(args.question)
|
||||
|
||||
if args.search:
|
||||
for hit in index.search(question, audience=args.audience, top_k=args.top, min_score=0):
|
||||
print(f"{hit.score:6.1f} (bm25 {hit.bm25:5.1f}) {hit.chunk.citation} {hit.chunk.section}")
|
||||
print(f" > {hit.passage[:300]}")
|
||||
return 0
|
||||
|
||||
print(f"provider={get_gateway().provider_name} audience={args.audience}\n")
|
||||
reply = asyncio.run(answer(question, audience=args.audience, index=index))
|
||||
print(reply.text if reply else fallback_text(args.audience))
|
||||
return 0
|
||||
|
||||
|
||||
if __name__ == "__main__":
|
||||
raise SystemExit(main())
|
||||
@@ -0,0 +1,350 @@
|
||||
"""Knowledge-base corpus: `config/rag/sources.yaml` + txt files -> citable chunks.
|
||||
|
||||
The txt files come from `docs/source/rag/pdf_to_txt.py`: paragraphs are separated by blank lines, pages by
|
||||
`--- стр. N ---` markers, tables are markdown, text transcribed from figures follows an
|
||||
`[Изображение: ...]` line. Chunking rules:
|
||||
|
||||
* a chunk never crosses a section boundary (numbered headings "2.1 ...", "Приложение Г5", ...), so its
|
||||
section title is reliable context; the title is stored separately and indexed with extra weight;
|
||||
* "Комментарии: ..." after a recommendation stays with the recommendation (the comment explains it);
|
||||
* a line starting in lowercase continues the previous paragraph (cut by a page break the converter missed);
|
||||
* tables are split by rows, every table piece repeats the table header, so a chunk is readable alone;
|
||||
* each chunk keeps the page range it came from, for the citation "[КР ПТСР 2023, стр. 45]"; inline
|
||||
"⟦стр. N⟧" markers (paragraph glued across a page break) are removed from the text but move the range.
|
||||
"""
|
||||
|
||||
import re
|
||||
from dataclasses import dataclass, field
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, Field
|
||||
|
||||
from app.config import get_settings
|
||||
|
||||
Audience = str # "doctor" | "patient" | "team"
|
||||
|
||||
PAGE_MARKER = re.compile(r"^--- стр\. (\d+) ---$")
|
||||
# A paragraph that flows onto the next page is glued by the converter; "⟦стр. N⟧" marks where page N begins.
|
||||
INLINE_PAGE = re.compile(r"\s*⟦стр\. (\d+)⟧\s*")
|
||||
TABLE_DIVIDER = re.compile(r"^\|(-+\|)+$")
|
||||
# "2.1 Жалобы и анамнез", "3.1.2. Купирующая терапия ..." — a numbered subsection title.
|
||||
SUBSECTION = re.compile(r"^(\d{1,2}(?:\.\d{1,2})+)\.?\s+([А-ЯЁA-Z].*)$") # not dates "28.07.2022 N ..."
|
||||
# Top-level KR sections: "1. Краткая информация ...", "3. Лечение, включая ...". Plain "1. ..." lines are
|
||||
# list items, so a top-level heading must start with one of the standard KR section names.
|
||||
TOPLEVEL = re.compile(
|
||||
r"^([1-9])\.\s+(Краткая информация|Диагностика|Лечение|Медицинская реабилитация|Профилактика"
|
||||
r"|Организация оказания|Дополнительная информация)"
|
||||
)
|
||||
NAMED = re.compile(
|
||||
r"^(Приложение [А-ЯЁ]\d*(?:-[А-ЯЁ]+\d*)?\b.*|Критерии оценки качества медицинской помощи|Список литературы"
|
||||
r"|Список сокращений|Термины и определения)$"
|
||||
)
|
||||
# Unnumbered short title lines (team specs): capitalised, short, no final punctuation, not a list item.
|
||||
SHORT_TITLE = re.compile(r"^[А-ЯЁ][^.:;!?|]{2,60}$")
|
||||
COMMENT = re.compile(r"^Комментари[йи]\s*:")
|
||||
SENTENCE_SPLIT = re.compile(r"(?<=[.!?…])\s+(?=[А-ЯЁA-Z0-9«\"(])")
|
||||
# Abbreviations after which a capital letter does not start a new sentence: "(см. Приложение Б5)".
|
||||
ABBREVIATION_END = re.compile(
|
||||
r"(?:\b(?:см|т\.\s?е|т\.\s?д|т\.\s?п|др|напр|рис|табл|стр|г|гг|им|ср|англ|лат|греч)|\b[А-ЯЁA-Z])\.$"
|
||||
)
|
||||
MAX_TITLE_CHARS = 300
|
||||
|
||||
|
||||
class DocumentMeta(BaseModel):
|
||||
id: str
|
||||
file: str
|
||||
title: str
|
||||
short: str
|
||||
issuer: str
|
||||
year: int
|
||||
icd: list[str] = Field(default_factory=list)
|
||||
audiences: list[Audience]
|
||||
|
||||
|
||||
class ChunkingConfig(BaseModel):
|
||||
max_chars: int = 1200
|
||||
min_chars: int = 200
|
||||
skip_sections: list[str] = Field(default_factory=list)
|
||||
|
||||
|
||||
class RetrievalConfig(BaseModel):
|
||||
top_k: int = 5
|
||||
bm25_k1: float = 1.5
|
||||
bm25_b: float = 0.75
|
||||
title_weight: int = 2
|
||||
min_score: float = 3.0
|
||||
rerank_candidates: int = 30
|
||||
window_sentences: int = 2
|
||||
window_weight: float = 0.5
|
||||
# section title prefix -> score multiplier, per audience ({"patient": {"Приложение В": 1.5}})
|
||||
section_boost: dict[str, dict[str, float]] = Field(default_factory=dict)
|
||||
# doc id -> regexes naming its disease; a question naming one disease favours that document
|
||||
doc_cues: dict[str, list[str]] = Field(default_factory=dict)
|
||||
doc_cue_boost: float = 1.0
|
||||
|
||||
|
||||
class AnswerConfig(BaseModel):
|
||||
max_chunks: int = 3
|
||||
max_passages: int = 2
|
||||
max_sentences: int = 3
|
||||
max_chars: int = 600
|
||||
min_coverage: float = 0.5
|
||||
second_passage_ratio: float = 0.8
|
||||
neighbor_ratio: float = 0.5
|
||||
|
||||
|
||||
class RagConfig(BaseModel):
|
||||
documents: list[DocumentMeta]
|
||||
chunking: ChunkingConfig = ChunkingConfig()
|
||||
retrieval: RetrievalConfig = RetrievalConfig()
|
||||
answer: AnswerConfig = AnswerConfig()
|
||||
synonyms: list[list[str]] = Field(default_factory=list)
|
||||
|
||||
|
||||
@dataclass(frozen=True)
|
||||
class Chunk:
|
||||
id: str # "<doc>#<n>"
|
||||
doc: DocumentMeta
|
||||
section: str # nearest heading ("" before the first one)
|
||||
page_start: int
|
||||
page_end: int
|
||||
text: str # display text: paragraphs and markdown table rows
|
||||
|
||||
@property
|
||||
def pages(self) -> str:
|
||||
return str(self.page_start) if self.page_start == self.page_end else f"{self.page_start}–{self.page_end}"
|
||||
|
||||
@property
|
||||
def citation(self) -> str:
|
||||
return f"[{self.doc.short}, стр. {self.pages}]"
|
||||
|
||||
|
||||
@dataclass
|
||||
class _Unit:
|
||||
"""Indivisible piece of a chunk: a paragraph (with its comment) or one table row."""
|
||||
|
||||
text: str
|
||||
page: int # page where the unit starts
|
||||
table_header: str | None = None # "| a | b |\n|---|---|" for table rows
|
||||
breaks: list[tuple[int, int]] = field(default_factory=list) # (offset in text, page starting there)
|
||||
|
||||
@property
|
||||
def page_end(self) -> int:
|
||||
return self.breaks[-1][1] if self.breaks else self.page
|
||||
|
||||
def page_at(self, offset: int) -> int:
|
||||
page = self.page
|
||||
for start, p in self.breaks:
|
||||
if start <= offset:
|
||||
page = p
|
||||
return page
|
||||
|
||||
def append(self, line: str, page: int, sep: str) -> None:
|
||||
"""Glue a continuation line; record a page break if it comes from a later page."""
|
||||
base = len(self.text) + len(sep)
|
||||
text, breaks = _strip_inline_pages(line)
|
||||
if page > self.page_end:
|
||||
self.breaks.append((base, page))
|
||||
self.breaks.extend((base + off, p) for off, p in breaks)
|
||||
self.text += sep + text
|
||||
|
||||
|
||||
def _strip_inline_pages(line: str) -> tuple[str, list[tuple[int, int]]]:
|
||||
"""Text without "⟦стр. N⟧" markers + (offset, page) of each marker in the cleaned text."""
|
||||
out, breaks, pos = [], [], 0
|
||||
for m in INLINE_PAGE.finditer(line):
|
||||
out.append(line[pos : m.start()])
|
||||
breaks.append((sum(len(x) for x in out) + 1, int(m.group(1))))
|
||||
out.append(" ")
|
||||
pos = m.end()
|
||||
out.append(line[pos:])
|
||||
return "".join(out), breaks
|
||||
|
||||
|
||||
def _new_unit(line: str, page: int) -> _Unit:
|
||||
text, breaks = _strip_inline_pages(line)
|
||||
return _Unit(text, page, breaks=breaks)
|
||||
|
||||
|
||||
@dataclass
|
||||
class _Section:
|
||||
title: str
|
||||
units: list[_Unit] = field(default_factory=list)
|
||||
|
||||
|
||||
def rag_dir() -> Path:
|
||||
return get_settings().config_dir / "rag"
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_config(path: Path | None = None) -> RagConfig:
|
||||
path = path or rag_dir() / "sources.yaml"
|
||||
return RagConfig.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
def heading(line: str) -> str | None:
|
||||
"""The line's text if it is a section heading, else `None`."""
|
||||
if len(line) > MAX_TITLE_CHARS or line.startswith("|"):
|
||||
return None
|
||||
if SUBSECTION.match(line) or TOPLEVEL.match(line) or NAMED.match(line):
|
||||
return line
|
||||
return None
|
||||
|
||||
|
||||
def _is_short_title(block: list[str], next_block: list[str] | None) -> bool:
|
||||
"""A lone short line followed by a body paragraph (unnumbered headings in team docs)."""
|
||||
return (
|
||||
len(block) == 1
|
||||
and bool(SHORT_TITLE.match(block[0]))
|
||||
and next_block is not None
|
||||
and not PAGE_MARKER.match(next_block[0])
|
||||
and (len(next_block) > 1 or len(next_block[0]) > 80 or next_block[0].startswith("|"))
|
||||
)
|
||||
|
||||
|
||||
def _blocks(text: str) -> list[list[str]]:
|
||||
"""Blank-line separated blocks of non-empty lines."""
|
||||
return [[ln for ln in b.splitlines() if ln.strip()] for b in re.split(r"\n\s*\n", text) if b.strip()]
|
||||
|
||||
|
||||
def _sections(text: str, skip: list[str]) -> list[_Section]:
|
||||
blocks = _blocks(text)
|
||||
sections = [_Section(title="")]
|
||||
page = 1
|
||||
skipping = False
|
||||
for i, block in enumerate(blocks):
|
||||
first = block[0]
|
||||
if first.startswith("# ") or first.startswith("Источник:"):
|
||||
continue # file header written by the converter
|
||||
m = PAGE_MARKER.match(first)
|
||||
if m:
|
||||
page = int(m.group(1))
|
||||
continue
|
||||
nxt = next((b for b in blocks[i + 1 :] if not PAGE_MARKER.match(b[0])), None)
|
||||
if first.startswith("|"):
|
||||
if not skipping:
|
||||
sections[-1].units.extend(_table_units(block, page))
|
||||
continue
|
||||
if first.startswith("[Изображение"):
|
||||
if not skipping: # transcribed figure: one unit, keeps its own line breaks
|
||||
sections[-1].units.append(_new_unit("\n".join(block[1:]) if len(block) > 1 else first, page))
|
||||
continue
|
||||
for j, line in enumerate(block):
|
||||
title = heading(line)
|
||||
if title is None and j == 0 and _is_short_title(block, nxt):
|
||||
title = line
|
||||
if title is not None:
|
||||
skipping = any(title.startswith(s) for s in skip)
|
||||
sections.append(_Section(title=title))
|
||||
continue
|
||||
if skipping:
|
||||
continue
|
||||
units = sections[-1].units
|
||||
if COMMENT.match(line) and units and units[-1].table_header is None:
|
||||
units[-1].append(line, page, "\n")
|
||||
elif line[0].islower() and units and units[-1].table_header is None:
|
||||
units[-1].append(line, page, " ") # paragraph continued after a page break or a figure
|
||||
else:
|
||||
units.append(_new_unit(line, page))
|
||||
return [s for s in sections if s.units]
|
||||
|
||||
|
||||
def _table_units(block: list[str], page: int) -> list[_Unit]:
|
||||
if len(block) >= 2 and TABLE_DIVIDER.match(block[1]):
|
||||
header = f"{block[0]}\n{block[1]}"
|
||||
rows = block[2:]
|
||||
else: # continuation without a header line (should not happen with the converter, but be safe)
|
||||
header, rows = "", block
|
||||
return [_Unit(row, page, table_header=header) for row in rows]
|
||||
|
||||
|
||||
def split_sentences(text: str) -> list[str]:
|
||||
"""Sentences of one line/paragraph; does not split after "см.", "т.е.", initials."""
|
||||
out: list[str] = []
|
||||
for part in SENTENCE_SPLIT.split(text):
|
||||
if out and ABBREVIATION_END.search(out[-1]):
|
||||
out[-1] += " " + part
|
||||
else:
|
||||
out.append(part)
|
||||
return [p.strip() for p in out if p.strip()]
|
||||
|
||||
|
||||
def _split_long(unit: _Unit, max_chars: int) -> list[_Unit]:
|
||||
if len(unit.text) <= max_chars or unit.table_header is not None:
|
||||
return [unit]
|
||||
parts: list[str] = []
|
||||
for sentence in split_sentences(unit.text):
|
||||
if parts and len(parts[-1]) + 1 + len(sentence) <= max_chars:
|
||||
parts[-1] += " " + sentence
|
||||
else:
|
||||
parts.append(sentence)
|
||||
out: list[_Unit] = []
|
||||
pos = 0
|
||||
for part in parts:
|
||||
start = unit.text.find(part[:40], pos)
|
||||
start = pos if start < 0 else start
|
||||
end = start + len(part) - 1
|
||||
first, last = unit.page_at(start), unit.page_at(end)
|
||||
out.append(_Unit(part, first, breaks=[(len(part) - 1, last)] if last != first else []))
|
||||
pos = start + len(part)
|
||||
return out
|
||||
|
||||
|
||||
def _render(units: list[_Unit]) -> str:
|
||||
out: list[str] = []
|
||||
header: str | None = None
|
||||
for u in units:
|
||||
if u.table_header is not None:
|
||||
if header != u.table_header:
|
||||
header = u.table_header
|
||||
if header:
|
||||
out.append(header)
|
||||
out.append(u.text)
|
||||
else:
|
||||
header = None
|
||||
out.append(u.text)
|
||||
return "\n".join(out)
|
||||
|
||||
|
||||
def _pack(section: _Section, max_chars: int, min_chars: int) -> list[list[_Unit]]:
|
||||
units = [p for u in section.units for p in _split_long(u, max_chars)]
|
||||
groups: list[list[_Unit]] = [[]]
|
||||
size = 0
|
||||
for u in units:
|
||||
if groups[-1] and size + len(u.text) > max_chars:
|
||||
groups.append([])
|
||||
size = 0
|
||||
groups[-1].append(u)
|
||||
size += len(u.text) + 1
|
||||
if len(groups) > 1 and sum(len(u.text) for u in groups[-1]) < min_chars:
|
||||
groups[-2].extend(groups.pop())
|
||||
return [g for g in groups if g]
|
||||
|
||||
|
||||
def chunk_document(doc: DocumentMeta, text: str, cfg: ChunkingConfig) -> list[Chunk]:
|
||||
chunks: list[Chunk] = []
|
||||
for section in _sections(text, cfg.skip_sections):
|
||||
for group in _pack(section, cfg.max_chars, cfg.min_chars):
|
||||
chunks.append(
|
||||
Chunk(
|
||||
id=f"{doc.id}#{len(chunks)}",
|
||||
doc=doc,
|
||||
section=section.title,
|
||||
page_start=group[0].page,
|
||||
page_end=max(u.page_end for u in group),
|
||||
text=_render(group),
|
||||
)
|
||||
)
|
||||
return chunks
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_chunks(config_path: Path | None = None) -> tuple[Chunk, ...]:
|
||||
cfg = load_config(config_path)
|
||||
base = (config_path.parent if config_path else rag_dir()).resolve()
|
||||
out: list[Chunk] = []
|
||||
for doc in cfg.documents:
|
||||
out.extend(chunk_document(doc, (base / doc.file).read_text(encoding="utf-8"), cfg.chunking))
|
||||
return tuple(out)
|
||||
@@ -0,0 +1,229 @@
|
||||
"""Lexical retrieval over the corpus: Okapi BM25 on Russian Snowball stems + synonym expansion.
|
||||
|
||||
Offline and deterministic (ADR-004): no embeddings, no network. Stop words are dropped before stemming;
|
||||
the section title is indexed `title_weight` times so a match with "3.2 Психофармакотерапия" counts more
|
||||
than a passing mention in the body.
|
||||
|
||||
Re-ranking: the best `rerank_candidates` chunks by BM25 get a bonus for their densest passage — a window
|
||||
of `window_sentences` consecutive sentences scored by the idf of query terms it contains. A chunk that
|
||||
answers in one place beats a long one that mentions the words in passing; the passage itself is returned
|
||||
with the hit and is what `answer()` quotes from.
|
||||
"""
|
||||
|
||||
import math
|
||||
import re
|
||||
from collections import Counter
|
||||
from dataclasses import dataclass
|
||||
from functools import lru_cache
|
||||
|
||||
from app.llm.rag.corpus import Audience, Chunk, RagConfig, load_chunks, load_config, split_sentences
|
||||
from app.llm.rag.stemmer import stem
|
||||
|
||||
_WORD = re.compile(r"[а-яёa-z0-9]+(?:-[а-яёa-z0-9]+)*", re.IGNORECASE)
|
||||
# `privacy.scrub()` placeholders ("[NAME]", "[PHONE]") are not words of the question.
|
||||
_PLACEHOLDER = re.compile(r"\[[A-Z_]+\]")
|
||||
|
||||
# Function words and generic KR boilerplate that carry no topical signal.
|
||||
STOP_WORDS = frozenset(
|
||||
"""
|
||||
а без более бы был была были было быть в вам вас ваш весь во вот все всего всех вы где да даже для до его
|
||||
ее если есть еще же за и из или им их к как ко когда кто ли либо мне может можно мой мы на над не него нее
|
||||
нет ни них но ну о об однако он она они оно от по под при про с со так также такой там те то тоже только
|
||||
том тот у уже хотя чего чем что чтобы эта эти это этот я ли ней нем
|
||||
какой какая какое какие каков такое такая такие сколько почему зачем меня мой моя мое мои себя сегодня будет
|
||||
""".split() # noqa: SIM905 — a word list reads better as text
|
||||
)
|
||||
|
||||
|
||||
def tokens(text: str) -> list[str]:
|
||||
"""Stems of content words (hyphenated words are kept whole and also split: "когнитивно-поведенческая")."""
|
||||
out: list[str] = []
|
||||
for word in _WORD.findall(_PLACEHOLDER.sub(" ", text).lower().replace("ё", "е")):
|
||||
parts = [p for p in word.split("-") if p not in STOP_WORDS and (len(p) > 1 or p.isdigit())]
|
||||
if "-" in word and len(parts) > 1:
|
||||
out.append("-".join(stem(p) for p in parts)) # the compound itself, in any case form
|
||||
out.extend(stem(p) for p in parts)
|
||||
return out
|
||||
|
||||
|
||||
EXPANSION_WEIGHT = 0.7
|
||||
SYNONYM_CREDIT = 0.8
|
||||
PREFIX_LEN = 6
|
||||
|
||||
|
||||
@dataclass(frozen=True)
|
||||
class Hit:
|
||||
chunk: Chunk
|
||||
score: float # BM25 + passage bonus (ranking key)
|
||||
bm25: float
|
||||
passage: str # densest window of the chunk for the query
|
||||
|
||||
|
||||
def sentences(text: str) -> list[str]:
|
||||
"""Sentences of a chunk; every line (table row, list item) is split on its own."""
|
||||
return [s for line in text.splitlines() for s in split_sentences(line)]
|
||||
|
||||
|
||||
class SynonymExpander:
|
||||
"""Adds the stems of every phrase in a synonym group when any phrase of the group is in the query.
|
||||
|
||||
Added stems weigh `EXPANSION_WEIGHT`: they widen recall but should not outrank the patient's own words.
|
||||
"""
|
||||
|
||||
def __init__(self, groups: list[list[str]]) -> None:
|
||||
self._groups = [[tokens(phrase) for phrase in group] for group in groups]
|
||||
# stem -> stems of the other phrases of its groups ("отменя" -> {"отмен", "брос", ...})
|
||||
self.related: dict[str, set[str]] = {}
|
||||
for group in self._groups:
|
||||
stems = {t for phrase in group for t in phrase}
|
||||
for t in stems:
|
||||
self.related.setdefault(t, set()).update(stems - {t})
|
||||
|
||||
def expand(self, query_tokens: list[str]) -> dict[str, float]:
|
||||
weights: dict[str, float] = {}
|
||||
for t in query_tokens:
|
||||
weights[t] = weights.get(t, 0.0) + 1.0
|
||||
present = set(query_tokens)
|
||||
for group in self._groups:
|
||||
if any(phrase and set(phrase) <= present for phrase in group):
|
||||
for phrase in group:
|
||||
for t in phrase:
|
||||
if t not in present: # a 3-word expansion of "птср" is one concept, not three
|
||||
weights[t] = max(weights.get(t, 0.0), EXPANSION_WEIGHT / len(phrase))
|
||||
return weights
|
||||
|
||||
|
||||
class BM25Index:
|
||||
def __init__(self, chunks: tuple[Chunk, ...], cfg: RagConfig) -> None:
|
||||
r = cfg.retrieval
|
||||
self._k1, self._b, self._min_score, self._top_k = r.bm25_k1, r.bm25_b, r.min_score, r.top_k
|
||||
self._candidates, self._window, self._window_weight = r.rerank_candidates, r.window_sentences, r.window_weight
|
||||
self._section_boost = r.section_boost
|
||||
self._doc_cues = {doc: re.compile("|".join(cues), re.IGNORECASE) for doc, cues in r.doc_cues.items() if cues}
|
||||
self._doc_cue_boost = r.doc_cue_boost
|
||||
self.chunks = chunks
|
||||
self._sentences = [[(s, set(tokens(s))) for s in sentences(c.text)] for c in chunks]
|
||||
self._expander = SynonymExpander(cfg.synonyms)
|
||||
self._tf: list[Counter[str]] = []
|
||||
df: Counter[str] = Counter()
|
||||
for c in chunks:
|
||||
tf = Counter(tokens(c.text) + tokens(c.section) * r.title_weight)
|
||||
self._tf.append(tf)
|
||||
df.update(tf.keys())
|
||||
self._len = [sum(tf.values()) for tf in self._tf]
|
||||
self._avg_len = sum(self._len) / max(len(self._len), 1)
|
||||
n = len(chunks)
|
||||
self._idf = {t: math.log(1 + (n - f + 0.5) / (f + 0.5)) for t, f in df.items()}
|
||||
|
||||
def query_terms(self, query: str) -> dict[str, float]:
|
||||
"""Query stems -> weight (repeated words count more, synonym expansions less)."""
|
||||
return self._expander.expand(tokens(query))
|
||||
|
||||
def _score(self, i: int, terms: dict[str, float]) -> float:
|
||||
tf, norm = self._tf[i], self._k1 * (1 - self._b + self._b * self._len[i] / self._avg_len)
|
||||
score = 0.0
|
||||
for term, weight in terms.items():
|
||||
f = tf.get(term)
|
||||
if f:
|
||||
score += self._idf[term] * f * (self._k1 + 1) / (f + norm) * weight
|
||||
return score
|
||||
|
||||
def boost(self, chunk: Chunk, audience: Audience | None, cued: set[str] | None = None) -> float:
|
||||
"""Section multiplier for the audience (`retrieval.section_boost`) × disease-cue multiplier."""
|
||||
boosts = self._section_boost.get(audience or "", {})
|
||||
section = next((b for prefix, b in boosts.items() if chunk.section.startswith(prefix)), 1.0)
|
||||
return section * (self._doc_cue_boost if cued and chunk.doc.id in cued else 1.0)
|
||||
|
||||
def cued_docs(self, query: str) -> set[str]:
|
||||
"""Documents whose disease the query names ("ТМС при депрессии" -> {"kr_depression"}).
|
||||
|
||||
Only a one-sided mention counts: a question naming both disorders favours neither.
