Source code for camcops_server.tasks.phq15

"""
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