Add interactive CCS case practice

2026-07-15 10:17:53 -05:00
parent d73fd5f2cf
commit 7256f93002
23 changed files with 1429 additions and 4 deletions
@@ -0,0 +1,87 @@
+using QuestionsApi.Models;
+using QuestionsApi.Services;
+using System.Text.Json;
+using Xunit;
+
+namespace QuestionsApi.Tests;
+
+public sealed class CcsCaseTests
+{
+    [Fact]
+    public void DkaImportArtifactMatchesTheCaseSchema()
+    {
+        var path = Path.GetFullPath(Path.Combine(AppContext.BaseDirectory, "../../../../../content/ccs/dka-emergency-001.json"));
+        var request = JsonSerializer.Deserialize<CcsImportRequest>(File.ReadAllText(path), new JsonSerializerOptions { PropertyNameCaseInsensitive = true });
+
+        Assert.NotNull(request);
+        Assert.Empty(CcsCaseValidator.ValidateImport(request!, new HashSet<string>()));
+        Assert.True(request!.Cases.Single().ScoringCriteria.Count >= 12);
+    }
+
+    [Fact]
+    public void PublishedCaseRequiresReferencesAndKnownOrders()
+    {
+        var request = ValidImport();
+        request.Cases[0].References = [];
+        request.Cases[0].OrderResponses.Add(new CcsCaseOrderDefinition { OrderCode = "unknown" });
+
+        var errors = CcsCaseValidator.ValidateImport(request, new HashSet<string>());
+
+        Assert.Contains(errors, value => value.Contains("reference", StringComparison.OrdinalIgnoreCase));
+        Assert.Contains(errors, value => value.Contains("unknown order code unknown"));
+    }
+
+    [Fact]
+    public void ScoringCreditsTimelySequencedCareAndPenalizesHarm()
+    {
+        var definition = ValidImport().Cases[0];
+        definition.ScoringCriteria =
+        [
+            new() { Id = "lab", ActionType = "order", TargetCode = "bmp", Points = 5, LatestMinute = 10, Rationale = "Check potassium." },
+            new() { Id = "insulin", ActionType = "order", TargetCode = "insulin", AfterTargetCode = "bmp", Points = 10, Rationale = "Start after potassium assessment." },
+            new() { Id = "bicarb", ActionType = "order", TargetCode = "bicarb", Points = -4, Rationale = "Avoid routine bicarbonate." }
+        ];
+        var attempt = new CcsAttempt { Actions =
+        [
+            new() { Type = "order", Code = "bmp", SimulatedMinute = 2 },
+            new() { Type = "order", Code = "insulin", SimulatedMinute = 4 },
+            new() { Type = "order", Code = "bicarb", SimulatedMinute = 5 }
+        ]};
+
+        var score = CcsStore.CalculateScore(attempt, definition);
+
+        Assert.Equal(11, score.EarnedPoints);
+        Assert.Equal(15, score.PossiblePoints);
+        Assert.Equal(73.3, score.Percent);
+        Assert.Contains(score.Criteria, value => value.CriterionId == "bicarb" && value.Status == "harmful");
+    }
+
+    [Fact]
+    public void ValidVersionedCasePassesValidation()
+    {
+        Assert.Empty(CcsCaseValidator.ValidateImport(ValidImport(), new HashSet<string>()));
+    }
+
+    private static CcsImportRequest ValidImport() => new()
+    {
+        Orders =
+        [
+            new() { Code = "bmp", CanonicalName = "Basic metabolic panel", Category = "laboratory" },
+            new() { Code = "insulin", CanonicalName = "Insulin infusion", Category = "medication" },
+            new() { Code = "bicarb", CanonicalName = "Sodium bicarbonate", Category = "medication" }
+        ],
+        Cases =
+        [
+            new()
+            {
+                ExternalId = "ccs-test-dka-001", Title = "Diabetic ketoacidosis", System = "Endocrine System",
+                PresentingLocation = "emergency_department", AllowedLocations = ["emergency_department", "icu"],
+                IsPublished = true, RealTimeMinutes = 20, Difficulty = 2,
+                InitialChart = new() { PatientSummary = "Adult with diabetes", ReasonForEncounter = "Vomiting" },
+                OrderResponses = [new() { OrderCode = "bmp", Result = "Potassium 4.9 mEq/L" }],
+                ScoringCriteria = [new() { Id = "lab", ActionType = "order", TargetCode = "bmp", Points = 5 }],
+                References = [new() { Title = "Consensus report", Publisher = "Example Society", Url = "https://example.org/consensus", Supports = "Case management and scoring", AccessedOn = "2026-07-15", Reviewer = "Question bank editorial review" }]
+            }
+        ]
+    };
+}