Add graphical duodenal ulcer interview

2026-08-05 23:14:51 -05:00
parent 7709d16018
commit 58dd370149
14 changed files with 768 additions and 29 deletions
@@ -50,10 +50,16 @@ public sealed class CcsStore
            await _orders.ReplaceOneAsync(value => value.Code == order.Code, order, new ReplaceOptions { IsUpsert = true });
        }
        var created = 0;
+        var skipped = 0;
        foreach (var incoming in request.Cases)
        {
            var current = await _cases.Find(value => value.ExternalId == incoming.ExternalId && value.IsCurrent)
                .SortByDescending(value => value.Version).FirstOrDefaultAsync();
+            if (current is not null && CaseContentDocument(current).Equals(CaseContentDocument(incoming)))
+            {
+                skipped++;
+                continue;
+            }
            if (current is not null)
                await _cases.UpdateOneAsync(value => value.Id == current.Id, Builders<CcsCaseRevision>.Update.Set(value => value.IsCurrent, false));
            incoming.Id = null;
@@ -63,7 +69,17 @@ public sealed class CcsStore
            await _cases.InsertOneAsync(incoming);
            created++;
        }
-        return new CcsImportResponse { OrdersUpserted = request.Orders.Count, CasesCreated = created };
+        return new CcsImportResponse { OrdersUpserted = request.Orders.Count, CasesCreated = created, CasesSkipped = skipped };
+    }
+
+    internal static BsonDocument CaseContentDocument(CcsCaseRevision value)
+    {
+        var document = value.ToBsonDocument();
+        document.Remove("_id");
+        document.Remove(nameof(CcsCaseRevision.Version));
+        document.Remove(nameof(CcsCaseRevision.IsCurrent));
+        document.Remove(nameof(CcsCaseRevision.CreatedUtc));
+        return document;
    }

    public async Task<List<CcsCaseSummary>> ListCasesAsync() =>
@@ -109,6 +125,7 @@ public sealed class CcsStore
        if (definition is null) throw new KeyNotFoundException("CCS case not found.");
        var now = DateTime.UtcNow;
        var interview = EffectiveInterview(definition);
+        var interviewStartNodeId = definition.InitialInterview.Topics.Count > 0 ? "opening" : interview.StartNodeId;
        var attempt = new CcsAttempt
        {
            UserId = userId,
@@ -118,7 +135,7 @@ public sealed class CcsStore
            CaseVersion = definition.Version,
            Mode = CcsAttemptModes.Timed,
            OpeningCompleted = false,
-            InterviewNodeId = interview.StartNodeId,
+            InterviewNodeId = interviewStartNodeId,
            Location = definition.PresentingLocation,
            CurrentVitals = new Dictionary<string, string>(definition.InitialChart.Vitals),
            VitalHistory =
@@ -126,9 +143,11 @@ public sealed class CcsStore
                new CcsVitalSnapshot { SimulatedMinute = 0, Values = new Dictionary<string, string>(definition.InitialChart.Vitals) }
            ],
            ActiveOrderCodes = definition.InitialChart.InitialOrderCodes.Distinct(StringComparer.OrdinalIgnoreCase).ToList(),
-            DeadlineUtc = now.AddMinutes(ActivePhaseMinutes(definition.RealTimeMinutes)),
-            HardDeadlineUtc = now.AddMinutes(definition.RealTimeMinutes),
-            RatingEligible = true,
+            DeadlineUtc = definition.ExperienceMode == CcsExperienceModes.GraphicalInterview
+                ? null : now.AddMinutes(ActivePhaseMinutes(definition.RealTimeMinutes)),
+            HardDeadlineUtc = definition.ExperienceMode == CcsExperienceModes.GraphicalInterview
+                ? null : now.AddMinutes(definition.RealTimeMinutes),
+            RatingEligible = definition.ExperienceMode != CcsExperienceModes.GraphicalInterview,
            Chart =
            [
                new CcsChartEntry { Category = CcsChartCategories.Progress, Code = "reason_for_encounter", Title = "Reason for encounter", Text = definition.InitialChart.ReasonForEncounter },
@@ -416,9 +435,7 @@ public sealed class CcsStore
            ? attempt.VitalHistory