|
||||
"""
|
||||
q = _PLACEHOLDER.sub(" ", query).replace("ё", "е")
|
||||
cued = {doc for doc, cue in self._doc_cues.items() if cue.search(q)}
|
||||
return cued if len(cued) < len(self._doc_cues) else set()
|
||||
|
||||
def overlap(self, text: str, terms: dict[str, float]) -> float:
|
||||
"""Sum of idf × weight of the query terms present in `text` (sentence relevance for `answer()`)."""
|
||||
present = set(tokens(text))
|
||||
return sum(self._idf.get(t, 0.0) * w for t, w in terms.items() if t in present)
|
||||
|
||||
def coverage(self, text: str, query: str) -> float:
|
||||
"""Share of the query's own (not synonym-expanded) idf mass found in `text`, 0..1.
|
||||
|
||||
A query word whose synonym — or a word with the same `PREFIX_LEN`-letter prefix, for stems Snowball
|
||||
leaves apart ("скрининговый"/"скрининг") — is in the text counts as `SYNONYM_CREDIT` of itself.
|
||||
A word absent from the corpus counts with twice the maximal idf — the strongest sign of an off-topic
|
||||
question: "как установить windows" is then mostly uncovered and `answer()` says there is
|
||||
no answer instead of quoting the nearest paragraph about "установить диагноз".
|
||||
"""
|
||||
own = set(tokens(query))
|
||||
if not own:
|
||||
return 0.0
|
||||
unseen = 2 * max(self._idf.values(), default=1.0)
|
||||
total = sum(self._idf.get(t, unseen) for t in own)
|
||||
present = set(tokens(text))
|
||||
prefixes = {p[:PREFIX_LEN] for p in present if len(p) >= PREFIX_LEN}
|
||||
covered = 0.0
|
||||
for t in own:
|
||||
if t in present:
|
||||
covered += self._idf[t]
|
||||
elif self._expander.related.get(t, set()) & present or (
|
||||
len(t) >= PREFIX_LEN and t[:PREFIX_LEN] in prefixes
|
||||
):
|
||||
covered += SYNONYM_CREDIT * self._idf.get(t, unseen) # said in the corpus' own words
|
||||
return min(1.0, covered / total)
|
||||
|
||||
def _passage(self, i: int, terms: dict[str, float]) -> tuple[float, str]:
|
||||
sents = self._sentences[i]
|
||||
best = (0.0, sents[0][0] if sents else "")
|
||||
for start in range(len(sents)):
|
||||
window = sents[start : start + self._window]
|
||||
present = set().union(*(toks for _, toks in window))
|
||||
score = sum(self._idf.get(t, 0.0) * w for t, w in terms.items() if t in present)
|
||||
if score > best[0]:
|
||||
best = (score, " ".join(text for text, _ in window))
|
||||
return best
|
||||
|
||||
def search(
|
||||
self,
|
||||
query: str,
|
||||
*,
|
||||
audience: Audience | None = None,
|
||||
docs: set[str] | None = None,
|
||||
top_k: int | None = None,
|
||||
min_score: float | None = None,
|
||||
) -> list[Hit]:
|
||||
"""Best chunks for `query`, filtered by audience/doc ids; empty if nothing passes `min_score` (BM25)."""
|
||||
terms = self.query_terms(query)
|
||||
if not terms:
|
||||
return []
|
||||
threshold = self._min_score if min_score is None else min_score
|
||||
scored = [
|
||||
(s, i)
|
||||
for i, c in enumerate(self.chunks)
|
||||
if (audience is None or audience in c.doc.audiences)
|
||||
and (docs is None or c.doc.id in docs)
|
||||
and (s := self._score(i, terms)) >= threshold
|
||||
]
|
||||
scored.sort(key=lambda x: (-x[0], x[1]))
|
||||
cued = self.cued_docs(query)
|
||||
hits = []
|
||||
for bm25, i in scored[: max(self._candidates, top_k or 0)]:
|
||||
bonus, passage = self._passage(i, terms)
|
||||
chunk = self.chunks[i]
|
||||
hits.append(
|
||||
Hit(chunk, (bm25 + self._window_weight * bonus) * self.boost(chunk, audience, cued), bm25, passage)
|
||||
)
|
||||
hits.sort(key=lambda h: -h.score) # stable: BM25 order breaks ties
|
||||
return hits[: top_k or self._top_k]
|
||||
|
||||
|
||||
@lru_cache
|
||||
def get_index() -> BM25Index:
|
||||
return BM25Index(load_chunks(), load_config())
|
||||
|
||||
|
||||
def retrieve(query: str, **kwargs) -> list[Hit]:
|
||||
"""Module-level shortcut: `retrieve("когда начинает действовать антидепрессант", audience="patient")`."""
|
||||
return get_index().search(query, **kwargs)
|
||||
@@ -0,0 +1,320 @@
|
||||
"""Grounded answers from the knowledge base: every sentence shown is quoted from a cited chunk.
|
||||
|
||||
Pipeline (deterministic except for the optional patient rephrasing):
|
||||
|
||||
1. **Dose guard (patient).** Dose questions are never answered — the dose is the doctor's decision.
|
||||
2. **Retrieve.** Top `answer.max_chunks` chunks for the audience (`team` documents never reach patients
|
||||
or doctors, see `config/rag/sources.yaml`).
|
||||
3. **Sentences.** Chunks are split into sentences; KR boilerplate is stripped (literature refs "[1, 15]").
|
||||
Doctors also get table rows as "column: value; ..." lines and evidence grades. For patients, sentences
|
||||
about prescribing/dosing or with forbidden content (`QUOTE_FILTER`) are dropped.
|
||||
4. **Passage.** In each chunk the best sentence (idf-weighted overlap with the query) is extended with
|
||||
adjacent relevant sentences into one contiguous passage — the answer reads as written in the source,
|
||||
not as a collage. The best passage, plus a second one if it scores close, is kept.
|
||||
5. **No-answer gate.** If the passages cover less than `answer.min_coverage` of the question's idf mass
|
||||
(e.g. "рецепт борща"), there is no answer -> `None`.
|
||||
6. **Rephrase (patient only).** The excerpt may be simplified via `gateway.phrase("rag_answer")`; a
|
||||
rephrasing that adds content (`med_qa.adds_content`) is rejected and the excerpt is shown verbatim.
|
||||
Doctors always get the verbatim text.
|
||||
7. **Framing.** Intro, citations "[КР ПТСР 2023, стр. 28]" and the doctor note from `config/texts/rag.yaml`
|
||||
are added outside the LLM, so they are always present.
|
||||
|
||||
Safety screening of the incoming message is the caller's job (guardrail #2): `answer()` expects text that
|
||||
already passed `app.core.safety` and `privacy.scrub()`. Logs carry only codes and counts.
|
||||
"""
|
||||
|
||||
import logging
|
||||
import re
|
||||
from dataclasses import dataclass
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.types import ScrubbedText
|
||||
from app.llm.gateway import FORBIDDEN_OUTPUT, MAX_REPLY_CHARS, get_gateway
|
||||
from app.llm.med_qa import DOSE_QUESTION, DOSING_SENTENCE, adds_content
|
||||
from app.llm.rag.corpus import TABLE_DIVIDER, AnswerConfig, Audience, Chunk, load_config, split_sentences
|
||||
from app.llm.rag.index import BM25Index, get_index, tokens
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
PHRASE_INTENT = "rag_answer"
|
||||
|
||||
LIT_REFS = re.compile(r"\s*\[\d+(?:\s*[-–,]\s*\d+)*\s*,?\]") # "[1, 15, 16]", "[48]", "[1-3]"
|
||||
GRADE = re.compile(r"\s*Уровень убедительности рекомендаций\s+[ABCАВС]\b.*$", re.IGNORECASE)
|
||||
BULLET = re.compile(r"^\s*(?:[-–—●•▪◦*]|\d+[.)])\s+")
|
||||
COMMENT_LABEL = re.compile(r"^Комментари[йи]\s*[:.]\s*")
|
||||
# KR sentences about prescribing are for the doctor: a patient reading "рекомендуется назначение
|
||||
# пароксетина" or "дозировка титруется" out of context takes it as advice (SPEC §7: no drug/dose advice).
|
||||
PRESCRIBING = re.compile(
|
||||
r"назнач|дозиров|титр|мг\b|мг/|доз[аеуыо]\b|дозы\b|/сут|в сутки|раза? в день|разово"
|
||||
r"|\d+\s*(?:[-–]\s*\d+\s*)?таблет",
|
||||
re.IGNORECASE,
|
||||
)
|
||||
# "что такое флэшбек" -> the term; its definition "Флэшбек (flashback – англ.) – ..." is preferred.
|
||||
DEFINITION_QUESTION = re.compile(r"^\s*что (?:такое|значит|означает|это за)\s+(.+?)[?.!\s]*$", re.IGNORECASE)
|
||||
LEADING_PLACEHOLDERS = re.compile(r"^(?:\s*\[[A-Z_]+\][\s,.:;!-]*)+") # "[NAME], что такое ПТСР?"
|
||||
DEFINITION_HEAD = re.compile(r"\s[–—-]\s(?![^(]*\))|\s[–—-]?\s?это\s") # dash outside "(… – англ.)", or "это"
|
||||
DEFINITION_HEAD_CHARS = 60
|
||||
DEFINITION_BONUS = 2.0 # multiplier for a sentence that starts with the asked term (picks it within a chunk)
|
||||
# The gateway's output filter targets the bot's own words. Two of its patterns also hit neutral quotes from
|
||||
# the KR — the definition "ПТСР – это расстройство, которое..." and "диагноз ставится на основании..." —
|
||||
# and would cut exactly the patient-information text. Quotes are checked against the rest of the filter
|
||||
# (dose/drug imperatives, "у вас депрессия", confidentiality promises).
|
||||
QUOTE_EXEMPT_PREFIXES = ("диагноз", "(это|похоже на|признаки)")
|
||||
QUOTE_FILTER = tuple(p for p in FORBIDDEN_OUTPUT if not p.pattern.startswith(QUOTE_EXEMPT_PREFIXES))
|
||||
MIN_SENTENCE_CHARS = 25
|
||||
LEAD_IN_CHARS = 80
|
||||
# A best sentence opening with a reference back ("Это помогает...") needs the sentence it refers to.
|
||||
ANAPHORA = re.compile(
|
||||
r"^(Это|Эти|Этот|Эта|Он|Она|Оно|Они|Такие|Такой|Данн\w+|При этом|Кроме того|Однако|Поэтому)\b"
|
||||
) # a best sentence this short ("Что такое ПТСР?") pulls in the next one as its answer
|
||||
|
||||
|
||||
class Citation(BaseModel):
|
||||
doc: str # document id from sources.yaml
|
||||
short: str # "КР ПТСР 2023"
|
||||
title: str
|
||||
section: str
|
||||
pages: str # "28" | "28–29"
|
||||
|
||||
@property
|
||||
def label(self) -> str:
|
||||
return f"{self.short}, стр. {self.pages}"
|
||||
|
||||
|
||||
class RagAnswer(BaseModel):
|
||||
text: str # framed answer: intro + body + sources (+ doctor note for patients)
|
||||
excerpt: str # the quoted passages, verbatim
|
||||
citations: list[Citation]
|
||||
audience: Audience
|
||||
coverage: float # share of the question covered by the passages (0..1)
|
||||
phrased_by_llm: bool
|
||||
|
||||
|
||||
class AudienceTexts(BaseModel):
|
||||
fallback: str
|
||||
intro: str
|
||||
sources_label: str
|
||||
doctor_note: str = ""
|
||||
|
||||
|
||||
@dataclass(frozen=True)
|
||||
class Passage:
|
||||
chunk: Chunk
|
||||
text: str
|
||||
score: float
|
||||
definition: bool = False # starts with the term asked in "что такое X?"
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_rag_texts(path: Path | None = None) -> dict[str, AudienceTexts]:
|
||||
path = path or get_settings().config_dir / "texts" / "rag.yaml"
|
||||
raw = yaml.safe_load(path.read_text(encoding="utf-8"))
|
||||
return {k: AudienceTexts.model_validate(v) for k, v in raw.items()}
|
||||
|
||||
|
||||
def fallback_text(audience: Audience = "patient") -> str:
|
||||
"""What the caller sends when `answer()` returns `None`."""
|
||||
return load_rag_texts()[audience].fallback
|
||||
|
||||
|
||||
def _clean(sentence: str, *, keep_grade: bool) -> str:
|
||||
s = BULLET.sub("", sentence)
|
||||
s = COMMENT_LABEL.sub("", s)
|
||||
if not keep_grade: # evidence grades matter to doctors, to a patient they are noise
|
||||
s = GRADE.sub("", s)
|
||||
s = LIT_REFS.sub("", s)
|
||||
return " ".join(s.split()).strip(" ;")
|
||||
|
||||
|
||||
def _cells(line: str) -> list[str]:
|
||||
return [c.strip() for c in line.strip().strip("|").split("|")]
|
||||
|
||||
|
||||
def _row_text(header: list[str], row: list[str]) -> str:
|
||||
pairs = [f"{h}: {v}" if h else v for h, v in zip(header, row, strict=False) if v]
|
||||
return LIT_REFS.sub("", "; ".join(pairs))
|
||||
|
||||
|
||||
def chunk_sentences(chunk: Chunk, *, clinical: bool) -> list[str | None]:
|
||||
"""Readable sentences of a chunk in reading order. `clinical` (doctor/team) keeps table rows as
|
||||
"column: value" lines and evidence grades. `None` marks a dropped row: passages do not span it."""
|
||||
out: list[str | None] = []
|
||||
lines = chunk.text.splitlines()
|
||||
header: list[str] | None = None
|
||||
for i, line in enumerate(lines):
|
||||
if line.startswith("|"):
|
||||
if TABLE_DIVIDER.match(line):
|
||||
continue
|
||||
if i + 1 < len(lines) and TABLE_DIVIDER.match(lines[i + 1]):
|
||||
header = _cells(line)
|
||||
continue
|
||||
out.append(_row_text(header or [], _cells(line)) if clinical else None)
|
||||
continue
|
||||
header = None
|
||||
out.extend(s for s in (_clean(p, keep_grade=clinical) for p in split_sentences(line)) if s)
|
||||
return out
|
||||
|
||||
|
||||
def _allowed(sentence: str | None, audience: Audience) -> bool:
|
||||
if sentence is None or len(sentence) < MIN_SENTENCE_CHARS and not sentence.endswith(("?", ":")):
|
||||
return False
|
||||
if sentence[0].islower():
|
||||
return False # tail of a paragraph cut by the chunk boundary: unreadable without its start
|
||||
if audience == "patient":
|
||||
return not (
|
||||
DOSING_SENTENCE.search(sentence)
|
||||
or PRESCRIBING.search(sentence)
|
||||
or any(p.search(sentence) for p in QUOTE_FILTER)
|
||||
)
|
||||
return True
|
||||
|
||||
|
||||
def _defined_term(question: str) -> set[str] | None:
|
||||
m = DEFINITION_QUESTION.match(LEADING_PLACEHOLDERS.sub("", question))
|
||||
return set(tokens(m.group(1))) or None if m else None
|
||||
|
||||
|
||||
def _is_definition(sentence: str, defined: set[str]) -> bool:
|
||||
""" "Флэшбек (flashback – англ.) – возврат..." / "ПТСР – это расстройство...": the term, then a dash."""
|
||||
head = DEFINITION_HEAD.split(sentence, maxsplit=1)
|
||||
return len(head) == 2 and len(head[0]) <= DEFINITION_HEAD_CHARS and bool(set(tokens(head[0])) & defined)
|
||||
|
||||
|
||||
def _sentence_score(index: BM25Index, sentence: str, terms: dict[str, float], defined: set[str] | None) -> float:
|
||||
score = index.overlap(sentence, terms)
|
||||
if defined and score > 0 and _is_definition(sentence, defined):
|
||||
score *= DEFINITION_BONUS
|
||||
return score
|
||||
|
||||
|
||||
def best_passage(
|
||||
index: BM25Index,
|
||||
chunk: Chunk,
|
||||
terms: dict[str, float],
|
||||
audience: Audience,
|
||||
cfg: AnswerConfig,
|
||||
defined: set[str] | None = None,
|
||||
cued: set[str] | None = None,
|
||||
) -> Passage | None:
|
||||
"""Best sentence of the chunk extended by adjacent relevant sentences (contiguous, within limits)."""
|
||||
sents = [s if _allowed(s, audience) else None for s in chunk_sentences(chunk, clinical=audience != "patient")]
|
||||
scores = [_sentence_score(index, s, terms, defined) if s else 0.0 for s in sents]
|
||||
if not scores or max(scores) <= 0:
|
||||
return None
|
||||
best = max(range(len(sents)), key=lambda i: (scores[i], -i))
|
||||
head = sents[best]
|
||||
assert head is not None # score > 0 implies an allowed sentence
|
||||
lo = hi = best
|
||||
size = len(head)
|
||||
|
||||
def fits(j: int) -> bool:
|
||||
if not 0 <= j < len(sents):
|
||||
return False
|
||||
s = sents[j]
|
||||
return s is not None and size + len(s) + 1 <= cfg.max_chars
|
||||
|
||||
# A short lead-in (question-like heading, "Комментарии:"-style intro) needs the sentence after it.
|
||||
def length(j: int) -> int:
|
||||
return len(sents[j] or "") + 1
|
||||
|
||||
if (size < LEAD_IN_CHARS or head.endswith(("?", ":"))) and fits(best + 1):
|
||||
hi += 1
|
||||
size += length(hi)
|
||||
if ANAPHORA.match(head) and fits(best - 1):
|
||||
lo -= 1
|
||||
size += length(lo)
|
||||
floor = cfg.neighbor_ratio * scores[best]
|
||||
while hi - lo + 1 < cfg.max_sentences:
|
||||
nxt = next((j for j in (hi + 1, lo - 1) if fits(j) and scores[j] > 0 and scores[j] >= floor), None)
|
||||
if nxt is None:
|
||||
break
|
||||
lo, hi = min(lo, nxt), max(hi, nxt)
|
||||
size += length(nxt)
|
||||
text = " ".join(s for s in sents[lo : hi + 1] if s)
|
||||
definition = scores[best] > index.overlap(head, terms) # got DEFINITION_BONUS
|
||||
return Passage(chunk, text, index.overlap(text, terms) * index.boost(chunk, audience, cued), definition)
|
||||
|
||||
|
||||
def select(index: BM25Index, question: str, audience: Audience, docs: set[str] | None = None) -> list[Passage]:
|
||||
"""Best passage, plus a second one from another chunk if it scores within `second_passage_ratio`."""
|
||||
cfg = load_config().answer
|
||||
hits = index.search(question, audience=audience, docs=docs, top_k=cfg.max_chunks)
|
||||
terms = index.query_terms(question)
|
||||
defined = _defined_term(question)
|
||||
cued = index.cued_docs(question)
|
||||
passages = [p for h in hits if (p := best_passage(index, h.chunk, terms, audience, cfg, defined, cued))]
|
||||
if not passages:
|
||||
return []
|
||||
# A definition answers "что такое X?" better than any passage that merely mentions X often.
|
||||
passages.sort(key=lambda p: (not p.definition, -p.score)) # stable: retrieval rank breaks ties
|
||||
top = passages[0]
|
||||
chosen = [top]
|
||||
for p in passages[1:]:
|
||||
if len(chosen) >= cfg.max_passages:
|
||||
break
|
||||
if p.score >= cfg.second_passage_ratio * top.score and p.text != top.text:
|
||||
chosen.append(p)
|
||||
return chosen
|
||||
|
||||
|
||||
def _citation(chunk: Chunk) -> Citation:
|
||||
return Citation(
|
||||
doc=chunk.doc.id, short=chunk.doc.short, title=chunk.doc.title, section=chunk.section, pages=chunk.pages
|
||||
)
|
||||
|
||||
|
||||
async def _rephrase(excerpt: str, question: str) -> tuple[str, bool]:
|
||||
if len(excerpt) > MAX_REPLY_CHARS or any(p.search(excerpt) for p in FORBIDDEN_OUTPUT):
|
||||
return excerpt, False # the gateway would reject any reply this long / with these words anyway
|
||||
text = await get_gateway().phrase(PHRASE_INTENT, {"excerpt": excerpt, "question": question})
|
||||
if " ".join(text.split()) == " ".join(excerpt.split()):
|
||||
return excerpt, False
|
||||
if adds_content(text, excerpt, question):
|
||||
log.warning("rag rephrasing rejected: adds content")
|
||||
return excerpt, False
|
||||
return text, True
|
||||
|
||||
|
||||
async def answer(
|
||||
question: ScrubbedText,
|
||||
*,
|
||||
audience: Audience = "patient",
|
||||
docs: set[str] | None = None,
|
||||
index: BM25Index | None = None,
|
||||
) -> RagAnswer | None:
|
||||
"""Answer strictly from the knowledge base, with citations; `None` -> caller sends `fallback_text()`."""
|
||||
if audience == "patient" and DOSE_QUESTION.search(question.lower()):
|
||||
log.info("rag: dose question redirected to doctor")
|
||||
return None
|
||||
index = index or get_index()
|
||||
passages = select(index, question, audience, docs)
|
||||
if not passages:
|
||||
log.info("rag: no relevant fragment audience=%s", audience)
|
||||
return None
|
||||
coverage = index.coverage(" ".join(p.text for p in passages), question)
|
||||
if coverage < load_config().answer.min_coverage:
|
||||
log.info("rag: low coverage audience=%s coverage=%.2f", audience, coverage)
|
||||
return None
|
||||
citations = [_citation(p.chunk) for p in passages]
|
||||
texts = load_rag_texts()[audience]
|
||||
|
||||
if audience == "patient":
|
||||
excerpt = " ".join(p.text for p in passages)
|
||||
body, by_llm = await _rephrase(excerpt, question)
|
||||
sources = "; ".join(dict.fromkeys(c.label for c in citations))
|
||||
text = f"{texts.intro} {body}\n\n{texts.sources_label}: {sources}."
|
||||
else: # doctor/team: verbatim quotes, each with its own citation
|
||||
excerpt = "\n".join(f"{p.text} [{c.label}]" for p, c in zip(passages, citations, strict=True))
|
||||
by_llm = False
|
||||
text = f"{texts.intro}\n{excerpt}"
|
||||
if texts.doctor_note:
|
||||
text += f"\n\n{texts.doctor_note}"
|
||||
log.info("rag: answered audience=%s passages=%d coverage=%.2f llm=%s", audience, len(passages), coverage, by_llm)
|
||||
return RagAnswer(
|
||||
text=text, excerpt=excerpt, citations=citations, audience=audience, coverage=coverage, phrased_by_llm=by_llm
|
||||
)
|
||||
@@ -0,0 +1,112 @@
|
||||
"""Russian Snowball stemmer (https://snowballstem.org/algorithms/russian/stemmer.html).
|
||||
|
||||
Self-contained because `pyproject.toml` is a frozen contract (#34): no new dependencies for the RAG.
|
||||
Latin words and digits pass through lowercased; "ё" is folded to "е".
|
||||
"""
|
||||
|
||||
import re
|
||||
from functools import lru_cache
|
||||
|
||||
_VOWELS = set("аеиоуыэюя")
|
||||
|
||||
# (suffixes, needs_a_ya): group-1 suffixes count only when preceded by "а"/"я" (which stays in the stem).
|
||||
_PERFECTIVE_GERUND = ((("вшись", "вши", "в"), True), (("ившись", "ывшись", "ивши", "ывши", "ив", "ыв"), False))
|
||||
_REFLEXIVE = ((("ся", "сь"), False),)
|
||||
_ADJECTIVE = (
|
||||
(
|
||||
(
|
||||
"ими", "ыми", "его", "ого", "ему", "ому", "ее", "ие", "ые", "ое", "ей", "ий", "ый", "ой", "ем",
|
||||
"им", "ым", "ом", "их", "ых", "ую", "юю", "ая", "яя", "ою", "ею",
|
||||
),
|
||||
False,
|
||||
),
|
||||
) # fmt: skip
|
||||
_PARTICIPLE = ((("ем", "нн", "вш", "ющ", "щ"), True), (("ивш", "ывш", "ующ"), False))
|
||||
_VERB = (
|
||||
(("ла", "на", "ете", "йте", "ли", "й", "л", "ем", "н", "ло", "но", "ет", "ют", "ны", "ть", "ешь", "нно"), True),
|
||||
(
|
||||
(
|
||||
"ила", "ыла", "ена", "ейте", "уйте", "ите", "или", "ыли", "ей", "уй", "ил", "ыл", "им", "ым", "ен",
|
||||
"ило", "ыло", "ено", "ят", "ует", "уют", "ит", "ыт", "ены", "ить", "ыть", "ишь", "ую", "ю",
|
||||
),
|
||||
False,
|
||||
),
|
||||
) # fmt: skip
|
||||
_NOUN = (
|
||||
(
|
||||
(
|
||||
"иями", "ями", "ами", "ией", "иям", "ием", "иях", "ев", "ов", "ие", "ье", "еи", "ии", "ей", "ой",
|
||||
"ий", "ям", "ем", "ам", "ом", "ах", "ях", "ию", "ью", "ия", "ья", "а", "е", "и", "й", "о", "у",
|
||||
"ы", "ь", "ю", "я",
|
||||
),
|
||||
False,
|
||||
),
|
||||
) # fmt: skip
|
||||
_DERIVATIONAL = ((("ость", "ост"), False),)
|
||||
_SUPERLATIVE = ((("ейше", "ейш"), False),)
|
||||
|
||||
_CYRILLIC_WORD = re.compile(r"^[а-я]+$")
|
||||
|
||||
|
||||
def _strip(word: str, start: int, groups: tuple[tuple[tuple[str, ...], bool], ...]) -> str | None:
|
||||
"""Remove the longest matching suffix lying in word[start:], or `None` if none matches."""
