Arxip222andClaude Opus 5.5
44814b7293
Clinical review of the questionnaires (ADR-013):
- Red-flag block first in stage 1 (config/instruments/red_flags.yaml); any «Да» stops the
questionnaire with an acute alert and the help screen of its category.
- One crisis rule: the crisis screen opens at a HIGH C-SSRS risk only; moderate stops and goes
to a psychiatrist (24 h as a guide), low is a flag with the safety plan. PHQ-9 item 9 with a
negative screener is a discrepancy flag; without a completed screener it asks the C-SSRS at once.
config/questionnaire.yaml: cssrs_positive_policy graded (C01).
- Every crisis leaves a callback task for the doctor on duty (post_crisis_call, one per patient)
and the app asks how the person is the next day, the safety plan one tap away.
- Routing: risk and flags first, scales second; PCL-5 >= 50 no longer means a priority
appointment (pcl5_severe is moderate on the dashboard too).
- Crisis numbers live only in config/texts/crisis.yaml; texts and the agent prompt refer to them
via {phone:<key>}. Fixes the children's helpline offered to adults by the chat agent.
Refs #92
Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
286 lines
9.6 KiB
Python
286 lines
9.6 KiB
Python
"""Deterministic fixture data returned by stub routes until #12 implements them (synthetic only).
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Lets the dashboard (lane C) be built against the frozen schemas right away. Mirrors the demo cabinet from
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docs/product/01_demo_persona.md: veteran Andrey on day 13 (red) plus seven other patients.
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"""
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from datetime import date, datetime, time, timedelta
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from zoneinfo import ZoneInfo
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from app.api.schemas import (
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AlertOut,
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DemoPersona,
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DiscontinuationRisk,
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DoseOut,
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PatientCard,
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PatientListItem,
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SeriesPoint,
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)
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from app.core.safety import fill_phones
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from app.integrations.base import Prescription
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TZ = ZoneInfo("Europe/Moscow")
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TODAY = date(2026, 10, 3)
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DOCTOR_ID = "doc-smirnova"
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# Synthetic personas for the demo console and the demo ЕМИАС sign-in of the patient web app.
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DEMO_PERSONAS: list[DemoPersona] = [
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DemoPersona(token="tok-andrey", display_name="Андрей С.", therapy_day=13, scenario="data/synthetic/andrey.jsonl"),
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]
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def _risk(score: int, factors: list[str]) -> DiscontinuationRisk:
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level = "high" if score >= 60 else "medium" if score >= 30 else "low"
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return DiscontinuationRisk(score=score, level=level, factors=factors)
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PATIENTS: list[PatientListItem] = [
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PatientListItem(
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token="tok-andrey",
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display_name="Андрей С.",
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age=34,
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modules=["veteran", "depression"],
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drug="сертралин 50 мг",
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therapy_day=13,
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next_visit=TODAY + timedelta(days=15),
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status_color="red",
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top_alert_level="acute",
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open_alerts=3,
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phq9_last=18,
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pcl5_last=44,
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trend="up",
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adherence_7d=1.0,
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discontinuation_risk=_risk(55, ["хотел бросить (день 5)", "алкоголь 3 дня", "настроение ≤ 3"]),
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last_event="PHQ-9 п.9 = 2 — кризисный протокол",
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),
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PatientListItem(
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token="tok-dmitry",
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display_name="Дмитрий В.",
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age=41,
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modules=["veteran"],
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drug="сертралин 100 мг",
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therapy_day=45,
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status_color="yellow",
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top_alert_level="moderate",
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open_alerts=1,
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phq9_last=11,
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pcl5_last=48,
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trend="up",
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adherence_7d=0.86,
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discontinuation_risk=_risk(25, ["бессонница"]),
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last_event="кошмары, сон < 4 ч 3 ночи",
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),
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PatientListItem(
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token="tok-sergey",
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display_name="Сергей П.",
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age=37,
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modules=["veteran"],
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drug="пароксетин 20 мг",
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therapy_day=30,
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status_color="yellow",
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top_alert_level="moderate",
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open_alerts=1,
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phq9_last=12,
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pcl5_last=41,
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trend="flat",
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adherence_7d=0.57,
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discontinuation_risk=_risk(70, ["пропуски 3 из 7", "нет ответа 2 дня"]),
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last_event="пропуски 3 из 7 дней",
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),
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PatientListItem(
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token="tok-nikolay",
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display_name="Николай Ф.",
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age=52,
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modules=["veteran"],
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drug="сертралин 50 мг",
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therapy_day=14,
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status_color="yellow",
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top_alert_level="moderate",
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open_alerts=1,
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phq9_last=13,
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pcl5_last=39,
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trend="flat",
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adherence_7d=0.86,
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discontinuation_risk=_risk(40, ["алкоголь 4 из 7"]),
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last_event="алкоголь 4 из 7 дней",
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),
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PatientListItem(
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token="tok-anna",
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display_name="Анна Л.",
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age=23,
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modules=["depression"],
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drug="флуоксетин 20 мг",
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therapy_day=8,
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status_color="yellow",
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top_alert_level="info",
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open_alerts=1,
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phq9_last=15,
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trend="flat",
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adherence_7d=1.0,
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discontinuation_risk=_risk(30, ["беспокойство"]),
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last_event="возраст < 25: усиленный мониторинг",
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),
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PatientListItem(
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token="tok-irina",
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display_name="Ирина К.",
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age=34,
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modules=["depression"],
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drug="эсциталопрам 10 мг",
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therapy_day=21,
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status_color="green",
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phq9_last=9,
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trend="down",
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adherence_7d=1.0,
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discontinuation_risk=_risk(5, []),
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last_event="PHQ-9 16 → 9",
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),
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PatientListItem(
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token="tok-olga",
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display_name="Ольга Н.",
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age=29,
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modules=["depression"],
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drug="сертралин 50 мг",
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therapy_day=10,
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status_color="green",
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phq9_last=12,
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trend="down",
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adherence_7d=1.0,
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discontinuation_risk=_risk(10, []),
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last_event="тошнота прошла",
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),
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PatientListItem(
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token="tok-pavel",
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display_name="Павел Р.",
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age=45,
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modules=["depression"],
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drug="эсциталопрам 10 мг",
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therapy_day=60,
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status_color="green",
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phq9_last=4,
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trend="down",
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adherence_7d=1.0,
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discontinuation_risk=_risk(5, []),
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last_event="ремиссия, PHQ-9 = 4",
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),
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]
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# Andrey's 13 days (docs/product/01_demo_persona.md): mood, sleep hours (bucket midpoint), alcohol 0/1/2.
