/*
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/>.
*/
#include "icd10schizophrenia.h"
#include "common/appstrings.h"
#include "common/textconst.h"
#include "lib/datetime.h"
#include "lib/stringfunc.h"
#include "lib/uifunc.h"
#include "maths/mathfunc.h"
#include "questionnairelib/commonoptions.h"
#include "questionnairelib/qudatetime.h"
#include "questionnairelib/questionnaire.h"
#include "questionnairelib/quheading.h"
#include "questionnairelib/qumcqgrid.h"
#include "questionnairelib/qutext.h"
#include "questionnairelib/qutextedit.h"
#include "tasklib/taskfactory.h"
#include "tasklib/taskregistrar.h"
using datetime::shortDate;
using mathfunc::countNull;
using mathfunc::countTrue;
using mathfunc::falseNotNull;
using stringfunc::standardResult;
using uifunc::yesNoUnknown;
const QString Icd10Schizophrenia::ICD10SZ_TABLENAME("icd10schizophrenia");
const QString PASSIVITY_BODILY("passivity_bodily");
const QString PASSIVITY_MENTAL("passivity_mental");
const QString HV_COMMENTARY("hv_commentary");
const QString HV_DISCUSSING("hv_discussing");
const QString HV_FROM_BODY("hv_from_body");
const QString DELUSIONS("delusions");
const QString DELUSIONAL_PERCEPTION("delusional_perception");
const QString THOUGHT_ECHO("thought_echo");
const QString THOUGHT_WITHDRAWAL("thought_withdrawal");
const QString THOUGHT_INSERTION("thought_insertion");
const QString THOUGHT_BROADCASTING("thought_broadcasting");
const QStringList A_NAMES{
PASSIVITY_BODILY,
PASSIVITY_MENTAL,
HV_COMMENTARY,
HV_DISCUSSING,
HV_FROM_BODY,
DELUSIONS,
DELUSIONAL_PERCEPTION,
THOUGHT_ECHO,
THOUGHT_WITHDRAWAL,
THOUGHT_INSERTION,
THOUGHT_BROADCASTING,
};
const QString HALLUCINATIONS_OTHER("hallucinations_other");
const QString THOUGHT_DISORDER("thought_disorder");
const QString CATATONIA("catatonia");
const QStringList B_NAMES{
HALLUCINATIONS_OTHER,
THOUGHT_DISORDER,
CATATONIA,
};
const QString NEGATIVE("negative");
const QStringList C_NAMES{
NEGATIVE,
};
const QString PRESENT_ONE_MONTH("present_one_month");
const QStringList D_NAMES{
PRESENT_ONE_MONTH,
};
const QString ALSO_MANIC("also_manic");
const QString ALSO_DEPRESSIVE("also_depressive");
const QString IF_MOOD_PSYCHOSIS_FIRST("if_mood_psychosis_first");
const QStringList E_NAMES{
ALSO_MANIC,
ALSO_DEPRESSIVE,
IF_MOOD_PSYCHOSIS_FIRST,
};
const QString NOT_ORGANIC_OR_SUBSTANCE("not_organic_or_substance");
const QStringList F_NAMES{
NOT_ORGANIC_OR_SUBSTANCE,
};
const QString BEHAVIOUR_CHANGE("behaviour_change");
const QString PERFORMANCE_DECLINE("performance_decline");
const QStringList G_NAMES{
BEHAVIOUR_CHANGE,
PERFORMANCE_DECLINE,
};
const QString SUBTYPE_PARANOID("subtype_paranoid");
const QString SUBTYPE_HEBEPHRENIC("subtype_hebephrenic");
const QString SUBTYPE_CATATONIC("subtype_catatonic");
const QString SUBTYPE_UNDIFFERENTIATED("subtype_undifferentiated");
const QString SUBTYPE_POSTSCHIZOPHRENIC_DEPRESSION(
"subtype_postschizophrenic_depression"
);
const QString SUBTYPE_RESIDUAL("subtype_residual");
const QString SUBTYPE_SIMPLE("subtype_simple");
const QString SUBTYPE_CENESTHOPATHIC("subtype_cenesthopathic");
const QStringList H_NAMES{
SUBTYPE_PARANOID,
SUBTYPE_HEBEPHRENIC,
SUBTYPE_CATATONIC,
SUBTYPE_UNDIFFERENTIATED,
SUBTYPE_POSTSCHIZOPHRENIC_DEPRESSION,
SUBTYPE_RESIDUAL,
SUBTYPE_SIMPLE,
SUBTYPE_CENESTHOPATHIC,
};
const QString DATE_PERTAINS_TO("date_pertains_to");
const QString COMMENTS("comments");
const QStringList INFORMATIVE
= (A_NAMES + B_NAMES + C_NAMES + D_NAMES + E_NAMES + F_NAMES + G_NAMES
