"""
camcops_server/tasks/slums.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 List, Optional
from sqlalchemy.sql.schema import Column
from sqlalchemy.sql.sqltypes import Integer, UnicodeText
from camcops_server.cc_modules.cc_blob import (
Blob,
blob_relationship,
get_blob_img_html,
)
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_html import (
answer,
get_yes_no_none,
subheading_spanning_two_columns,
td,
tr,
tr_qa,
)
from camcops_server.cc_modules.cc_request import CamcopsRequest
from camcops_server.cc_modules.cc_sqla_coltypes import (
BIT_CHECKER,
CamcopsColumn,
PermittedValueChecker,
SummaryCategoryColType,
ZERO_TO_THREE_CHECKER,
)
from camcops_server.cc_modules.cc_summaryelement import SummaryElement
from camcops_server.cc_modules.cc_task import (
Task,
TaskHasClinicianMixin,
TaskHasPatientMixin,
)
from camcops_server.cc_modules.cc_text import SS
from camcops_server.cc_modules.cc_trackerhelpers import (
TrackerInfo,
TrackerLabel,
)
# =============================================================================
# SLUMS
# =============================================================================
ZERO_OR_TWO_CHECKER = PermittedValueChecker(permitted_values=[0, 2])
[docs]class Slums(TaskHasClinicianMixin, TaskHasPatientMixin, Task):
"""
Server implementation of the SLUMS task.
"""
__tablename__ = "slums"
shortname = "SLUMS"
provides_trackers = True
alert = CamcopsColumn(
"alert",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Is the patient alert? (0 no, 1 yes)",
)
highschooleducation = CamcopsColumn(
"highschooleducation",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Does that patient have at least a high-school level of "
"education? (0 no, 1 yes)",
)
q1 = CamcopsColumn(
"q1",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q1 (day) (0-1)",
)
q2 = CamcopsColumn(
"q2",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q2 (year) (0-1)",
)
q3 = CamcopsColumn(
"q3",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q3 (state) (0-1)",
)
q5a = CamcopsColumn(
"q5a",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q5a (money spent) (0-1)",
)
q5b = CamcopsColumn(
"q5b",
Integer,
permitted_value_checker=ZERO_OR_TWO_CHECKER,
comment="Q5b (money left) (0 or 2)",
) # worth 2 points
q6 = CamcopsColumn(
"q6",
Integer,
permitted_value_checker=ZERO_TO_THREE_CHECKER,
comment="Q6 (animal naming) (0-3)",
) # from 0 to 3 points
q7a = CamcopsColumn(
"q7a",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q7a (recall apple) (0-1)",
)
q7b = CamcopsColumn(
"q7b",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q7b (recall pen) (0-1)",
)
q7c = CamcopsColumn(
"q7c",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q7c (recall tie) (0-1)",
)
q7d = CamcopsColumn(
"q7d",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q7d (recall house) (0-1)",
)
q7e = CamcopsColumn(
"q7e",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q7e (recall car) (0-1)",
)
q8b = CamcopsColumn(
"q8b",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q8b (reverse 648) (0-1)",
)
q8c = CamcopsColumn(
"q8c",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q8c (reverse 8537) (0-1)",
)
q9a = CamcopsColumn(
"q9a",
Integer,
permitted_value_checker=ZERO_OR_TWO_CHECKER,
comment="Q9a (clock - hour markers) (0 or 2)",
) # worth 2 points
q9b = CamcopsColumn(
"q9b",
Integer,
permitted_value_checker=ZERO_OR_TWO_CHECKER,
comment="Q9b (clock - time) (0 or 2)",
) # worth 2 points
q10a = CamcopsColumn(
"q10a",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q10a (X in triangle) (0-1)",
)
q10b = CamcopsColumn(
"q10b",
Integer,
permitted_value_checker=BIT_CHECKER,
comment="Q10b (biggest figure) (0-1)",
)
q11a = CamcopsColumn(
"q11a",
Integer,
permitted_value_checker=ZERO_OR_TWO_CHECKER,
comment="Q11a (story - name) (0 or 2)",
) # worth 2 points
q11b = CamcopsColumn(
"q11b",
Integer,
permitted_value_checker=ZERO_OR_TWO_CHECKER,
comment="Q11b (story - occupation) (0 or 2)",
) # worth 2 points
q11c = CamcopsColumn(
"q11c",
Integer,
permitted_value_checker=ZERO_OR_TWO_CHECKER,
comment="Q11c (story - back to work) (0 or 2)",
) # worth 2 points
q11d = CamcopsColumn(
"q11d",
Integer,
permitted_value_checker=ZERO_OR_TWO_CHECKER,
comment="Q11d (story - state) (0 or 2)",
) # worth 2 points
clockpicture_blobid = CamcopsColumn(
"clockpicture_blobid",
Integer,
is_blob_id_field=True,
blob_relationship_attr_name="clockpicture",
comment="BLOB ID of clock picture",
)
shapespicture_blobid = CamcopsColumn(
"shapespicture_blobid",
Integer,
is_blob_id_field=True,
blob_relationship_attr_name="shapespicture",
comment="BLOB ID of shapes picture",
)
comments = Column("comments", UnicodeText, comment="Clinician's comments")