|
||||
best: tuple[int, str] | None = None
|
||||
for suffixes, needs_a_ya in groups:
|
||||
for suffix in suffixes:
|
||||
if not word.endswith(suffix) or len(word) - len(suffix) < start:
|
||||
continue
|
||||
if needs_a_ya and (len(word) - len(suffix) - 1 < start or word[-len(suffix) - 1] not in "ая"):
|
||||
continue
|
||||
if best is None or len(suffix) > best[0]:
|
||||
best = (len(suffix), word[: -len(suffix)])
|
||||
return None if best is None else best[1]
|
||||
|
||||
|
||||
def _regions(word: str) -> tuple[int, int]:
|
||||
"""RV (after the first vowel) and R2 start indices."""
|
||||
rv = next((i + 1 for i, ch in enumerate(word) if ch in _VOWELS), len(word))
|
||||
|
||||
def after_vc(start: int) -> int:
|
||||
for i in range(start + 1, len(word)):
|
||||
if word[i] not in _VOWELS and word[i - 1] in _VOWELS:
|
||||
return i + 1
|
||||
return len(word)
|
||||
|
||||
return rv, after_vc(after_vc(0))
|
||||
|
||||
|
||||
@lru_cache(maxsize=65536)
|
||||
def stem(word: str) -> str:
|
||||
word = word.lower().replace("ё", "е")
|
||||
if not _CYRILLIC_WORD.match(word):
|
||||
return word
|
||||
rv, r2 = _regions(word)
|
||||
|
||||
# Step 1
|
||||
out = _strip(word, rv, _PERFECTIVE_GERUND)
|
||||
if out is None:
|
||||
word = _strip(word, rv, _REFLEXIVE) or word
|
||||
out = _strip(word, rv, _ADJECTIVE)
|
||||
if out is not None:
|
||||
out = _strip(out, rv, _PARTICIPLE) or out
|
||||
else:
|
||||
out = _strip(word, rv, _VERB)
|
||||
if out is None:
|
||||
out = _strip(word, rv, _NOUN)
|
||||
word = out if out is not None else word
|
||||
|
||||
# Step 2
|
||||
if word.endswith("и") and len(word) - 1 >= rv:
|
||||
word = word[:-1]
|
||||
# Step 3
|
||||
word = _strip(word, r2, _DERIVATIONAL) or word
|
||||
# Step 4
|
||||
if word.endswith("нн") and len(word) - 1 >= rv:
|
||||
return word[:-1]
|
||||
sup = _strip(word, rv, _SUPERLATIVE)
|
||||
if sup is not None:
|
||||
word = sup
|
||||
return word[:-1] if word.endswith("нн") else word
|
||||
if word.endswith("ь") and len(word) - 1 >= rv:
|
||||
word = word[:-1]
|
||||
return word
|
||||
+162
@@ -0,0 +1,162 @@
|
||||
"""Speech-to-text for the patient's voice input (#116, slide 11: record → check the text → send).
|
||||
|
||||
The service only transcribes: the text goes back to the patient to check and edit, and reaches the dialog as an
|
||||
ordinary text message — safety, `scrub()` and the LLM gateway apply there. Audio is never stored or logged.
|
||||
|
||||
* `OpenRouterSTT` — an audio-capable model via OpenRouter `/chat/completions` (`input_audio`). TEMPORARY, synthetic
|
||||
data only (ADR-014): voice is personal data that `scrub()` cannot depersonalise, and OpenRouter is a foreign
|
||||
service (152-FZ). Real patients need an RF provider (SaluteSpeech, #121) behind the same `SpeechToText` contract.
|
||||
* `MockSTT` — offline, returns a fixed synthetic phrase (ADR-004: the demo works without network).
|
||||
"""
|
||||
|
||||
import asyncio
|
||||
import base64
|
||||
import logging
|
||||
import struct
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
from typing import Protocol
|
||||
|
||||
import httpx
|
||||
import yaml
|
||||
from pydantic import BaseModel
|
||||
|
||||
from app.config import Settings
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
_RETRY_STATUSES = {429, 500, 502, 503, 504}
|
||||
_ATTEMPTS = 3
|
||||
|
||||
|
||||
class SttTexts(BaseModel):
|
||||
system: str
|
||||
user: str
|
||||
silence_marker: str
|
||||
mock_transcript: str
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_texts(path: Path | None = None) -> SttTexts:
|
||||
from app.config import get_settings
|
||||
|
||||
path = path or get_settings().config_dir / "texts" / "stt.yaml"
|
||||
return SttTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
class SttError(RuntimeError):
|
||||
"""The provider failed (network, HTTP error, bad response)."""
|
||||
|
||||
|
||||
class SttNoSpeech(SttError):
|
||||
"""The recording holds no recognisable speech."""
|
||||
|
||||
|
||||
class InvalidAudio(ValueError):
|
||||
pass
|
||||
|
||||
|
||||
def wav_seconds(audio: bytes) -> float:
|
||||
"""Duration of a PCM WAV file; raises `InvalidAudio` for anything else."""
|
||||
if len(audio) < 44 or audio[:4] != b"RIFF" or audio[8:12] != b"WAVE":
|
||||
raise InvalidAudio("not a WAV file")
|
||||
pos, byte_rate = 12, 0
|
||||
while pos + 8 <= len(audio):
|
||||
chunk_id, size = audio[pos : pos + 4], struct.unpack_from("<I", audio, pos + 4)[0]
|
||||
if chunk_id == b"fmt " and size >= 16:
|
||||
byte_rate = struct.unpack_from("<I", audio, pos + 16)[0]
|
||||
elif chunk_id == b"data":
|
||||
if not byte_rate:
|
||||
break
|
||||
return min(size, len(audio) - pos - 8) / byte_rate
|
||||
pos += 8 + size + (size & 1)
|
||||
raise InvalidAudio("malformed WAV")
|
||||
|
||||
|
||||
class SpeechToText(Protocol):
|
||||
name: str
|
||||
|
||||
async def transcribe(self, audio: bytes, fmt: str = "wav") -> str: ...
|
||||
|
||||
|
||||
class MockSTT:
|
||||
name = "mock"
|
||||
|
||||
async def transcribe(self, audio: bytes, fmt: str = "wav") -> str:
|
||||
return load_texts().mock_transcript
|
||||
|
||||
|
||||
class OpenRouterSTT:
|
||||
name = "openrouter"
|
||||
|
||||
def __init__(self, settings: Settings, client: httpx.AsyncClient | None = None) -> None:
|
||||
self._key = settings.openrouter_api_key
|
||||
self._model = settings.stt_model
|
||||
self._url = settings.openrouter_base_url.rstrip("/") + "/chat/completions"
|
||||
self._timeout = settings.stt_timeout_s
|
||||
self._proxy = settings.openrouter_proxy_url or None
|
||||
self._client = client
|
||||
|
||||
async def transcribe(self, audio: bytes, fmt: str = "wav") -> str:
|
||||
texts = load_texts()
|
||||
content = [
|
||||
{"type": "text", "text": texts.user},
|
||||
{"type": "input_audio", "input_audio": {"data": base64.b64encode(audio).decode(), "format": fmt}},
|
||||
]
|
||||
body = {
|
||||
"model": self._model,
|
||||
"messages": [{"role": "system", "content": texts.system}, {"role": "user", "content": content}],
|
||||
"temperature": 0,
|
||||
"max_tokens": 800,
|
||||
# Transcription needs no thinking: with reasoning on, gemini-2.5-flash takes ~60 s instead of ~3 s.
|
||||
"reasoning": {"enabled": False},
|
||||
}
|
||||
data = await self._post(body)
|
||||
try:
|
||||
text = (data["choices"][0]["message"]["content"] or "").strip()
|
||||
except (KeyError, IndexError, TypeError) as exc:
|
||||
raise SttError("bad response") from exc
|
||||
text = text.strip("«»\"' \n")
|
||||
if not text or text.lower() == texts.silence_marker.lower():
|
||||
raise SttNoSpeech("no speech")
|
||||
return text
|
||||
|
||||
async def _post(self, body: dict) -> dict:
|
||||
headers = {"Authorization": f"Bearer {self._key}", "X-Title": "PTSRaiAgent prototype (synthetic data)"}
|
||||
for attempt in range(_ATTEMPTS):
|
||||
try:
|
||||
if self._client is not None:
|
||||
resp = await self._client.post(self._url, json=body, headers=headers, timeout=self._timeout)
|
||||
else:
|
||||
async with httpx.AsyncClient(timeout=self._timeout, proxy=self._proxy) as client:
|
||||
resp = await client.post(self._url, json=body, headers=headers)
|
||||
except httpx.HTTPError as exc:
|
||||
if attempt + 1 == _ATTEMPTS:
|
||||
raise SttError(type(exc).__name__) from exc
|
||||
await asyncio.sleep(0.5 * 2**attempt)
|
||||
continue
|
||||
if resp.status_code in _RETRY_STATUSES and attempt + 1 < _ATTEMPTS:
|
||||
log.warning("stt openrouter http %s, retry %d", resp.status_code, attempt + 1)
|
||||
await asyncio.sleep(0.5 * 2**attempt)
|
||||
continue
|
||||
if resp.status_code != 200:
|
||||
# Provider error bodies carry no patient data — log the message to make failures diagnosable.
|
||||
log.error("stt openrouter http %s: %s", resp.status_code, resp.text[:200])
|
||||
raise SttError(f"http {resp.status_code}")
|
||||
try:
|
||||
return resp.json()
|
||||
except ValueError as exc:
|
||||
raise SttError("bad json") from exc
|
||||
raise SttError("retries exhausted")
|
||||
|
||||
|
||||
def get_stt(settings: Settings) -> SpeechToText | None:
|
||||
"""The configured provider; `None` = voice input is off. `auto` = OpenRouter if a key is set, else mock."""
|
||||
mode = settings.stt_provider
|
||||
if mode == "auto":
|
||||
mode = "openrouter" if settings.openrouter_api_key else "mock"
|
||||
if mode == "openrouter":
|
||||
return OpenRouterSTT(settings) if settings.openrouter_api_key else None
|
||||
if mode == "mock":
|
||||
return MockSTT()
|
||||
return None
|
||||
+18
-6
@@ -30,13 +30,25 @@ async def lifespan(_: FastAPI) -> AsyncGenerator[None, None]:
|
||||
# In compose Postgres is required and healthy before the app starts; this branch is for running the
|
||||
# API (and its tests) without a database. Endpoints touching the DB will fail until it is reachable.
|
||||
log.error("db init failed, continuing without db: %s", type(exc).__name__)
|
||||
if settings.max_enabled:
|
||||
raise # MAX requires persistent bindings and a delivery queue.
|
||||
# Lanes fill these in (#13, #11); main.py itself stays frozen (#34).
|
||||
await scheduler.start()
|
||||
await telegram.start()
|
||||
yield
|
||||
await telegram.stop()
|
||||
await scheduler.stop()
|
||||
await dispose()
|
||||
max_channel = None
|
||||
try:
|
||||
await telegram.start()
|
||||
if settings.max_enabled:
|
||||
from app.channels import max_bot
|
||||
|
||||
max_channel = max_bot
|
||||
await max_channel.start()
|
||||
await scheduler.start()
|
||||
yield
|
||||
finally:
|
||||
await scheduler.stop()
|
||||
if max_channel is not None:
|
||||
await max_channel.stop()
|
||||
await telegram.stop()
|
||||
await dispose()
|
||||
|
||||
|
||||
app = FastAPI(title="PTSRaiAgent API", version="0.1.0", lifespan=lifespan)
|
||||
|
||||
@@ -0,0 +1,257 @@
|
||||
"""Demo scheduler on the virtual clock (#13, SPEC §8, ADR-005).
|
||||
|
||||
`run_until(now)` replays, in time order, every event that is due by `now` and still fresh
|
||||
(`config/scheduler.yaml`):
|
||||
|
||||
* med_reminder — a `doses` row (pending) per prescription time, then `system:med_reminder {dose_id, drug, dose}`;
|
||||
* missed — a reminded dose still pending `missed_after_hours` later → status `missed` → monitoring;
|
||||
* daily_checkin — `system:daily_checkin` at the check-in time;
|
||||
* scale_due — scales due by the module schedules (`config/modules.yaml`) → `system:scale_due`;
|
||||
* evaluation — once a day `MonitoringService.after_data_change()`: catches silence > N days (rule
|
||||
`no_contact_3d`) and missed doses even when the patient writes nothing.
|
||||
|
||||
The rules decide (ADR-007); the scheduler only turns their dialog actions into system events for the engine
|
||||
(`reach_out` → `system:reach_out`, `schedule_scale` → `system:scale_due`). Replies go to `integrations.outbox`.
|
||||
|
||||
Idempotent: a delivered event is stored in `scheduler_events` under a unique key and never sent again; a failed
|
||||
delivery is not stored and is retried on the next run while it is fresh (at least once). Only patients with
|
||||
consent (and adult) are contacted; while a crisis is open no reminders, check-ins or scales are sent.
|
||||
Time comes only from the arguments / `app.core.clock` (guardrail #4).
|
||||
"""
|
||||
|
||||
from __future__ import annotations
|
||||
|
||||
import logging
|
||||
from dataclasses import dataclass, field
|
||||
from datetime import date, datetime, time, timedelta
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
from typing import Any
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, ConfigDict, Field
|
||||
from sqlalchemy import select
|
||||
from sqlalchemy.ext.asyncio import AsyncSession
|
||||
|
||||
from app.config import get_settings
|
||||
from app.core.modules import due_scales, load_modules
|
||||
from app.core.rules import Action
|
||||
from app.db import repo
|
||||
from app.db.clinical import DialogState, Dose, PatientProfile, Prescription
|
||||
from app.db.scheduler import SchedulerEvent
|
||||
from app.db.session import get_clinical_session
|
||||
from app.dialog.contracts import Event, Reply, get_engine
|
||||
from app.integrations.base import integrations
|
||||
from app.services.contracts import get_monitoring
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
# ------------------------------------------------------------------------------------------------ config
|
||||
|
||||
|
||||
class _Strict(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid", frozen=True)
|
||||
|
||||
|
||||
class DosesConfig(_Strict):
|
||||
late_hours: float = Field(gt=0)
|
||||
missed_after_hours: float = Field(gt=0)
|
||||
|
||||
|
||||
class Window(_Strict):
|
||||
time: time
|
||||
late_hours: float = Field(gt=0)
|
||||
|
||||
|
||||
class SchedulerConfig(_Strict):
|
||||
enabled: bool = True
|
||||
tick_seconds: float = Field(gt=0)
|
||||
doses: DosesConfig
|
||||
daily_checkin: Window
|
||||
scales: Window
|
||||
evaluation: Window
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_config(path: Path | None = None) -> SchedulerConfig:
|
||||
path = path or get_settings().config_dir / "scheduler.yaml"
|
||||
return SchedulerConfig.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------------ jobs
|
||||
|
||||
# Same due time → this order: the dose before the check-in that asks about it.
|
||||
_ORDER = {"evaluation": 0, "missed": 1, "med_reminder": 2, "scale_due": 3, "daily_checkin": 4}
|
||||
|
||||
|
||||
@dataclass(order=True)
|
||||
class Job:
|
||||
due: datetime
|
||||
rank: int
|
||||
token: str
|
||||
key: str
|
||||
kind: str = field(compare=False)
|
||||
params: dict[str, Any] = field(default_factory=dict, compare=False)
|
||||
|
||||
|
||||
def _job(due: datetime, token: str, key: str, kind: str, **params: Any) -> Job:
|
||||
return Job(due=due, rank=_ORDER[kind], token=token, key=key, kind=kind, params=params)
|
||||
|
||||
|
||||
def _at(day: date, t: time, now: datetime) -> datetime:
|
||||
return datetime.combine(day, t, tzinfo=now.tzinfo)
|
||||
|
||||
|
||||
def _fresh(due: datetime, now: datetime, late_hours: float) -> bool:
|
||||
return due <= now < due + timedelta(hours=late_hours)
|
||||
|
||||
|
||||
def _window(day: date, w: Window, now: datetime) -> datetime | None:
|
||||
due = _at(day, w.time, now)
|
||||
return due if _fresh(due, now, w.late_hours) else None
|
||||
|
||||
|
||||
async def _dose_jobs(s: AsyncSession, p: PatientProfile, now: datetime, cfg: SchedulerConfig) -> list[Job]:
|
||||
jobs: list[Job] = []
|
||||
today = now.date()
|
||||
for rx in (await s.scalars(select(Prescription).where(Prescription.token == p.token))).all():
|
||||
start = rx.start_date or p.therapy_start
|
||||
for day in (today - timedelta(days=1), today): # a fresh dose is never older than a day
|
||||
if (start and day < start) or (rx.end_date and day > rx.end_date):
|
||||
continue
|
||||
for raw in (rx.schedule or {}).get("times", []):
|
||||
planned = _at(day, time.fromisoformat(raw), now)
|
||||
if _fresh(planned, now, cfg.doses.late_hours):
|
||||
key = f"dose:{rx.id}:{planned.isoformat(timespec='minutes')}"
|
||||
jobs.append(_job(planned, p.token, key, "med_reminder", rx_id=rx.id, planned_at=planned))
|
||||
return jobs
|
||||
|
||||
|
||||
async def _missed_jobs(s: AsyncSession, token: str, now: datetime, cfg: SchedulerConfig) -> list[Job]:
|
||||
after = timedelta(hours=cfg.doses.missed_after_hours)
|
||||
stmt = select(Dose).where(Dose.token == token, Dose.status == "pending", Dose.planned_at <= now - after)
|
||||
return [_job(d.planned_at + after, token, f"missed:{d.id}", "missed", dose_id=d.id) for d in await s.scalars(stmt)]
|
||||
|
||||
|
||||
async def _scale_jobs(s: AsyncSession, p: PatientProfile, now: datetime, cfg: SchedulerConfig) -> list[Job]:
|
||||
due_at = _window(now.date(), cfg.scales, now)
|
||||
if due_at is None:
|
||||
return []
|
||||
last: dict[str, date] = {}
|
||||
for r in await repo.list_scale_results(s, p.token):
|
||||
if r.complete:
|
||||
last[r.scale] = r.ts.astimezone(now.tzinfo).date()
|
||||
if p.therapy_start:
|
||||
# A scale never taken counts from the visit where therapy started, not as overdue on day 0.
|
||||
for mod in load_modules().modules.values():
|
||||
for entry in mod.schedule:
|
||||
last.setdefault(entry.scale, p.therapy_start)
|
||||
therapy_day = (now.date() - p.therapy_start).days if p.therapy_start else 0
|
||||
scales = due_scales(set(p.modules or []), therapy_day, last, now.date())
|
||||
return [_job(due_at, p.token, f"scale:{sc}:{now.date()}", "scale_due", scale=sc) for sc in scales]
|
||||
|
||||
|
||||
async def collect(now: datetime, cfg: SchedulerConfig | None = None) -> list[Job]:
|
||||
"""Due and fresh, not yet delivered events of all contactable patients, in time order."""
|
||||
cfg = cfg or load_config()
|
||||
jobs: list[Job] = []
|
||||
async with get_clinical_session() as s:
|
||||
for p in (await s.scalars(select(PatientProfile).order_by(PatientProfile.token))).all():
|
||||
state = await s.get(DialogState, p.token)
|
||||
data = state.data if state is not None else {}
|
||||
if data.get("consent") is not True or data.get("adult") is not True:
|
||||
continue
|
||||
mine = await _missed_jobs(s, p.token, now, cfg)
|
||||
if (due := _window(now.date(), cfg.evaluation, now)) is not None:
|
||||
mine.append(_job(due, p.token, f"eval:{now.date()}", "evaluation"))
|
||||
if not (data.get("crisis") or {}).get("open"):
|
||||
mine += await _dose_jobs(s, p, now, cfg)
|
||||
mine += await _scale_jobs(s, p, now, cfg)
|
||||
if (due := _window(now.date(), cfg.daily_checkin, now)) is not None:
|
||||
mine.append(_job(due, p.token, f"checkin:{now.date()}", "daily_checkin"))
|
||||
done = set((await s.scalars(select(SchedulerEvent.key).where(SchedulerEvent.token == p.token))).all())
|
||||
jobs += [j for j in mine if j.key not in done]
|
||||
return sorted(jobs)
|
||||
|
||||
|
||||
# ------------------------------------------------------------------------------------------------ delivery
|
||||
|
||||
|
||||
async def _system(token: str, kind: str, **params: Any) -> None:
|
||||
replies: list[Reply] = await get_engine().handle(
|
||||
token,
|
||||
Event(type="system", system=kind, params=params), # type: ignore[arg-type]
|
||||
)
|
||||
if replies:
|
||||
await integrations.outbox.push(token, replies)
|
||||
|
||||
|
||||
async def _after_rules(token: str) -> None:
|
||||
"""Monitoring pass outside a dialog: hand the rules' dialog actions to the engine as system events."""
|
||||
actions: list[Action] = await get_monitoring().after_data_change(token)
|
||||
for a in actions:
|
||||
if a.type == "reach_out":
|
||||
await _system(token, "reach_out", **a.params)
|
||||
elif a.type == "schedule_scale" and a.params.get("scale"):
|
||||
await _system(token, "scale_due", scale=a.params["scale"], scheduled=bool(a.params.get("scheduled")))
|
||||
elif a.type == "crisis":
|
||||
log.warning("scheduler crisis action token=%s code=%s", token, a.code) # alert already persisted
|
||||
|
||||
|
||||
async def _ensure_dose(token: str, rx_id: int, planned_at: datetime) -> tuple[int, Prescription]:
|
||||
async with get_clinical_session() as s:
|
||||
rx = await s.get(Prescription, rx_id)
|
||||
assert rx is not None
|
||||
dose = await s.scalar(
|
||||
select(Dose).where(Dose.token == token, Dose.prescription_id == rx_id, Dose.planned_at == planned_at)
|
||||
)
|
||||
if dose is None:
|
||||
dose = Dose(token=token, prescription_id=rx_id, planned_at=planned_at, status="pending")
|
||||
s.add(dose)
|
||||
await s.flush()
|
||||
return dose.id, rx
|
||||
|
||||
|
||||
async def _mark_missed(dose_id: int) -> bool:
|
||||
async with get_clinical_session() as s:
|
||||
dose = await s.get(Dose, dose_id)
|
||||
if dose is None or dose.status != "pending":
|
||||
return False # answered meanwhile
|
||||
dose.status = "missed"
|
||||
return True
|
||||
|
||||
|
||||
async def _run(job: Job, now: datetime) -> None:
|
||||
if job.kind == "med_reminder":
|
||||
dose_id, rx = await _ensure_dose(job.token, job.params["rx_id"], job.params["planned_at"])
|
||||
await _system(job.token, "med_reminder", dose_id=dose_id, drug=rx.drug, dose=rx.dose)
|
||||
elif job.kind == "missed":
|
||||
if await _mark_missed(job.params["dose_id"]):
|
||||
await _after_rules(job.token)
|
||||
elif job.kind == "daily_checkin":
|
||||
await _system(job.token, "daily_checkin")
|
||||
elif job.kind == "scale_due":
|
||||
await _system(job.token, "scale_due", scale=job.params["scale"], scheduled=True)
|
||||
elif job.kind == "evaluation":
|
||||
await _after_rules(job.token)
|
||||
|
||||
|
||||
async def _done(job: Job, now: datetime) -> None:
|
||||
async with get_clinical_session() as s:
|
||||
s.add(SchedulerEvent(token=job.token, key=job.key, kind=job.kind, due_at=job.due, done_at=now))
|
||||
|
||||
|
||||
async def run_until(now: datetime, cfg: SchedulerConfig | None = None) -> list[Job]:
|
||||
"""Deliver every due event up to `now` in time order; returns the delivered jobs."""
|
||||
delivered: list[Job] = []
|
||||
for job in await collect(now, cfg):
|
||||
try:
|
||||
await _run(job, now)
|
||||
except Exception as exc: # noqa: BLE001 — one patient's failure must not stop the others
|
||||
log.error("scheduler job failed token=%s kind=%s error=%s", job.token, job.kind, type(exc).__name__)
|
||||
continue
|
||||
await _done(job, now)
|
||||
delivered.append(job)
|
||||
if delivered:
|
||||
log.info("scheduler delivered=%s", [(j.token, j.kind) for j in delivered])
|
||||
return delivered
|
||||
+47
-13
@@ -1,4 +1,4 @@
|
||||
"""Questionnaire jobs on the demo clock; clinical release disabled by default.
|
||||
"""Scheduler on the demo clock: questionnaire jobs when that release is on, else the demo scheduler (#13).
|
||||
|
||||
One scheduler per database. PostgreSQL's advisory transaction lock serializes
|
||||
workers; an asyncio lock does the same within a SQLite demonstration process.
