From de22042e23741c8725dead138cd611405c3520a9 Mon Sep 17 00:00:00 2001 From: Aakash Singh Date: Tue, 28 May 2024 16:08:40 +0530 Subject: [PATCH] Symptoms table (#2186) * consultation depth backend Co-authored-by: Rithvik Nishad Co-authored-by: Aakash Singh * refactor * fix migrations * fix test and dummy data * add is_migrated field * add created by to symptoms bulk create * fix discharge summary * make onset date non nullable * fixes unknown field excluded * fix tests * fix validations * update bulk migration to exclude symptom if already created earlier for a consultation * add clinical_impression_status to indicate symptom status * update migrations * review suggestions * add trigger for marked as errors * fix validation * fix updates * rename consultation symptom to encounter symptom * fix unable to mark as entered in error * update discharge summary pdf * add test cases and minor fixes * allow create symptoms to be empty * update migration to ignore asymptomatic symptom * rebase migrations --------- Co-authored-by: Hritesh Shanty Co-authored-by: Rithvik Nishad Co-authored-by: rithviknishad --- care/facility/api/serializers/daily_round.py | 5 +- .../api/serializers/encounter_symptom.py | 126 +++++ .../api/serializers/patient_consultation.py | 77 +++- care/facility/api/serializers/patient_icmr.py | 4 +- .../api/viewsets/encounter_symptom.py | 57 +++ care/facility/api/viewsets/patient.py | 4 - .../management/commands/load_event_types.py | 25 +- .../migrations/0439_encounter_symptoms.py | 263 +++++++++++ care/facility/models/__init__.py | 1 + care/facility/models/daily_round.py | 6 +- care/facility/models/encounter_symptom.py | 94 ++++ care/facility/models/patient_consultation.py | 18 +- care/facility/models/patient_icmr.py | 21 +- .../tests/test_encounter_symptom_api.py | 431 ++++++++++++++++++ .../tests/test_patient_consultation_api.py | 19 +- .../utils/reports/discharge_summary.py | 6 + .../patient_discharge_summary_pdf.html | 63 ++- care/utils/tests/test_utils.py | 14 +- config/api_router.py | 2 + data/dummy/facility.json | 78 ---- 20 files changed, 1154 insertions(+), 160 deletions(-) create mode 100644 care/facility/api/serializers/encounter_symptom.py create mode 100644 care/facility/api/viewsets/encounter_symptom.py create mode 100644 care/facility/migrations/0439_encounter_symptoms.py create mode 100644 care/facility/models/encounter_symptom.py create mode 100644 care/facility/tests/test_encounter_symptom_api.py diff --git a/care/facility/api/serializers/daily_round.py b/care/facility/api/serializers/daily_round.py index 0ec6bda9af..eea3e21d61 100644 --- a/care/facility/api/serializers/daily_round.py +++ b/care/facility/api/serializers/daily_round.py @@ -14,7 +14,7 @@ from care.facility.models.bed import Bed from care.facility.models.daily_round import DailyRound from care.facility.models.notification import Notification -from care.facility.models.patient_base import SYMPTOM_CHOICES, SuggestionChoices +from care.facility.models.patient_base import SuggestionChoices from care.facility.models.patient_consultation import PatientConsultation from care.users.api.serializers.user import UserBaseMinimumSerializer from care.utils.notification_handler import NotificationGenerator @@ -24,9 +24,6 @@ class DailyRoundSerializer(serializers.ModelSerializer): id = serializers.CharField(source="external_id", read_only=True) - additional_symptoms = serializers.MultipleChoiceField( - choices=SYMPTOM_CHOICES, required=False - ) deprecated_covid_category = ChoiceField( choices=COVID_CATEGORY_CHOICES, required=False ) # Deprecated diff --git a/care/facility/api/serializers/encounter_symptom.py b/care/facility/api/serializers/encounter_symptom.py new file mode 100644 index 0000000000..858ab7f9c8 --- /dev/null +++ b/care/facility/api/serializers/encounter_symptom.py @@ -0,0 +1,126 @@ +from copy import copy + +from