dr.js

'use strict';

import mongoose from 'mongoose';

const STATUS = ['registered', 'partial', 'final', 'corrected', 'appended', 'cancelled', 'entered-in-error'];

const REQUEST = ['DiagnosticOrder', 'ProcedureRequest'];

/*
 * AU  -> Audiology                            |  NRS -> Nursing Service Measures
 * BG  -> Blood Gases                          |  OSL -> Outside Lab
 * BLB -> Blood Bank                           |  OT  -> Occupational Therapy
 * CG  -> Cytogenetics                         |  OTH -> Other
 * CH  -> Chemistry                            |  OUS -> OB Ultrasound
 * CP  -> Cytopathology                        |  PF  -> Pulmonary Function
 * CT  -> CAT Scan                             |  PHR -> Pharmacy
 * CTH -> Cardiac Catheterization              |  PHY -> Physician (Hx.Dx,admission note,etc)
 * CUS -> Cardiac Ultrasound                   |  PT  -> Physical Therapy
 * EC  -> Electrocardiac(e.g.EKG,EEC,Holter)   |  RAD -> Radiology
 * EN  -> Electroneuro (EEG, EMG,EP,PSG)       |  RC  -> Respiratory Care (therapy)
 * GE  -> Genetics                             |  RT  -> Radiation Therapy
 * HM  -> Hematology                           |  RUS -> Radiology Ultrasound
 * ICU -> Bedside ICU Monitoring               |  RX  -> Radiograph
 * IMM -> Immunology                           |  SP  -> Surgical Pathology
 * LAB -> Laboratory                           |  SR  -> Serology
 * MB -> Microbiology                          |  TX  -> Toxicology
 * MCB -> Mycobacteriology                     |  VR  -> Virology
 * MYC -> Mycology                             |  VUS -> Vascular Ultrasound
 * NMR -> Nuclear Magnetic Resonance           |  XRC ->	Cineradiograph
 * NMS -> Nuclear Medicine Scan
 */

const CATEGORY = ['AU', 'BG', 'BLB', 'CG', 'CH', 'CP', 'CT', 'CTH', 'CUS', 'EC', 'EN', 'GE', 'HM', 'ICU', 'IMM', 'LAB',
  'MB', 'MCB', 'MYC', 'NMR', 'NMS', 'NRS', 'OSL', 'OT', 'OTH', 'OUS', 'PF', 'PHR', 'PHY', 'PT', 'RAD',
  'RC', 'RT', 'RUS', 'RX', 'SP', 'SR', 'TX', 'VR', 'VUS', 'XRC'];

/*
 * <   ->	Off scale low                      |  N     -> Normal
 * >   ->	Off scale high                     |  ND    -> Not Detected
 * A	 -> Abnormal                           |  NEG	  -> Negative
 * AA	 -> Critically abnormal                |  NR	  -> Non-reactive
 * B   ->	Better                             |  NS	  -> Non-susceptible
 * D	 -> Significant change down            |  POS	  -> Positive
 * DET ->	Detected                           |  R	    -> Resistant
 * H   ->	High                               |  RR	  -> Reactive
 * HH	 -> Critically high                    |  S	    -> Susceptible
 * HU	 -> Very high                          |  SDD	  -> Susceptible-dose dependent
 * I   ->	Intermediate                       |  SYN-R	-> Synergy - resistant
 * IE	 -> Insufficient evidence              |  SYN-S	-> Synergy - susceptible
 * IND ->	Indeterminate                      |  U	    -> Significant change up
 * L	 -> Low                                |  VS    -> Very susceptible. (IFMSO)**
 * LL	 -> Critically low                     |  W	    -> Worse
 * LU	 -> Very low                           |  WR   	-> Weakly reactive
 * MS	 -> Moderately susceptible (IFMSO)**   |

 ** IFMSO:  Indicates for microbiology susceptibilities only
 */
const INTERPRETATION = ["<", ">", "A", "AA", "B", "D", "DET", "H", "HH", "HU", "I", "IE", "IND", "L", "LL", "LU", "MS",
  "N", "ND", "NEG", "NR", "NS", "POS", "R", "RR", "S", "SDD", "SYN-R", "SYN-S", "U", "VS", "W", "WR"];

const ObservationSchema = new mongoose.Schema({
  //TODO loinc codes for Observation codes.
  code: {type: mongoose.Schema.Types.ObjectId, ref: 'ObservationCode'},
  effective: {type: Date},
  //TODO Decide whether a single type of value is going, or is flexible and Unit.
  value: {type: String},
  interpretation: {type: String, enum: INTERPRETATION},
  comments: {type: String},
  // TODO get codes from https://www.hl7.org/fhir/valueset-observation-methods.html
  method: {type: String}
});

const SpecimenSchema = new mongoose.Schema({});

const DiagnosticReportSchema = new mongoose.Schema({
  status: {type: String, required: true, enum: STATUS},
  category: {type: String, required: true, enum: CATEGORY},
  code: {type: mongoose.Schema.Types.ObjectId, ref: 'Procedure', required: true},
  subject: {type: mongoose.Schema.Types.ObjectId, ref: 'Patient', required: true},
  effectiveDate: {type: Date, required: true},
  issued: {type: Date, required: true},
  performer: {type: mongoose.Schema.Types.ObjectId, ref: 'Practitioner'},
  request: [{
    kind: {type: String, enum: REQUEST},
    item: {type: mongoose.Schema.Types.ObjectId, refPath: 'request.kind'},
    _id: false
  }],
  observation: [{type: ObservationSchema}],
  specimen: [{type: SpecimenSchema}],
  image: [{link: String, comment: String, _id: false}],
  conclusion: {type: String},
  codedDiagnosis: [{type: mongoose.Schema.Types.ObjectId, ref: 'Disease', _id: false}]
});

export default mongoose.model('DiagnosticReport', DiagnosticReportSchema);