|
||||
@@ -12,16 +12,23 @@ from datetime import datetime
|
||||
from zoneinfo import ZoneInfo
|
||||
|
||||
from sqlalchemy import select, text
|
||||
from sqlalchemy.exc import SQLAlchemyError
|
||||
|
||||
from app.core import clock
|
||||
from app.core.intake_questions import DIARY_KINDS
|
||||
from app.core.intake_runtime import due_scales, intake_enabled, load_runtime
|
||||
from app.core.questionnaire import load_policy
|
||||
from app.db import repo
|
||||
from app.db.clinical import PatientProfile
|
||||
from app.db.intake import QuestionnaireTask
|
||||
from app.db.session import get_clinical_session
|
||||
from app.dialog.contracts import Event, Reply, get_engine
|
||||
from app.dialog.contracts import Button, Event, Reply, get_engine
|
||||
from app.dialog.texts import load_dialog_texts
|
||||
from app.integrations.base import integrations
|
||||
from app.scheduler import demo
|
||||
from app.services import monitoring
|
||||
from app.services import questionnaire as service
|
||||
from app.services.followup import next_day_check_due
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
_worker = None
|
||||
@@ -38,20 +45,31 @@ async def plan():
|
||||
state = await repo.get_dialog_state(session, profile.token)
|
||||
if not state or state.data.get("consent") is not True or state.data.get("adult") is not True:
|
||||
continue
|
||||
crisis = state.data.get("crisis")
|
||||
if next_day_check_due(crisis, now):
|
||||
# The day after a crisis the app asks how the person is, the safety plan one tap away.
|
||||
texts = load_dialog_texts()
|
||||
plan_button = Button(label=texts.safety_plan.title.rstrip(":"), data="safety_plan")
|
||||
await integrations.outbox.push(
|
||||
profile.token, [Reply(text=texts.reach_out.after_crisis, buttons=[[plan_button]], kind="question")]
|
||||
)
|
||||
state.data = {**state.data, "crisis": {**crisis, "followup_sent": now.isoformat()}}
|
||||
rows = await service.records(session, profile.token)
|
||||
initial = next((r for r in reversed(rows) if r.kind == "intake" and r.status == "complete"), None)
|
||||
if initial is None:
|
||||
continue
|
||||
last_activity = max([r.day for r in rows if r.kind == "diary" and r.status == "complete"] + [initial.day])
|
||||
diaries = [r.day for r in rows if r.kind in DIARY_KINDS and r.status == "complete"]
|
||||
last_activity = max([*diaries, initial.day])
|
||||
high_risk = profile.enhanced_monitoring or bool(state.data.get("crisis"))
|
||||
if high_risk and (local.date() - last_activity).days >= p.high_risk_silence_days:
|
||||
await service.alert(session, profile.token, f"silence:{last_activity}", "high_risk_silence", now)
|
||||
if (state.data.get("crisis") or {}).get("open") or state.data.get("intake_review_required"):
|
||||
continue
|
||||
if local.hour >= p.daily_hour and not any(
|
||||
r.kind == "diary" and r.day == local.date() and r.status == "complete" for r in rows
|
||||
):
|
||||
await service.queue_task(session, profile.token, "diary", f"diary:{local.date()}", now)
|
||||
done = {r.kind for r in rows if r.day == local.date() and r.status == "complete"}
|
||||
# Stage 2 diary: morning block after waking, evening block at evening_hour («Этап 2», p.2).
|
||||
for kind, hour in (("diary_morning", p.morning_hour), ("diary_evening", p.evening_hour)):
|
||||
if local.hour >= hour and kind not in done:
|
||||
await service.queue_task(session, profile.token, kind, f"{kind}:{local.date()}", now)
|
||||
last = {}
|
||||
for row in rows:
|
||||
if row.status != "complete":
|
||||
@@ -79,12 +97,21 @@ async def plan():
|
||||
after_crisis=crisis_date,
|
||||
policy=p,
|
||||
)
|
||||
if scales or local.hour >= p.daily_hour:
|
||||
# Suicide-risk module: C-SSRS «since last contact» every day, only under risk monitoring.
|
||||
if profile.enhanced_monitoring and local.hour >= p.evening_hour and "cssrs_since_contact" not in done:
|
||||
await service.queue_task(session, profile.token, "cssrs_since_contact", f"cssrs:{local.date()}", now)
|
||||
totals = initial.details.get("totals", {})
|
||||
modules = set(profile.modules or [])
|
||||
policy = load_policy()
|
||||
# PHQ-9 only with depression or a positive PHQ-2; PCL-5 only with PTSD or a positive TSQ («Этап 2», p.3).
|
||||
wanted = {
|
||||
"phq9": "depression" in modules or bool(totals.get("phq9", {}).get("complete")),
|
||||
"pcl5": "veteran" in modules or (totals.get("tsq", {}).get("total") or 0) >= policy.tsq_expand_at,
|
||||
"rus_audit_s": True,
|
||||
}
|
||||
for sid in scales:
|
||||
if sid == "pcl5" and initial.answers.get("trauma") != 1:
|
||||
continue
|
||||
await service.queue_task(session, profile.token, sid, f"{sid}:{local.date()}", now)
|
||||
if wanted[sid]:
|
||||
await service.queue_task(session, profile.token, sid, f"{sid}:{local.date()}", now)
|
||||
|
||||
|
||||
async def deliver():
|
||||
@@ -146,6 +173,9 @@ async def run_until_now():
|
||||
return
|
||||
await service.dispatch_notices()
|
||||
if not intake_enabled():
|
||||
# Questionnaire release off → the demo scheduler (doses, check-ins, scales, silence) runs instead.
|
||||
if demo.load_config().enabled:
|
||||
await demo.run_until(clock.now())
|
||||
return
|
||||
await plan()
|
||||
await deliver()
|
||||
@@ -158,12 +188,16 @@ async def _run():
|
||||
await run_until_now()
|
||||
except Exception as exc:
|
||||
log.error("questionnaire scheduler error=%s", type(exc).__name__)
|
||||
await asyncio.sleep(30)
|
||||
await asyncio.sleep(demo.load_config().tick_seconds)
|
||||
|
||||
|
||||
async def start():
|
||||
global _worker
|
||||
if _worker is None and intake_enabled():
|
||||
try:
|
||||
await monitoring.init_clock_persistence()
|
||||
except (OSError, SQLAlchemyError) as exc:
|
||||
log.error("clock persistence unavailable error=%s", type(exc).__name__)
|
||||
if _worker is None and (intake_enabled() or demo.load_config().enabled):
|
||||
_worker = asyncio.create_task(_run())
|
||||
|
||||
|
||||
|
||||
@@ -0,0 +1,24 @@
|
||||
"""Pseudonymous care routing; no identity fields or changes to clinical release gates."""
|
||||
|
||||
from hashlib import sha256
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel, ConfigDict, Field
|
||||
|
||||
from app.config import get_settings
|
||||
|
||||
|
||||
class AnonymousCare(BaseModel):
|
||||
model_config = ConfigDict(extra="forbid", str_strip_whitespace=True)
|
||||
doctor_id: str = Field(min_length=1, max_length=64)
|
||||
|
||||
|
||||
def doctor_id() -> str:
|
||||
path = get_settings().config_dir / "anonymous_care.yaml"
|
||||
return AnonymousCare.model_validate(yaml.safe_load(path.read_text())).doctor_id
|
||||
|
||||
|
||||
def display_name(token: str) -> str:
|
||||
# Do not use a piece of the bearer token itself as the public patient label.
|
||||
label = sha256(("anonymous-patient:" + token).encode()).hexdigest()[:10].upper()
|
||||
return f"Пациент {label}"
|
||||
@@ -0,0 +1,43 @@
|
||||
"""Follow-up after a crisis (clinical review 2026-10-04: «план безопасности и звонок после кризиса — обязательно»).
|
||||
|
||||
Every crisis — from the safety lexicon, a rule (PHQ-9 item 9, C-SSRS high) or the questionnaire (red flags, high
|
||||
risk) — leaves a task for the doctor on duty: call the patient back, about 24 hours as a guide. The task is an alert
|
||||
on the dashboard; «позвонили» is its acknowledgement (`repo.ack_alert`, audited). One open task per patient: a
|
||||
repeated crisis signal does not pile up callbacks. On the next day the app itself asks how the person is, with the
|
||||
safety plan at hand (`app/scheduler/jobs.py`).
|
||||
"""
|
||||
|
||||
from datetime import datetime, timedelta
|
||||
|
||||
from sqlalchemy.ext.asyncio import AsyncSession
|
||||
|
||||
from app.core.types import AlertLevel
|
||||
from app.db import repo
|
||||
from app.db.clinical import Alert
|
||||
|
||||
POST_CRISIS_CALL = "post_crisis_call"
|
||||
ON_DUTY = "on-duty"
|
||||
CALL_WITHIN = timedelta(hours=24) # a guide, not a guarantee
|
||||
NEXT_DAY_CHECK_AFTER = timedelta(hours=20)
|
||||
|
||||
|
||||
async def schedule_post_crisis_call(session: AsyncSession, token: str, now: datetime, *, source: str) -> Alert | None:
|
||||
if POST_CRISIS_CALL in await repo.open_alert_codes(session, token):
|
||||
return None
|
||||
return await repo.add_alert(
|
||||
session,
|
||||
token=token,
|
||||
level=AlertLevel.HIGH,
|
||||
code=POST_CRISIS_CALL,
|
||||
reason="Перезвонить пациенту после кризиса — дежурный специалист, ориентир 24 ч. Отметка «позвонили» — "
|
||||
"подтверждение этого сигнала.",
|
||||
ts=now,
|
||||
params={"due_at": (now + CALL_WITHIN).isoformat(), "assignee": ON_DUTY, "source": source},
|
||||
)
|
||||
|
||||
|
||||
def next_day_check_due(crisis: dict | None, now: datetime) -> bool:
|
||||
"""The day after a crisis the app asks how the person is — once per crisis episode."""
|
||||
if not crisis or not crisis.get("opened_at") or crisis.get("followup_sent"):
|
||||
return False
|
||||
return now - datetime.fromisoformat(crisis["opened_at"]) >= NEXT_DAY_CHECK_AFTER
|
||||
@@ -0,0 +1,173 @@
|
||||
"""The patient's garden (#118, slide 13): light gamification over all modules.
|
||||
|
||||
Deterministic, no LLM (guardrail 3), rules in `config/garden.yaml` (ADR-008). Computed on the fly from existing
|
||||
activity rows — no own table, no migration (ADR-003), and changing the rules replays the whole history.
|
||||
|
||||
«Without pressure»: points only add up (a skipped day takes nothing away), growth counts the fact of an activity
|
||||
and never its content (scale scores, mood), and there is no comparison between patients. Only the patient sees it.
|
||||
An honest «Пропущу» on a dose grows the garden like «Принял(а)», so the garden never rewards a false «taken» (#120).
|
||||
After a recent acute/high alert the garden is `quiet`: growth stays, celebration does not.
|
||||
"""
|
||||
|
||||
from collections import defaultdict
|
||||
from collections.abc import Iterable
|
||||
from datetime import date, datetime, timedelta
|
||||
from functools import lru_cache
|
||||
from pathlib import Path
|
||||
from typing import Literal
|
||||
|
||||
import yaml
|
||||
from pydantic import BaseModel
|
||||
from sqlalchemy import select
|
||||
from sqlalchemy.ext.asyncio import AsyncSession
|
||||
|
||||
from app.core import clock
|
||||
from app.core.intake_questions import DIARY_KINDS
|
||||
from app.db.clinical import Alert, DailyCheckin, Dose, ScaleResult
|
||||
from app.db.intake import QuestionnaireRecord
|
||||
|
||||
Activity = Literal["meds", "diary", "questionnaire"]
|
||||
|
||||
|
||||
class ActivityRule(BaseModel):
|
||||
points: int
|
||||
daily_cap: int
|
||||
|
||||
|
||||
class TitleRule(BaseModel):
|
||||
from_steps: int
|
||||
title: str
|
||||
|
||||
|
||||
class QuietRule(BaseModel):
|
||||
alert_levels: list[str]
|
||||
hours: int
|
||||
|
||||
|
||||
class GardenConfig(BaseModel):
|
||||
activities: dict[Activity, ActivityRule]
|
||||
answered_dose_statuses: list[str]
|
||||
quiet: QuietRule
|
||||
step_points: int
|
||||
stages_per_plant: int
|
||||
max_plants: int
|
||||
titles: list[TitleRule]
|
||||
today: dict[Activity, str]
|
||||
|
||||
|
||||
@lru_cache
|
||||
def load_config(path: Path | None = None) -> GardenConfig:
|
||||
from app.config import get_settings
|
||||
|
||||
path = path or get_settings().config_dir / "garden.yaml"
|
||||
return GardenConfig.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
|
||||
|
||||
|
||||
class Plant(BaseModel):
|
||||
stage: int # 0 = not yet sprouted … stages_per_plant = in bloom
|
||||
|
||||
|
||||
class TodayItem(BaseModel):
|
||||
activity: Activity
|
||||
title: str
|
||||
done: bool
|
||||
detail: str | None = None # e.g. "1 из 2" for doses
|
||||
|
||||
|
||||
class Garden(BaseModel):
|
||||
points: int
|
||||
steps: int
|
||||
title: str
|
||||
step_points: int
|
||||
points_in_step: int # progress towards the next growth step: «8 из 10»
|
||||
plants: list[Plant]
|
||||
today: list[TodayItem]
|
||||
quiet: bool = False # recent acute/high alert: no «Сад подрос», no grow-in animation
|
||||
|
||||
|
||||
def compute(events: Iterable[tuple[Activity, date]], today: date, cfg: GardenConfig | None = None) -> Garden:
|
||||
"""Points from (activity, day) events: per-day caps, events after `today` (demo clock) ignored."""
|
||||
cfg = cfg or load_config()
|
||||
per_day: dict[tuple[Activity, date], int] = defaultdict(int)
|
||||
for kind, day in events:
|
||||
if day <= today:
|
||||
per_day[(kind, day)] += 1
|
||||
points = sum(
|
||||
min(n, cfg.activities[kind].daily_cap) * cfg.activities[kind].points for (kind, _), n in per_day.items()
|
||||
)
|
||||
steps = points // cfg.step_points
|
||||
plants = [
|
||||
Plant(stage=max(0, min(cfg.stages_per_plant, steps - i * cfg.stages_per_plant))) for i in range(cfg.max_plants)
|
||||
]
|
||||
title = next(t.title for t in sorted(cfg.titles, key=lambda t: -t.from_steps) if steps >= t.from_steps)
|
||||
return Garden(
|
||||
points=points,
|
||||
steps=steps,
|
||||
title=title,
|
||||
step_points=cfg.step_points,
|
||||
points_in_step=points % cfg.step_points,
|
||||
plants=plants,
|
||||
today=[],
|
||||
)
|
||||
|
||||
|
||||
def _day(ts: datetime, tz) -> date:
|
||||
return ts.astimezone(tz).date()
|
||||
|
||||
|
||||
async def garden_for(s: AsyncSession, token: str) -> Garden:
|
||||
cfg = load_config()
|
||||
now = clock.now()
|
||||
tz, today = now.tzinfo, now.date()
|
||||
events: list[tuple[Activity, date]] = []
|
||||
|
||||
doses = (await s.scalars(select(Dose).where(Dose.token == token))).all()
|
||||
for d in doses:
|
||||
if d.status in cfg.answered_dose_statuses:
|
||||
events.append(("meds", _day(d.answered_at or d.planned_at, tz)))
|
||||
checkins = (await s.scalars(select(DailyCheckin).where(DailyCheckin.token == token))).all()
|
||||
for c in checkins:
|
||||
if c.mood is not None:
|
||||
events.append(("diary", c.day))
|
||||
records = (await s.scalars(select(QuestionnaireRecord).where(QuestionnaireRecord.token == token))).all()
|
||||
for r in records:
|
||||
if r.status != "complete":
|
||||
continue
|
||||
if r.kind in DIARY_KINDS:
|
||||
events.append(("diary", r.day))
|
||||
else:
|
||||
events.append(("questionnaire", _day(r.completed_at, tz) if r.completed_at else r.day))
|
||||
scales = (await s.scalars(select(ScaleResult).where(ScaleResult.token == token))).all()
|
||||
for sc in scales:
|
||||
if sc.complete:
|
||||
events.append(("questionnaire", _day(sc.ts, tz)))
|
||||
|
||||
garden = compute(events, today, cfg)
|
||||
since = now - timedelta(hours=cfg.quiet.hours)
|
||||
recent_alert = await s.scalar(
|
||||
select(Alert.id)
|
||||
.where(Alert.token == token, Alert.level.in_(cfg.quiet.alert_levels), Alert.ts >= since, Alert.ts <= now)
|
||||
.limit(1)
|
||||
)
|
||||
garden.quiet = recent_alert is not None
|
||||
done_today = {kind for kind, day in events if day == today}
|
||||
|
||||
items: list[TodayItem] = []
|
||||
due = [d for d in doses if _day(d.planned_at, tz) == today]
|
||||
if due:
|
||||
answered = sum(d.status in cfg.answered_dose_statuses for d in due)
|
||||
due_now = sum(d.planned_at <= now for d in due)
|
||||
items.append(
|
||||
TodayItem(
|
||||
activity="meds",
|
||||
title=cfg.today["meds"],
|
||||
done=answered > 0 and answered >= due_now,
|
||||
detail=f"{answered} из {len(due)}",
|
||||
)
|
||||
)
|
||||
items.append(TodayItem(activity="diary", title=cfg.today["diary"], done="diary" in done_today))
|
||||
# A questionnaire is not due every day: show it only once done, so an empty day is never a «missed» item.
|
||||
if "questionnaire" in done_today:
|
||||
items.append(TodayItem(activity="questionnaire", title=cfg.today["questionnaire"], done=True))
|
||||
garden.today = items
|
||||
return garden
|
||||
@@ -0,0 +1,191 @@
|
||||
"""Monitoring service (#38): patient snapshot → deterministic rules → persisted alerts (ADR-007).
|
||||
|
||||
`after_data_change(token)` is called by the dialog engine after it commits clinical data (and by the scheduler
|
||||
on silence). It builds a `PatientSnapshot`, runs `app.core.rules.evaluate`, then in one transaction:
|
||||
* writes every `alert`/`crisis` action to `alerts` (a crisis is an `acute` alert) and, for a crisis,
|
||||
an audit record `crisis_acute` (guardrail #6);
|
||||
* applies `enhanced_monitoring` to the profile;
|
||||
* refreshes the cached `status_color` of the profile (ADR-006; the source of truth stays the open alerts).
|
||||
After the commit the doctor is notified through `integrations.notifier` (a crisis also goes to the doctor on
|
||||
duty), and only the *dialog* actions are returned to the engine — it never creates alerts itself.
|
||||
|
||||
A crisis rule whose acute alert is still open stays silent: the crisis script is already running and the
|
||||
doctor already knows, so it is neither restarted nor re-alerted (`rules.evaluate` never suppresses crises).
|
||||
|
||||
The virtual clock offset is persisted in `clock_state` (ADR-005) by `init_clock_persistence()`.
|
||||
"""
|
||||
|
||||
import asyncio
|
||||
import logging
|
||||
from datetime import datetime, timedelta
|
||||
|
||||
from sqlalchemy.exc import SQLAlchemyError
|
||||
from sqlalchemy.ext.asyncio import AsyncSession
|
||||
|
||||
from app.core import clock
|
||||
from app.core.rules import Action, evaluate, patient_status
|
||||
from app.core.types import AlertLevel
|
||||
from app.db import repo
|
||||
from app.db.audit import audit
|
||||
from app.db.session import get_clinical_session
|
||||
from app.integrations.base import integrations
|
||||
from app.services.contracts import register_monitoring
|
||||
from app.services.followup import schedule_post_crisis_call
|
||||
from app.services.snapshot import build_snapshot
|
||||
|
||||
log = logging.getLogger(__name__)
|
||||
|
||||
SYSTEM_ACTOR = "system"
|
||||
# Notification address of the doctor on duty: acute alerts must reach someone even when the attending doctor
|
||||
# is off (SPEC: crisis → immediate escalation). The notifier maps it to the duty channel.
|
||||
ON_DUTY_DOCTOR = "on-duty"
|
||||
# Persisted by the service itself, never passed to the dialog engine.
|
||||
_SERVICE_ACTIONS = frozenset({"alert", "enhanced_monitoring"})
|
||||
|
||||
|
||||
async def refresh_status(session: AsyncSession, token: str) -> str:
|
||||
"""Recompute and cache the dashboard colour from open alerts (also call it after an ack)."""
|
||||
alerts = await repo.list_alerts(session, token=token, open_only=True)
|
||||
status = patient_status(AlertLevel[a.level.upper()] for a in alerts)
|
||||
await repo.upsert_profile(session, token=token, status_color=status.color)
|
||||
return status.color
|
||||
|
||||
|
||||
# Which data a crisis rule is triggered by: a crisis for the same code is raised again only when such data is
|
||||
# newer than the last alert with that code (acked or not) — otherwise an acked PHQ-9 item 9 re-fired on every
|
||||
# data change for 24 h (seen live: AUDIT-C answers 0/0/0 → crisis again).
|
||||
_CRISIS_TRIGGERS: dict[str, tuple[str, ...]] = {
|
||||
"phq9_item9": ("phq9",),
|
||||
"cssrs_high": ("cssrs_screen",),
|
||||
"cssrs_moderate": ("cssrs_screen",),
|
||||
"weapon_access_risk": ("phq9", "cssrs_screen"),
|
||||
}
|
||||
|
||||
|
||||
async def _drop_handled_crises(s: AsyncSession, token: str, actions: list[Action]) -> list[Action]:
|
||||
crisis_codes = {a.code for a in actions if a.type == "crisis"}
|
||||
if not crisis_codes:
|
||||
return actions
|
||||
alerts = await repo.list_alerts(s, token=token)
|
||||
results = await repo.list_scale_results(s, token)
|
||||
handled: set[str] = set()
|
||||
for code in crisis_codes:
|
||||
last_alert = max((a.ts for a in alerts if a.code == code), default=None)
|
||||
if last_alert is None:
|
||||
continue
|
||||
scales = _CRISIS_TRIGGERS.get(code)
|
||||
last_data = max((r.ts for r in results if scales is None or r.scale in scales), default=None)
|
||||
if last_data is None or last_data <= last_alert:
|
||||
handled.add(code)
|
||||
if handled:
|
||||
log.info("monitoring token=%s crisis already handled=%s", token, sorted(handled))
|
||||
return [a for a in actions if a.code not in handled]
|
||||
|
||||
|
||||
def _drop_running_crises(actions: list[Action], open_acute: set[str]) -> list[Action]:
|
||||
"""Silence every action of a crisis rule whose acute alert is still open (see module docstring)."""
|
||||
running = {a.code for a in actions if a.type == "crisis" and a.code in open_acute}
|
||||
return [a for a in actions if a.code not in running]
|
||||
|
||||
|
||||
class RuleMonitoring:
|
||||
async def after_data_change(self, token: str) -> list[Action]:
|
||||
now = clock.now()
|
||||
notify: list[tuple[str, str, str]] = [] # (doctor_id, level, text) — sent after the commit
|
||||
async with get_clinical_session() as s:
|
||||
profile = await repo.get_profile(s, token)
|
||||
snapshot = await build_snapshot(s, token, now, profile=profile)
|
||||
if profile is None or snapshot is None:
|
||||
return []
|
||||
open_acute = {a.code for a in await repo.list_alerts(s, token=token, open_only=True) if a.level == "acute"}
|
||||
actions = _drop_running_crises(evaluate(snapshot), open_acute)
|
||||
actions = await _drop_handled_crises(s, token, actions)
|
||||
for action in actions:
|
||||
if action.type == "enhanced_monitoring":
|
||||
profile.enhanced_monitoring = True
|
||||
if not action.creates_alert or action.level is None:
|
||||
continue
|
||||
alert = await repo.add_alert(
|
||||
s,
|
||||
token=token,
|
||||
level=action.level,
|
||||
code=action.code,
|
||||
reason=action.reason_ru,
|
||||
ts=now,
|
||||
params=action.params,
|
||||
)
|
||||
level = action.level.name.lower()
|
||||
notify.append((profile.doctor_id, level, action.reason_ru))
|
||||
if action.type == "crisis":
|
||||
await audit(
|
||||
s,
|
||||
actor=SYSTEM_ACTOR,
|
||||
action="crisis_acute",
|
||||
token=token,
|
||||
details={"alert_id": alert.id, "code": action.code},
|
||||
ts=now,
|
||||
)
|
||||
notify.append((ON_DUTY_DOCTOR, level, action.reason_ru))
|
||||
await schedule_post_crisis_call(s, token, now, source=f"rule:{action.code}")
|
||||
await refresh_status(s, token)
|
||||
log.info("monitoring token=%s actions=%s", token, [a.code for a in actions])
|
||||
for doctor_id, level, text in notify:
|
||||
await _notify(doctor_id, level, text, token)
|
||||
return [a for a in actions if a.type not in _SERVICE_ACTIONS]
|
||||
|
||||
async def is_in_crisis(self, token: str) -> bool:
|
||||
async with get_clinical_session() as s:
|
||||
alerts = await repo.list_alerts(s, token=token, open_only=True)
|
||||
return any(a.level == "acute" for a in alerts)
|
||||
|
||||
|
||||
async def _notify(doctor_id: str, level: str, text: str, token: str) -> None:
|
||||
# The alert is already committed and visible on the dashboard; a failing channel must not undo it.
|
||||
try:
|
||||
await integrations.notifier.send(doctor_id, level, text, token) # type: ignore[arg-type]
|
||||
except Exception as exc: # noqa: BLE001 — any channel error
|
||||
log.warning("notify failed token=%s level=%s error=%s", token, level, type(exc).__name__)
|
||||
|
||||
|
||||
register_monitoring(RuleMonitoring)
|
||||
|
||||
|
||||
# ---------------------------------------------------------------------------------- demo clock persistence
|
||||
|
||||
_writes: set[asyncio.Task[None]] = set()
|
||||
|
||||
|
||||
async def _write_offset() -> None:
|
||||
# Writes the offset current at write time, so out-of-order tasks still leave the latest value stored.
|
||||
try:
|
||||
async with get_clinical_session() as s:
|
||||
await repo.save_clock_offset(s, clock.offset().total_seconds())
|
||||
except (OSError, SQLAlchemyError) as exc:
|
||||
log.warning("clock offset not saved error=%s", type(exc).__name__)
|
||||
|
||||
|
||||
def _save_offset(_: timedelta) -> None:
|
||||
"""Sync hook for `clock.register_persistence`: schedules the DB write on the running loop."""