django.db import transaction +from django.utils.timezone import now +from rest_framework import serializers + +from care.facility.events.handler import create_consultation_events +from care.facility.models.encounter_symptom import ( + ClinicalImpressionStatus, + EncounterSymptom, + Symptom, +) +from care.users.api.serializers.user import UserBaseMinimumSerializer + + +class EncounterSymptomSerializer(serializers.ModelSerializer): + id = serializers.UUIDField(source="external_id", read_only=True) + created_by = UserBaseMinimumSerializer(read_only=True) + updated_by = UserBaseMinimumSerializer(read_only=True) + + class Meta: + model = EncounterSymptom + exclude = ( + "consultation", + "external_id", + "deleted", + ) + read_only_fields = ( + "created_date", + "modified_date", + "is_migrated", + ) + + def validate_onset_date(self, value): + if value and value > now(): + raise serializers.ValidationError("Onset date cannot be in the future") + return value + + def validate(self, attrs): + validated_data = super().validate(attrs) + consultation = ( + self.instance.consultation + if self.instance + else self.context["consultation"] + ) + + onset_date = ( + self.instance.onset_date + if self.instance + else validated_data.get("onset_date") + ) + if cure_date := validated_data.get("cure_date"): + if cure_date < onset_date: + raise serializers.ValidationError( + {"cure_date": "Cure date should be after onset date"} + ) + + if validated_data.get("symptom") != Symptom.OTHERS and validated_data.get( + "other_symptom" + ): + raise serializers.ValidationError( + { + "other_symptom": "Other symptom should be empty when symptom type is not OTHERS" + } + ) + + if validated_data.get("symptom") == Symptom.OTHERS and not validated_data.get( + "other_symptom" + ): + raise serializers.ValidationError( + { + "other_symptom": "Other symptom should not be empty when symptom type is OTHERS" + } + ) + + if EncounterSymptom.objects.filter( + consultation=consultation, + symptom=validated_data.get("symptom"), + other_symptom=validated_data.get("other_symptom") or "", + cure_date__isnull=True, + clinical_impression_status=ClinicalImpressionStatus.IN_PROGRESS, + ).exists(): + raise serializers.ValidationError( + {"symptom": "An active symptom with the same details already exists"} + ) + + return validated_data + + def create(self, validated_data): + validated_data["consultation"] = self.context["consultation"] + validated_data["created_by"] = self.context["request"].user + + with transaction.atomic(): + instance: EncounterSymptom = super().create(validated_data) + + create_consultation_events( + instance.consultation_id, + instance, + instance.created_by_id, + instance.created_date, + ) + + return instance + + def update(self, instance, validated_data): + validated_data["updated_by"] = self.context["request"].user + + with transaction.atomic(): + old_instance = copy(instance) + instance = super().update(instance, validated_data) + + create_consultation_events( + instance.consultation_id, + instance, + instance.updated_by_id, + instance.modified_date, + old=old_instance, + ) + + return instance + + +class EncounterCreateSymptomSerializer(serializers.ModelSerializer): + class Meta: + model = EncounterSymptom + fields = ("symptom", "other_symptom", "onset_date", "cure_date") diff --git a/care/facility/api/serializers/patient_consultation.py b/care/facility/api/serializers/patient_consultation.py index ad0cd8ece3..e08a80ea78 100644 --- a/care/facility/api/serializers/patient_consultation.py +++ b/care/facility/api/serializers/patient_consultation.py @@ -19,6 +19,10 @@ ConsultationDiagnosisSerializer, ) from care.facility.api.serializers.daily_round import DailyRoundSerializer +from care.facility.api.serializers.encounter_symptom import ( + EncounterCreateSymptomSerializer, + EncounterSymptomSerializer, +) from care.facility.api.serializers.facility