Source code for camcops_server.tasks.gad7

#!/usr/bin/env python

"""
camcops_server/tasks/gad7.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.sqltypes import 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, 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 SummaryCategoryColType
from camcops_server.cc_modules.cc_summaryelement import SummaryElement
from camcops_server.cc_modules.cc_task import (
    get_from_dict,
    Task,
    TaskHasPatientMixin,
)
from camcops_server.cc_modules.cc_text import SS
from camcops_server.cc_modules.cc_trackerhelpers import (
    TrackerInfo,
    TrackerLabel,
)


# =============================================================================
# GAD-7
# =============================================================================

class Gad7Metaclass(DeclarativeMeta):
    # noinspection PyInitNewSignature
    def __init__(cls: Type['Gad7'],
                 name: str,
                 bases: Tuple[Type, ...],
                 classdict: Dict[str, Any]) -> None:
        add_multiple_columns(
            cls, "q", 1, cls.NQUESTIONS,
            minimum=0, maximum=3,
            comment_fmt="Q{n}, {s} (0 not at all - 3 nearly every day)",
            comment_strings=[
                "nervous/anxious/on edge",
                "can't stop/control worrying",
                "worrying too much about different things",
                "trouble relaxing",
                "restless",
                "irritable",
                "afraid"
            ]
        )
        super().__init__(name, bases, classdict)


[docs]class Gad7(TaskHasPatientMixin, Task, metaclass=Gad7Metaclass): """ Server implementation of the GAD-7 task. """ __tablename__ = "gad7" shortname = "GAD-7" provides_trackers = True NQUESTIONS = 7 TASK_FIELDS = strseq("q", 1, NQUESTIONS) MAX_SCORE = 21
[docs] @staticmethod def longname(req: "CamcopsRequest") -> str: _ = req.gettext return _("Generalized Anxiety Disorder Assessment")
[docs] def get_trackers(self, req: CamcopsRequest) -> List[TrackerInfo]: return [TrackerInfo( value=self.total_score(), plot_label="GAD-7 total score", axis_label="Total score (out of 21)", axis_min=-0.5, axis_max=self.MAX_SCORE + 0.5, horizontal_lines=[14.5, 9.5, 4.5], horizontal_labels=[ TrackerLabel(17, req.sstring(SS.SEVERE)), TrackerLabel(12, req.sstring(SS.MODERATE)), TrackerLabel(7, req.sstring(SS.MILD)), TrackerLabel(2.25, req.sstring(SS.NONE)), ] )]
[docs] def get_clinical_text(self, req: CamcopsRequest) -> List[CtvInfo]: if not self.is_complete(): return CTV_INCOMPLETE return [CtvInfo(content=( f"GAD-7 total score {self.total_score()}/{self.MAX_SCORE} " f"({self.severity(req)})" ))]
[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="Severity"), ]
[docs] def is_complete(self) -> bool: return ( self.all_fields_not_none(self.TASK_FIELDS) and self.field_contents_valid() )
def total_score(self) -> int: return self.sum_fields(self.TASK_FIELDS) def severity(self, req: CamcopsRequest) -> str: score = self.total_score() if score >= 15: severity = req.sstring(SS.SEVERE) elif score >= 10: severity = req.sstring(SS.MODERATE) elif score >= 5: severity = req.sstring(SS.MILD) else: severity = req.sstring(SS.NONE) return severity
[docs] def get_task_html(self, req: CamcopsRequest) -> str: score = self.total_score() severity = self.severity(req) answer_dict = {None: None} for option in range(0, 4): answer_dict[option] = ( str(option) + " — " + self.wxstring(req, "a" + str(option)) ) q_a = "" for q in range(1, self.NQUESTIONS + 1): q_a += tr_qa( self.wxstring(req, "q" + str(q)), get_from_dict(answer_dict, getattr(self, "q" + str(q))) ) return """ <div class="{CssClass.SUMMARY}"> <table class="{CssClass.SUMMARY}"> {tr_is_complete} {total_score} {anxiety_severity} </table> </div> <div class="{CssClass.EXPLANATION}"> Ratings are over the last 2 weeks. </div> <table class="{CssClass.TASKDETAIL}"> <tr> <th width="50%">Question</th> <th width="50%">Answer</th> </tr> {q_a} </table> <div class="{CssClass.FOOTNOTES}"> [1] ≥15 severe, ≥10 moderate, ≥5 mild. Score ≥10 identifies: generalized anxiety disorder with sensitivity 89%, specificity 82% (Spitzer et al. 2006, PubMed ID 16717171); panic disorder with sensitivity 74%, specificity 81% (Kroenke et al. 2010, PMID 20633738); social anxiety with sensitivity 72%, specificity 80% (Kroenke et al. 2010); post-traumatic stress disorder with sensitivity 66%, specificity 81% (Kroenke et al. 2010). The majority of evidence contributing to these figures comes from primary care screening studies. </div> """.format( CssClass=CssClass, tr_is_complete=self.get_is_complete_tr(req), total_score=tr( req.sstring(SS.TOTAL_SCORE), answer(score) + " / {}".format(self.MAX_SCORE) ), anxiety_severity=tr( self.wxstring(req, "anxiety_severity") + " <sup>[1]</sup>", severity ), q_a=q_a, )
[docs] def get_snomed_codes(self, req: CamcopsRequest) -> List[SnomedExpression]: codes = [SnomedExpression(req.snomed(SnomedLookup.GAD7_PROCEDURE_ASSESSMENT))] # noqa if self.is_complete(): codes.append(SnomedExpression( req.snomed(SnomedLookup.GAD7_SCALE), { req.snomed(SnomedLookup.GAD7_SCORE): self.total_score(), } )) return codes