|
||||
try:
|
||||
loop = asyncio.get_running_loop()
|
||||
except RuntimeError:
|
||||
log.warning("clock offset not saved: no running event loop")
|
||||
return
|
||||
task = loop.create_task(_write_offset())
|
||||
_writes.add(task)
|
||||
task.add_done_callback(_writes.discard)
|
||||
|
||||
|
||||
async def flush_clock_writes() -> None:
|
||||
"""Wait for pending offset writes (tests, shutdown)."""
|
||||
if _writes:
|
||||
await asyncio.gather(*list(_writes))
|
||||
|
||||
|
||||
async def init_clock_persistence() -> datetime:
|
||||
"""Restore the virtual clock offset from `clock_state` and save every later change there."""
|
||||
async with get_clinical_session() as s:
|
||||
stored = timedelta(seconds=await repo.load_clock_offset(s))
|
||||
clock.register_persistence(lambda: stored, _save_offset)
|
||||
log.info("clock offset restored seconds=%s", int(stored.total_seconds()))
|
||||
return clock.now()
|
||||
@@ -47,6 +47,7 @@ async def create_record(ctx, kind, *, task=None):
|
||||
sex = profile.sex if profile else None
|
||||
if sex is None and prior:
|
||||
sex = prior.details.get("sex")
|
||||
day = ctx.now.astimezone(ZoneInfo(runtime.timezone)).date()
|
||||
row = QuestionnaireRecord(
|
||||
id=uuid4().hex,
|
||||
token=ctx.token,
|
||||
@@ -54,7 +55,7 @@ async def create_record(ctx, kind, *, task=None):
|
||||
version=content()["version"],
|
||||
policy_version=load_policy().version,
|
||||
started_at=ctx.now,
|
||||
day=ctx.now.astimezone(ZoneInfo(runtime.timezone)).date(),
|
||||
day=day,
|
||||
status="active",
|
||||
answers={},
|
||||
details={
|
||||
@@ -69,6 +70,8 @@ async def create_record(ctx, kind, *, task=None):
|
||||
"weekly_pcl": kind == "pcl5" and bool((ctx.data.get("crisis") or {}).get("closed_at")),
|
||||
"answer_metadata": {},
|
||||
"task_id": task.id if task else None,
|
||||
# Days since stage 1: rotates the PHQ-9 items of the depression diary module (3 a day).
|
||||
"day_index": (day - prior.day).days if prior else 0,
|
||||
},
|
||||
)
|
||||
ctx.session.add(row)
|
||||
@@ -79,7 +82,7 @@ async def create_record(ctx, kind, *, task=None):
|
||||
return row
|
||||
|
||||
|
||||
def save_answer(row, question, value, now):
|
||||
def save_answer(row, question, value, now, *, derived=False):
|
||||
"""Anchor recall windows to administration, never to the day of a resumed answer."""
|
||||
day = row.day
|
||||
starts = {
|
||||
@@ -105,8 +108,8 @@ def save_answer(row, question, value, now):
|
||||
"period": question.period,
|
||||
"period_start": starts[question.period].isoformat() if question.period in starts else None,
|
||||
"period_end": day.isoformat(),
|
||||
"source": "patient",
|
||||
"derived": False,
|
||||
"source": "derived" if derived else "patient",
|
||||
"derived": derived,
|
||||
},
|
||||
},
|
||||
}
|
||||
@@ -258,6 +261,16 @@ async def queue_task(session, token, kind, key, now):
|
||||
return row
|
||||
|
||||
|
||||
async def outstanding_task(session, token, kind):
|
||||
return await session.scalar(
|
||||
select(QuestionnaireTask).where(
|
||||
QuestionnaireTask.token == token,
|
||||
QuestionnaireTask.kind == kind,
|
||||
QuestionnaireTask.status.in_(("pending", "active")),
|
||||
)
|
||||
)
|
||||
|
||||
|
||||
async def lock_patient(session, token):
|
||||
# PostgreSQL serializes callbacks from different workers. SQLite tests additionally
|
||||
# use the engine's in-process lock. Consent and answers share this transaction.
|
||||
|
||||
@@ -0,0 +1,93 @@
|
||||
"""Patient snapshot for the rules engine, assembled from the clinical DB (ADR-007).
|
||||
|
||||
Maps storage names to `app.core.rules` names (`sleep_bucket` → `sleep_hours_bucket`, `alcohol_bucket` →
|
||||
`alcohol`), derives age from `birth_year` and the therapy day from `therapy_start`. Time comes in as `as_of`
|
||||
(from `app.core.clock`), never from the wall clock. Must not import `app.db.identity` (guardrail #5).
|
||||
"""
|
||||
|
||||
from datetime import datetime, timedelta
|
||||
from typing import Any, get_args
|
||||
|
||||
from sqlalchemy import func, select
|
||||
from sqlalchemy.ext.asyncio import AsyncSession
|
||||
|
||||
from app.core.rules import (
|
||||
CssrsRisk,
|
||||
DailyCheckin,
|
||||
DoseRecord,
|
||||
Module,
|
||||
PatientSnapshot,
|
||||
ScalePoint,
|
||||
)
|
||||
from app.db import repo
|
||||
from app.db.clinical import Dose, Message, PatientProfile
|
||||
|
||||
# Risk screens are stored as scale results but reach the rules as `cssrs_risk`, not as scale points.
|
||||
CSSRS_SCALES = frozenset({"cssrs_screen", "cssrs"})
|
||||
# A C-SSRS result counts as the current risk for this long (same window as PHQ-9 item 9 and the dialog's
|
||||
# C-SSRS cooldown): one old "high" must not restart the crisis protocol after the doctor has acted on it.
|
||||
CSSRS_RECENT = timedelta(hours=24)
|
||||
# Unknown sex/age fall back to the more cautious option: lower AUDIT-C cut-off, young-adult monitoring.
|
||||
_UNKNOWN_SEX = "f"
|
||||
_UNKNOWN_AGE = 0
|
||||
|
||||
_MODULES = frozenset(get_args(Module))
|
||||
_CSSRS_RISKS = frozenset(get_args(CssrsRisk))
|
||||
|
||||
|
||||
def _cssrs_risk(results: list[Any], as_of: datetime) -> CssrsRisk | None:
|
||||
recent = [r for r in results if r.scale in CSSRS_SCALES and as_of - CSSRS_RECENT < r.ts <= as_of]
|
||||
if not recent:
|
||||
return None
|
||||
severity = recent[-1].severity
|
||||
return severity if severity in _CSSRS_RISKS else None
|
||||
|
||||
|
||||
async def build_snapshot(
|
||||
session: AsyncSession, token: str, as_of: datetime, *, profile: PatientProfile | None = None
|
||||
) -> PatientSnapshot | None:
|
||||
"""Snapshot of everything the rules may look at; None if the patient has no clinical profile."""
|
||||
profile = profile or await repo.get_profile(session, token)
|
||||
if profile is None:
|
||||
return None
|
||||
|
||||
checkins = [
|
||||
DailyCheckin(
|
||||
day=c.day,
|
||||
mood=c.mood,
|
||||
med_taken=c.med_taken,
|
||||
sleep_hours_bucket=c.sleep_bucket, # type: ignore[arg-type]
|
||||
alcohol=c.alcohol_bucket, # type: ignore[arg-type]
|
||||
side_effects=list(c.side_effects or []),
|
||||
quit_intent=bool(c.quit_intent),
|
||||
nightmares=c.nightmares,
|
||||
)
|
||||
for c in await repo.list_checkins(session, token)
|
||||
]
|
||||
results = [r for r in await repo.list_scale_results(session, token) if r.complete]
|
||||
doses = (await session.scalars(select(Dose).where(Dose.token == token).order_by(Dose.planned_at))).all()
|
||||
last_in = await session.scalar(
|
||||
select(func.max(Message.ts)).where(Message.token == token, Message.direction == "in")
|
||||
)
|
||||
state = await repo.get_dialog_state(session, token)
|
||||
facts = (state.data.get("facts") or {}) if state is not None else {}
|
||||
|
||||
return PatientSnapshot(
|
||||
token=token,
|
||||
as_of=as_of,
|
||||
age=as_of.year - profile.birth_year if profile.birth_year else _UNKNOWN_AGE,
|
||||
sex=profile.sex if profile.sex in ("m", "f") else _UNKNOWN_SEX, # type: ignore[arg-type]
|
||||
modules={m for m in profile.modules or [] if m in _MODULES}, # type: ignore[misc]
|
||||
therapy_day=(as_of.date() - profile.therapy_start).days if profile.therapy_start else 0,
|
||||
checkins=checkins,
|
||||
scale_results=[
|
||||
ScalePoint(scale=r.scale, ts=r.ts, total=r.total, item9=r.item9, scheduled=r.scheduled)
|
||||
for r in results
|
||||
if r.scale not in CSSRS_SCALES
|
||||
],
|
||||
doses=[DoseRecord(planned_at=d.planned_at, status=d.status) for d in doses], # type: ignore[arg-type]
|
||||
cssrs_risk=_cssrs_risk(results, as_of),
|
||||
weapon_access=facts.get("weapon_access"),
|
||||
last_patient_message_at=last_in,
|
||||
open_alert_codes=await repo.open_alert_codes(session, token),
|
||||
)
|
||||
@@ -7,3 +7,4 @@
|
||||
- `modules.yaml` — модули и расписания шкал
|
||||
- `lexicon/risk_ru.yaml` — лексикон риска
|
||||
- `texts/` — тексты для пациента (кризисный скрипт, согласие, перефразировки)
|
||||
- `rag/` — база знаний (ADR-011): `sources.yaml` (документы, параметры поиска, синонимы) и `corpus/*.txt`, собранные из PDF в `docs/source/rag/`
|
||||
|
||||
@@ -0,0 +1,3 @@
|
||||
# Routing for the current prototype: anonymous patients use the same doctor workspace,
|
||||
# without an identity record. Set this to the responsible clinic's doctor when deploying.
|
||||
doctor_id: doc-smirnova
|
||||
@@ -0,0 +1,50 @@
|
||||
# Сад (#118, слайд 13): лёгкая геймификация поверх модулей. Расчёт детерминированный, без LLM.
|
||||
# Принципы «без давления» (вычитка — #120):
|
||||
# 1. Сад не вянет: очки только прибавляются, пропуск ничего не отнимает.
|
||||
# 2. Рост не зависит от ответов: считается факт активности, а не баллы шкал или настроение.
|
||||
# 3. Нет соревнования: только свой сад, никаких сравнений.
|
||||
# 4. Растит честная отметка, а не «правильный» ответ: «Пропущу» по дозе растит сад так же, как «Принял(а)»,
|
||||
# иначе сад подталкивал бы отмечать приём, которого не было, и искажал бы данные о приёме для врача.
|
||||
# 5. После кризиса — тишина: рост сохраняется, но без поздравлений и анимации.
|
||||
|
||||
# Очки за активность и дневной лимит по каждому типу (чтобы пять одинаковых действий подряд не давали пятикратный рост).
|
||||
activities:
|
||||
meds: # ответ по назначенной дозе: «Принял(а)» или «Пропущу» (см. answered_dose_statuses)
|
||||
points: 2
|
||||
daily_cap: 4
|
||||
diary: # ежедневный чек-ин или запись дневника
|
||||
points: 3
|
||||
daily_cap: 1
|
||||
questionnaire: # завершённый опрос (шкала, этап опроса)
|
||||
points: 4
|
||||
daily_cap: 1
|
||||
|
||||
# Какие ответы по дозе растят сад. missed (доза осталась без ответа) не растит, но и ничего не отнимает.
|
||||
answered_dose_statuses: [taken, skipped]
|
||||
|
||||
# Тишина после кризиса: если за последние hours часов был алерт одного из этих уровней (в т.ч. по шкале
|
||||
# или опросу, не только в чате), сад не поздравляет и не анимирует рост.
|
||||
quiet:
|
||||
alert_levels: [acute, high]
|
||||
hours: 72
|
||||
|
||||
# Каждые step_points очков — один шаг роста. Растения растут по очереди: у каждого stages_per_plant стадий
|
||||
# (росток → стебель → бутон → цветок); распустился один — проклёвывается следующий.
|
||||
step_points: 10
|
||||
stages_per_plant: 4
|
||||
max_plants: 6
|
||||
|
||||
# Название сада по числу шагов роста (берётся последний порог ≤ шагов).
|
||||
titles:
|
||||
- {from_steps: 0, title: "Сад ждёт первых ростков"}
|
||||
- {from_steps: 1, title: "Появились первые ростки"}
|
||||
- {from_steps: 4, title: "Распустился первый цветок"}
|
||||
- {from_steps: 10, title: "Сад растёт"}
|
||||
- {from_steps: 18, title: "Сад цветёт"}
|
||||
- {from_steps: 24, title: "Цветущий сад"}
|
||||
|
||||
# Подписи пунктов «Сегодня».
|
||||
today:
|
||||
meds: "Отметка о лекарствах"
|
||||
diary: "Запись в дневнике"
|
||||
questionnaire: "Назначенный опрос"
|
||||
+73
-178
@@ -1,189 +1,84 @@
|
||||
version: diary-v2-2026-10-03
|
||||
core:
|
||||
- id: mood
|
||||
text: 'Какое у Вас сегодня настроение?
|
||||
# Stage 2 daily diary — «Этап 2: наблюдение после диагноза» (@Andrey, 2026-10-03), p.1–3.
|
||||
# Every block comes from an instrument checked for frequent use; there are no own questions. No validated thresholds
|
||||
# exist for daily data: the diary shows a trend and brings a full scale forward, routes come from full scales only.
|
||||
# Modules follow the screening result of stage 1 (profile modules): depression → «depression», PTSD → «veteran».
|
||||
version: diary-v3-2026-10-04
|
||||
|
||||
0 — самое плохое, 10 — самое хорошее.'
|
||||
options:
|
||||
- value: 0
|
||||
label: '0'
|
||||
- value: 1
|
||||
label: '1'
|
||||
- value: 2
|
||||
label: '2'
|
||||
- value: 3
|
||||
label: '3'
|
||||
- value: 4
|
||||
label: '4'
|
||||
- value: 5
|
||||
label: '5'
|
||||
- value: 6
|
||||
label: '6'
|
||||
- value: 7
|
||||
label: '7'
|
||||
- value: 8
|
||||
label: '8'
|
||||
- value: 9
|
||||
label: '9'
|
||||
- value: 10
|
||||
label: '10'
|
||||
# Core — everyone. Morning block after waking (the sleep diary is built for it), evening block at 20:00.
|
||||
morning:
|
||||
- id: sleep_hours
|
||||
text: Сколько часов Вы спали прошлой ночью?
|
||||
source: Consensus Sleep Diary
|
||||
text: Сколько часов Вы спали этой ночью?
|
||||
numeric: true
|
||||
- id: rested
|
||||
text: 'Насколько Вы выспались?
|
||||
|
||||
0 — совсем не выспались, 4 — полностью выспались.'
|
||||
max: 24
|
||||
- id: sleep_quality
|
||||
source: Consensus Sleep Diary
|
||||
text: Как Вы оцениваете качество своего сна?
|
||||
options:
|
||||
- value: 0
|
||||
label: '0'
|
||||
- value: 1
|
||||
label: '1'
|
||||
- value: 2
|
||||
label: '2'
|
||||
- value: 3
|
||||
label: '3'
|
||||
- value: 4
|
||||
label: '4'
|
||||
- {value: 0, label: Очень плохо}
|
||||
- {value: 1, label: Плохо}
|
||||
- {value: 2, label: Удовлетворительно}
|
||||
- {value: 3, label: Хорошо}
|
||||
- {value: 4, label: Очень хорошо}
|
||||
- id: alcohol_portions
|
||||
source: принцип Timeline Followback; порция по RUS-AUDIT
|
||||
text: |-
|
||||
Сколько стандартных порций алкоголя Вы выпили вчера?
|
||||
|
||||
Одна порция — 100 мл вина, 250 мл пива или 30 мл крепкого алкоголя. Если не пили — введите 0.
|
||||
numeric: true
|
||||
max: 50
|
||||
evening:
|
||||
- id: mood
|
||||
source: ежедневная оценка настроения (недельные средние коррелируют с PHQ-9)
|
||||
text: |-
|
||||
Как Вы оцениваете своё настроение сегодня?
|
||||
|
||||
0 — самое плохое, 10 — самое хорошее.
|
||||
options:
|
||||
- {value: 0, label: '0'}
|
||||
- {value: 1, label: '1'}
|
||||
- {value: 2, label: '2'}
|
||||
- {value: 3, label: '3'}
|
||||
- {value: 4, label: '4'}
|
||||
- {value: 5, label: '5'}
|
||||
- {value: 6, label: '6'}
|
||||
- {value: 7, label: '7'}
|
||||
- {value: 8, label: '8'}
|
||||
- {value: 9, label: '9'}
|
||||
- {value: 10, label: '10'}
|
||||
- id: medication
|
||||
text: Приняли ли Вы сегодня лекарства по схеме?
|
||||
source: КР ПТСР — дневник приёма лекарств
|
||||
text: Приняли ли Вы сегодня лекарства, назначенные врачом?
|
||||
options:
|
||||
- value: full
|
||||
label: По схеме
|
||||
- value: partial
|
||||
label: Частично
|
||||
- value: none
|
||||
label: Нет
|
||||
- value: not_prescribed
|
||||
label: Не назначены
|
||||
- {value: 'yes', label: Да}
|
||||
- {value: 'no', label: Нет}
|
||||
- {value: not_prescribed, label: Лекарства не назначены}
|
||||
- id: medication_reason
|
||||
text: Почему не приняли лекарства по схеме?
|
||||
source: КР ПТСР — дневник приёма лекарств
|
||||
text: Почему не приняли?
|
||||
options:
|
||||
- value: forgot
|
||||
label: Забыл(а)
|
||||
- value: side_effects
|
||||
label: Побочные эффекты
|
||||
- value: declined
|
||||
label: Не хочу
|
||||
- value: ran_out
|
||||
label: Закончились
|
||||
- value: other
|
||||
label: Другая причина
|
||||
- id: side_effects
|
||||
text: Беспокоили ли Вас сегодня побочные эффекты лекарств?
|
||||
options: &id001
|
||||
- value: 1
|
||||
label: Да
|
||||
- value: 0
|
||||
label: Нет
|
||||
- id: substances
|
||||
text: Употребляли ли Вы сегодня алкоголь или другие вещества?
|
||||
options: *id001
|
||||
- id: comment
|
||||
text: Что хотите передать врачу?
|
||||
optional: true
|
||||
ptsd:
|
||||
- id: intrusions
|
||||
text: 'Насколько за последние сутки Вас беспокоили: нежелательные воспоминания о событии?'
|
||||
options: &id002
|
||||
- value: 0
|
||||
label: Совсем нет
|
||||
- value: 1
|
||||
label: Немного
|
||||
- value: 2
|
||||
label: Умеренно
|
||||
- value: 3
|
||||
label: Сильно
|
||||
- value: 4
|
||||
label: Крайне сильно
|
||||
- id: nightmares
|
||||
text: 'Насколько за последние сутки Вас беспокоили: кошмары прошлой ночью?'
|
||||
options: *id002
|
||||
- id: avoidance
|
||||
text: 'Насколько за последние сутки Вас беспокоили: желание избегать мест, людей и мыслей, напоминающих о событии?'
|
||||
options: *id002
|
||||
- id: hypervigilance
|
||||
text: 'Насколько за последние сутки Вас беспокоили: настороженность, вздрагивание, ощущение опасности?'
|
||||
options: *id002
|
||||
- id: irritability
|
||||
text: 'Насколько за последние сутки Вас беспокоили: раздражительность или вспышки гнева?'
|
||||
options: *id002
|
||||
- {value: forgot, label: Забыл(а)}
|
||||
- {value: side_effects, label: Побочные эффекты}
|
||||
- {value: declined, label: Решил(а) не принимать}
|
||||
- {value: ran_out, label: Закончились}
|
||||
|
||||
# Depression module: PHQ-9 items with the official Russian text (config/instruments/intake_forms.yaml), answer
|
||||
# options adapted to one day. Three items a day in rotation: day 1 — items 1–3, day 2 — 4–6, day 3 — 7–9.
|
||||
# Item 9 ≥1 → stop and the crisis protocol (stage 1 rule).
|
||||
depression:
|
||||
- id: interest
|
||||
text: 'Насколько Вам сегодня было интересно и приятно что-то делать?
|
||||
|
||||
0 — совсем нет, 4 — крайне сильно.'
|
||||
options: *id002
|
||||
- id: depressed
|
||||
text: Насколько Вы сегодня чувствовали подавленность или безнадёжность?
|
||||
options: *id002
|
||||
- id: energy
|
||||
text: 'Насколько у Вас сегодня были силы и энергия?
|
||||
|
||||
0 — совсем нет, 4 — крайне сильно.'
|
||||
options: *id002
|
||||
- id: planned_activity
|
||||
text: Сделали ли Вы сегодня хотя бы одно запланированное дело?
|
||||
options: *id001
|
||||
suicide:
|
||||
- id: death_thoughts
|
||||
text: Были ли у Вас сегодня мысли о смерти или о том, что не хочется жить?
|
||||
options: *id001
|
||||
- id: thoughts_intensity
|
||||
text: 'Если да — насколько сильными они были?
|
||||
|
||||
0 — совсем слабые, 10 — максимально сильные.'
|
||||
form: phq9
|
||||
items_per_day: 3
|
||||
question: 'Насколько сегодня Вас беспокоило:'
|
||||
options:
|
||||
- value: 0
|
||||
label: '0'
|
||||
- value: 1
|
||||
label: '1'
|
||||
- value: 2
|
||||
label: '2'
|
||||
- value: 3
|
||||
label: '3'
|
||||
- value: 4
|
||||
label: '4'
|
||||
- value: 5
|
||||
label: '5'
|
||||
- value: 6
|
||||
label: '6'
|
||||
- value: 7
|
||||
label: '7'
|
||||
- value: 8
|
||||
label: '8'
|
||||
- value: 9
|
||||
label: '9'
|
||||
- value: 10
|
||||
label: '10'
|
||||
- id: hope
|
||||
text: 'Насколько Вы верите, что станет лучше?
|
||||
- {value: 0, label: Совсем нет}
|
||||
- {value: 1, label: Немного}
|
||||
- {value: 2, label: Умеренно}
|
||||
- {value: 3, label: Сильно}
|
||||
|
||||
0 — совсем не верю, 10 — полностью верю.'
|
||||
options:
|
||||
- value: 0
|
||||
label: '0'
|
||||
- value: 1
|
||||
label: '1'
|
||||
- value: 2
|
||||
label: '2'
|
||||
- value: 3
|
||||
label: '3'
|
||||
- value: 4
|
||||
label: '4'
|
||||
- value: 5
|
||||
label: '5'
|
||||
- value: 6
|
||||
label: '6'
|
||||
- value: 7
|
||||
label: '7'
|
||||
- value: 8
|
||||
label: '8'
|
||||
- value: 9
|
||||
label: '9'
|
||||
- value: 10
|
||||
label: '10'
|
||||
- id: burden
|
||||
text: Чувствовали ли Вы себя обузой для близких?
|
||||
options: *id001
|
||||
weekly: true
|
||||
# PTSD module: short 4-item PCL-5 (Price et al., 2016), one item per cluster B, C, D, E; «today» instead of «the
|
||||
# past month», options 0–4 of PCL-5. Item numbers must still be checked against the article (PDF p.7, «Медику»).
|
||||
ptsd:
|
||||
form: pcl5
|
||||
items: [pcl5_1, pcl5_7, pcl5_10, pcl5_18]
|
||||
question: 'Насколько сильно сегодня Вас беспокоили:'
|
||||
|
||||
@@ -0,0 +1,27 @@
|
||||
# Red flags — asked first in stage 1, before any scale (clinical review 2026-10-04: «обязательно»).
|
||||
# Any «Да» stops the questionnaire: an acute alert to the doctor, a callback task for the doctor on duty and the
|
||||
# help screen (crisis script variant by `category`, config/texts/crisis.yaml). Wording — team draft, the doctor
|
||||
# approves it (#8). These are not a scale: there is no score, only a stop rule.
|
||||
version: red-flags-v1-2026-10-04
|
||||
intro: "Сначала несколько коротких вопросов о безопасности. Отвечайте так, как есть сейчас."
