Arxip222andClaude Opus 5.5
290b0d6151
- Sign-in: centred ЕМИАС card without the sidebar; anonymous entry asks «Депрессия / ПТСР».
- Stage 1 is the same for everyone and follows the fixed order of the MVP questionnaire:
PHQ-2 → trauma filter/TSQ → RUS-AUDIT-S → C-SSRS → context; stage 2 only where stage 1
is positive. Starts without a profile.
- After stage 1 the patient sees a preliminary result (screening, not a diagnosis), stored
with the record; it switches on the diary modules (depression / PTSD).
- Stage 2 diary: morning (sleep, sleep quality, alcohol) and evening (mood, medication,
3 PHQ-9 items in rotation, short PCL-5); C-SSRS since last contact only under risk;
flags on weekly means against the personal norm; scheduled full scales with change
(remission, response, worsening).
- Questionnaire log: GET /me/{token}/results and the «Мои результаты» screen.
- Questionnaires centred without the sidebar and without scale names; «Продолжить позже»
goes home; confirmations are toasts; free-text comments are optional.
- Demo policy config/questionnaire_demo.yaml (INTAKE_DEMO only, not a clinical approval).
ADR-012.
Refs #77
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
475 lines
21 KiB
Python
475 lines
21 KiB
Python
"""Synthetic released-config integration tests. Production approvals stay empty."""
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import asyncio
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import shutil
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from datetime import UTC, datetime, timedelta
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import pytest
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import yaml
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from sqlalchemy import select
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from app.config import get_settings
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from app.core import clock
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from app.core.scales import clear_cache
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from app.db import repo, session
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from app.db.bootstrap import init_db
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from app.db.intake import QuestionnaireNotice, QuestionnaireRecord, QuestionnaireTask
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from app.dialog.contracts import Event
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from app.dialog.engine import Engine
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from app.integrations.base import MemoryNotifier, MemoryOutbox, integrations
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from app.llm.gateway import LLMGateway
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from app.llm.mock import MockTasks
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from app.scheduler import jobs
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from app.services import questionnaire as service
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TOKEN = "b" * 32
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NOW = datetime(2026, 10, 3, 17, tzinfo=UTC)
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@pytest.fixture
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async def released(tmp_path, monkeypatch):
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config = tmp_path / "config"
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shutil.copytree(get_settings().config_dir, config)
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for name in ("questionnaire", "intake_runtime"):
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path = config / f"{name}.yaml"
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data = yaml.safe_load(path.read_text())
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approval = dict(
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reviewer="Synthetic test",
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decision_reference="fixture-only",
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approved_at=NOW.isoformat(),
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policy_version=data["version"],
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)
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data["approval"] = approval
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if name == "questionnaire":
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data.update(cssrs_positive_policy="graded", rus_audit_s_expand_at=1)
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else:
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data.update(enabled=True, content_review=approval, contact_review=approval)
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path.write_text(yaml.safe_dump(data, allow_unicode=True))
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monkeypatch.setattr(get_settings(), "config_dir", config)
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monkeypatch.setattr(clock, "now", lambda: NOW)
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monkeypatch.setattr(integrations, "notifier", MemoryNotifier())
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monkeypatch.setattr(integrations, "outbox", MemoryOutbox())
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clear_cache()
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await session.configure(identity_url="sqlite+aiosqlite:///:memory:", clinical_url="sqlite+aiosqlite:///:memory:")
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await init_db()
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async with session.get_clinical_session() as s:
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await repo.upsert_profile(s, token=TOKEN, doctor_id="synthetic-doctor", modules=["veteran"], sex="m")
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await repo.set_dialog_state(s, token=TOKEN, state="idle", data={"consent": True, "adult": True}, now=NOW)
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yield Engine(gateway=LLMGateway(MockTasks()))
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await session.configure()
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clear_cache()
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async def rows(cls=QuestionnaireRecord):
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async with session.get_clinical_session() as s:
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return list((await s.scalars(select(cls))).all())
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async def press(e, data):
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return await e.handle(TOKEN, Event(type="button", button=data))
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def answer_button(replies, choices=None):
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choices = choices or {}
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for reply in reversed(replies):
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for line in reply.buttons:
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for b in line:
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if b.data.startswith("iq:"):
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item = b.data.split(":")[2]
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index = choices.get(item, 1 if item.startswith("cssrs_") else 0)
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for line2 in reply.buttons:
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for other in line2:
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if other.data.endswith(":" + str(index)) and other.data.startswith("iq:"):
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return other.data
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return None
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async def complete_intake(e, choices=None):
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replies = await press(e, "intake:start")
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for _ in range(100):
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button = answer_button(replies, choices)
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if button is None:
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return replies
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replies = await press(e, button)
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raise AssertionError("intake did not terminate")
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async def to_cssrs(e, choices=None):
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"""Stage 1 up to the C-SSRS screener, which comes after PHQ-2, the trauma filter and RUS-AUDIT-S."""