import FacilityBasicInfoSerializer from care.facility.events.handler import create_consultation_events from care.facility.models import ( @@ -32,13 +36,17 @@ ) from care.facility.models.asset import AssetLocation from care.facility.models.bed import Bed, ConsultationBed +from care.facility.models.encounter_symptom import ( + ClinicalImpressionStatus, + EncounterSymptom, + Symptom, +) from care.facility.models.icd11_diagnosis import ( ConditionVerificationStatus, ConsultationDiagnosis, ) from care.facility.models.notification import Notification from care.facility.models.patient_base import ( - SYMPTOM_CHOICES, NewDischargeReasonEnum, RouteToFacility, SuggestionChoices, @@ -66,7 +74,6 @@ class PatientConsultationSerializer(serializers.ModelSerializer): source="suggestion", ) - symptoms = serializers.MultipleChoiceField(choices=SYMPTOM_CHOICES) deprecated_covid_category = ChoiceField( choices=COVID_CATEGORY_CHOICES, required=False ) @@ -151,7 +158,13 @@ class PatientConsultationSerializer(serializers.ModelSerializer): help_text="Bulk create diagnoses for the consultation upon creation", ) diagnoses = ConsultationDiagnosisSerializer(many=True, read_only=True) - + create_symptoms = EncounterCreateSymptomSerializer( + many=True, + write_only=True, + required=False, + help_text="Bulk create symptoms for the consultation upon creation", + ) + symptoms = EncounterSymptomSerializer(many=True, read_only=True) medico_legal_case = serializers.BooleanField(default=False, required=False) def get_discharge_prescription(self, consultation): @@ -332,6 +345,7 @@ def create(self, validated_data): raise ValidationError({"route_to_facility": "This field is required"}) create_diagnosis = validated_data.pop("create_diagnoses") + create_symptoms = validated_data.pop("create_symptoms") action = -1 review_interval = -1 if "action" in validated_data: @@ -407,6 +421,19 @@ def create(self, validated_data): ] ) + symptoms = EncounterSymptom.objects.bulk_create( + EncounterSymptom( + consultation=consultation, + symptom=obj.get("symptom"), + onset_date=obj.get("onset_date"), + cure_date=obj.get("cure_date"), + clinical_impression_status=obj.get("clinical_impression_status"), + other_symptom=obj.get("other_symptom") or "", + created_by=self.context["request"].user, + ) + for obj in create_symptoms + ) + if bed and consultation.suggestion == SuggestionChoices.A: consultation_bed = ConsultationBed( bed=bed, @@ -444,7 +471,7 @@ def create(self, validated_data): create_consultation_events( consultation.id, - (consultation, *diagnosis), + (consultation, *diagnosis, *symptoms), consultation.created_by.id, consultation.created_date, ) @@ -502,6 +529,45 @@ def validate_create_diagnoses(self, value): return value + def validate_create_symptoms(self, value): + if self.instance: + raise ValidationError("Bulk create symptoms is not allowed on update") + + counter: set[int | str] = set() + for obj in value: + item: int | str = obj["symptom"] + if obj["symptom"] == Symptom.OTHERS: + other_symptom = obj.get("other_symptom") + if not other_symptom: + raise ValidationError( + { + "other_symptom": "Other symptom should not be empty when symptom type is OTHERS" + } + ) + item: str = other_symptom.strip().lower() + if item in counter: + # Reject if duplicate symptoms are provided + raise ValidationError("Duplicate symptoms are not allowed") + counter.add(item) + + current_time = now() + for obj in value: + if obj["onset_date"] > current_time: + raise ValidationError( + {"onset_date": "Onset date cannot be in the future"} + ) + + if cure_date := obj.get("cure_date"): + if cure_date < obj["onset_date"]: + raise ValidationError( + {"cure_date": "Cure date should be after onset date"} + ) + obj["clinical_impression_status"] = ClinicalImpressionStatus.COMPLETED + else: + obj["clinical_impression_status"] = ClinicalImpressionStatus.IN_PROGRESS + + return value + def validate_encounter_date(self, value): if value < MIN_ENCOUNTER_DATE: raise ValidationError( @@ -623,6 +689,9 @@ def validate(self, attrs): if not self.instance and "create_diagnoses" not in validated: raise ValidationError({"create_diagnoses": ["This field is required."]