/*
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 "phq9.h"
#include "common/textconst.h"
#include "maths/mathfunc.h"
#include "lib/stringfunc.h"
#include "lib/uifunc.h"
#include "questionnairelib/questionnaire.h"
#include "questionnairelib/qumcq.h"
#include "questionnairelib/qumcqgrid.h"
#include "questionnairelib/qutext.h"
#include "tasklib/taskfactory.h"
#include "tasklib/taskregistrar.h"
using mathfunc::anyNull;
using mathfunc::sumInt;
using mathfunc::totalScorePhrase;
using stringfunc::strnum;
using stringfunc::strseq;
const int FIRST_Q = 1;
const int LAST_SCORED_Q = 9;
const int N_QUESTIONS = 10;
const int MAX_QUESTION_SCORE = 27;
const QString QPREFIX("q");
const QString Phq9::PHQ9_TABLENAME("phq9");
void initializePhq9(TaskFactory& factory)
{
static TaskRegistrar<Phq9> registered(factory);
}
Phq9::Phq9(CamcopsApp& app, DatabaseManager& db, const int load_pk) :
Task(app, db, PHQ9_TABLENAME, false, false, false), // ... anon, clin, resp
m_questionnaire(nullptr)
{
addFields(strseq(QPREFIX, FIRST_Q, N_QUESTIONS), QMetaType::fromType<int>());
load(load_pk); // MUST ALWAYS CALL from derived Task constructor.
}
// ============================================================================
// Class info
// ============================================================================
QString Phq9::shortname() const
{
return "PHQ-9";
}
QString Phq9::longname() const
{
return tr("Patient Health Questionnaire-9");
}
QString Phq9::description() const
{
return tr("Self-scoring of the 9 depressive symptoms in DSM-IV.");
}
// ============================================================================
// Instance info
// ============================================================================
bool Phq9::isComplete() const
{
if (anyNull(values(strseq(QPREFIX, FIRST_Q, LAST_SCORED_Q)))) {
return false;
}
if (value("q10").isNull()) {
if (totalScore() == 0) {
// You don't have to answer question 10 if the others are all
// complete with a score of zero.
return true;
}
return false;
}
return true;
}
QStringList Phq9::summary() const
{
return QStringList{totalScorePhrase(totalScore(), MAX_QUESTION_SCORE)};
}
QStringList Phq9::detail() const
{
using stringfunc::bold;
using uifunc::yesNo;
const int totalscore = totalScore();
const QString sev = severity(totalscore);
const int ncore = nCoreSymptoms();
const int nother = nOtherSymptoms();
const int ntotal = ncore + nother;
const bool mds = (ncore >= 1) && (ntotal >= 5);
const bool ods = (ncore >= 1) && (ntotal >= 2) && (ntotal <= 4);
// Scoring: ref PMID 10568646,
// http://www.phqscreeners.com/instructions/instructions.pdf
const QString spacer = " ";
QStringList lines = completenessInfo();
lines += fieldSummaries("q", "_s", spacer, QPREFIX, FIRST_Q, N_QUESTIONS);
lines.append("");
lines += summary();
lines.append("");
lines.append(xstring("mds") + spacer + bold(yesNo(mds)));
lines.append(xstring("ods") + spacer + bold(yesNo(ods)));
lines.append(xstring("depression_severity") + spacer + bold(sev));
return lines;
}
OpenableWidget* Phq9::editor(const bool read_only)
{
const NameValueOptions options_q1_9{
{xstring("a0"), 0},
{xstring("a1"), 1},
{xstring("a2"), 2},
{xstring("a3"), 3},
};
const NameValueOptions options_q10{
{xstring("fa0"), 0},
{xstring("fa1"), 1},
{xstring("fa2"), 2},
{xstring("fa3"), 3},
};
QuPagePtr page((new QuPage{
(new QuText(xstring("stem")))->setBold(true),
new QuMcqGrid(
{
QuestionWithOneField(xstring("q1"), fieldRef("q1")),
QuestionWithOneField(xstring("q2"), fieldRef("q2")),
QuestionWithOneField(xstring("q3"), fieldRef("q3")),
QuestionWithOneField(xstring("q4"), fieldRef("q4")),
QuestionWithOneField(xstring("q5"), fieldRef("q5")),
QuestionWithOneField(xstring("q6"), fieldRef("q6")),
QuestionWithOneField(xstring("q7"), fieldRef("q7")),
QuestionWithOneField(xstring("q8"), fieldRef("q8")),
QuestionWithOneField(xstring("q9"), fieldRef("q9")),
},
options_q1_9
),
(new QuText(xstring("finalq")))->setBold(true),
new QuMcq(fieldRef("q10"), options_q10),
})->setTitle(xstring("title_main")));
for (const QString& main_q_fieldname : strseq(QPREFIX,
FIRST_Q, LAST_SCORED_Q)) {
FieldRefPtr fr = fieldRef(main_q_fieldname);
connect(fr.data(), &FieldRef::valueChanged,
this, &Phq9::mainScoreChanged);
}
m_questionnaire = new Questionnaire(m_app, {page});
m_questionnaire->setType(QuPage::PageType::Patient);
m_questionnaire->setReadOnly(read_only);
mainScoreChanged();
return m_questionnaire;
}
// ============================================================================
// Task-specific calculations
// ============================================================================
int Phq9::totalScore() const
{
return sumInt(values(strseq(QPREFIX, FIRST_Q, LAST_SCORED_Q)));
}
int Phq9::nCoreSymptoms() const
{
int n = 0;
for (const QString& fieldname : strseq(QPREFIX, 1, 2)) {
if (valueInt(fieldname) >= 2) {
n += 1;
}
}
return n;
}
int Phq9::nOtherSymptoms() const
{
int n = 0;
for (const QString& fieldname : strseq(QPREFIX, 3, 8)) {
if (valueInt(fieldname) >= 2) {
n += 1;
}
}
if (valueInt(strnum(QPREFIX, 9)) >= 1) {
// Suicidality: counted WHENEVER present
n += 1;
}
return n;
}
QString Phq9::severity(const int score)
{
if (score >= 20) return TextConst::severe();
if (score >= 15) return TextConst::moderatelySevere();
if (score >= 10) return TextConst::moderate();
if (score >= 5) return TextConst::mild();
return TextConst::none();
}
void Phq9::mainScoreChanged()
{
// Question 10 is only mandatory if we're scoring above zero for
// the main questions (1-9).
if (!m_questionnaire) {
return;
}
const bool q10_mandatory = totalScore() > 0;
FieldRefPtr fr_q10 = fieldRef("q10");
fr_q10->setMandatory(q10_mandatory);
}