#!/usr/bin/env python
"""
camcops_server/tasks/phq15.py
===============================================================================
Copyright (C) 2012, University of Cambridge, Department of Psychiatry.
Created by Rudolf Cardinal (rnc1001@cam.ac.uk).
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 <https://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, get_yes_no, 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,
)
# =============================================================================
# PHQ-15
# =============================================================================
class Phq15Metaclass(DeclarativeMeta):
# noinspection PyInitNewSignature
def __init__(
cls: Type["Phq15"],
name: str,
bases: Tuple[Type, ...],
classdict: Dict[str, Any],
) -> None:
add_multiple_columns(
cls,
"q",
1,
cls.NQUESTIONS,
minimum=0,
maximum=2,
comment_fmt="Q{n} ({s}) (0 not bothered at all - "
"2 bothered a lot)",
comment_strings=[
"stomach pain",
"back pain",
"limb/joint pain",
"F - menstrual",
"headaches",
"chest pain",
"dizziness",
"fainting",
"palpitations",
"breathless",
"sex",
"constipation/diarrhoea",
"nausea/indigestion",
"energy",
"sleep",
],
)
super().__init__(name, bases, classdict)
[docs]class Phq15(TaskHasPatientMixin, Task, metaclass=Phq15Metaclass):
"""
Server implementation of the PHQ-15 task.
"""
__tablename__ = "phq15"
shortname = "PHQ-15"
provides_trackers = True
NQUESTIONS = 15
MAX_TOTAL = 30
ONE_TO_THREE = strseq("q", 1, 3)
FIVE_TO_END = strseq("q", 5, NQUESTIONS)
TASK_FIELDS = strseq("q", 1, NQUESTIONS)
[docs] @staticmethod
def longname(req: "CamcopsRequest") -> str:
_ = req.gettext
return _("Patient Health Questionnaire-15")
# noinspection PyUnresolvedReferences
[docs] def is_complete(self) -> bool:
if not self.field_contents_valid():
return False
if self.any_fields_none(self.ONE_TO_THREE):
return False
if self.any_fields_none(self.FIVE_TO_END):
return False
if self.is_female():
return self.q4 is not None
else:
return True
[docs] def get_trackers(self, req: CamcopsRequest) -> List[TrackerInfo]:
return [
TrackerInfo(
value=self.total_score(),
plot_label="PHQ-15 total score (rating somatic symptoms)",
axis_label=f"Score for Q1-15 (out of {self.MAX_TOTAL})",
axis_min=-0.5,
axis_max=self.MAX_TOTAL + 0.5,
horizontal_lines=[14.5, 9.5, 4.5],
horizontal_labels=[
TrackerLabel(22, 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"PHQ-15 total score "
f"{self.total_score()}/{self.MAX_TOTAL} "
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_TOTAL})",
),
SummaryElement(
name="severity",
coltype=SummaryCategoryColType,
value=self.severity(req),
comment="Severity",
),
]
def total_score(self) -> int:
return self.sum_fields(self.TASK_FIELDS)
def num_severe(self) -> int:
n = 0
for i in range(1, self.NQUESTIONS + 1):
value = getattr(self, "q" + str(i))
if value is not None and value >= 2:
n += 1
return n
def severity(self, req: CamcopsRequest) -> str:
score = self.total_score()
if score >= 15:
return req.sstring(SS.SEVERE)
elif score >= 10:
return req.sstring(SS.MODERATE)
elif score >= 5:
return req.sstring(SS.MILD)
else:
return req.sstring(SS.NONE)
[docs] def get_task_html(self, req: CamcopsRequest) -> str:
score = self.total_score()
nsevere = self.num_severe()
somatoform_likely = nsevere >= 3
severity = self.severity(req)
answer_dict = {None: None}
for option in range(0, 3):
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))),
)
h = """
<div class="{CssClass.SUMMARY}">
<table class="{CssClass.SUMMARY}">
{tr_is_complete}
{total_score}
{n_severe_symptoms}
{exceeds_somatoform_cutoff}
{symptom_severity}
</table>
</div>
<table class="{CssClass.TASKDETAIL}">
<tr>
<th width="70%">Question</th>
<th width="30%">Answer</th>
</tr>
{q_a}
</table>
<div class="{CssClass.FOOTNOTES}">
[1] In males, maximum score is actually 28.
[2] Questions with scores ≥2 are considered severe.
[3] ≥3 severe symptoms.
[4] Total score ≥15 severe, ≥10 moderate, ≥5 mild,
otherwise none.
</div>
""".format(
CssClass=CssClass,
tr_is_complete=self.get_is_complete_tr(req),
total_score=tr(
req.sstring(SS.TOTAL_SCORE) + " <sup>[1]</sup>",
answer(score) + f" / {self.MAX_TOTAL}",
),
n_severe_symptoms=tr_qa(
self.wxstring(req, "n_severe_symptoms") + " <sup>[2]</sup>",
nsevere,
),
exceeds_somatoform_cutoff=tr_qa(
self.wxstring(req, "exceeds_somatoform_cutoff")
+ " <sup>[3]</sup>",
get_yes_no(req, somatoform_likely),
),
symptom_severity=tr_qa(
self.wxstring(req, "symptom_severity") + " <sup>[4]</sup>",
severity,
),
q_a=q_a,
)
return h
[docs] def get_snomed_codes(self, req: CamcopsRequest) -> List[SnomedExpression]:
procedure = req.snomed(SnomedLookup.PHQ15_PROCEDURE)
codes = [SnomedExpression(procedure)]
if self.is_complete():
scale = req.snomed(SnomedLookup.PHQ15_SCALE)
score = req.snomed(SnomedLookup.PHQ15_SCORE)
codes.append(SnomedExpression(scale, {score: self.total_score()}))
return codes