|
||||
options:
|
||||
- {value: 1, label: Да}
|
||||
- {value: 0, label: Нет}
|
||||
items:
|
||||
- id: rf_psychosis
|
||||
text: Слышите ли Вы сейчас голоса или видите то, чего не видят и не слышат другие люди?
|
||||
category: null
|
||||
- id: rf_harm_others
|
||||
text: Есть ли у Вас сейчас мысли причинить вред другому человеку?
|
||||
category: harm_others
|
||||
- id: rf_weapons
|
||||
text: Есть ли у Вас дома или рядом доступ к оружию?
|
||||
category: null
|
||||
# Asked and stored, but NOT a stop rule (team decision 2026-10-04: weapon ownership is common in Russia).
|
||||
trigger: false
|
||||
- id: rf_violence
|
||||
text: Угрожает ли Вам сейчас кто-то дома или применяет к Вам насилие?
|
||||
category: domestic_violence
|
||||
- id: rf_intoxication
|
||||
text: Находитесь ли Вы сейчас в состоянии сильного опьянения или тяжёлой отмены алкоголя либо других веществ?
|
||||
category: null
|
||||
@@ -1,17 +1,27 @@
|
||||
version: intake-v2-2026-10-03
|
||||
version: intake-v3-2026-10-04
|
||||
enabled: false
|
||||
approval: null
|
||||
# Release decisions cover texts, diary anchors/thresholds, schedules and contact readiness.
|
||||
content_review: null
|
||||
contact_review: null
|
||||
timezone: Europe/Moscow
|
||||
daily_hour: 19
|
||||
mood_baseline_days: 7
|
||||
mood_bad_days: 3
|
||||
mood_drop: 3
|
||||
sleep_bad_days: 3
|
||||
# Stage 2 diary («Этап 2: наблюдение после диагноза»): morning block after waking, evening block at 20:00.
|
||||
morning_hour: 8
|
||||
evening_hour: 20
|
||||
# Personal norm = the first `norm_days` of observation; compared with the mean of the last `week_days`.
|
||||
# Flag numbers are the team's candidates (PDF «Этап 2», p.4) — agree with the doctor.
|
||||
norm_days: 14
|
||||
week_days: 7
|
||||
min_norm_values: 7
|
||||
min_week_values: 4
|
||||
mood_drop: 3 # weekly mood mean fell ≥3 below the norm → unscheduled PHQ-9
|
||||
depression_item_rise: 1.0 # weekly mean of a PHQ-9 diary item rose ≥1 above its norm → PHQ-9 earlier
|
||||
ptsd_sum_rise: 3.0 # weekly mean of the 4-item PCL-5 sum rose ≥3 above the norm → PCL-5 earlier
|
||||
sleep_bad_days: 3 # <4 h or «очень плохо» three nights in a row → flag to the doctor
|
||||
sleep_hours_below: 4
|
||||
nightmares_at: 3
|
||||
alcohol_heavy_portions: 6 # ≥6 standard drinks a day = heavy day (volumes of RUS-AUDIT item 3)
|
||||
alcohol_heavy_days: 2 # heavy days in a week → full RUS-AUDIT
|
||||
adherence_below: 0.8 # share of days with medication taken over a week
|
||||
missed_medication_days: 3
|
||||
high_risk_silence_days: 2
|
||||
medication_days: [7, 14, 28]
|
||||
|
||||
@@ -1,7 +1,8 @@
|
||||
# Review candidate from the supplied MVP PDF, not a signed clinical protocol.
|
||||
version: mvp-v2-review-2026-10-03
|
||||
approval: null
|
||||
cssrs_positive_policy: pending
|
||||
# C01 decided by the team after the clinical review (2026-10-04, ADR-013): crisis screen at HIGH risk only.
|
||||
cssrs_positive_policy: graded
|
||||
rus_audit_s_expand_from_zone: null
|
||||
phq2_expand_at: 2
|
||||
tsq_expand_at: 6
|
||||
@@ -9,5 +10,4 @@ phq9_psychologist_at: 5
|
||||
phq9_specialist_at: 10
|
||||
phq9_priority_at: 20
|
||||
pcl5_specialist_at: 31
|
||||
pcl5_priority_at: 50
|
||||
pcl5_behavior_flag_at: 3
|
||||
|
||||
@@ -0,0 +1,20 @@
|
||||
# DEMO ONLY (INTAKE_DEMO=1 + demo clock, synthetic data). NOT a clinical approval: the real policy is
|
||||
# config/questionnaire.yaml and stays closed until the doctor's decisions C01–C09 (docs/clinical/README.md).
|
||||
# Values follow the MVP PDF so the demo can reach a result and stage 2:
|
||||
# C01 → graded: low C-SSRS risk shows the safety plan and continues (PDF p.11, routing table);
|
||||
# C02 → full RUS-AUDIT from zone II of RUS-AUDIT-S (WHO zones, Bunova 2022).
|
||||
version: mvp-v2-demo-2026-10-04
|
||||
approval:
|
||||
reviewer: "DEMO — синтетические данные, не клиническое согласование"
|
||||
decision_reference: "INTAKE_DEMO"
|
||||
approved_at: "2026-10-04T00:00:00+03:00"
|
||||
policy_version: mvp-v2-demo-2026-10-04
|
||||
cssrs_positive_policy: graded
|
||||
rus_audit_s_expand_from_zone: 2
|
||||
phq2_expand_at: 2
|
||||
tsq_expand_at: 6
|
||||
phq9_psychologist_at: 5
|
||||
phq9_specialist_at: 10
|
||||
phq9_priority_at: 20
|
||||
pcl5_specialist_at: 31
|
||||
pcl5_behavior_flag_at: 3
|
||||
File diff suppressed because it is too large
Load Diff
File diff suppressed because it is too large
Load Diff
@@ -0,0 +1,184 @@
|
||||
# Модуль «Лекарства»: спецификация для разработки
|
||||
|
||||
Источник: meds_module_spec.pdf, страниц: 10. Документ команды от Oct 4, 2026, автор @Andrey. Текст перенесён вручную и сверен с PDF: автоматическое извлечение ломает вёрстку выносок и таблиц. Символ «|» внутри ячеек заменён на «/».
|
||||
|
||||
--- стр. 1 ---
|
||||
|
||||
Модуль следит не за абстрактными «лекарствами», а за конкретным препаратом пациента. Он напоминает о приёме, узнаёт причины пропусков, спрашивает о побочных эффектах этого препарата и работает по 10 правилам (M1–M10). Данные взяты из двух клинических рекомендаций Минздрава: по депрессии (2024) и по ПТСР (2023).
|
||||
|
||||
Что передаём:
|
||||
- этот документ — логика модуля;
|
||||
- файл meds_reference.json (прилагается к ссылке) — справочник на 47 препаратов, тексты для пациента и параметры правил;
|
||||
- вкладка «Справочник препаратов» — тот же справочник в виде таблицы, для проверки медиком.
|
||||
|
||||
Как модуль встраивается в этап 2. Вечерний вопрос о лекарствах, опрос о побочных эффектах на 7-й, 14-й и 28-й день и флаги «меньше 80% дней» и «пропуск 3 дня подряд» не меняются. Модуль добавляет к ним данные о препарате и новые правила.
|
||||
|
||||
| В MVP | После хакатона |
|
||||
|---|---|
|
||||
| Справочник из JSON | Тексты инструкций из ГРЛС в карточке препарата |
|
||||
| Назначение: ввод в кабинете врача или из имитации ЕМИАС | Назначения из ЕМИАС (электронные рецепты) |
|
||||
| Напоминание о приёме и отметка в дневнике | Схема постепенной отмены препарата |
|
||||
| Опрос о побочных эффектах по профилю препарата | Ввод результатов анализов |
|
||||
| Правила M1–M10 и блок в сводке врачу | Проверка взаимодействий для врача |
|
||||
|
||||
--- стр. 2 ---
|
||||
|
||||
Границы: бот следит, но не лечит
|
||||
|
||||
Препарат и дозу всегда выбирает врач. Если приложение начнёт давать советы о лечении, его могут счесть медицинским изделием, а к ним требования строже.
|
||||
|
||||
| Бот делает | Бот не делает никогда |
|
||||
|---|---|
|
||||
| Хранит назначение врача: препарат, дозу, время приёма | Не предлагает препарат, дозу, смену или отмену |
|
||||
| Напоминает о приёме и отмечает, принят ли препарат | На вопросы «можно ли бросить» или «можно ли увеличить дозу» отвечает только «обсудите с врачом» и ставит флаг |
|
||||
| Спрашивает о побочных эффектах, характерных для этого препарата | Не исправляет и не блокирует дозу вне диапазона — только просит проверить ввод (M10) |
|
||||
| Показывает карточку препарата из проверенных источников | Не проверяет для пациента взаимодействия лекарств |
|
||||
| Сигналит врачу по правилам M1–M10 | Не ставит диагноз и не оценивает, «работает ли» лечение, — это делает врач по шкалам |
|
||||
|
||||
Модель данных
|
||||
|
||||
Шесть сущностей. Drug читается из JSON и в приложении не редактируется, остальные создаёт приложение.
|
||||
|
||||
| Сущность | Поля | Откуда берётся |
|
||||
|---|---|---|
|
||||
| Drug | id, name_ru, class, indications.{depression/ptsd}.{min_mg, max_mg, start_mg, off_label}, diary_items[], red_flags[], monitoring[], withdrawal_risk, overdose_danger, max_course_days | meds_reference.json |
|
||||
|
||||
--- стр. 3 ---
|
||||
|
||||
| Сущность | Поля | Откуда берётся |
|
||||
|---|---|---|
|
||||
| Prescription | id, patient_id, drug_id, indication (F32/F33/F43.1), dose_mg_per_day, times[] (например, "09:00"), start_date, source (emias / doctor / patient), status (active / stopped), history[] (дата, старая и новая доза) | имитация ЕМИАС или кабинет врача; ввод пациентом — с пометкой «со слов пациента» |
|
||||
| DoseLog | prescription_id, date, taken (bool), reason (forgot / side_effects / decided_not_to / ran_out), logged_at | вечерний дневник |
|
||||
| SideEffectReport | date, trigger (scheduled / missed_dose / button), fibser.{freq, intensity, burden}, items[]: {item_id, severity: mild/severe}, red_flags[] | опрос о побочных эффектах |
|
||||
| MedEvent | prescription_id, type (start / dose_change / stop), date, baseline_scale_ids[] | создаётся при изменении Prescription |
|
||||
| MedFlag | rule_id (M1…M10), patient_id, prescription_id, created_at, recipient, due_at, status (open / acknowledged), evidence (ответы, по которым сработало правило) | движок правил |
|
||||
|
||||
Связь с расписанием этапа 2. Любой MedEvent включает строку «Начало или смена лекарств»: полные шкалы и опрос о побочных эффектах на 7-й, 14-й, 28-й день, далее раз в 4 недели. Исходный замер для M5 — последняя полная шкала за 14 дней до события. Если её нет, шкалу проводят в день события.
|
||||
|
||||
Дневник и опросы
|
||||
|
||||
В обычный день добавляется только отметка по каждому препарату. Подробно спрашиваем по расписанию или после пропуска.
|
||||
|
||||
--- стр. 4 ---
|
||||
|
||||
1. Напоминание. Push-уведомление во время из Prescription.times: «Время принять {препарат} {доза}» и кнопка «Принял(а)». Нажатие сразу создаёт DoseLog с taken = true, и вечером этот препарат уже не спрашиваем.
|
||||
|
||||
2. Вечерний вопрос (уже есть в ядре этапа 2), теперь по каждому препарату:
|
||||
1. «Приняли ли Вы сегодня лекарства, назначенные врачом?» — да, все / не все / нет.
|
||||
2. Если «не все» — выбрать, какие не приняты.
|
||||
3. По каждому непринятому — причина: забыл(а) · побочные эффекты · решил(а) не принимать · закончились.
|
||||
Причина напрямую запускает правила: «побочные эффекты» → внеплановый опрос (п. 3) и M8, «решил(а) не принимать» → M2, «закончились» → M3.
|
||||
|
||||
3. Опрос о побочных эффектах. Проводится в трёх случаях: по расписанию этапа 2 (7-й, 14-й, 28-й день, далее раз в 4 недели), после пропуска «из-за побочных эффектов» и по кнопке «Сообщить о побочном эффекте», которая доступна всегда.
|
||||
1. Три вопроса FIBSER: как часто, насколько сильно, насколько мешают жить (из этапа 2).
|
||||
2. Если частота > 0 — «Что именно беспокоит?»: список из diary_items всех активных препаратов без повторов, плюс «другое» с текстом. У каждого пункта два ответа: немного / сильно мешает.
|
||||
3. Вопросы о срочных симптомах — только из red_flags активных препаратов, с ответом да / нет. Ответ «да» → M7.
|
||||
Список пунктов для препарата формируется так. Для 16 антидепрессантов берём эффекты с оценкой «++» и «+++» из таблицы 3 КР по депрессии. Для остальных препаратов — эффекты, которые названы в тексте КР. В JSON список уже собран: например, у сертралина это тошнота, бессонница, сексуальные проблемы и головная боль.
|
||||
|
||||
4. Карточки о сроках эффекта. Текст expect_effect_depression показываем в 1-й и 14-й день после начала, expect_effect_ptsd — в 1-й и 7-й. Тексты лежат в JSON, в разделе texts.
|
||||
|
||||
--- стр. 5 ---
|
||||
|
||||
Контрольные точки после начала лечения
|
||||
|
||||
[Изображение: текст перенесён вручную]
|
||||
Схема «Ответ оценивают к 4–6 неделе, лечение длится месяцы». Подзаголовок: «Фазы после начала или смены препарата: что делает модуль и что говорят КР». Таблица по фазам:
|
||||
|
||||
| Строка | Недели 1–2 | Недели 3–6 | Месяцы и годы |
|
||||
|---|---|---|---|
|
||||
| Модуль (что делает бот) | Дни 7 и 14: шкалы и опрос о побочных. Карточка «когда ждать эффекта» | День 28: шкалы, побочные и проверка ответа — M5. Бензодиазепин дольше допустимого — M4 | Шкалы и опрос о побочных раз в 4 недели до конца курса |
|
||||
| Депрессия (КР 2024) | Раннее улучшение (1–2 недели) — благоприятный признак | Эффект через 3–4 недели, у СИОЗС — до 6–8 недель; снижение на 25–50% — ответ недостаточен | Тот же препарат и доза 4–6 мес. после улучшения; при РДР — 3–5 лет |
|
||||
| ПТСР (КР 2023) | СИОЗС: в 1-ю неделю тревога может усилиться; следить за суицидальным риском | Эффект оценивают через 4–6 недель; бензодиазепины — не дольше 3–4 недель | Курс 6–12 месяцев после стабилизации |
|
||||
|
||||
Подпись под схемой: «Фазы после начала лечения · модуль, депрессия, ПТСР».
|
||||
|
||||
M5 проверяет ответ на 28-й день при обоих диагнозах. Для ПТСР это ранняя граница окна из КР: окончательно эффект оценивают до 6-й недели, поэтому флаг — повод для врача посмотреть, а не сигнал тревоги.
|
||||
|
||||
Правила сигналов M1–M10
|
||||
|
||||
К флагам этапа 2 по лекарствам (меньше 80% дней с приёмом, пропуск 3 дня подряд, тяжёлый день алкоголя при приёме лекарств) добавляются десять правил. Пороги и сроки хранятся в rules[].params в JSON и меняются без правки кода. Строки с пометкой «черновик» нужно согласовать с психиатром.
|
||||
|
||||
--- стр. 6 ---
|
||||
|
||||
| ID | Условие | Что делает приложение | Кто получает, срок | Основание |
|
||||
|---|---|---|---|---|
|
||||
| M1 | У препарата withdrawal_risk = high (венлафаксин, пароксетин, ТЦА, бензодиазепины) и он пропущен 2 дня подряд | Текст withdrawal_missed и вопрос «Стало ли хуже после пропуска?» | Лечащий психиатр: ответ «хуже» — 24 ч, иначе — до 3 рабочих дней. Черновик | КР депрессия 3.6; КР ПТСР 3.2 |
|
||||
| M2 | Причина пропуска «решил(а) не принимать» | Тексты dont_stop_alone (+ why_continue_depression при F32/F33), флаг | Лечащий психиатр, до 3 рабочих дней. Черновик | КР депрессия, прил. В; КР ПТСР 6.1 |
|
||||
| M3 | Причина «закончились» | Текст ran_out; 2 дня подряд → флаг | Лечащий врач, до 3 рабочих дней. Черновик | команда |
|
||||
| M4 | Бензодиазепин принимается дольше max_course_days | Отметка в кабинете и сводке | Лечащий психиатр, к следующему визиту | КР ПТСР 3.2 |
|
||||
| M5 | 28-й день после MedEvent: PHQ-9 снизился меньше чем на 50% (F32/F33) или PCL-5 — меньше чем на 10 баллов (F43.1) от исходного | Флаг «нет ответа к 4-й неделе» | Лечащий психиатр, до 3 рабочих дней. Черновик | КР депрессия 3.1–3.2; КР ПТСР 3.2; пороги ответа — этап 2 |
|
||||
|
||||
--- стр. 7 ---
|
||||
|
||||
| ID | Условие | Что делает приложение | Кто получает, срок | Основание |
|
||||
|---|---|---|---|---|
|
||||
| M6 | Сработал сигнал C-SSRS (умеренный или высокий риск), а у пациента активен препарат с overdose_danger | Пометка «препарат опасен при передозировке» в этом же сигнале, новый сигнал не создаётся | Как у сигнала C-SSRS | КР депрессия 3.1.3 |
|
||||
| M7 | Пациент отметил срочный симптом из red_flags | Текст red_flag (врач сегодня; при тяжёлом состоянии 103/112), флаг | Лечащий психиатр, 24 ч. Черновик | КР депрессия 3.1, 3.3; КР ПТСР 3.2 |
|
||||
| M8 | FIBSER «насколько мешают» ≥ 5 из 6 или пропуск «из-за побочных» в 2 из 7 дней | Текст side_effects_general, флаг | Лечащий психиатр, до 3 рабочих дней. Черновик | КР депрессия, прил. В |
|
||||
| M9 | У активного препарата есть monitoring | Строка «Контроль по КР: …» в сводке врачу, это не сигнал | Лечащий врач, в сводке | КР депрессия 3.1, 3.3; КР ПТСР 3.2 |
|
||||
| M10 | При сохранении назначения доза вне min_mg – max_mg для этого диагноза | «Проверьте ввод» тому, кто вводит; пометка в сводке; сохранение не блокируется | Тот, кто вводит, сразу | Приложения А3 обеих КР |
|
||||
|
||||
Все флаги попадают в кабинет врача с датой, правилом и ответами, по которым правило сработало, как в этапе 2.
|
||||
|
||||
Карточка препарата, сводка врачу, демо
|
||||
|
||||
Карточка препарата построена по списку «что сообщить пациенту» из КР по депрессии (приложение В). Поля с источником «инструкция» в MVP показывают «Уточните у врача или в инструкции». Для 2–3 демо-препаратов их можно заполнить вручную.
|
||||
|
||||
--- стр. 8 ---
|
||||
|
||||
| Поле | Источник | Пример: сертралин при ПТСР |
|
||||
|---|---|---|
|
||||
| Название, доза, время приёма | Prescription | Сертралин, 50 мг в сутки, в 09:00 |
|
||||
| Когда ждать эффекта | indications.*.expected_response | Эффект оценивают через 4–6 недель |
|
||||
| Сколько принимать | indications.*.course + решение врача | Обычно 6–12 месяцев после стабилизации |
|
||||
| Частые побочные эффекты | diary_items | Тошнота, бессонница, сексуальные проблемы, головная боль |
|
||||
| Когда срочно к врачу | red_flags | Необычные кровотечения или синяки |
|
||||
| Не прекращать самостоятельно | texts.dont_stop_alone | общий текст |
|
||||
| Как принимать, связь с едой, что делать при пропуске | инструкция (ГРЛС) | — |
|
||||
| Алкоголь, вождение, беременность | инструкция (ГРЛС) | — |
|
||||
|
||||
Блок «Лекарства» в сводке врачу (дополняет сводку этапа 2), по каждому препарату:
|
||||
- препарат, доза, дата начала и неделя приёма рядом с ожидаемым сроком ответа (например, «неделя 3 из 4–6»);
|
||||
- доля дней с приёмом за 4 недели и причины пропусков;
|
||||
- побочные эффекты: FIBSER и пункты «что именно» по замерам, срочные симптомы;
|
||||
- ответ на 28-й день (M5), контроль по КР (M9), пометки M4 и M10.
|
||||
|
||||
Демо: ветеран Иван, ПТСР. Этот сценарий стыкуется с демо этапа 2: там ухудшение на 3-й неделе, здесь видна его причина.
|
||||
|
||||
--- стр. 9 ---
|
||||
|
||||
1. День 0. Врач в кабинете назначает сертралин 50 мг в сутки (препарат 1-й линии по КР ПТСР). Включается расписание «Начало или смена лекарств», пациент получает карточку expect_effect_ptsd.
|
||||
2. День 3. Отметка «не принял — побочные эффекты». Внеплановый опрос: тошнота «немного», бессонница «сильно мешает».
|
||||
3. День 7. Плановые шкалы и опрос о побочных эффектах.
|
||||
4. Дни 17–19. Три дня подряд «решил не принимать». На 17-й день срабатывает M2 (карточка и флаг врачу), на 19-й — флаг этапа 2 «пропуск 3 дня».
|
||||
5. Неделя 3. Ухудшение по дневнику → внеплановый PCL-5 → повторный триаж (сценарий этапа 2). В сводке врач видит, что ухудшение совпало с прекращением приёма из-за бессонницы.
|
||||
|
||||
Для питча: КР по ПТСР (раздел 3.2) прямо рекомендуют для соблюдения режима «ведение дневника приёма лекарств или телефонное приложение с напоминанием». В разделе 6.1 сказано, что пациенты часто бросают лекарства после улучшения и состояние ухудшается.
|
||||
|
||||
Черновые параметры — согласовать с психиатрами
|
||||
|
||||
Код можно писать сейчас: все числа ниже лежат в JSON и заменяются без правки логики. Вопросы к врачам по этапу 2 собраны в документе «Этап 2: вопросы к психиатрам».
|
||||
|
||||
| Параметр | Черновое значение | Основание |
|
||||
|---|---|---|
|
||||
| M1: сколько дней пропуска препарата с риском отмены | 2 дня подряд | риск — КР; число — команда |
|
||||
| M4: предел курса бензодиазепинов | 21 день; диазепам 28; алпразолам 90 | КР ПТСР 3.2 |
|
||||
| M5: день проверки ответа | 28-й день для обоих диагнозов | КР: депрессия 3–4 недели, ПТСР 4–6 недель |
|
||||
| M5: исходный замер | последняя полная шкала за 14 дней до старта, иначе в день старта | команда |
|
||||
| M8: «сильно мешают» | FIBSER-бремя ≥ 5 из 6 или 2 пропуска из-за побочных за 7 дней | порог FIBSER сверить с оригиналом шкалы |
|
||||
|
||||
--- стр. 10 ---
|
||||
|
||||
| Параметр | Черновое значение | Основание |
|
||||
|---|---|---|
|
||||
| M7: список срочных симптомов и текст пациенту | 5 симптомов из JSON, текст red_flag | симптомы — КР; текст — команда |
|
||||
| Сроки реакции | 24 ч / до 3 рабочих дней / к визиту | как в этапе 2 |
|
||||
| Ввод назначения пациентом | разрешён, с пометкой «со слов пациента» | команда |
|
||||
| Все тексты для пациента из texts | черновики | вычитать врачу |
|
||||
|
||||
Источники
|
||||
- Клинические рекомендации «Депрессивный эпизод, рекуррентное депрессивное расстройство», Минздрав РФ, 2024, Российское общество психиатров. Использованы разделы 3.1–3.6 и приложения А3 (табл. 2 — дозы, табл. 3 — побочные эффекты), Б5 (синдром отмены), В (информация для пациента).
|
||||
- Клинические рекомендации «Посттравматическое стрессовое расстройство», Минздрав РФ, 2023, ID 753, Российское общество психиатров. Использованы разделы 3.2 и 6.1, приложения А3 (дозы), Б1 (алгоритм терапии), В. Срок пересмотра — не позднее 2025 года: проверить, не вышла ли новая версия.
|
||||
- «Этап 2: наблюдение после диагноза» — наш документ о расписании, флагах и сроках реакции.
|
||||
|
||||
Расхождения внутри КР отмечены в JSON в поле note. Пример: хлорпротиксен в тексте КР по ПТСР — 15–100 мг, а в таблице — 25–150 мг.