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replies = await press(e, "intake:start")
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for _ in range(20):
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button = answer_button(replies, {"trauma": 1, **(choices or {})})
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if ":cssrs_" in button:
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return replies
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replies = await press(e, button)
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raise AssertionError("C-SSRS not reached")
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async def test_minimal_intake_raw_data_not_imputed_and_restart(released):
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await complete_intake(released, {"trauma": 1, "tbi": 1, "psychotropics": 1})
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(row,) = await rows()
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assert row.status == "complete"
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assert row.answers["trauma"] == 0 and not any(k.startswith("tsq_") for k in row.answers)
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assert row.details["totals"]["tsq"]["total"] is None
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assert row.details["totals"]["phq9"]["total"] is None
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assert row.details["totals"]["rus_audit_s"]["total"] == 0
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assert row.details["totals"]["cssrs_recent"]["risk"] == "none"
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assert row.details["decision"]["primary_route"] == "self_help"
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async def test_pause_restart_and_duplicate_callbacks(released):
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replies = await press(released, "intake:start")
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old = answer_button(replies)
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await asyncio.gather(press(released, old), press(released, old))
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(row,) = await rows()
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assert row.answers == {"phq9_1": 0}
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await press(released, "intake:pause")
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restarted = Engine(gateway=LLMGateway(MockTasks()))
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replies = await press(restarted, "intake:resume")
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assert "phq9_2" in answer_button(replies)
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await press(restarted, old)
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assert (await rows())[0].answers == {"phq9_1": 0}
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assert all(len(b.data.encode()) <= 64 for r in replies for line in r.buttons for b in line)
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@pytest.mark.parametrize("signal", ["help", "phq", "cssrs"])
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async def test_immediate_stop_preserves_partial_answers(released, signal):
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replies = await press(released, "intake:start")
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if signal == "help":
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replies = await press(released, "intake:help")
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elif signal == "cssrs":
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replies = await to_cssrs(released)
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for item in ("cssrs_q1", "cssrs_q2", "cssrs_q3", "cssrs_q4"):
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replies = await press(released, answer_button(replies, {item: 0}))
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else:
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replies = await complete_existing(released, replies, {"trauma": 1, "phq9_1": 2, "phq9_9": 1})
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assert any(r.kind == "crisis" for r in replies)
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(row,) = await rows()
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assert row.status == "interrupted" and row.completed_at is None
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notices = await rows(QuestionnaireNotice)
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assert len(notices) == 1 and notices[0].status == "test_sink"
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assert "уведомлён" not in replies[0].text
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async def complete_existing(e, replies, choices):
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for _ in range(100):
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button = answer_button(replies, choices)
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if not button:
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return replies
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replies = await press(e, button)
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raise AssertionError("not terminated")
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async def test_full_tsq_expands_at_six_and_carries_alcohol_answers(released):
