ElebobaandClaude Opus 5.5
0c8cedc0c6
CI / ruff · pytest (pull_request) Successful in 23s
Pydantic schema for config/scales/*.yaml, cached loader, score() with severity bands (sex-specific for AUDIT-C), rule-based C-SSRS triage, flags (PHQ-9 item 9, PCL-5 >= 33, PHQ-4 subscales) and delta(). Starting literature thresholds for phq9, gad7, pcl5, auditc, pcptsd5, cssrs_screen, phq4; final values are approved by the psychiatrist (#8). Refs #3 Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
324 lines
9.6 KiB
Python
324 lines
9.6 KiB
Python
from pathlib import Path
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import pytest
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import yaml
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from pydantic import ValidationError
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from app.core.scales import ScaleDef, ScaleResult, delta, load_all, load_scale, score
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def answers_for(scale_id: str, total: int) -> dict[str, int]:
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"""Fill items greedily (each up to its max option) so the plain sum equals `total`."""
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scale = load_scale(scale_id)
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out: dict[str, int] = {}
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left = total
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for item in scale.items:
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v = min(left, item.max_value)
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out[item.id] = v
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left -= v
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assert left == 0, f"{scale_id}: total {total} unreachable"
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return out
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def severity(scale_id: str, total: int, **kw: object) -> str:
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return score(scale_id, answers_for(scale_id, total), **kw).severity_code
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# ---------------------------------------------------------------- loading
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def test_all_scales_load_with_expected_item_counts() -> None:
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counts = {k: len(v.items) for k, v in load_all().items()}
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expected = {"phq9": 9, "gad7": 7, "pcl5": 20, "auditc": 3, "pcptsd5": 5, "cssrs_screen": 6, "phq4": 4}
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assert counts == expected
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def test_unknown_scale() -> None:
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with pytest.raises(KeyError):
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load_scale("nope")
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def test_phq9_item9_buttons_only() -> None:
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phq9 = load_scale("phq9")
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assert [i.id for i in phq9.items if i.buttons_only] == ["phq9_9"]
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assert all(i.buttons_only for i in load_scale("cssrs_screen").items)
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def test_clinical_notes_present() -> None:
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for scale in load_all().values():
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assert scale.translation_note, scale.id
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assert scale.license_note, scale.id
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# ---------------------------------------------------------------- band boundaries
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@pytest.mark.parametrize(
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("scale_id", "boundaries"),
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[
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(
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"phq9",
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[
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(0, "minimal"),
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(4, "minimal"),
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(5, "mild"),
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(9, "mild"),
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(10, "moderate"),
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(14, "moderate"),
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(15, "moderately_severe"),
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(19, "moderately_severe"),
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(20, "severe"),
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(27, "severe"),
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],
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),
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(
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"gad7",
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[
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(0, "minimal"),
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(4, "minimal"),
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(5, "mild"),
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(9, "mild"),
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(10, "moderate"),
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(14, "moderate"),
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(15, "severe"),
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(21, "severe"),
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],
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),
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(
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"pcl5",
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[
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(0, "below_threshold"),
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(32, "below_threshold"),
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(33, "probable"),
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(49, "probable"),
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(50, "high"),
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(80, "high"),
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],
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),
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("pcptsd5", [(0, "negative"), (2, "negative"), (3, "positive"), (5, "positive")]),
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("phq4", [(0, "normal"), (2, "normal"), (3, "mild"), (5, "mild"), (6, "moderate"), (9, "severe")]),
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],
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)
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def test_band_boundaries(scale_id: str, boundaries: list[tuple[int, str]]) -> None:
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for total, code in boundaries:
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assert severity(scale_id, total) == code, (scale_id, total)
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def test_result_fields() -> None:
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r = score("phq9", answers_for("phq9", 12))
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assert r == ScaleResult(
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scale="phq9",
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total=12,
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max_total=27,
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severity_code="moderate",
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severity_label="Умеренная",
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complete=True,
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answered=9,
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flags=[],
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)
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# ---------------------------------------------------------------- flags
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def test_phq9_item9_flag() -> None:
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base = {f"phq9_{i}": 0 for i in range(1, 10)}
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assert score("phq9", base).flags == []
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r = score("phq9", base | {"phq9_9": 1})
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assert r.flags == ["phq9_item9_positive"]
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# Item 9 flag fires regardless of the low total.
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assert r.severity_code == "minimal"
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def test_phq9_item9_flag_in_incomplete_questionnaire() -> None:
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r = score("phq9", {"phq9_9": 2})
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assert not r.complete
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assert "phq9_item9_positive" in r.flags
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def test_pcl5_probable_flag() -> None:
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assert score("pcl5", answers_for("pcl5", 32)).flags == []
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assert score("pcl5", answers_for("pcl5", 33)).flags == ["pcl5_probable_ptsd"]
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def test_pcptsd5_flag() -> None:
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assert score("pcptsd5", answers_for("pcptsd5", 2)).flags == []
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assert score("pcptsd5", answers_for("pcptsd5", 3)).flags == ["pcptsd5_positive"]
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def test_phq4_subscale_flags() -> None:
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zero = {"phq4_1": 0, "phq4_2": 0, "phq4_3": 0, "phq4_4": 0}
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assert score("phq4", zero | {"phq4_1": 1, "phq4_2": 1, "phq4_3": 1, "phq4_4": 1}).flags == []
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assert score("phq4", zero | {"phq4_1": 2, "phq4_2": 1}).flags == ["phq4_anxiety_positive"]
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assert score("phq4", zero | {"phq4_3": 3}).flags == ["phq4_depression_positive"]
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both = score("phq4", {"phq4_1": 3, "phq4_2": 0, "phq4_3": 0, "phq4_4": 3})
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assert both.flags == ["phq4_anxiety_positive", "phq4_depression_positive"]
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# ---------------------------------------------------------------- AUDIT-C by sex
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@pytest.mark.parametrize(
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("total", "sex", "code"),
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[
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(3, "m", "negative"),
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(4, "m", "positive"),
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(2, "f", "negative"),
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(3, "f", "positive"),
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# Unknown sex: the more sensitive (female) cut-off.