|
||||
@@ -0,0 +1,108 @@
|
||||
# База знаний RAG (#60): документы, параметры поиска, синонимы.
|
||||
# Тексты в corpus/ собраны из PDF конвертером docs/source/rag/pdf_to_txt.py — правьте PDF/figures/manual
|
||||
# и перегенерируйте, а не редактируйте txt руками.
|
||||
#
|
||||
# audiences — кому можно показывать выдержки:
|
||||
# doctor — врач (дашборд, подсказки по КР);
|
||||
# patient — пациент (только экстрактивно, без дозировок, с припиской «решение за врачом»);
|
||||
# team — внутренние документы команды (логика модулей), пациенту и врачу не показываются.
|
||||
|
||||
documents:
|
||||
- id: kr_ptsd
|
||||
file: corpus/kr_ptsd.txt
|
||||
title: "Клинические рекомендации «Посттравматическое стрессовое расстройство»"
|
||||
short: "КР ПТСР 2023"
|
||||
issuer: "Минздрав РФ, Российское общество психиатров"
|
||||
year: 2023
|
||||
icd: [F43.1]
|
||||
audiences: [doctor, patient]
|
||||
- id: kr_depression
|
||||
file: corpus/kr_depression.txt
|
||||
title: "Клинические рекомендации «Депрессивный эпизод, рекуррентное депрессивное расстройство»"
|
||||
short: "КР Депрессия 2024"
|
||||
issuer: "Минздрав РФ, Российское общество психиатров"
|
||||
year: 2024
|
||||
icd: [F32, F33]
|
||||
audiences: [doctor, patient]
|
||||
- id: meds_module_spec
|
||||
file: corpus/meds_module_spec.txt
|
||||
title: "Модуль «Лекарства»: спецификация для разработки"
|
||||
short: "Спецификация модуля «Лекарства»"
|
||||
issuer: "команда MedITron"
|
||||
year: 2026
|
||||
icd: []
|
||||
audiences: [team]
|
||||
|
||||
chunking:
|
||||
max_chars: 1200 # целевой размер фрагмента; абзац длиннее режется по предложениям
|
||||
min_chars: 200 # короткий хвост раздела приклеивается к предыдущему фрагменту того же раздела
|
||||
# Разделы, которые не индексируются (шум для поиска). Сравнение — по началу заголовка.
|
||||
skip_sections:
|
||||
- "Список литературы"
|
||||
- "Список сокращений" # аббревиатуры раскрываются через synonyms ниже, сам список только засоряет поиск
|
||||
|
||||
retrieval:
|
||||
top_k: 5
|
||||
bm25_k1: 1.5
|
||||
bm25_b: 0.75
|
||||
title_weight: 2 # заголовок раздела повторяется в индексе столько раз — совпадение с ним весомее
|
||||
min_score: 3.0 # ниже — считаем, что в базе нет ответа
|
||||
rerank_candidates: 30 # сколько лучших по BM25 фрагментов переранжировать по самому плотному отрывку
|
||||
window_sentences: 2 # размер отрывка (предложений подряд)
|
||||
window_weight: 0.5 # вес оценки отрывка относительно BM25
|
||||
# Множитель оценки для разделов (по началу заголовка) в зависимости от аудитории.
|
||||
# «Приложение В» в обеих КР — «Информация для пациента»: написано для пациента, ему и показываем в первую очередь.
|
||||
# «Приложение Г» — бланки шкал и история их валидации, «Критерии оценки качества» — для организаторов
|
||||
# здравоохранения: пациенту это шум.
|
||||
section_boost:
|
||||
patient:
|
||||
"Приложение В": 1.5
|
||||
"Приложение Г": 0.5
|
||||
"Критерии оценки качества": 0.5
|
||||
# Заболевание в вопросе -> профильная КР (регулярные выражения по вопросу в нижнем регистре).
|
||||
# Если названы оба — ни одна не получает преимущества. Иначе «ТМС при депрессии» отвечался цитатой из КР ПТСР.
|
||||
doc_cues:
|
||||
kr_depression: ["(?<!анти)депресс", "\\bдэ\\b", "\\bрдр\\b"]
|
||||
kr_ptsd: ["птср", "посттравмат", "травм", "\\bвойн", "боев", "фронт", "ветеран", "\\bсво\\b", "ptsd"]
|
||||
doc_cue_boost: 2.0
|
||||
|
||||
answer:
|
||||
max_chunks: 5 # в скольких лучших фрагментах ищем отрывок
|
||||
max_passages: 2 # отрывков в ответе (второй — только если почти так же хорош)
|
||||
second_passage_ratio: 0.8
|
||||
max_sentences: 3 # предложений в отрывке (подряд, как в источнике)
|
||||
neighbor_ratio: 0.5 # соседнее предложение входит в отрывок, если его релевантность >= доли лучшего
|
||||
max_chars: 600
|
||||
min_coverage: 0.5 # доля «веса» слов вопроса, найденная в отрывках; ниже — «ответа нет»
|
||||
|
||||
# Синонимы и аббревиатуры: запрос расширяется всеми формами группы (сравнение — по основам слов).
|
||||
synonyms:
|
||||
- ["птср", "посттравматическое стрессовое расстройство"]
|
||||
- ["кптср", "комплексное посттравматическое стрессовое расстройство"]
|
||||
- ["рдр", "рекуррентное депрессивное расстройство"]
|
||||
- ["дэ", "депрессивный эпизод"]
|
||||
- ["ад", "антидепрессант"]
|
||||
- ["сиозс", "селективные ингибиторы обратного захвата серотонина"]
|
||||
- ["сиозсн", "ингибиторы обратного захвата серотонина и норадреналина"]
|
||||
- ["тца", "трициклические антидепрессанты"]
|
||||
- ["кпт", "когнитивно-поведенческая психотерапия"]
|
||||
- ["дпдг", "emdr", "десенсибилизация и переработка травмы движениями глаз"]
|
||||
- ["сопа", "синдром отмены антидепрессантов"]
|
||||
- ["эст", "электросудорожная терапия"]
|
||||
- ["ртмс", "транскраниальная магнитная стимуляция"]
|
||||
- ["кошмар", "кошмарные сновидения"]
|
||||
- ["бессонница", "инсомния", "нарушения сна"]
|
||||
- ["флешбэк", "флэшбек", "навязчивые воспоминания"]
|
||||
- ["суицид", "самоубийство", "суицидальные мысли"]
|
||||
# Разговорная лексика пациента -> термины КР.
|
||||
- ["таблетки", "препарат", "лекарство"]
|
||||
- ["бросить", "отменять", "отменить", "отмена", "прекратить", "прекращение приема"]
|
||||
- ["подействовать", "действовать", "помогать", "эффект", "улучшение"]
|
||||
- ["антидепрессивный", "тимоаналептический"]
|
||||
- ["привыкание", "зависимость"]
|
||||
- ["спорт", "физическая активность", "физические упражнения", "физическая нагрузка"]
|
||||
- ["побочка", "побочные эффекты", "нежелательные явления"]
|
||||
- ["тошнит", "тошнота"]
|
||||
- ["выпить", "спиртное", "алкоголь"]
|
||||
- ["сколько длится", "продолжительность", "длительность"]
|
||||
- ["психолог", "психотерапия"]
|
||||
+6
-3
@@ -47,6 +47,7 @@ rules:
|
||||
reason_ru: "C-SSRS: высокий риск (намерение/план или поведение)"
|
||||
|
||||
- id: weapon_access_risk
|
||||
enabled: false # team decision 2026-10-04: weapon ownership is common in Russia — the answer triggers nothing
|
||||
description: >
|
||||
Access to weapons together with any suicide-risk signal (recent PHQ-9 item 9 >= 1 or C-SSRS >= moderate).
|
||||
Means restriction is one of the most evidence-based suicide-prevention measures → crisis safety block.
|
||||
@@ -62,7 +63,7 @@ rules:
|
||||
params: {}
|
||||
actions:
|
||||
- {type: alert, level: high}
|
||||
reason_ru: "C-SSRS: умеренный риск, врачу в течение 24 ч"
|
||||
reason_ru: "C-SSRS: умеренный риск, психиатр — ориентир 24 ч"
|
||||
|
||||
# ---------------------------------------------------------------- scale thresholds (yellow)
|
||||
- id: phq9_severe
|
||||
@@ -73,10 +74,12 @@ rules:
|
||||
reason_ru: "PHQ-9 = {total} (тяжёлая депрессия, порог {threshold})"
|
||||
|
||||
- id: pcl5_severe
|
||||
description: Latest PCL-5 total >= 50 → doctor within 24 h.
|
||||
description: >
|
||||
Latest PCL-5 total >= 50 → planned specialist review. Not a priority appointment by itself: risk and flags
|
||||
come first, scales second (clinical review 2026-10-04).
|
||||
params: {threshold: 50}
|
||||
actions:
|
||||
- {type: alert, level: high}
|
||||
- {type: alert, level: moderate}
|
||||
reason_ru: "PCL-5 = {total} (порог {threshold})"
|
||||
|
||||
- id: phq9_rise
|
||||
|
||||
@@ -0,0 +1,25 @@
|
||||
# Demo scheduler on the virtual clock (#13, SPEC §8, ADR-005). Local times are in settings.tz.
|
||||
# Read by app/scheduler/demo.py; used only while the questionnaire release (intake_runtime.yaml) is off.
|
||||
#
|
||||
# Every event is delivered once (idempotency key in `scheduler_events`) and only while it is fresh: an event
|
||||
# older than its late window is not sent at all — after a long jump of the demo clock the patient does not
|
||||
# receive a pile of yesterday's reminders, and an undelivered reminder never turns into a "missed" dose.
|
||||
|
||||
enabled: true
|
||||
tick_seconds: 30
|
||||
|
||||
doses:
|
||||
late_hours: 2 # reminder not delivered if the dose time is older than this
|
||||
missed_after_hours: 2 # reminded dose without an answer → status "missed" (SPEC §8)
|
||||
|
||||
daily_checkin:
|
||||
time: "20:00"
|
||||
late_hours: 4
|
||||
|
||||
scales:
|
||||
time: "10:00" # scales due today (config/modules.yaml schedules) are offered from this hour
|
||||
late_hours: 10
|
||||
|
||||
evaluation:
|
||||
time: "09:00" # daily monitoring pass: silence > N days, missed doses → caring contact
|
||||
late_hours: 15
|
||||
@@ -1,4 +1,6 @@
|
||||
# Кризисный скрипт (guardrail №2, issue #4). Отправляется ДОСЛОВНО при safety = acute; LLM не вызывается.
|
||||
# `resources` — ЕДИНСТВЕННАЯ таблица телефонов приложения: остальные тексты и промпты ссылаются на неё через
|
||||
# `{phone:<ключ>}` (app/core/safety.py::fill_phones). Источники и проверка — docs/clinical/crisis-contacts.md.
|
||||
# СТАТУС: черновик, утверждает психиатр (#8).
|
||||
#
|
||||
# Выбор варианта (app/core/safety.py::crisis_reply): `<audience>.<категория>` по порядку category_priority,
|
||||
@@ -17,6 +19,11 @@ resources:
|
||||
name: "Психологическая помощь МЧС России"
|
||||
phone: "+7 (495) 989-50-50"
|
||||
note: "круглосуточно; стоимость звонка по тарифу оператора"
|
||||
# For minors only (age gate stop text); not a general adult crisis line (docs/clinical/crisis-contacts.md).
|
||||
child_helpline:
|
||||
name: "Детский телефон доверия"
|
||||
phone: "8-800-2000-122"
|
||||
note: "для детей, подростков и родителей; бесплатно, анонимно"
|
||||
police:
|
||||
name: "Полиция"
|
||||
phone: "102"
|
||||
|
||||
@@ -16,6 +16,9 @@ settings:
|
||||
crisis_flags: [phq9_item9_positive, cssrs_high]
|
||||
# Шкала-скрининг суицидального риска (POSSIBLE и положительный п.9 PHQ-9 → эта шкала).
|
||||
risk_screen_scale: cssrs_screen
|
||||
# Брошенный шаг (чек-ин, шкала): если пациент молчит дольше N часов, следующее событие сначала возвращает
|
||||
# диалог в idle (уже данные ответы сохранены), затем обрабатывается. 0 — выключено. На кризис не действует.
|
||||
abandon_after_hours: 6
|
||||
|
||||
commands:
|
||||
# Текстовые команды отзыва согласия (сравниваются после приведения к нижнему регистру).
|
||||
@@ -50,7 +53,7 @@ age_gate:
|
||||
unclear: "Не удалось понять ответ. Нажмите кнопку или напишите год рождения четырьмя цифрами, например 1990."
|
||||
minor_stop: |-
|
||||
Спасибо, что ответили. Этот помощник рассчитан на взрослых, поэтому дальше я не смогу с вами работать и не сохраняю ваши ответы.
|
||||
Если вам тяжело или нужна поддержка — позвоните на Детский телефон доверия 8-800-2000-122 (бесплатно, анонимно, круглосуточно) или расскажите взрослому, которому доверяете: родителям, учителю, школьному психологу.
|
||||
Если вам тяжело или нужна поддержка — позвоните на Детский телефон доверия {phone:child_helpline} (бесплатно, анонимно) или расскажите взрослому, которому доверяете: родителям, учителю, школьному психологу.
|
||||
Если есть угроза жизни прямо сейчас — звоните 112.
|
||||
|
||||
idle:
|
||||
@@ -60,6 +63,7 @@ idle:
|
||||
buttons:
|
||||
checkin: "Как я сегодня"
|
||||
med_question: "Вопрос о лекарстве"
|
||||
kb_question: "Вопрос о лечении"
|
||||
contact_doctor: "Связаться с врачом"
|
||||
revoke: "Отозвать согласие"
|
||||
# Заглушки кнопок меню; ветки ветерана (#36/#37) и med_qa (#15) подменяют их своими триггерами.
|
||||
@@ -75,9 +79,9 @@ revoked:
|
||||
|
||||
crisis:
|
||||
# Повторный острый сигнал в уже открытом кризисе: скрипт второй раз не шлём, только это + ресурсы.
|
||||
repeat: "Я рядом. Ваш при угрозе жизни звоните 112. Если вам угрожает опасность прямо сейчас — позвоните:"
|
||||
repeat: "Я рядом. Если вам угрожает опасность прямо сейчас — позвоните:"
|
||||
# Любое другое сообщение, пока кризис открыт (до подтверждения врача).
|
||||
hold: "Я на связи и читаю вас. Не ждите ответа врача, если помощь нужна сейчас. Если станет хуже — звоните 112 или на телефон доверия +7 (495) 989-50-50."
|
||||
hold: "Я на связи и читаю вас. Не ждите ответа врача, если помощь нужна сейчас. Если станет хуже — звоните 112 или на телефон доверия {phone:helpline}."
|
||||
# Врач подтвердил кризисный алерт (doctor_ack): выходим из кризиса.
|
||||
closed: "Ваш врач получил сообщение и в курсе вашей ситуации. Спасибо, что остаётесь на связи. Если снова станет тяжело — напишите мне в любой момент."
|
||||
|
||||
@@ -97,7 +101,7 @@ safety_plan:
|
||||
- "Что помогает мне самому: прогулка, душ, дыхание, любимое дело."
|
||||
- "Люди и места, которые отвлекают: к кому можно пойти."
|
||||
- "Кому позвонить, если тяжело: близкий человек, сослуживец."
|
||||
- "Специалисты: ваш врач, телефон доверия +7 (495) 989-50-50, экстренные службы 112."
|
||||
- "Специалисты: ваш врач, телефон доверия {phone:helpline}, экстренные службы 112."
|
||||
- "Безопасная среда: оружие и лишние лекарства — на хранение близкому человеку."
|
||||
means_restriction: "Если дома есть оружие или запас лекарств — попросите близкого человека временно хранить их у себя."
|
||||
|
||||
@@ -105,10 +109,15 @@ reach_out:
|
||||
silence: "Давно не было вестей от вас. Как вы? Можно ответить одним словом — мне важно знать, что с вами всё в порядке."
|
||||
missed_doses: "Заметил, что несколько приёмов препарата пропущено. Всё ли в порядке? Если что-то мешает — расскажите, я передам врачу."
|
||||
default: "Хотел узнать, как вы. Напишите пару слов, когда будет удобно."
|
||||
# The day after a crisis (app/services/followup.py); the doctor on duty also calls back.
|
||||
after_crisis: "Как вы сегодня? Вчера было очень тяжело — мне важно знать, что вы в порядке. Ваш план безопасности под кнопкой ниже. С вами также свяжется дежурный специалист. Если станет хуже — звоните 112 или на телефон доверия {phone:helpline}."
|
||||
|
||||
visit:
|
||||
button: "Записаться к врачу раньше"
|
||||
|
||||
unavailable: |-
|
||||
Сейчас у меня технические неполадки, и я не могу сохранить ваше сообщение. Пожалуйста, напишите чуть позже.
|
||||
Если вам плохо прямо сейчас — звоните 112 или на телефон доверия +7 (495) 989-50-50.
|
||||
Если вам плохо прямо сейчас — звоните 112 или на телефон доверия {phone:helpline}.
|
||||
|
||||
# Answer to an off-script question is followed by the pending question again (engine side answer).
|
||||
side_answer_return: "Вернёмся к вопросу:"
|
||||
|
||||
@@ -14,7 +14,11 @@ sex: "Укажите пол для интерпретации алкогольн
|
||||
tbi: "Были ли у Вас контузия или черепно-мозговая травма?"
|
||||
psychotropics: "Принимаете ли Вы сейчас психотропные препараты?"
|
||||
missing_followup: "Для оценки изменений со времени прошлого контакта нужна консультация специалиста. Если Вам нужна помощь сейчас, нажмите кнопку ниже."
|
||||
side_effects: "Беспокоили ли Вас за последнее время побочные эффекты лекарств?"
|
||||
numeric_portions: "Введите число стандартных порций, например 0 или 2."
|
||||
diary_done: "Дневник на сегодня уже заполнен. Спасибо!"
|
||||
periods:
|
||||
since_last_contact: "С момента Вашего последнего ответа на эти вопросы."
|
||||
past_month: "За последний месяц."
|
||||
lifetime: "За всю жизнь."
|
||||
past_3_months: "За последние три месяца."
|
||||
|
||||
@@ -0,0 +1,66 @@
|
||||
# Вопросы пациента о состоянии и лечении → база знаний по клиническим рекомендациям (#64, RAG #60).
|
||||
# Зона clinical вычитывает формулировки. Сам ответ — только цитата из КР с источником (config/texts/rag.yaml
|
||||
# задаёт его обрамление); здесь — тексты диалога и признаки того, что свободное сообщение — вопрос.
|
||||
|
||||
# Кнопка меню «Вопрос о лечении» → бот просит написать вопрос.
|
||||
prompt: |-
|
||||
Напишите ваш вопрос о состоянии или лечении — например, «что такое флэшбек?» или «помогает ли психотерапия?».
|
||||
Я отвечу цитатой из клинических рекомендаций Минздрава и укажу источник. Вопросы о дозе и о вашем препарате решает врач.
|
||||
|
||||
# Вопрос о дозе (увеличить, уменьшить, полтаблетки): бот не отвечает по существу — это решение врача.
|
||||
dose_redirect: "Дозу и схему приёма подбирает только ваш врач — менять их самостоятельно нельзя. Могу передать ваш вопрос врачу: нажмите «Связаться с врачом»."
|
||||
|
||||
# Свободное сообщение считается вопросом, если в нём есть «?» или оно начинается с одного из этих слов.
|
||||
# Тогда бот ищет ответ в базе знаний; если ответа нет — отвечает обычной фразой поддержки.
|
||||
question_starts:
|
||||
- "что такое"
|
||||
- "что значит"
|
||||
- "что означает"
|
||||
- "почему"
|
||||
- "зачем"
|
||||
- "как"
|
||||
- "когда"
|
||||
- "сколько"
|
||||
- "можно ли"
|
||||
- "нужно ли"
|
||||
- "надо ли"
|
||||
- "помогает ли"
|
||||
- "поможет ли"
|
||||
- "правда ли"
|
||||
- "бывает ли"
|
||||
- "что делать"
|
||||
- "что будет"
|
||||
- "чем"
|
||||
- "где"
|
||||
- "есть ли"
|
||||
- "что содержится"
|
||||
- "что содержат"
|
||||
- "что входит"
|
||||
- "что в составе"
|
||||
- "какой состав"
|
||||
- "какие побочки"
|
||||
- "какие побочные"
|
||||
- "состав"
|
||||
- "какие"
|
||||
- "можно"
|
||||
- "из чего"
|
||||
- "в чём"
|
||||
- "в чем"
|
||||
- "расскажи"
|
||||
- "объясни"
|
||||
|
||||
# Бытовые фразы — не вопросы о лечении, даже со «?»: «как дела?», «как ты?». База знаний для них не ищется
|
||||
# (иначе «как дела» находит «линия делит» — у слов одна основа), бот отвечает обычной фразой поддержки.
|
||||
small_talk:
|
||||
- "как дела"
|
||||
- "как ты"
|
||||
- "как вы"
|
||||
- "как жизнь"
|
||||
- "как поживаете"
|
||||
- "что нового"
|
||||
- "кто ты"
|
||||
- "ты кто"
|
||||
- "ты бот"
|
||||
- "ты робот"
|
||||
- "привет"
|
||||
- "спасибо"
|
||||
@@ -0,0 +1,8 @@
|
||||
connected: "Уведомления подключены. Здесь будут появляться напоминания с сайта. Отключить их можно командой /stop."
|
||||
not_connected: "Чтобы получать уведомления, откройте сайт и подключите MAX в настройках уведомлений."
|
||||
invalid: "Не удалось подключить уведомления. Создайте новую ссылку на сайте. Если MAX уже подключён к другому аккаунту, сначала отключите прежнюю привязку."
|
||||
stopped: "Уведомления отключены. Подключить их снова можно по новой ссылке с сайта."
|
||||
help: "Этот бот присылает уведомления. Пройти тесты, посмотреть результаты и продолжить общение можно на сайте. Команда /stop отключает уведомления."
|
||||
notification: "На сайте есть напоминание для вас. Откройте личный кабинет, чтобы продолжить."
|
||||
completed: "Прохождение теста завершено. Подробности доступны в личном кабинете на сайте."
|
||||
open_site: "Открыть сайт"
|
||||
@@ -0,0 +1,98 @@
|
||||
# Тексты приёма препарата (issue #37): напоминание, пропуск, побочные эффекты, вопрос о лекарстве, ответы
|
||||
# на действия правил med_info (отсроченный эффект, алкоголь, побочные эффекты).
|
||||
# СТАТУС: черновик, утверждает психиатр (#8).
|
||||
#
|
||||
# Правила текстов: без диагнозов и названий расстройств; без советов по дозам и схеме приёма (решает врач);
|
||||
# не использовать слова, которые звучат как постановка на учёт или слежка (проверяется тестом). Ответы о
|
||||
# препарате берутся только из выдержки инструкции ГРЛС (app/llm/med_qa.py); тексты ниже — обрамление и
|
||||
# запасные варианты, если выдержки нет.
|
||||
|
||||
status: "черновик, утверждает психиатр (#8)"
|
||||
|
||||
reminder:
|
||||
# {drug}, {dose} — из назначения врача (МНН и дозировка как в назначении, без изменений).
|
||||
text: "Время принять {drug} {dose}. Отметьте, пожалуйста, как получилось."
|
||||
text_no_drug: "Время принять препарат, назначенный врачом. Отметьте, пожалуйста, как получилось."
|
||||
taken: "Принял(а)"
|
||||
skip: "Пропущу"
|
||||
side_effects: "Есть побочные эффекты"
|
||||
|
||||
taken_ack: "Отлично, отметил приём. Спасибо!"
|
||||
# Кнопка от напоминания, которое уже неактуально (например, вчерашнего).
|
||||
stale: "Это напоминание уже неактуально. Если хотите отметить самочувствие — нажмите «Как я сегодня»."
|
||||
|
||||
skip:
|
||||
question: "Понял, отметил. Подскажите, что помешало? Это поможет вашему врачу."
|
||||
reasons:
|
||||
forgot: "Забыл(а)"
|
||||
side_effects: "Из-за побочных эффектов"
|
||||
quit: "Решил(а) бросить"
|
||||
other: "Другое"
|
||||
ack:
|
||||
forgot: "Понял, бывает. Завтра напомню в обычное время."
|
||||
quit: "Спасибо, что честно сказали — это важно, и решать это лучше вместе с врачом."
|
||||
other: "Понял, отметил. Если захотите рассказать подробнее — просто напишите."
|
||||
|
||||
side_effects:
|
||||
question: "Что беспокоит? Выберите вариант или «Другое», чтобы описать своими словами."
|
||||
options:
|
||||
nausea: "Тошнота"
|
||||
insomnia: "Бессонница"
|
||||
headache: "Головная боль"
|
||||
dizziness: "Головокружение"
|
||||
agitation: "Беспокойство"
|
||||
other: "Другое"
|
||||
# Короткий вопрос к инструкции препарата (med_qa, раздел «побочные эффекты») для выбранного эффекта.
|
||||
questions:
|
||||
nausea: "тошнота после приёма, когда пройдёт"
|
||||
insomnia: "бессонница, нарушения сна"
|
||||
headache: "головная боль"
|
||||
dizziness: "головокружение"
|
||||
agitation: "беспокойство, тревога"
|
||||
describe: "Опишите, пожалуйста, коротко, что вы заметили."
|
||||
ack: "Спасибо, отметил. Ваш врач увидит это в вашей карточке."
|
||||
# Тот же эффект был и вчера: инструкцию второй раз не повторяем.
|
||||
repeat: "Понимаю, это неприятно. Я отмечаю это каждый день, и ваш врач увидит, если не проходит."
|
||||
ask_dose: "А препарат сегодня приняли?"