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choices = {"tsq_" + str(i): 0 if i <= 6 else 1 for i in range(1, 11)}
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choices.update(rus_audit_3=1, rus_audit_1=1, tbi=1, psychotropics=1)
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await complete_intake(released, choices)
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(row,) = await rows()
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assert row.status == "complete"
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assert row.details["totals"]["tsq"]["total"] == 6
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assert row.details["totals"]["pcl5"]["total"] == 0
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assert row.details["totals"]["rus_audit"]["complete"]
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assert row.answers["rus_audit_3"] == 1
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assert len([k for k in row.answers if k.startswith("rus_audit_")]) == 10
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async def test_alcohol_conflict_keeps_positive_short_answer(released):
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await complete_intake(released, {"trauma": 1, "rus_audit_3": 1, "rus_audit_1": 0})
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(row,) = await rows()
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assert row.status == "review_required" and row.answers["rus_audit_3"] == 1
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assert row.details["stop_reason"] == "answer_conflict"
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async def test_low_risk_shows_safety_plan_but_moderate_stops(released):
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replies = await to_cssrs(released)
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replies = await press(released, answer_button(replies, {"cssrs_q1": 0}))
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replies = await press(released, answer_button(replies))
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replies = await press(released, answer_button(replies))
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assert any(r.kind == "safety_plan" for r in replies)
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# The screener ends stage 1; the context questions follow (sex is known from the profile).
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assert ":tbi:" in answer_button(replies)
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async def test_notification_failure_retry_and_consent_cancellation(released, monkeypatch):
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class Failing:
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async def send(self, *args, **kwargs):
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raise OSError("sensitive error content must not be stored")
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monkeypatch.setattr(integrations, "notifier", Failing())
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await press(released, "intake:start")
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await press(released, "intake:help")
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(notice,) = await rows(QuestionnaireNotice)
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assert notice.status == "pending" and notice.error_code == "OSError" and notice.attempts == 1
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monkeypatch.setattr(clock, "now", lambda: NOW + timedelta(minutes=3))
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notifier = MemoryNotifier()
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monkeypatch.setattr(integrations, "notifier", notifier)
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await service.dispatch_notices()
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await service.dispatch_notices()
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assert len(notifier.sent) == 1
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assert (await rows(QuestionnaireNotice))[0].attempts == 2
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await press(released, "consent:revoke")
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async with session.get_clinical_session() as s:
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state = await repo.get_dialog_state(s, TOKEN)
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assert state.data["consent"] is False and "questionnaire_record" not in state.data
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async def test_scheduler_idempotent_and_failed_outbox_recovery(released, monkeypatch):
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await complete_intake(released, {"trauma": 1, "tbi": 1, "psychotropics": 1})
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class Failing:
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async def push(self, *args):
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raise OSError()
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monkeypatch.setattr(integrations, "outbox", Failing())
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await jobs.run_until_now()
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tasks = await rows(QuestionnaireTask)
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# 20:00 Moscow: both parts of the diary are due; no risk monitoring → no daily C-SSRS.