); // but not H
void initializeIcd10Schizophrenia(TaskFactory& factory)
{
static TaskRegistrar<Icd10Schizophrenia> registered(factory);
}
Icd10Schizophrenia::Icd10Schizophrenia(
CamcopsApp& app, DatabaseManager& db, const int load_pk
) :
Task(app, db, ICD10SZ_TABLENAME, false, true, false)
// ... anon, clin, resp
{
addFields(A_NAMES, QMetaType::fromType<bool>());
addFields(B_NAMES, QMetaType::fromType<bool>());
addFields(C_NAMES, QMetaType::fromType<bool>());
addFields(D_NAMES, QMetaType::fromType<bool>());
addFields(E_NAMES, QMetaType::fromType<bool>());
addFields(F_NAMES, QMetaType::fromType<bool>());
addFields(G_NAMES, QMetaType::fromType<bool>());
addFields(H_NAMES, QMetaType::fromType<bool>());
addField(DATE_PERTAINS_TO, QMetaType::fromType<QDate>());
addField(COMMENTS, QMetaType::fromType<QString>());
load(load_pk); // MUST ALWAYS CALL from derived Task constructor.
// Extra initialization:
if (load_pk == dbconst::NONEXISTENT_PK) {
setValue(DATE_PERTAINS_TO, datetime::nowDate(), false);
}
}
// ============================================================================
// Class info
// ============================================================================
QString Icd10Schizophrenia::shortname() const
{
return "ICD10-schizophrenia";
}
QString Icd10Schizophrenia::longname() const
{
return tr("ICD-10 criteria for schizophrenia (F20)");
}
QString Icd10Schizophrenia::description() const
{
return TextConst::icd10();
}
QString Icd10Schizophrenia::infoFilenameStem() const
{
return "icd";
}
// ============================================================================
// Instance info
// ============================================================================
bool Icd10Schizophrenia::isComplete() const
{
return !valueIsNull(DATE_PERTAINS_TO) && !meetsGeneralCriteria().isNull();
}
QStringList Icd10Schizophrenia::summary() const
{
return QStringList{
standardResult(
appstring(appstrings::DATE_PERTAINS_TO),
shortDate(value(DATE_PERTAINS_TO))
),
standardResult(
xstring("meets_general_criteria"),
yesNoUnknown(meetsGeneralCriteria())
),
};
}
QStringList Icd10Schizophrenia::detail() const
{
QStringList lines = completenessInfo();
lines.append(standardResult(
appstring(appstrings::DATE_PERTAINS_TO),
shortDate(value(DATE_PERTAINS_TO))
));
lines.append(fieldSummary(COMMENTS, TextConst::examinerComments()));
lines.append("");
for (const QString& fieldname :
(A_NAMES + B_NAMES + C_NAMES + D_NAMES + E_NAMES + F_NAMES + G_NAMES
+ H_NAMES)) {
lines.append(fieldSummary(fieldname, xstring(fieldname)));
}
lines.append("");
lines += standardResult(
xstring("meets_general_criteria"), yesNoUnknown(meetsGeneralCriteria())
);
return lines;
}
OpenableWidget* Icd10Schizophrenia::editor(const bool read_only)
{
const NameValueOptions true_false_options
= CommonOptions::falseTrueBoolean();
const NameValueOptions present_absent_options
= CommonOptions::absentPresentBoolean();
auto heading = [this](const QString& xstringname) -> QuElement* {
return new QuHeading(xstring(xstringname));
};
auto text = [this](const QString& xstringname) -> QuElement* {
return new QuText(xstring(xstringname));
};
auto grid = [this, &true_false_options, &present_absent_options](
const QStringList& fields_xstrings, bool present_absent
) -> QuElement* {
// Assumes the xstring name matches the fieldname (as it does)
const NameValueOptions& options
= present_absent ? present_absent_options : true_false_options;