clockpicture = blob_relationship(
"Slums", "clockpicture_blobid"
) # type: Optional[Blob]
shapespicture = blob_relationship(
"Slums", "shapespicture_blobid"
) # type: Optional[Blob]
PREAMBLE_FIELDS = ["alert", "highschooleducation"]
SCORED_FIELDS = [
"q1",
"q2",
"q3",
"q5a",
"q5b",
"q6",
"q7a",
"q7b",
"q7c",
"q7d",
"q7e",
"q8b",
"q8c",
"q9a",
"q9b",
"q10a",
"q10b",
"q11a",
"q11b",
"q11c",
"q11d",
]
MAX_SCORE = 30
[docs] @staticmethod
def longname(req: "CamcopsRequest") -> str:
_ = req.gettext
return _("St Louis University Mental Status")
[docs] def get_trackers(self, req: CamcopsRequest) -> List[TrackerInfo]:
if self.highschooleducation == 1:
hlines = [26.5, 20.5]
y_upper = 28.25
y_middle = 23.5
else:
hlines = [24.5, 19.5]
y_upper = 27.25
y_middle = 22
return [
TrackerInfo(
value=self.total_score(),
plot_label="SLUMS 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=hlines,
horizontal_labels=[
TrackerLabel(y_upper, req.sstring(SS.NORMAL)),
TrackerLabel(y_middle, self.wxstring(req, "category_mci")),
TrackerLabel(17, self.wxstring(req, "category_dementia")),
],
)
]
[docs] def get_clinical_text(self, req: CamcopsRequest) -> List[CtvInfo]:
if not self.is_complete():
return CTV_INCOMPLETE
return [
CtvInfo(
content=f"SLUMS total score "
f"{self.total_score()}/{self.MAX_SCORE} "
f"({self.category(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="category",
coltype=SummaryCategoryColType,
value=self.category(req),
comment="Category",
),
]
[docs] def is_complete(self) -> bool:
return (
self.all_fields_not_none(self.PREAMBLE_FIELDS + self.SCORED_FIELDS)
and self.field_contents_valid()
)
def total_score(self) -> int:
return self.sum_fields(self.SCORED_FIELDS)
def category(self, req: CamcopsRequest) -> str:
score = self.total_score()
if self.highschooleducation == 1:
if score >= 27:
return req.sstring(SS.NORMAL)
elif score >= 21:
return self.wxstring(req, "category_mci")
else:
return self.wxstring(req, "category_dementia")
else:
if score >= 25:
return req.sstring(SS.NORMAL)
elif score >= 20:
return self.wxstring(req, "category_mci")
else:
return self.wxstring(req, "category_dementia")
[docs] def get_task_html(self, req: CamcopsRequest) -> str:
score = self.total_score()
category = self.category(req)
h = """
{clinician_comments}
<div class="{CssClass.SUMMARY}">
<table class="{CssClass.SUMMARY}">
{tr_is_complete}
{total_score}
{category}
</table>
</div>
<table class="{CssClass.TASKDETAIL}">
<tr>
<th width="80%">Question</th>
<th width="20%">Score</th>
</tr>
""".format(
clinician_comments=self.get_standard_clinician_comments_block(
req, self.comments
),
CssClass=CssClass,
tr_is_complete=self.get_is_complete_tr(req),
total_score=tr(
req.sstring(SS.TOTAL_SCORE),
answer(score) + f" / {self.MAX_SCORE}",
),
category=tr_qa(
req.sstring(SS.CATEGORY) + " <sup>[1]</sup>", category
),
)
h += tr_qa(
self.wxstring(req, "alert_s"), get_yes_no_none(req, self.alert)
)
h += tr_qa(
self.wxstring(req, "highschool_s"),
get_yes_no_none(req, self.highschooleducation),
)
h += tr_qa(self.wxstring(req, "q1_s"), self.q1)
h += tr_qa(self.wxstring(req, "q2_s"), self.q2)
h += tr_qa(self.wxstring(req, "q3_s"), self.q3)
h += tr(
"Q5 <sup>[2]</sup> (money spent, money left " "[<i>scores 2</i>]",
", ".join(answer(x) for x in (self.q5a, self.q5b)),
)
h += tr_qa(
"Q6 (animal fluency) [<i>≥15 scores 3, 10–14 scores 2, "
"5–9 scores 1, 0–4 scores 0</i>]",
self.q6,
)
h += tr(
"Q7 (recall: apple, pen, tie, house, car)",
", ".join(
answer(x)
for x in (self.q7a, self.q7b, self.q7c, self.q7d, self.q7e)
),
)
h += tr(
"Q8 (backwards: 648, 8537)",
", ".join(answer(x) for x in (self.q8b, self.q8c)),
)
h += tr(
"Q9 (clock: hour markers, time [<i>score 2 each</i>]",
", ".join(answer(x) for x in (self.q9a, self.q9b)),
)
h += tr(
"Q10 (X in triangle; which is biggest?)",
", ".join(answer(x) for x in (self.q10a, self.q10b)),
)
h += tr(
"Q11 (story: Female’s name? Job? When back to work? "
"State she lived in? [<i>score 2 each</i>])",
", ".join(
answer(x) for x in (self.q11a, self.q11b, self.q11c, self.q11d)
),
)
h += f"""
</table>
<table class="{CssClass.TASKDETAIL}">
"""
h += subheading_spanning_two_columns("Images of tests: clock, shapes")
# noinspection PyTypeChecker
h += tr(
td(
get_blob_img_html(self.clockpicture),
td_width="50%",
td_class=CssClass.PHOTO,
),
td(
get_blob_img_html(self.shapespicture),
td_width="50%",
td_class=CssClass.PHOTO,
),
literal=True,
)
h += f"""
</table>
<div class="{CssClass.FOOTNOTES}">
[1] With high school education:
≥27 normal, ≥21 MCI, ≤20 dementia.
Without high school education:
≥25 normal, ≥20 MCI, ≤19 dementia.
(Tariq et al. 2006, PubMed ID 17068312.)
[2] Q4 (learning the five words) isn’t scored.
</div>
"""
return h