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assert {t.kind for t in tasks} == {"diary_morning", "diary_evening"}
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morning = next(t for t in tasks if t.kind == "diary_morning")
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assert morning.delivery and morning.sent_at is None
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outbox = MemoryOutbox()
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monkeypatch.setattr(integrations, "outbox", outbox)
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await jobs.run_until_now()
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await jobs.run_until_now()
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assert len(await rows(QuestionnaireTask)) == 2
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assert len(outbox.drain(TOKEN)) == 1
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assert len(await rows()) == 2
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async def test_since_contact_risk_check_opens_the_evening_diary(released):
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async with session.get_clinical_session() as s:
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task = await service.queue_task(s, TOKEN, "cssrs_since_contact", "synthetic", NOW)
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task_id = task.id
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replies = await released.handle(
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TOKEN, Event(type="system", system="daily_checkin", params={"questionnaire_task": task_id})
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)
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assert any("последнего ответа" in r.text for r in replies)
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for _ in range(5):
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button = answer_button(replies)
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if ":cssrs_" not in (button or ""):
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break
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replies = await press(released, button)
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risk = next(r for r in await rows() if r.kind == "cssrs_since_contact")
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assert risk.status == "complete" and risk.answers == {
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"cssrs_q1": 0,
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"cssrs_q2": 0,
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"cssrs_q6_lifetime": 0,
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"cssrs_q6_recent": 0,
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}
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assert risk.details["answer_metadata"]["cssrs_q6_recent"]["derived"] is True
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assert ":mood:" in answer_button(replies)
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assert any(r.kind == "diary_evening" and r.status == "active" for r in await rows())
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async def test_disabled_or_no_adult_confirmation_cannot_start(released):
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async with session.get_clinical_session() as s:
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state = await repo.get_dialog_state(s, TOKEN)
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state.data = {"consent": True}
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await press(released, "intake:start")
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assert await rows() == []
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async def review_risk_record(e):
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from app.api.questionnaire import ReviewIn, review
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risk = next(r for r in reversed(await rows()) if r.kind == "cssrs_since_contact")
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return await review(
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TOKEN,
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risk.id,
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ReviewIn(
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doctor_id="synthetic-doctor", assessment_performed=True, decision="resume", reference="synthetic/assessment"
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),
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)
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async def run_diary(e, replies, choices=None, numbers=("6,5", "2")):
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"""Answers the open diary questions; numeric items take `numbers` in turn."""
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numbers = list(numbers)
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for _ in range(30):
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button = answer_button(replies, choices)
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if button:
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replies = await press(e, button)
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elif any("часов" in r.text or "порци" in r.text for r in replies) and numbers:
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replies = await e.handle(TOKEN, Event(type="text", text=numbers.pop(0)))
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else:
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return replies
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raise AssertionError("diary did not terminate")
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async def test_doctor_review_is_audited_and_unblocks_diary(released):
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from fastapi import HTTPException
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from app.api.questionnaire import ReviewIn, history, review
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from app.db.audit import AuditLog
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await complete_intake(released, {"trauma": 1, "tbi": 1, "psychotropics": 1})