            : [new CcsVitalSnapshot { SimulatedMinute = attempt.SimulatedMinute, Values = new Dictionary<string, string>(attempt.CurrentVitals) }];
        CcsInterviewStateResponse? interview = null;
-        var interviewDefinition = EffectiveInterview(definition);
-        var currentInterviewNode = interviewDefinition.Nodes.FirstOrDefault(value =>
-            value.Id.Equals(attempt.InterviewNodeId, StringComparison.OrdinalIgnoreCase));
+        var currentInterviewNode = CurrentInterviewNode(attempt, definition);
        if (currentInterviewNode is not null)
        {
            interview = new CcsInterviewStateResponse
@@ -440,9 +457,13 @@ public sealed class CcsStore
            FinalOrdersDeadlineUtc = attempt.FinalOrdersDeadlineUtc,
            CreatedUtc = attempt.CreatedUtc, RealTimeMinutes = definition.RealTimeMinutes,
            ElapsedSeconds = Math.Max(0, (int)Math.Round(((attempt.CompletedUtc ?? DateTime.UtcNow) - attempt.CreatedUtc).TotalSeconds)),
+            ExperienceMode = definition.ExperienceMode, GraphicalPresentation = definition.GraphicalPresentation,
            PatientSummary = definition.InitialChart.PatientSummary, ReasonForEncounter = definition.InitialChart.ReasonForEncounter,
-            Appearance = definition.InitialChart.Appearance, History = definition.InitialChart.History,
-            HistorySections = definition.InitialChart.HistorySections,
+            Appearance = definition.InitialChart.Appearance,
+            History = definition.ExperienceMode == CcsExperienceModes.GraphicalInterview && !completed
+                ? "" : definition.InitialChart.History,
+            HistorySections = definition.ExperienceMode == CcsExperienceModes.GraphicalInterview && !completed
+                ? [] : definition.InitialChart.HistorySections,
            Vitals = attempt.CurrentVitals, Chart = attempt.Chart, ActiveOrderCodes = attempt.ActiveOrderCodes,
            ActiveOrders = activeOrders, VitalHistory = vitalHistory,
            PendingResults = attempt.PendingResults.Select(value => new CcsPendingResult
@@ -452,6 +473,8 @@ public sealed class CcsStore
            AvailableExams = attempt.State == CcsAttemptStates.Active ? definition.Exams : [],
            AllowedLocations = attempt.State == CcsAttemptStates.Active ? definition.AllowedLocations : [],
            Interview = interview,
+            InterviewDebrief = completed && definition.ExperienceMode == CcsExperienceModes.GraphicalInterview
+                ? definition.InitialInterview.Debrief : null,
            Score = completed ? attempt.Score : null, Rating = completed ? attempt.Rating : null,
            References = completed ? definition.References : []
        };
@@ -460,6 +483,11 @@ public sealed class CcsStore
    public static void ApplyDialogueChoice(CcsAttempt attempt, CcsCaseRevision definition, string choiceId, DateTime now)
    {
        if (attempt.OpeningCompleted == true) throw new InvalidOperationException("The initial interview is already complete.");
+        if (definition.InitialInterview.Topics.Count > 0)
+        {
+            ApplyTopicChoice(attempt, definition.InitialInterview, choiceId, now);
+            return;
+        }
        var interview = EffectiveInterview(definition);
        var node = interview.Nodes.FirstOrDefault(value =>
            value.Id.Equals(attempt.InterviewNodeId, StringComparison.OrdinalIgnoreCase))
@@ -730,9 +758,73 @@ public sealed class CcsStore
        ExternalId = value.ExternalId, Title = value.Title, System = value.System,
        PresentingLocation = value.PresentingLocation, RealTimeMinutes = value.RealTimeMinutes,
        Difficulty = value.Difficulty, Tags = value.Tags,
-        InteractiveInterviewAvailable = EffectiveInterview(value).Nodes.Count > 0
+        InteractiveInterviewAvailable = value.InitialInterview.Topics.Count > 0 || EffectiveInterview(value).Nodes.Count > 0,
+        GraphicalPresentationAvailable = !string.IsNullOrWhiteSpace(value.GraphicalPresentation.SceneKey)
+            && !string.IsNullOrWhiteSpace(value.GraphicalPresentation.PatientAssetKey),
