Source code for camcops_server.tasks.ciwa

#!/usr/bin/env python

"""
camcops_server/tasks/ciwa.py

===============================================================================

    Copyright (C) 2012-2019 Rudolf Cardinal (rudolf@pobox.com).

    This file is part of CamCOPS.

    CamCOPS is free software: you can redistribute it and/or modify
    it under the terms of the GNU General Public License as published by
    the Free Software Foundation, either version 3 of the License, or
    (at your option) any later version.

    CamCOPS is distributed in the hope that it will be useful,
    but WITHOUT ANY WARRANTY; without even the implied warranty of
    MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
    GNU General Public License for more details.

    You should have received a copy of the GNU General Public License
    along with CamCOPS. If not, see <http://www.gnu.org/licenses/>.

===============================================================================

"""

from typing import Any, Dict, List, Tuple, Type

from cardinal_pythonlib.stringfunc import strseq
from sqlalchemy.ext.declarative import DeclarativeMeta
from sqlalchemy.sql.schema import Column
from sqlalchemy.sql.sqltypes import Float, Integer

from camcops_server.cc_modules.cc_constants import CssClass
from camcops_server.cc_modules.cc_ctvinfo import CTV_INCOMPLETE, CtvInfo
from camcops_server.cc_modules.cc_db import add_multiple_columns
from camcops_server.cc_modules.cc_html import (
    answer,
    subheading_spanning_two_columns,
    tr,
    tr_qa,
)
from camcops_server.cc_modules.cc_request import CamcopsRequest
from camcops_server.cc_modules.cc_snomed import SnomedExpression, SnomedLookup
from camcops_server.cc_modules.cc_sqla_coltypes import (
    CamcopsColumn,
    MIN_ZERO_CHECKER,
    PermittedValueChecker,
    SummaryCategoryColType,
)
from camcops_server.cc_modules.cc_summaryelement import SummaryElement
from camcops_server.cc_modules.cc_task import (
    get_from_dict,
    Task,
    TaskHasClinicianMixin,
    TaskHasPatientMixin,
)
from camcops_server.cc_modules.cc_text import SS
from camcops_server.cc_modules.cc_trackerhelpers import (
    TrackerLabel,
    TrackerInfo,
)


# =============================================================================
# CIWA
# =============================================================================

class CiwaMetaclass(DeclarativeMeta):
    # noinspection PyInitNewSignature
    def __init__(cls: Type['Ciwa'],
                 name: str,
                 bases: Tuple[Type, ...],
                 classdict: Dict[str, Any]) -> None:
        add_multiple_columns(
            cls, "q", 1, cls.NSCOREDQUESTIONS - 1,
            minimum=0, maximum=7,
            comment_fmt="Q{n}, {s} (0-7, higher worse)",
            comment_strings=[
                "nausea/vomiting", "tremor", "paroxysmal sweats", "anxiety",
                "agitation", "tactile disturbances", "auditory disturbances",
                "visual disturbances", "headache/fullness in head"
            ]
        )
        super().__init__(name, bases, classdict)