|
||||
dose_yes: "Да, принял(а)"
|
||||
dose_no: "Нет"
|
||||
|
||||
# Ежедневный чек-ин: если сегодня ещё нет отметки о приёме.
|
||||
checkin:
|
||||
question: "Сегодня приняли {drug}?"
|
||||
question_no_drug: "Сегодня приняли назначенный препарат?"
|
||||
"yes": "Да"
|
||||
"no": "Нет"
|
||||
later: "Ещё нет"
|
||||
|
||||
question:
|
||||
prompt: "Напишите ваш вопрос о препарате. Я отвечаю только по официальной инструкции, а если ответа в ней нет — подскажу обратиться к врачу."
|
||||
no_prescription: "Я не нашёл в карточке назначенного препарата. Пожалуйста, уточните вопрос у вашего врача."
|
||||
|
||||
# Ответы на действие правила med_info. Ответ = lead + выдержка из инструкции (med_qa по разделу section,
|
||||
# вопрос question) + notice. Если выдержки нет — lead + fallback + notice.
|
||||
med_info:
|
||||
delayed_effect:
|
||||
section: onset
|
||||
question: "когда начнёт действовать препарат, нет эффекта, только хуже"
|
||||
lead: "Понимаю, что сейчас тяжело."
|
||||
fallback: "Эффект таких препаратов обычно наступает не сразу, а через 2–4 недели регулярного приёма. Пожалуйста, не прекращайте приём самостоятельно."
|
||||
notice: "Я сообщил вашему врачу — он свяжется с вами, чтобы обсудить, как вы себя чувствуете."
|
||||
alcohol_interaction:
|
||||
section: alcohol
|
||||
question: "можно ли алкоголь вместе с препаратом, сон"
|
||||
lead: "Спасибо, что честно рассказали."
|
||||
fallback: "В инструкции к препарату есть предупреждение о совместном приёме с алкоголем, а алкоголь сам по себе ухудшает сон."
|
||||
notice: "Я передал это вашему врачу."
|
||||
nausea:
|
||||
section: side_effects
|
||||
question: "тошнота после приёма, когда пройдёт"
|
||||
lead: ""
|
||||
fallback: "Тошнота часто встречается в первые дни приёма и обычно проходит сама."
|
||||
notice: "Если станет хуже — напишите мне, я передам врачу."
|
||||
side_effects:
|
||||
section: side_effects
|
||||
question: "побочные эффекты в начале приёма"
|
||||
lead: ""
|
||||
fallback: "Спасибо, что сообщили о самочувствии. Я отмечу это для вашего врача."
|
||||
notice: "Если станет хуже — напишите мне, я передам врачу."
|
||||
@@ -21,6 +21,8 @@ phrases:
|
||||
doctor_notified: "Я передал информацию вашему врачу. Он свяжется с вами."
|
||||
# med_qa: базовый смысл = выдержка из инструкции ГРЛС; LLM только упрощает её, ничего не добавляя.
|
||||
med_answer: "{excerpt}"
|
||||
# RAG (#60): базовый смысл = выдержка из клинических рекомендаций; LLM только упрощает её, ничего не добавляя.
|
||||
rag_answer: "{excerpt}"
|
||||
|
||||
# Шаблон саммари для врача (только по структурированным данным).
|
||||
summary:
|
||||
|
||||
@@ -0,0 +1,24 @@
|
||||
# Тексты ответов из базы знаний (RAG, #60). Зона clinical вычитывает формулировки.
|
||||
# Сам ответ — ТОЛЬКО предложения из клинических рекомендаций (экстрактивно); здесь — обрамление.
|
||||
# Правила: без советов по дозам, без рекомендаций препаратов, решение о лечении — за врачом.
|
||||
|
||||
patient:
|
||||
# Ничего не нашлось / вопрос о дозе — честно говорим и отправляем к врачу.
|
||||
fallback: "В клинических рекомендациях я не нашёл ответа на этот вопрос. Уточните, пожалуйста, у вашего врача."
|
||||
# Пациент должен понимать, что это выдержка из документа для врачей, а не совет бота.
|
||||
intro: "В клинических рекомендациях Минздрава сказано:"
|
||||
sources_label: "Источник"
|
||||
# Всегда в конце (не проходит через LLM).
|
||||
doctor_note: "Это общая информация из документа для врачей. Что подходит именно вам, решает ваш лечащий врач."
|
||||
|
||||
doctor:
|
||||
fallback: "В базе знаний (КР ПТСР 2023, КР Депрессия 2024) нет фрагмента по этому запросу."
|
||||
intro: "По клиническим рекомендациям:"
|
||||
sources_label: "Источники"
|
||||
doctor_note: ""
|
||||
|
||||
team:
|
||||
fallback: "В документах команды нет фрагмента по этому запросу."
|
||||
intro: "По документам команды:"
|
||||
sources_label: "Источники"
|
||||
doctor_note: ""
|
||||
@@ -0,0 +1,120 @@
|
||||
# Patient-facing interpretation of questionnaire results (ADR-008: texts in config). The rules that pick a text are
|
||||
# deterministic (app/core/interpretation.py) and use the thresholds of config/questionnaire*.yaml, PDF «Опросники для
|
||||
# MVP» (stage 1) and «Этап 2» (follow-up). The app never diagnoses: every result is a screening result.
|
||||
disclaimer: "Это результат скрининга, а не диагноз. Диагноз ставит врач после очной консультации."
|
||||
|
||||
intake:
|
||||
ok:
|
||||
title: "Признаков депрессии и ПТСР не выявлено"
|
||||
text: "По Вашим ответам сейчас нет признаков, которые требуют обращения к специалисту. Можно спать спокойно: продолжайте короткий дневник — так Вы заметите изменения раньше."
|
||||
attention:
|
||||
title: "Есть признаки, которые стоит обсудить со специалистом"
|
||||
text: "Это не диагноз, но ответы похожи на те, что бывают при состояниях ниже. Ниже — что именно мы заметили и что делать дальше."
|
||||
|
||||
findings:
|
||||
depression_suspected:
|
||||
title: "Предположение депрессии"
|
||||
text: "Ответы указывают на выраженные симптомы депрессии за последние 2 недели. Включаем модуль «Депрессия» в ежедневном дневнике."
|
||||
depression_mild:
|
||||
title: "Лёгкие симптомы депрессии"
|
||||
text: "Есть отдельные симптомы сниженного настроения. Они часто проходят сами, но за ними стоит последить."
|
||||
ptsd_suspected:
|
||||
title: "Склонность к ПТСР"
|
||||
text: "Ответы указывают на выраженные последствия пережитого травматического события за последний месяц. Включаем модуль «ПТСР» в ежедневном дневнике."
|
||||
ptsd_signs:
|
||||
title: "Отдельные признаки посттравматического стресса"
|
||||
text: "После травматического события есть отдельные реакции, но их выраженность ниже порога вероятного ПТСР."
|
||||
alcohol_risky:
|
||||
title: "Рискованное употребление алкоголя"
|
||||
text: "Употребление алкоголя выше безопасного уровня. Стоит сократить его и обсудить это с врачом."
|
||||
alcohol_high:
|
||||
title: "Высокий риск зависимости от алкоголя"
|
||||
text: "Рекомендуем консультацию нарколога — параллельно с основным маршрутом."
|
||||
suicide_low:
|
||||
title: "Тяжёлые мысли"
|
||||
text: "Вы отметили мысли о смерти. Мы добавили план безопасности и будем каждый день коротко спрашивать о самочувствии. Если станет тяжело — звоните 112 или на телефон доверия {phone:helpline}."
|
||||
tbi:
|
||||
title: "Контузия или ЧМТ"
|
||||
text: "Рекомендуем консультацию невролога."
|
||||
|
||||
routes:
|
||||
urgent_psychiatrist: "Срочно свяжитесь с психиатром — ориентир: в течение 24 часов."
|
||||
priority_psychiatrist: "Рекомендуем приоритетную запись к психиатру в ближайшие дни."
|
||||
psychiatrist_or_psychotherapist: "Рекомендуем плановую запись к психиатру или психотерапевту."
|
||||
psychologist: "Рекомендуем консультацию психолога."
|
||||
self_help: "Достаточно самопомощи и короткого ежедневного дневника."
|
||||
|
||||
modules:
|
||||
title: "Что дальше"
|
||||
diary: "Каждый день — короткий дневник: 3 вопроса утром и 2 вечером{modules}. Полные опросники — по расписанию."
|
||||
names:
|
||||
depression: "«Депрессия»"
|
||||
veteran: "«ПТСР»"
|
||||
with: ", плюс модуль {names}"
|
||||
|
||||
scales:
|
||||
phq9:
|
||||
title: "Опросник PHQ-9 (депрессия)"
|
||||
levels:
|
||||
minimal: "минимальные симптомы"
|
||||
mild: "лёгкие симптомы"
|
||||
moderate: "умеренные симптомы"
|
||||
moderately_severe: "умеренно тяжёлые симптомы"
|
||||
severe: "тяжёлые симптомы"
|
||||
pcl5:
|
||||
title: "Опросник PCL-5 (ПТСР)"
|
||||
levels:
|
||||
below: "ниже порога вероятного ПТСР"
|
||||
probable: "выше порога вероятного ПТСР"
|
||||
rus_audit_s:
|
||||
title: "Опросник RUS-AUDIT-S (алкоголь)"
|
||||
levels:
|
||||
zone_1: "относительно низкий риск"
|
||||
zone_2: "опасное употребление"
|
||||
zone_3: "пагубное употребление"
|
||||
zone_4: "риск зависимости"
|
||||
unknown: "нельзя оценить без указания пола"
|
||||
score: "{title}: {total} — {level}."
|
||||
change:
|
||||
remission: "Это ремиссия по шкале — отличный результат."
|
||||
response: "По сравнению с началом наблюдения — ответ на лечение."
|
||||
improved: "По сравнению с началом наблюдения — клинически значимое улучшение."
|
||||
stable: "По сравнению с началом наблюдения существенных изменений нет."
|
||||
worse: "По сравнению с прошлым замером состояние ухудшилось. Врач получит сигнал и пересмотрит план."
|
||||
|
||||
diary:
|
||||
saved: "Спасибо, дневник за {part} сохранён."
|
||||
parts:
|
||||
morning: "утро"
|
||||
evening: "вечер"
|
||||
flags:
|
||||
phq9_due_mood: "Настроение за неделю заметно ниже Вашей обычной нормы — предложим полный опросник PHQ-9 раньше срока."
|
||||
phq9_due_depression: "Симптомы депрессии за неделю выше Вашей нормы — предложим полный опросник PHQ-9 раньше срока."
|
||||
pcl5_due_ptsd: "Симптомы ПТСР за неделю выше Вашей нормы — предложим полный опросник PCL-5 раньше срока."
|
||||
sleep_review: "Несколько ночей подряд очень плохой или короткий сон. Врач увидит это в сводке."
|
||||
alcohol_on_medication: "Много алкоголя при приёме лекарств опасно. Врач получит отметку."
|
||||
rus_audit_due_alcohol: "За неделю было несколько дней с большим количеством алкоголя — предложим опросник об алкоголе."
|
||||
medication_contact: "Несколько дней подряд без лекарств. Не прекращайте приём без врача — мы сообщим ему."
|
||||
adherence_review: "За неделю лекарства пропущены чаще, чем в 1 из 5 дней. Обсудите это с врачом."
|
||||
side_effects_review: "Вы отметили побочные эффекты — врач получит отметку."
|
||||
|
||||
cssrs:
|
||||
none: "Спасибо за ответы."
|
||||
low: "Спасибо, что ответили честно. Откройте план безопасности, если станет тяжело."
|
||||
|
||||
kinds:
|
||||
intake: "Первичный опрос"
|
||||
diary_morning: "Дневник — утро"
|
||||
diary_evening: "Дневник — вечер"
|
||||
cssrs_since_contact: "Вопросы о безопасности"
|
||||
phq9: "PHQ-9 по расписанию"
|
||||
pcl5: "PCL-5 по расписанию"
|
||||
rus_audit_s: "Алкоголь по расписанию"
|
||||
diary: "Дневник"
|
||||
status:
|
||||
complete: "пройден"
|
||||
review_required: "остановлен для оценки специалиста"
|
||||
interrupted: "прерван: открыта экстренная помощь"
|
||||
active: "в процессе"
|
||||
paused: "на паузе"
|
||||
cancelled: "отменён"
|
||||
@@ -0,0 +1,17 @@
|
||||
# Распознавание голоса пациента (#116). Модель только расшифровывает речь — не отвечает и не советует.
|
||||
# Расшифровка возвращается пациенту на проверку и уходит в диалог обычным текстом (safety → scrub → LLM).
|
||||
|
||||
# Системная инструкция модели распознавания.
|
||||
system: >-
|
||||
Ты — система распознавания речи. Дословно расшифруй русскую речь из аудио.
|
||||
Выведи только расшифровку: без кавычек, пояснений и ответа на сказанное.
|
||||
Ставь знаки препинания. Если в записи совсем нет речи — выведи ровно [тишина].
|
||||
|
||||
# Текст рядом с аудио в сообщении пользователя.
|
||||
user: "Расшифруй эту аудиозапись."
|
||||
|
||||
# Что модель возвращает, если речи нет (сравнивается без учёта регистра).
|
||||
silence_marker: "[тишина]"
|
||||
|
||||
# Офлайн-режим (STT_PROVIDER=mock): фиксированная фраза демо-пациента, синтетика.
|
||||
mock_transcript: "Сегодня долго не мог уснуть. Хочу обсудить это на следующей встрече."
|
||||
@@ -0,0 +1,62 @@
|
||||
# Тексты ежедневного чек-ина и плановых шкал (issue #37, ADR-002, CLINICAL_MODULES §1–2).
|
||||
# Ядро (настроение + приём) задаётся всем; вопрос про сон и кошмары — модулю veteran; алкоголь — см. settings.
|
||||
# СТАТУС: черновик, утверждает психиатр (#8).
|
||||
#
|
||||
# Правила текстов: без диагнозов и названий расстройств; без советов по дозам; пациент не видит баллов шкал;
|
||||
# не использовать слова, которые звучат как постановка на учёт или слежка (проверяется тестом).
|
||||
|
||||
status: "черновик, утверждает психиатр (#8)"
|
||||
|
||||
settings:
|
||||
# Модули, которым задаётся вопрос про сон и кошмары (modules.yaml: daily_question = sleep_nightmares).
|
||||
sleep_modules: [veteran]
|
||||
# Ежедневный вопрос об алкоголе: модули, где он задаётся всегда (у ветеранов алкоголь — частый способ
|
||||
# «заглушить» бессонницу и фактор риска, CLINICAL_MODULES §1); остальным — при положительном AUDIT-C
|
||||
# (порог берётся из правила auditc_positive в config/rules.yaml, ADR-002).
|
||||
alcohol_daily_modules: [veteran]
|
||||
# Плановые шкалы, перед которыми показывается дружелюбное вступление (см. scale_intros).
|
||||
intro_scales: [pcl5, phq9, dar5, auditc]
|
||||
|
||||
checkin:
|
||||
start: "Добрый день! Короткая отметка о самочувствии — это займёт меньше минуты."
|
||||
mood:
|
||||
question: "Как ваше настроение сегодня по шкале от 0 до 10? 0 — очень плохо, 10 — отлично."
|
||||
sleep:
|
||||
question: "Сколько часов удалось поспать прошлой ночью?"
|
||||
options:
|
||||
"<4": "Меньше 4 ч"
|
||||
"4-6": "4–6 ч"
|
||||
"6-8": "6–8 ч"
|
||||
">8": "Больше 8 ч"
|
||||
nightmares:
|
||||
question: "Снились ли кошмары или тяжёлые сны?"
|
||||
"yes": "Да"
|
||||
"no": "Нет"
|
||||
alcohol:
|
||||
question: "Выпивали ли вы алкоголь за последние сутки?"
|
||||
clarify: "Вы упомянули алкоголь. Сколько примерно выпили за последние сутки?"
|
||||
options:
|
||||
none: "Не пил(а)"
|
||||
"1-2": "1–2 порции"
|
||||
more: "Больше"
|
||||
text:
|
||||
question: "Как вы? Можно пару слов — что было за день, что беспокоит."
|
||||
skip: "Пропустить"
|
||||
buttons_hint: "Выберите, пожалуйста, вариант кнопкой."
|
||||
done: "Спасибо, записал. Если что-то изменится — пишите в любое время."
|
||||
already_done: "Сегодня вы уже отмечались, спасибо! Если хотите что-то добавить — просто напишите."
|
||||
|
||||
visit:
|
||||
# Нажата кнопка «Записаться к врачу раньше» (действие правила suggest_visit). Онлайн-записи пока нет —
|
||||
# просьба передаётся врачу как факт в карточке.
|
||||
requested: "Передал врачу просьбу о более раннем визите. С вами свяжутся, чтобы договориться о времени. Если станет хуже до визита — пишите мне или звоните 112."
|
||||
|
||||
# Дружелюбное вступление перед шкалой (параметр intro у start_scale). Пациент не видит баллов.
|
||||
scale_intros:
|
||||
scheduled:
|
||||
pcl5: "Раз в две недели я прошу ответить на вопросы о том, как беспокоят тяжёлые воспоминания и их последствия. Это займёт 3–4 минуты. Так ваш врач увидит, что меняется со временем."
|
||||
phq9: "Пора для короткого опроса о настроении и силах за последние две недели — 9 вопросов. Отвечайте так, как есть, правильных ответов нет."
|
||||
dar5: "Несколько вопросов о раздражительности и вспышках гнева. После службы это бывает у многих, и врачу важно видеть, как это меняется."
|
||||
auditc: "Три коротких вопроса об алкоголе. Отвечайте как есть: это нужно врачу, чтобы лечение было безопасным."
|
||||
unscheduled:
|
||||
phq9: "Последние дни настроение ниже обычного. Давайте я задам несколько вопросов — так ваш врач лучше поймёт, как вы сейчас."
|
||||
@@ -0,0 +1,93 @@
|
||||
# Тексты стартового онбординга ветерана (issue #36): вступление, вопрос о травматическом опыте, пол для AUDIT-C,
|
||||
# вопрос о доступе к оружию, блок безопасного хранения, итог, FAQ.
|
||||
# СТАТУС: черновик, утверждает психиатр (#8). Ответы FAQ — формулировку проверяет юрист.
|
||||
#
|
||||
# Правила (проверяются тестом tests/test_dialog_veteran_onboarding.py):
|
||||
# * тон — как у сослуживца: на «вы», коротко, без жалости и без нравоучений;
|
||||
# * без слов «диагноз», «расстройство», «психолог», «психиатр», «болезнь», «псих»;
|
||||
# * о сервисе — никогда «учёт», «контроль», «надзор» (страх пациента можно процитировать только в подписи
|
||||
# кнопки FAQ — так человек узнаёт свой вопрос);
|
||||
# * пациент не видит баллов и названий шкал.
|
||||
|
||||
status: "черновик, утверждает психиатр (#8)"
|
||||
|
||||
settings:
|
||||
# Флаги шкал (config/scales/*.yaml), которые считаются сигналом риска для блока безопасного хранения оружия.
|
||||
# Положительный п.9 PHQ-9 и C-SSRS — суицидальный риск; AUDIT-C — алкоголь как фактор риска при доступе к оружию.
|
||||
# The weapon question exists but affects nothing (team decision 2026-10-04): no safety block, no trigger.
|
||||
weapon_risk_flags: []
|
||||
|
||||
intro:
|
||||
text: |-
|
||||
Рад, что вы здесь. Пара слов, прежде чем начнём.
|
||||
|
||||
После возвращения многие замечают одно и то же: сон сбит, в голову лезет прошлое, тело всё ещё «на дежурстве», раздражает то, что раньше не трогало, тянет выпить, чтобы отпустило. Это частая реакция на то, через что вы прошли, а не слабость — и с этим реально работают.
|
||||
|
||||
Сейчас будет несколько коротких вопросов про сон, напряжение, настроение и алкоголь — минут пять, почти всё кнопками. Ответы увидит только ваш лечащий врач: так он сможет помогать точнее.
|
||||
go: "Начнём"
|
||||
repeat: "Когда будете готовы — нажмите «Начнём». Если есть вопросы, ответы на частые — кнопками ниже."
|
||||
resume: "Давайте продолжим с того места, где остановились. Осталось немного."
|
||||
|
||||
buttons_hint: "Пожалуйста, выберите вариант кнопкой ниже."
|
||||
|
||||
exposure:
|
||||
question: |-
|
||||
Бывало ли с вами событие, которое сильно напугало, потрясло или было по-настоящему опасным для жизни — на службе, в бою или в другое время?
|
||||
Подробности рассказывать не нужно.
|
||||
answer_yes: "Да"
|
||||
answer_no: "Нет"
|
||||
decline: "Не хочу отвечать"
|
||||
ack_yes: "Понял. Несколько вопросов о том, как это даёт о себе знать сейчас."
|
||||
ack_other: "Хорошо, идём дальше."
|
||||
|
||||
sex:
|
||||
question: "Один уточняющий вопрос: ваш пол? Он нужен только для того, чтобы правильно учесть ответы про алкоголь — нормы для мужчин и женщин разные."
|
||||
male: "Мужской"
|
||||
female: "Женский"
|
||||
decline: "Не хочу отвечать"
|
||||
|
||||
weapon:
|
||||
question: |-
|
||||
Последний вопрос, он про безопасность, а не про проверку: есть ли у вас сейчас доступ к оружию — табельному, охотничьему, наградному или любому другому?
|
||||
no_access: "Нет"
|
||||
self: "Есть, хранится у меня"
|
||||
others_or_safe: "Есть, у других / в сейфе"
|
||||
decline: "Не хочу отвечать"
|
||||
ack: "Спасибо, что ответили."
|
||||
# Блок безопасного хранения — фиксированный текст, показывается только при доступе к оружию И сигнале риска.
|
||||
safety_block_self: |-
|
||||
Одна просьба — без нравоучений. Пока вам тяжело, пусть оружие и патроны побудут у того, кому вы доверяете: у брата, друга, в сейфе, ключ от которого у другого человека. Дело не в недоверии к вам. В трудную минуту важно, чтобы между мыслью и действием было время — это одна из самых надёжных мер защиты, и так делают многие.
|
||||
Это можно спокойно обсудить с врачом на приёме.
|
||||
safety_block_stored: |-
|
||||
Хорошо, что оружие хранится не под рукой. Пусть пока так и остаётся: ключ или код — у человека, которому вы доверяете, а патроны — отдельно. В трудную минуту важно, чтобы между мыслью и действием было время.
|
||||
Это можно спокойно обсудить с врачом на приёме.
|
||||
safety_block_unknown: |-
|
||||
Понимаю, что не хочется об этом говорить. Просто на всякий случай: если дома есть оружие или большой запас лекарств, пусть пока они побудут у человека, которому вы доверяете. В трудную минуту важно, чтобы между мыслью и действием было время.
|
||||
|
||||
result:
|
||||
intro: "Спасибо, что ответили на всё. Коротко, что видно по ответам:"
|
||||
calm: "Сейчас серьёзных трудностей по ответам не видно. Хорошо — будем держать руку на пульсе."
|
||||
load: "Нагрузка сейчас заметная. Так бывает у многих после возвращения, и это то, с чем врач может помочь."
|
||||
ptsd: "• Прошлое пока не отпускает: напряжение, воспоминания, сон."
|
||||
mood: "• Настроение и силы ниже, чем хотелось бы."
|
||||
alcohol: "• Алкоголь — стоит обсудить с врачом, особенно если назначат препараты: они с алкоголем плохо сочетаются."
|
||||
next: "Ваши ответы уже у лечащего врача — он обсудит их с вами на приёме. А я буду на связи каждый день с одним коротким вопросом и напоминанием о препарате."
|
||||
|
||||
faq:
|
||||
who:
|
||||
button: "Кто увидит мои ответы?"
|
||||
# формулировку проверяет юрист
|
||||
text: |-
|
||||
Только ваш лечащий врач — тот, кто дал вам код подключения. Перед автоматической обработкой из сообщений удаляются имена, телефоны и другие личные данные. Данные хранятся в России.
|
||||
Отозвать согласие и остановить обработку можно в любой момент — кнопкой «Отозвать согласие» или командой /revoke.
|
||||
unit:
|
||||
button: "Это попадёт на учёт / в часть?"
|
||||
# формулировку проверяет юрист
|
||||
text: |-
|
||||
Нет. Это добровольная консультативная помощь между визитами к врачу. Ваши ответы не передаются в часть, военкомат, работодателю или кому-то ещё без вашего согласия — кроме случаев, прямо предусмотренных законом. Отказ от помощника никак не влияет на ваше лечение.
|
||||
licences:
|
||||
button: "Заберут права на оружие или вождение?"
|
||||
# формулировку проверяет юрист
|
||||
text: |-
|
||||
Помощник не выдаёт заключений и не отправляет ваши ответы ни в ГИБДД, ни в Росгвардию, ни на медкомиссии. Допуск к оружию и вождению решает отдельная медицинская комиссия по своим правилам, установленным законом.
|
||||
Как именно это связано с вашим лечением — спросите лечащего врача прямо. Это нормальный вопрос, его задают многие, и честный ответ лучше, чем откладывать помощь из-за неизвестности.
|
||||
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Reference in New Issue
Block a user