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async with session.get_clinical_session() as s:
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(await repo.get_profile(s, TOKEN)).enhanced_monitoring = True
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replies = await run_diary(released, await press(released, "menu:checkin"))
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# Evening: the risk check comes first; thoughts of a method (q3) are a moderate risk → stop for a specialist.
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replies = await press(released, "menu:checkin")
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replies = await complete_existing(released, replies, {"cssrs_q1": 0, "cssrs_q2": 0, "cssrs_q3": 0})
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risk = next(r for r in await rows() if r.kind == "cssrs_since_contact")
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assert risk.status == "review_required"
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with pytest.raises(HTTPException) as exc:
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await review(
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TOKEN,
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risk.id,
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ReviewIn(doctor_id="other-doctor", assessment_performed=True, decision="resume", reference="test"),
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)
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assert exc.value.status_code == 404
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await released.handle(TOKEN, Event(type="system", system="doctor_ack"))
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async with session.get_clinical_session() as s:
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assert (await repo.get_dialog_state(s, TOKEN)).data.get("intake_review_required")
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await review_risk_record(released)
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await jobs.run_until_now()
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assert any(r.kind == "diary_evening" and r.status == "active" for r in await rows())
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await history(TOKEN, "synthetic-doctor")
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audits = await rows(AuditLog)
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assert {a.action for a in audits} >= {"view_questionnaires", "review_questionnaire"}
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async def test_diary_morning_then_evening_with_the_ptsd_module(released):
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await complete_intake(released, {"trauma": 1, "tbi": 1, "psychotropics": 1})
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replies = await press(released, "menu:checkin")
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assert any("часов" in r.text for r in replies)
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invalid = await released.handle(TOKEN, Event(type="text", text="nan"))
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assert any("число часов" in r.text for r in invalid)
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replies = await run_diary(released, invalid, {"sleep_quality": 3})
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assert any("утро" in r.text for r in replies)
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morning = next(r for r in await rows() if r.kind == "diary_morning")
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assert morning.status == "complete"
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assert morning.answers == {"sleep_hours": 6.5, "sleep_quality": 3, "alcohol_portions": 2.0}
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replies = await run_diary(released, await press(released, "menu:checkin"), {"mood": 7, "medication": 2})
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evening = next(r for r in await rows() if r.kind == "diary_evening")
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assert evening.status == "complete" and evening.answers["medication"] == "not_prescribed"
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assert "medication_reason" not in evening.answers
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assert {"dpcl_1", "dpcl_7", "dpcl_10", "dpcl_18"} <= set(evening.answers)
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assert evening.details["interpretation"]["kind"] == "diary_evening"
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replies = await press(released, "menu:checkin")
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assert any("уже заполнен" in r.text for r in replies)
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async def test_depression_module_item9_stops_with_crisis(released, monkeypatch):
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await complete_intake(released, {"trauma": 1, "tbi": 1, "psychotropics": 1})
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async with session.get_clinical_session() as s:
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await repo.upsert_profile(s, token=TOKEN, modules=["depression"])
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monkeypatch.setattr(clock, "now", lambda: NOW + timedelta(days=2))
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await run_diary(released, await press(released, "menu:checkin"))
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replies = await run_diary(released, await press(released, "menu:checkin"), {"medication": 2, "dphq_9": 1})
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assert any(r.kind == "crisis" for r in replies)
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evening = next(r for r in await rows() if r.kind == "diary_evening")
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assert evening.answers["dphq_9"] == 1 and evening.status == "interrupted"
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async def test_unknown_sex_goes_to_review_without_a_zone(released):
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async with session.get_clinical_session() as s:
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(await repo.get_profile(s, TOKEN)).sex = None
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await complete_intake(released, {"trauma": 1, "sex": 2})
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(row,) = await rows()
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assert row.status == "review_required" and row.answers["sex"] == "unknown"
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async def test_version_change_blocks_resume_and_preserves_answers(released):
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replies = await press(released, "intake:start")
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await press(released, answer_button(replies))
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await press(released, "intake:pause")
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path = get_settings().config_dir / "instruments/intake_forms.yaml"
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data = yaml.safe_load(path.read_text())
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data["version"] = "synthetic-next-version"
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path.write_text(yaml.safe_dump(data, allow_unicode=True))
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await press(released, "intake:resume")
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(row,) = await rows()
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assert row.status == "review_required" and row.answers == {"phq9_1": 0}
|
|
|
|
|
|
async def test_followup_delta_uses_comparable_complete_baseline(released):
|
|
await complete_intake(released, {"trauma": 1, "phq9_1": 2, "tbi": 1, "psychotropics": 1})
|
|
async with session.get_clinical_session() as s:
|
|
task = await service.queue_task(s, TOKEN, "phq9", "synthetic-repeat", NOW)
|
|
task_id = task.id
|
|
replies = await released.handle(
|
|
TOKEN, Event(type="system", system="daily_checkin", params={"questionnaire_task": task_id})
|
|
)
|
|
replies = await complete_existing(released, replies, {"phq9_1": 3, "phq9_2": 3, "phq9_3": 1})
|
|
repeat = next(r for r in await rows() if r.kind == "phq9")
|
|
assert repeat.status == "complete" and repeat.details["delta"]["value"] == 5
|
|
assert repeat.details["delta"]["retriage"] is True
|
|
|
|
|
|
async def test_silence_uses_completed_checkins_not_empty_records(released, monkeypatch):
|
|
await complete_intake(released, {"trauma": 1, "tbi": 1, "psychotropics": 1})
|
|
async with session.get_clinical_session() as s:
|
|
(await repo.get_profile(s, TOKEN)).enhanced_monitoring = True
|
|
monkeypatch.setattr(clock, "now", lambda: NOW + timedelta(days=2))
|
|
await jobs.plan()
|
|
await jobs.plan()
|
|
notices = await rows(QuestionnaireNotice)
|
|
assert len([n for n in notices if n.event_key.startswith("silence:")]) == 1
|
|
|
|
|
|
async def test_stop_any_policy_interrupts_first_positive(released):
|
|
path = get_settings().config_dir / "questionnaire.yaml"
|
|
data = yaml.safe_load(path.read_text())
|
|
data["cssrs_positive_policy"] = "stop_any"
|
|
path.write_text(yaml.safe_dump(data, allow_unicode=True))
|
|
replies = await to_cssrs(released)
|
|
replies = await press(released, answer_button(replies, {"cssrs_q1": 0}))
|
|
assert any(r.kind == "crisis" for r in replies)
|
|
assert (await rows())[0].answers["cssrs_q1"] == 1
|
|
|
|
|
|
async def test_diary_schedule_uses_moscow_date(released, monkeypatch):
|
|
await complete_intake(released, {"trauma": 1, "tbi": 1, "psychotropics": 1})
|
|
monkeypatch.setattr(clock, "now", lambda: NOW.replace(hour=4, minute=59))
|
|
await jobs.plan()
|
|
assert await rows(QuestionnaireTask) == []
|
|
monkeypatch.setattr(clock, "now", lambda: NOW.replace(hour=5, minute=0))
|
|
await jobs.plan()
|
|
assert {t.kind for t in await rows(QuestionnaireTask)} == {"diary_morning"}
|
|
monkeypatch.setattr(clock, "now", lambda: NOW.replace(hour=17, minute=0))
|
|
await jobs.plan()
|
|
assert {t.kind for t in await rows(QuestionnaireTask)} == {"diary_morning", "diary_evening"}
|
|
|
|
|
|
async def test_resumed_answer_keeps_original_period(released, monkeypatch):
|
|
replies = await press(released, "intake:start")
|
|
await press(released, answer_button(replies))
|
|
await press(released, "intake:pause")
|
|
monkeypatch.setattr(clock, "now", lambda: NOW + timedelta(days=1))
|
|
replies = await press(released, "intake:resume")
|
|
await press(released, answer_button(replies))
|
|
(record,) = await rows()
|
|
metadata = record.details["answer_metadata"]["phq9_2"]
|
|
assert metadata["period_start"] == "2026-09-19"
|
|
assert metadata["period_end"] == "2026-10-03"
|
|
assert metadata["answered_at"].startswith("2026-10-04")
|
|
|
|
|
|
async def test_intake_result_is_shown_logged_and_sets_the_diary_modules(released):
|
|
from app.api.patient_web import my_results
|
|
|
|
choices = {f"phq9_{i}": 2 for i in range(1, 9)}
|
|
choices.update(trauma=1, tbi=1, psychotropics=1)
|
|
replies = await complete_intake(released, choices)
|
|
assert any("Предположение депрессии" in r.text for r in replies)
|
|
assert any("не диагноз" in r.text for r in replies)
|
|
(row,) = await rows()
|
|
interpretation = row.details["interpretation"]
|
|
assert interpretation["codes"] == ["depression_suspected"] and interpretation["modules"] == ["depression"]
|
|
async with session.get_clinical_session() as s:
|
|
# A doctor's modules (diagnosis) stay; the screening only adds to them.
|
|
assert (await repo.get_profile(s, TOKEN)).modules == ["veteran", "depression"]
|
|
results = await my_results(TOKEN)
|
|
assert results.conclusion.title == interpretation["title"]
|
|
assert [h.kind for h in results.history] == ["intake"] and results.history[0].status_title == "пройден"
|
|
|
|
|
|
async def test_without_a_doctor_the_screening_defines_the_modules(released):
|
|
async with session.get_clinical_session() as s:
|
|
await repo.upsert_profile(s, token=TOKEN, doctor_id="", modules=["veteran"])
|
|
replies = await complete_intake(released, {"trauma": 1, "tbi": 1, "psychotropics": 1})
|
|
assert any("не выявлено" in r.text for r in replies)
|
|
async with session.get_clinical_session() as s:
|
|
assert (await repo.get_profile(s, TOKEN)).modules == []
|