QVector<QuestionWithOneField> qfields;
for (const QString& fieldname : fields_xstrings) {
qfields.append(QuestionWithOneField(
xstring(fieldname), fieldRef(fieldname, false)
));
}
const int n = options.size();
const QVector<int> v(n, 1);
return (new QuMcqGrid(qfields, options))
->setExpand(true)
->setWidth(n, v);
};
QuPagePtr page((new QuPage{
getClinicianQuestionnaireBlockRawPointer(),
new QuText(appstring(appstrings::DATE_PERTAINS_TO)),
(new QuDateTime(fieldRef(DATE_PERTAINS_TO)))
->setMode(QuDateTime::Mode::DefaultDate)
->setOfferNowButton(true),
text("comments"),
heading("core"),
grid(A_NAMES, true),
heading("other_positive"),
grid(B_NAMES, true),
heading("negative_title"),
grid(C_NAMES, true),
heading("other_criteria"),
grid(D_NAMES, false),
text("duration_comment"),
grid(E_NAMES, false),
text("affective_comment"),
grid(F_NAMES, false),
heading("simple_title"),
grid(G_NAMES, true),
heading("subtypes"),
grid(H_NAMES, true),
new QuHeading(TextConst::comments()),
new QuTextEdit(fieldRef(COMMENTS, false)),
})
->setTitle(longname()));
for (const QString& fieldname : INFORMATIVE) {
connect(
fieldRef(fieldname).data(),
&FieldRef::valueChanged,
this,
&Icd10Schizophrenia::updateMandatory
);
}
updateMandatory();
auto questionnaire = new Questionnaire(m_app, {page});
questionnaire->setType(QuPage::PageType::Clinician);
questionnaire->setReadOnly(read_only);
return questionnaire;
}
// ============================================================================
// Task-specific calculations
// ============================================================================
QVariant Icd10Schizophrenia::meetsGeneralCriteria() const
{
const QVector<QVariant> va = values(A_NAMES);
const QVector<QVariant> vb = values(B_NAMES);
const QVector<QVariant> vc = values(C_NAMES);
const int t1 = countTrue(va); // t for true
const int u1 = countNull(va); // u for unknown
const int t2 = countTrue(vb) + countTrue(vc);
const int u2 = countNull(vb) + countNull(vc);
if (t1 + u1 < 1 && t2 + u2 < 2) {
// Not schizophrenia: insufficient symptoms
return false;
}
if (falseNotNull(value(PRESENT_ONE_MONTH))) {
// Not schizophrenia: not present for long enough
return false;
}
if ((valueBool(ALSO_MANIC) || valueBool(ALSO_DEPRESSIVE))
&& falseNotNull(value(IF_MOOD_PSYCHOSIS_FIRST))) {
// Not schizophrenia: affective disorder preceded psychosis
return false;
}
if (falseNotNull(value(NOT_ORGANIC_OR_SUBSTANCE))) {
// Not schizophrenia: organic or substance-induced, instead
return false;
}
const bool symptoms = t1 >= 1 || t2 >= 2;
const bool duration = valueBool(PRESENT_ONE_MONTH);
const bool no_mood_exclusion = (falseNotNull(value(ALSO_MANIC))
&& falseNotNull(value(ALSO_DEPRESSIVE)))
|| valueBool(IF_MOOD_PSYCHOSIS_FIRST);
// ... (not manic AND not depressed) OR (if mood, psychosis came first)
const bool no_organic_substance_exclusion
= valueBool(NOT_ORGANIC_OR_SUBSTANCE);
if (symptoms && duration && no_mood_exclusion
&& no_organic_substance_exclusion) {
// Positive diagnosis of schizophrenia
return true;
}
// Uncertain; return NULL
return QVariant();
}
// ============================================================================
// Signal handlers
// ============================================================================
void Icd10Schizophrenia::updateMandatory()
{
const bool known = !meetsGeneralCriteria().isNull();
const bool need = !known;
for (const QString& fieldname : INFORMATIVE) {
fieldRef(fieldname)->setMandatory(need, this);
}
}