}) + if not self.instance and "create_symptoms" not in validated: + raise ValidationError({"create_symptoms": ["This field is required."]}) + return validated diff --git a/care/facility/api/serializers/patient_icmr.py b/care/facility/api/serializers/patient_icmr.py index e252ea4631..b90b5645dc 100644 --- a/care/facility/api/serializers/patient_icmr.py +++ b/care/facility/api/serializers/patient_icmr.py @@ -1,6 +1,6 @@ from rest_framework import serializers -from care.facility.models import DISEASE_CHOICES, SAMPLE_TYPE_CHOICES, SYMPTOM_CHOICES +from care.facility.models import DISEASE_CHOICES, SAMPLE_TYPE_CHOICES from care.facility.models.patient_icmr import ( PatientConsultationICMR, PatientIcmr, @@ -124,7 +124,7 @@ class Meta: class ICMRMedicalConditionSerializer(serializers.ModelSerializer): date_of_onset_of_symptoms = serializers.DateField() - symptoms = serializers.ListSerializer(child=ChoiceField(choices=SYMPTOM_CHOICES)) + symptoms = serializers.ListSerializer(child=serializers.CharField()) hospitalization_date = serializers.DateField() hospital_phone_number = serializers.CharField( source="consultation.facility.phone_number" diff --git a/care/facility/api/viewsets/encounter_symptom.py b/care/facility/api/viewsets/encounter_symptom.py new file mode 100644 index 0000000000..3f49cef2de --- /dev/null +++ b/care/facility/api/viewsets/encounter_symptom.py @@ -0,0 +1,57 @@ +from django.shortcuts import get_object_or_404 +from django_filters import rest_framework as filters +from dry_rest_permissions.generics import DRYPermissions +from rest_framework.permissions import IsAuthenticated +from rest_framework.viewsets import ModelViewSet + +from care.facility.api.serializers.encounter_symptom import EncounterSymptomSerializer +from care.facility.models.encounter_symptom import ( + ClinicalImpressionStatus, + EncounterSymptom, +) +from care.utils.queryset.consultation import get_consultation_queryset + + +class EncounterSymptomFilter(filters.FilterSet): + is_cured = filters.BooleanFilter(method="filter_is_cured") + + def filter_is_cured(self, queryset, name, value): + if value: + return queryset.filter(cure_date__isnull=False) + return queryset.filter(cure_date__isnull=True) + + +class EncounterSymptomViewSet(ModelViewSet): + serializer_class = EncounterSymptomSerializer + permission_classes = (IsAuthenticated, DRYPermissions) + queryset = EncounterSymptom.objects.all() + filter_backends = (filters.DjangoFilterBackend,) + filterset_class = EncounterSymptomFilter + lookup_field = "external_id" + + def get_consultation_obj(self): + return get_object_or_404( + get_consultation_queryset(self.request.user).filter( + external_id=self.kwargs["consultation_external_id"] + ) + ) + + def get_queryset(self): + consultation = self.get_consultation_obj() + return self.queryset.filter(consultation_id=consultation.id) + + def get_serializer_context(self): + context = super().get_serializer_context() + context["consultation"] = self.get_consultation_obj() + return context + + def perform_destroy(self, instance): + serializer = self.get_serializer( + instance, + data={ + "clinical_impression_status": ClinicalImpressionStatus.ENTERED_IN_ERROR + }, + partial=True, + ) + serializer.is_valid(raise_exception=True) + self.perform_update(serializer) diff --git a/care/facility/api/viewsets/patient.py b/care/facility/api/viewsets/patient.py index a79360d76c..36748513ec 100644 --- a/care/facility/api/viewsets/patient.py +++ b/care/facility/api/viewsets/patient.py @@ -178,9 +178,6 @@ def filter_by_category(self, queryset, name, value): last_consultation_discharge_date = filters.DateFromToRangeFilter( field_name="last_consultation__discharge_date" ) - last_consultation_symptoms_onset_date = filters.DateFromToRangeFilter( - field_name="last_consultation__symptoms_onset_date" - ) last_consultation_admitted_bed_type_list = MultiSelectFilter( method="filter_by_bed_type", ) @@ -449,7 +446,6 @@ class PatientViewSet( "last_vaccinated_date", "last_consultation_encounter_date", "last_consultation_discharge_date", - "last_consultation_symptoms_onset_date", ] CSV_EXPORT_LIMIT = 7 diff --git a/care/facility/management/commands/load_event_types.py b/care/facility/management/commands/load_event_types.py index f0cc50d186..7e5d689f48 100644 --- a/care/facility/management/commands/load_event_types.py +++ b/care/facility/management/commands/load_event_types.py @@ -33,14 +33,6 @@ class Command(BaseCommand): { "name": "CLINICAL", "children": ( - { - "name": "SYMPTOMS", - "fields": ( - "symptoms", - "other_symptoms", - "symptoms_onset_date", - ), - }, { "name": "DEATH", "fields": ("death_datetime", "death_confirmed_doctor"), @@ -108,10 +100,6 @@ class Command(BaseCommand): "review_after", ), "children": ( - { - "name": "ROUND_SYMPTOMS", # todo resolve clash with consultation symptoms - "fields": ("additional_symptoms",), - }, { "name": "PHYSICAL_EXAMINATION", "fields": ("physical_examination_info",), @@ -239,12 +227,25 @@ class Command(BaseCommand): "model": "ConsultationDiagnosis", "fields": ("diagnosis", "verification_status", "is_principal"), }, + { + "name": "SYMPTOMS", + "model": "EncounterSymptom", + "fields": ( + "symptom", + "other_symptom", + "onset_date", + "cure_date", + "clinical_impression_status", + ), + }, ) inactive_event_types: Tuple[str, ...] = ( "RESPIRATORY", "INTAKE_OUTPUT", "VENTILATOR_MODES", + "SYMPTOMS", + "ROUND_SYMPTOMS", "TREATING_PHYSICIAN", ) diff --git a/care/facility/migrations/0439_encounter_symptoms.py b/care/facility/migrations/0439_encounter_symptoms.py new file mode 100644 index 0000000000..67f9b17f45 --- /dev/null +++ b/care/facility/migrations/0439_encounter_symptoms.py @@ -0,0 +1,263 @@ +# Generated by Django 4.2.10 on 2024-05-17 10:52 + +import uuid + +import django.db.models.deletion +from django.conf import settings +from django.core.paginator import Paginator +from django.db import migrations, models + +import care.facility.models.mixins.permissions.patient + + +def backfill_symptoms_table(apps, schema_editor): + EncounterSymptom = apps.get_model("facility", "EncounterSymptom") + PatientConsultation = apps.get_model("facility", "PatientConsultation") + DailyRound = apps.get_model("facility", "DailyRound") + + paginator = Paginator(PatientConsultation.objects.all().order_by("id"), 100) + for page_number in paginator.page_range: + bulk = [] + for consultation in paginator.page(page_number).object_list: + consultation_symptoms_set = set() + for symptom in consultation.deprecated_symptoms: + try: + symptom_id = int(symptom) + if symptom_id == 1: + # Asymptomatic + continue + if symptom_id == 9: + # Other symptom + if not consultation.deprecated_other_symptoms: + # invalid other symptom + continue + consultation_symptoms_set.add( + consultation.deprecated_other_symptoms.lower() + ) + else: + consultation_symptoms_set.add(symptom_id) + bulk.append( + EncounterSymptom( + symptom=symptom_id, + other_symptom=consultation.deprecated_other_symptoms + if symptom_id == 9 # Other symptom + else "", + onset_date=consultation.deprecated_symptoms_onset_date + or consultation.encounter_date, + created_date=consultation.created_date, + created_by=consultation.created_by, + consultation=consultation, + is_migrated=True, + ) + ) + except ValueError: + print( + f"Invalid Symptom {symptom} for Consultation {consultation.id}" + ) + + for daily_round in DailyRound.objects.filter(consultation=consultation): + for symptom in daily_round.deprecated_additional_symptoms: + try: + symptom_id = int(symptom) + if symptom_id == 1: + # Asymptomatic + continue + if symptom_id == 9: + # Other symptom + if not daily_round.deprecated_other_symptoms: + # invalid other symptom + continue + if ( + daily_round.deprecated_other_symptoms.lower() + in consultation_symptoms_set + ): + # Skip if symptom already exists + continue + consultation_symptoms_set.add( + daily_round.deprecated_other_symptoms.lower() + ) + elif symptom_id in consultation_symptoms_set: + # Skip if symptom already exists + continue + else: + consultation_symptoms_set.add(symptom_id) + + bulk.append( + EncounterSymptom( + symptom=symptom_id, + other_symptom=daily_round.deprecated_other_symptoms + if symptom_id == 9 # Other symptom + else "", + onset_date=daily_round.created_date, + created_date=daily_round.created_date, + created_by=daily_round.created_by, + consultation=daily_round.consultation, + is_migrated=True, + ) + ) + except ValueError: + print( + f"Invalid Symptom {symptom} for DailyRound {daily_round.id}" + ) + EncounterSymptom.objects.bulk_create(bulk) + + +class Migration(migrations.Migration): + dependencies = [ + migrations.swappable_dependency(settings.AUTH_USER_MODEL), + ("facility", "0438_alter_dailyround_patient_category_and_more"), + ] + + operations = [ + migrations.RenameField( + model_name="dailyround", + old_name="additional_symptoms", + new_name="deprecated_additional_symptoms", + ), + migrations.RenameField( + model_name="dailyround", + old_name="other_symptoms", + new_name="deprecated_other_symptoms", + ), + migrations.RenameField( + model_name="patientconsultation", + old_name="other_symptoms", + new_name="deprecated_other_symptoms", + ), + migrations.RenameField( + model_name="patientconsultation", + old_name="symptoms", + new_name="deprecated_symptoms", + ), + migrations.RenameField( + model_name="patientconsultation", + old_name="symptoms_onset_date", + new_name="deprecated_symptoms_onset_date", + ), + migrations.CreateModel( + name="EncounterSymptom", + fields=[ + ( + "id", + models.BigAutoField( + auto_created=True, + primary_key=True, + serialize=False, + verbose_name="ID", + ), + ), + ( + "external_id", + models.UUIDField(db_index=True, default=uuid.uuid4, unique=True), + ), + ( + "created_date", + models.DateTimeField(auto_now_add=True, db_index=True, null=True), + ), + ( + "modified_date", + models.DateTimeField(auto_now=True, db_index=True, null=True), + ), + ("deleted", models.BooleanField(db_index=True, default=False)), + ( + "symptom", + models.SmallIntegerField( + choices=[ + (9, "Others"), + (2, "Fever"), + (3, "Sore Throat"), + (4, "Cough"), + (5, "Breathlessness"), + (6, "Myalgia"), + (7, "Abdominal Discomfort"), + (8, "Vomiting"), + (11, "Sputum"), + (12, "Nausea"), + (13, "Chest Pain"), + (14, "Hemoptysis"), + (15, "Nasal Discharge"), + (16, "Body Ache"), + (17, "Diarrhoea"), + (18, "Pain"), + (19, "Pedal Edema"), + (20, "Wound"), + (21, "Constipation"), + (22, "Headache"), + (23, "Bleeding"), + (24, "Dizziness"), + (25, "Chills"), + (26, "General Weakness"), + (27, "Irritability"), + (28, "Confusion"), + (29, "Abdominal Pain"), + (30, "Joint Pain"), + (31, "Redness Of Eyes"), + (32, "Anorexia"), + (33, "New Loss Of Taste"), + (34, "New Loss Of Smell"), + ] + ), + ), + ("other_symptom", models.CharField(blank=True, default="")), + ("onset_date", models.DateTimeField(null=False, blank=False)), + ("cure_date", models.DateTimeField(blank=True, null=True)), + ( + "clinical_impression_status", + models.CharField( + choices=[ + ("in-progress", "In Progress"), + ("completed", "Completed"), + ("entered-in-error", "Entered in