[docs]class Ciwa(TaskHasPatientMixin, TaskHasClinicianMixin, Task, metaclass=CiwaMetaclass): """ Server implementation of the CIWA-Ar task. """ __tablename__ = "ciwa" shortname = "CIWA-Ar" provides_trackers = True NSCOREDQUESTIONS = 10 SCORED_QUESTIONS = strseq("q", 1, NSCOREDQUESTIONS) q10 = CamcopsColumn( "q10", Integer, permitted_value_checker=PermittedValueChecker(minimum=0, maximum=4), comment="Q10, orientation/clouding of sensorium (0-4, higher worse)" ) t = Column( "t", Float, comment="Temperature (degrees C)" ) hr = CamcopsColumn( "hr", Integer, permitted_value_checker=MIN_ZERO_CHECKER, comment="Heart rate (beats/minute)" ) sbp = CamcopsColumn( "sbp", Integer, permitted_value_checker=MIN_ZERO_CHECKER, comment="Systolic blood pressure (mmHg)" ) dbp = CamcopsColumn( "dbp", Integer, permitted_value_checker=MIN_ZERO_CHECKER, comment="Diastolic blood pressure (mmHg)" ) rr = CamcopsColumn( "rr", Integer, permitted_value_checker=MIN_ZERO_CHECKER, comment="Respiratory rate (breaths/minute)" ) MAX_SCORE = 67
[docs] @staticmethod def longname(req: "CamcopsRequest") -> str: _ = req.gettext return _("Clinical Institute Withdrawal Assessment for Alcohol " "Scale, Revised")
[docs] def get_trackers(self, req: CamcopsRequest) -> List[TrackerInfo]: return [TrackerInfo( value=self.total_score(), plot_label="CIWA total score", axis_label=f"Total score (out of {self.MAX_SCORE})", axis_min=-0.5, axis_max=self.MAX_SCORE + 0.5, horizontal_lines=[14.5, 7.5], horizontal_labels=[ TrackerLabel(17, req.sstring(SS.SEVERE)), TrackerLabel(11, req.sstring(SS.MODERATE)), TrackerLabel(3.75, req.sstring(SS.MILD)), ] )]
[docs] def get_clinical_text(self, req: CamcopsRequest) -> List[CtvInfo]: if not self.is_complete(): return CTV_INCOMPLETE return [CtvInfo( content=f"CIWA total score: {self.total_score()}/{self.MAX_SCORE}" )]
[docs] def get_summaries(self, req: CamcopsRequest) -> List[SummaryElement]: return self.standard_task_summary_fields() + [ SummaryElement(name="total", coltype=Integer(), value=self.total_score(), comment=f"Total score (/{self.MAX_SCORE})"), SummaryElement(name="severity", coltype=SummaryCategoryColType, value=self.severity(req), comment="Likely severity"), ]
[docs] def is_complete(self) -> bool: return (self.all_fields_not_none(self.SCORED_QUESTIONS) and self.field_contents_valid())
def total_score(self) -> int: return self.sum_fields(self.SCORED_QUESTIONS) def severity(self, req: CamcopsRequest) -> str: score = self.total_score() if score >= 15: severity = self.wxstring(req, "category_severe") elif score >= 8: severity = self.wxstring(req, "category_moderate") else: severity = self.wxstring(req, "category_mild") return severity
[docs] def get_task_html(self, req: CamcopsRequest) -> str: score = self.total_score() severity = self.severity(req) answer_dicts_dict = {} for q in self.SCORED_QUESTIONS: d = {None: None} for option in range(0, 8): if option > 4 and q == "q10": continue d[option] = self.wxstring(req, q + "_option" + str(option)) answer_dicts_dict[q] = d q_a = "" for q in range(1, Ciwa.NSCOREDQUESTIONS + 1): q_a += tr_qa( self.wxstring(req, "q" + str(q) + "_s"), get_from_dict(answer_dicts_dict["q" + str(q)], getattr(self, "q" + str(q))) ) tr_total_score = tr( req.sstring(SS.TOTAL_SCORE), answer(score) + f" / {self.MAX_SCORE}" ) tr_severity = tr_qa( self.wxstring(req, "severity") + " <sup>[1]</sup>", severity ) return f""" <div class="{CssClass.SUMMARY}"> <table class="{CssClass.SUMMARY}"> {self.get_is_complete_tr(req)} {tr_total_score} {tr_severity} </table> </div> <table class="{CssClass.TASKDETAIL}"> <tr> <th width="35%">Question</th> <th width="65%">Answer</th> </tr> {q_a} {subheading_spanning_two_columns( self.wxstring(req, "vitals_title"))} {tr_qa(self.wxstring(req, "t"), self.t)} {tr_qa(self.wxstring(req, "hr"), self.hr)} {tr(self.wxstring(req, "bp"), answer(self.sbp) + " / " + answer(self.dbp))} {tr_qa(self.wxstring(req, "rr"), self.rr)} </table> <div class="{CssClass.FOOTNOTES}"> [1] Total score ≥15 severe, ≥8 moderate, otherwise mild/minimal. </div> """
[docs] def get_snomed_codes(self, req: CamcopsRequest) -> List[SnomedExpression]: codes = [SnomedExpression(req.snomed(SnomedLookup.CIWA_AR_PROCEDURE_ASSESSMENT))] # noqa if self.is_complete(): codes.append(SnomedExpression( req.snomed(SnomedLookup.CIWA_AR_SCALE), { req.snomed(SnomedLookup.CIWA_AR_SCORE): self.total_score(), } )) return codes