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_ANDREY_DAYS = [
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(4, 7, 0),
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(4, 5, 0),
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(4, 5, 0),
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(3, 5, 0),
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(3, 5, 0),
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(4, 7, 0),
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(4, 7, 0),
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(4, 3, 1),
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(4, 3, 2),
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(4, 3, 2),
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(3, 5, 1),
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(3, 5, 0),
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(2, 3, 0),
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]
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def _dt(d: date, hh: int = 9) -> datetime:
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return datetime.combine(d, time(hh), TZ)
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def andrey_card() -> PatientCard:
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start = TODAY - timedelta(days=12)
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series: list[SeriesPoint] = []
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for i, (mood, sleep, alc) in enumerate(_ANDREY_DAYS):
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d = start + timedelta(days=i)
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series += [
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SeriesPoint(day=d, metric="mood", value=mood),
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SeriesPoint(day=d, metric="sleep_hours", value=sleep),
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SeriesPoint(day=d, metric="alcohol", value=alc),
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]
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series += [
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SeriesPoint(day=start - timedelta(days=3), metric="phq9", value=14),
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SeriesPoint(day=start - timedelta(days=3), metric="pcl5", value=46),
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SeriesPoint(day=start - timedelta(days=3), metric="auditc", value=3),
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SeriesPoint(day=start + timedelta(days=6), metric="phq9", value=13),
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SeriesPoint(day=start + timedelta(days=6), metric="pcl5", value=44),
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SeriesPoint(day=TODAY, metric="phq9", value=18, scheduled=False),
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]
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doses = [
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DoseOut(planned_at=_dt(start + timedelta(days=i), 8), drug="сертралин", status="skipped" if i == 4 else "taken")
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for i in range(13)
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]
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alerts = [
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AlertOut(
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id=3,
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token="tok-andrey",
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patient_name="Андрей С.",
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ts=_dt(TODAY, 21),
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level="acute",
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color="red",
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code="phq9_item9",
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reason="PHQ-9 п.9 = 2 (мысли о смерти/самоповреждении)",
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),
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AlertOut(
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id=2,
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token="tok-andrey",
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patient_name="Андрей С.",
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ts=_dt(start + timedelta(days=9), 21),
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level="moderate",
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color="yellow",
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code="alcohol_3d",
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reason="Алкоголь 3 дня подряд на фоне СИОЗС",
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),
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AlertOut(
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id=1,
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token="tok-andrey",
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patient_name="Андрей С.",
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ts=_dt(start + timedelta(days=9), 21),
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level="moderate",
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color="yellow",
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code="sleep_lt4_3n",
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reason="Сон < 4 ч три ночи подряд",
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),
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AlertOut(
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id=0,
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token="tok-andrey",
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patient_name="Андрей С.",
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ts=_dt(start + timedelta(days=4), 21),
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level="high",
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color="yellow",
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code="quit_intent",
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reason="Намерение прекратить приём",
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acked_by=DOCTOR_ID,
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acked_at=_dt(start + timedelta(days=5), 11),
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),
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]
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return PatientCard(
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patient=PATIENTS[0],
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prescriptions=[Prescription(drug="сертралин", dose="50 мг", instructions="утром после еды", start_date=start)],
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series=series,
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doses=doses,
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alerts=alerts,
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safety_plan=[
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"Мои сигналы: не сплю, пью, «всё бессмысленно»",
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"Что помогает: прогулка с собакой, душ",
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"Люди и места: брат Олег, спортзал",
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"Кому звонить: жена, сослуживец Миша",
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fill_phones("Специалисты: д-р Смирнова, {phone:helpline}, 112"),
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"Безопасная среда: ружьё хранится у брата",
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],
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summary="За 13 дней: приверженность 12/13, эпизод намерения бросить на 5-й день (снят после звонка врача). "
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"С 8-го дня сон < 4 ч и алкоголь; к 13-му дню настроение 2/10, внеплановый PHQ-9 = 18 (рост с 13), "
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"п.9 = 2. Обсудить: безопасность, коррекция терапии сна, алкоголь.",
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)
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def card(token: str) -> PatientCard | None:
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if token == "tok-andrey":
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return andrey_card()
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item = next((p for p in PATIENTS if p.token == token), None)
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if item is None:
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return None
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return PatientCard(patient=item, prescriptions=[], series=[], doses=[], alerts=[], summary=item.last_event)
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def all_alerts() -> list[AlertOut]:
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return andrey_card().alerts
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