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(2, None, "negative"),
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(3, None, "positive"),
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(0, "m", "negative"),
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(12, "f", "positive"),
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],
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)
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def test_auditc_by_sex(total: int, sex: str | None, code: str) -> None:
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r = score("auditc", answers_for("auditc", total), sex=sex) # type: ignore[arg-type]
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assert r.severity_code == code
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assert (r.flags == ["auditc_positive"]) == (code == "positive")
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# ---------------------------------------------------------------- C-SSRS triage
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def cssrs(*yes: int) -> dict[str, int]:
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return {f"cssrs_{i}": int(i in yes) for i in range(1, 7)}
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@pytest.mark.parametrize(
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("yes", "level"),
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[
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((), "none"),
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((1,), "low"),
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((2,), "low"),
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((1, 2), "low"),
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((1, 2, 3), "moderate"),
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((3,), "moderate"),
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((1, 2, 3, 4), "high"),
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((5,), "high"),
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((6,), "high"),
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((1, 6), "high"),
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],
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)
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def test_cssrs_triage(yes: tuple[int, ...], level: str) -> None:
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r = score("cssrs_screen", cssrs(*yes))
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assert r.severity_code == level
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assert r.total == len(yes)
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assert r.max_total == 6
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def test_cssrs_flags() -> None:
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assert score("cssrs_screen", cssrs(4)).flags == ["cssrs_high"]
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assert score("cssrs_screen", cssrs(3)).flags == ["cssrs_moderate"]
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assert score("cssrs_screen", cssrs(1)).flags == []
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def test_cssrs_partial_high_answer_still_high() -> None:
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# Screen version skips q3–q5 when q2 = no, so partial answers are normal; risk must still be detected.
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r = score("cssrs_screen", {"cssrs_1": 1, "cssrs_2": 0, "cssrs_6": 1})
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assert r.severity_code == "high"
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assert not r.complete
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# ---------------------------------------------------------------- incomplete / invalid
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def test_incomplete_no_imputation() -> None:
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r = score("phq9", {"phq9_1": 3, "phq9_2": 3})
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assert r.total == 6
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assert r.answered == 2
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assert r.complete is False
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assert r.severity_code == "mild" # lower bound, not prorated (prorating would give 27)
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def test_empty_answers() -> None:
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r = score("gad7", {})
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assert (r.total, r.answered, r.complete, r.severity_code) == (0, 0, False, "minimal")
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@pytest.mark.parametrize(
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"answers",
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[
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{"phq9_1": 4},
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{"phq9_1": -1},
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{"phq9_10": 1},
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{"gad7_1": 1},
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{"phq9_1": True},
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{"phq9_1": "2"},
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],
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)
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def test_invalid_answers(answers: dict[str, int]) -> None:
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with pytest.raises(ValueError):
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score("phq9", answers)
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def test_cssrs_rejects_non_binary() -> None:
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with pytest.raises(ValueError):
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score("cssrs_screen", {"cssrs_1": 2})
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def test_pcl5_accepts_4_phq9_does_not() -> None:
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assert score("pcl5", {"pcl5_1": 4}).total == 4
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with pytest.raises(ValueError):
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score("phq9", {"phq9_1": 4})
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# ---------------------------------------------------------------- delta
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def test_delta() -> None:
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prev = score("phq9", answers_for("phq9", 8))
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cur = score("phq9", answers_for("phq9", 14))
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assert delta(prev, cur) == 6
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assert delta(cur, prev) == -6
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def test_delta_rejects_mismatch_and_incomplete() -> None:
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phq = score("phq9", answers_for("phq9", 8))
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with pytest.raises(ValueError):
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delta(phq, score("gad7", answers_for("gad7", 8)))
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with pytest.raises(ValueError):
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delta(phq, score("phq9", {"phq9_1": 1}))
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# ---------------------------------------------------------------- schema validation
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def _raw(scale_id: str) -> dict:
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path = Path(__file__).resolve().parent.parent / "config" / "scales" / f"{scale_id}.yaml"
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return yaml.safe_load(path.read_text(encoding="utf-8"))
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def test_schema_rejects_gap_in_bands() -> None:
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raw = _raw("phq9")
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raw["severity"][1]["min"] = 6
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with pytest.raises(ValidationError):
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ScaleDef.model_validate(raw)
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def test_schema_rejects_wrong_range() -> None:
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raw = _raw("gad7")
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raw["range"]["max"] = 27
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with pytest.raises(ValidationError):
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ScaleDef.model_validate(raw)
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def test_schema_rejects_unknown_item_in_flag() -> None:
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raw = _raw("phq9")
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raw["flags"][0]["when"]["item"] = "phq9_99"
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with pytest.raises(ValidationError):
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ScaleDef.model_validate(raw)
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def test_schema_rejects_typo_key() -> None:
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raw = _raw("phq9")
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raw["flagz"] = raw.pop("flags")
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with pytest.raises(ValidationError):
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ScaleDef.model_validate(raw)
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def test_load_all_from_custom_dir(tmp_path: Path) -> None:
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(tmp_path / "scales").mkdir()
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(tmp_path / "scales" / "gad7.yaml").write_text(yaml.safe_dump(_raw("gad7"), allow_unicode=True), "utf-8")
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assert list(load_all(tmp_path)) == ["gad7"]
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