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Rebuild CCS case workflow

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hz
2026-07-23 04:43:02 -05:00
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docs/CCS_CASE_AUTHORING.md
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@@ -6,16 +6,21 @@ Use `content/ccs/dka-emergency-001.json` as the canonical example. Set `validate
## Case structure
- `initialChart` defines the opening history, appearance, vitals, location, simulated start, and standing orders.
- `initialChart` defines the opening history, appearance, vitals, simulated start, and standing orders. Use ordered `historySections` (`code`, `title`, `text`) for the HPI, medical history, medications, allergies, family/social history, and review of systems. The legacy `history` field remains the fallback.
- `allowedLocations` controls patient movement.
- `exams` defines selectable examination components and their simulated duration.
- `orderResponses` maps reusable catalog codes to case-specific results, delays, and vital-sign changes.
- Catalog orders may define `displayRoute`, `displayFrequency`, and `resultSection`. These are presentation defaults, not user-entered dosing instructions.
- `orderResponses` maps reusable catalog codes to case-specific results, delays, vital-sign changes, and an optional result-section override.
- `events` defines timed progression. `requiresOrderCodes` requires every listed order; `requiresAnyOrderCodes` supports equivalent alternatives.
- `scoringCriteria` awards or subtracts points for timing, sequence, and harmful care. `targetCodes` supports clinically equivalent actions; `afterTargetCode` enforces sequence.
- `references` stores the source title, publisher, HTTPS URL, supported claims, access date, and reviewer inside each case revision.
Order codes and event/criterion IDs must be stable lowercase identifiers. Case content should not expose the diagnosis in the opening chart or rely on unstructured text matching for scoring. Add aliases to the order catalog so users can find an order using common clinical wording.
## Scoring and prediction
Valid result sections are `lab`, `imaging`, `other_test`, and `treatment`; progress notes, vital snapshots, and the order sheet are generated by the runtime.
Practice attempts are scored for feedback but do not affect prediction. Only the first completed timed attempt for each distinct case contributes to the CCS estimate. The combined provisional prediction uses the latest Day 1 simulation and a separately reported CCS estimate; it is not presented as an official USMLE scoring formula.
## Timing, scoring, and prediction
New CCS attempts are timed. `realTimeMinutes` is the total wall-clock allowance: the runtime reserves its final two minutes for final orders, so a 20-minute case has 18 minutes of active management plus two minutes of case-end orders. Opening dialogs count against this limit and reconnecting does not pause it.
Only the first completed timed attempt for each distinct case contributes to the CCS estimate. Legacy practice attempts remain reviewable but cannot be newly created. The combined provisional prediction uses the latest Day 1 simulation and a separately reported CCS estimate; it is not presented as an official USMLE scoring formula.