+        ExperienceMode = value.ExperienceMode, GraphicalPresentation = value.GraphicalPresentation
    };

+    internal static CcsDialogueNode? CurrentInterviewNode(CcsAttempt attempt, CcsCaseRevision definition)
+    {
+        var topicInterview = definition.InitialInterview;
+        if (topicInterview.Topics.Count > 0)
+        {
+            if (attempt.InterviewNodeId.Equals("complete", StringComparison.OrdinalIgnoreCase))
+                return new CcsDialogueNode
+                {
+                    Id = "complete", PatientText = topicInterview.ClosingPatientText, IsTerminal = true
+                };
+            var patientText = attempt.InterviewNodeId.Equals("opening", StringComparison.OrdinalIgnoreCase)
+                ? topicInterview.OpeningPatientText
+                : topicInterview.Topics.FirstOrDefault(value =>
+                    value.Id.Equals(attempt.InterviewNodeId, StringComparison.OrdinalIgnoreCase))?.PatientText;
+            if (string.IsNullOrWhiteSpace(patientText)) return null;
+            var visited = attempt.InterviewChoiceIds.ToHashSet(StringComparer.OrdinalIgnoreCase);
+            var choices = topicInterview.Topics.Where(value => !visited.Contains(value.Id)
+                    && value.PrerequisiteTopicIds.All(visited.Contains))
+                .Select(value => new CcsDialogueChoice
+                {
+                    Id = value.Id, Text = value.ClinicianText, NextNodeId = value.Id
+                }).ToList();
+            if (topicInterview.Topics.Where(value => value.Required).All(value => visited.Contains(value.Id)))
+                choices.Add(new CcsDialogueChoice
+                {
+                    Id = "finish_interview", Text = topicInterview.FinishChoiceText, NextNodeId = "complete"
+                });
+            return new CcsDialogueNode
+            {
+                Id = attempt.InterviewNodeId, PatientText = patientText, Choices = choices
+            };
+        }
+        var interview = EffectiveInterview(definition);
+        return interview.Nodes.FirstOrDefault(value =>
+            value.Id.Equals(attempt.InterviewNodeId, StringComparison.OrdinalIgnoreCase));
+    }
+
+    private static void ApplyTopicChoice(CcsAttempt attempt, CcsInitialInterview interview, string choiceId, DateTime now)
+    {
+        if (choiceId.Equals("finish_interview", StringComparison.OrdinalIgnoreCase))
+        {
+            var visited = attempt.InterviewChoiceIds.ToHashSet(StringComparer.OrdinalIgnoreCase);
+            if (!interview.Topics.Where(value => value.Required).All(value => visited.Contains(value.Id)))
+                throw new ArgumentException("Complete the core interview topics before finishing.");
+            attempt.Actions.Add(Action("dialogue_choice", "finish_interview", attempt.SimulatedMinute, now));
+            attempt.InterviewChoiceIds.Add("finish_interview");
+            attempt.InterviewNodeId = "complete";
+            attempt.OpeningCompleted = true;
+            return;
+        }
+        var topic = interview.Topics.FirstOrDefault(value => value.Id.Equals(choiceId, StringComparison.OrdinalIgnoreCase))
+            ?? throw new ArgumentException("The dialogue choice is not available at the current interview node.");
+        if (attempt.InterviewChoiceIds.Contains(topic.Id, StringComparer.OrdinalIgnoreCase))
+            throw new ArgumentException("That interview topic has already been covered.");
+        if (!topic.PrerequisiteTopicIds.All(value => attempt.InterviewChoiceIds.Contains(value, StringComparer.OrdinalIgnoreCase)))
+            throw new ArgumentException("That interview topic is not available yet.");
+        attempt.Actions.Add(Action("dialogue_choice", topic.Id, attempt.SimulatedMinute, now));
+        attempt.InterviewChoiceIds.Add(topic.Id);
+        attempt.InterviewNodeId = topic.Id;
+    }
+
    internal static CcsInitialInterview EffectiveInterview(CcsCaseRevision definition)
    {
        if (!string.IsNullOrWhiteSpace(definition.InitialInterview.StartNodeId)