Error"), + ], + default="in-progress", + max_length=255, + ), + ), + ( + "consultation", + models.ForeignKey( + blank=True, + null=True, + on_delete=django.db.models.deletion.PROTECT, + related_name="symptoms", + to="facility.patientconsultation", + ), + ), + ( + "created_by", + models.ForeignKey( + blank=True, + null=True, + on_delete=django.db.models.deletion.PROTECT, + related_name="+", + to=settings.AUTH_USER_MODEL, + ), + ), + ( + "updated_by", + models.ForeignKey( + blank=True, + null=True, + on_delete=django.db.models.deletion.PROTECT, + related_name="+", + to=settings.AUTH_USER_MODEL, + ), + ), + ( + "is_migrated", + models.BooleanField( + default=False, + help_text="This field is to throw caution to data that was previously ported over", + ), + ), + ], + options={ + "abstract": False, + }, + bases=( + models.Model, + care.facility.models.mixins.permissions.patient.ConsultationRelatedPermissionMixin, + ), + ), + migrations.RunPython(backfill_symptoms_table, migrations.RunPython.noop), + ] diff --git a/care/facility/models/__init__.py b/care/facility/models/__init__.py index de348c5fad..f5f21da821 100644 --- a/care/facility/models/__init__.py +++ b/care/facility/models/__init__.py @@ -5,6 +5,7 @@ from .asset import * # noqa from .bed import * # noqa from .daily_round import * # noqa +from .encounter_symptom import * # noqa from .events import * # noqa from .facility import * # noqa from .icd11_diagnosis import * # noqa diff --git a/care/facility/models/daily_round.py b/care/facility/models/daily_round.py index afb05147fb..4b2457e50c 100644 --- a/care/facility/models/daily_round.py +++ b/care/facility/models/daily_round.py @@ -141,14 +141,14 @@ class InsulinIntakeFrequencyType(enum.Enum): max_digits=4, decimal_places=2, blank=True, null=True, default=None ) physical_examination_info = models.TextField(null=True, blank=True) - additional_symptoms = MultiSelectField( + deprecated_additional_symptoms = MultiSelectField( choices=SYMPTOM_CHOICES, default=1, null=True, blank=True, max_length=get_max_length(SYMPTOM_CHOICES, None), - ) - other_symptoms = models.TextField(default="", blank=True) + ) # Deprecated + deprecated_other_symptoms = models.TextField(default="", blank=True) # Deprecated deprecated_covid_category = models.CharField( choices=COVID_CATEGORY_CHOICES, max_length=8, diff --git a/care/facility/models/encounter_symptom.py b/care/facility/models/encounter_symptom.py new file mode 100644 index 0000000000..1322decbf1 --- /dev/null +++ b/care/facility/models/encounter_symptom.py @@ -0,0 +1,94 @@ +from django.db import models +from django.utils.translation import gettext_lazy as _ + +from care.facility.models.mixins.permissions.patient import ( + ConsultationRelatedPermissionMixin, +) +from care.facility.models.patient_consultation import PatientConsultation +from care.utils.models.base import BaseModel + + +class ClinicalImpressionStatus(models.TextChoices): + """ + See: https://fhir-ru.github.io/valueset-clinicalimpression-status.html + """ + + IN_PROGRESS = "in-progress", _("In Progress") + COMPLETED = "completed", _("Completed") + ENTERED_IN_ERROR = "entered-in-error", _("Entered in Error") + + +class Symptom(models.IntegerChoices): + OTHERS = 9 + FEVER = 2 + SORE_THROAT = 3 + COUGH = 4 + BREATHLESSNESS = 5 + MYALGIA = 6 + ABDOMINAL_DISCOMFORT = 7 + VOMITING = 8 + SPUTUM = 11 + NAUSEA = 12 + CHEST_PAIN = 13 + HEMOPTYSIS = 14 + NASAL_DISCHARGE = 15 + BODY_ACHE = 16 + DIARRHOEA = 17 + PAIN = 18 + PEDAL_EDEMA = 19 + WOUND = 20 + CONSTIPATION = 21 + HEADACHE = 22 + BLEEDING = 23 + DIZZINESS = 24 + CHILLS = 25 + GENERAL_WEAKNESS = 26 + IRRITABILITY = 27 + CONFUSION = 28 + ABDOMINAL_PAIN = 29 + JOINT_PAIN = 30 + REDNESS_OF_EYES = 31 + ANOREXIA = 32 + NEW_LOSS_OF_TASTE = 33 + NEW_LOSS_OF_SMELL = 34 + + +class EncounterSymptom(BaseModel, ConsultationRelatedPermissionMixin): + symptom = models.SmallIntegerField(choices=Symptom.choices, null=False, blank=False) + other_symptom = models.CharField(default="", blank=True, null=False) + onset_date = models.DateTimeField(null=False, blank=False) + cure_date = models.DateTimeField(null=True, blank=True) + clinical_impression_status = models.CharField( + max_length=255, + choices=ClinicalImpressionStatus.choices, + default=ClinicalImpressionStatus.IN_PROGRESS, + ) + consultation = models.ForeignKey( + PatientConsultation, + null=True, + blank=True, + on_delete=models.PROTECT, + related_name="symptoms", + ) + created_by = models.ForeignKey( + "users.User", null=True, blank=True, on_delete=models.PROTECT, related_name="+" + ) + updated_by = models.ForeignKey( + "users.User", null=True, blank=True, on_delete=models.PROTECT, related_name="+" + ) + is_migrated = models.BooleanField( + default=False, + help_text="This field is to throw caution to data that was previously ported over", + ) + + def save(self, *args, **kwargs): + if self.other_symptom and self.symptom != Symptom.OTHERS: + raise ValueError("Other Symptom should be empty when Symptom is not OTHERS") + + if self.clinical_impression_status != ClinicalImpressionStatus.ENTERED_IN_ERROR: + if self.onset_date and self.cure_date: + self.clinical_impression_status = ClinicalImpressionStatus.COMPLETED + elif self.onset_date and not self.cure_date: + self.clinical_impression_status = ClinicalImpressionStatus.IN_PROGRESS + + super().save(*args, **kwargs) diff --git a/care/facility/models/patient_consultation.py b/care/facility/models/patient_consultation.py index 91dad91de4..1e787d7885 100644 --- a/care/facility/models/patient_consultation.py +++ b/care/facility/models/patient_consultation.py @@ -72,15 +72,17 @@ class PatientConsultation(PatientBaseModel, ConsultationRelatedPermissionMixin): deprecated_icd11_principal_diagnosis = models.CharField( max_length=100, default="", blank=True, null=True ) # Deprecated in favour of ConsultationDiagnosis M2M model - symptoms = MultiSelectField( + deprecated_symptoms = MultiSelectField( choices=SYMPTOM_CHOICES, default=1, null=True, blank=True, max_length=get_max_length(SYMPTOM_CHOICES, None), - ) - other_symptoms = models.TextField(default="", blank=True) - symptoms_onset_date = models.DateTimeField(null=True, blank=True) + ) # Deprecated + deprecated_other_symptoms = models.TextField(default="", blank=True) # Deprecated + deprecated_symptoms_onset_date = models.DateTimeField( + null=True, blank=True + ) # Deprecated deprecated_covid_category = models.CharField( choices=COVID_CATEGORY_CHOICES, max_length=8, @@ -256,8 +258,8 @@ def get_related_consultation(self): CSV_MAPPING = { "consultation_created_date": "Date of Consultation", "encounter_date": "Date of Admission", - "symptoms_onset_date": "Date of Onset of Symptoms", - "symptoms": "Symptoms at time of consultation", + "deprecated_symptoms_onset_date": "Date of Onset of Symptoms", + "deprecated_symptoms": "Symptoms at time of consultation", "deprecated_covid_category": "Covid Category", "category": "Category", "examination_details": "Examination Details", @@ -276,8 +278,8 @@ def get_related_consultation(self): # CSV_DATATYPE_DEFAULT_MAPPING = { # "encounter_date": (None, models.DateTimeField(),), - # "symptoms_onset_date": (None, models.DateTimeField(),), - # "symptoms": ("-", models.CharField(),), + # "deprecated_symptoms_onset_date": (None, models.DateTimeField(),), + # "deprecated_symptoms": ("-", models.CharField(),), # "category": ("-", models.CharField(),), # "examination_details": ("-", models.CharField(),), # "suggestion": ("-", models.CharField(),), diff --git a/care/facility/models/patient_icmr.py b/care/facility/models/patient_icmr.py index 677b278322..e6f06da451 100644 --- a/care/facility/models/patient_icmr.py +++ b/care/facility/models/patient_icmr.py @@ -10,6 +10,7 @@ PatientContactDetails, PatientRegistration, PatientSample, + Symptom, ) @@ -187,19 +188,19 @@ def medical_conditions_list(self): @property def symptoms(self): - return [ - symptom - for symptom in self.consultation.symptoms - # if SYMPTOM_CHOICES[0][0] not in self.consultation.symptoms.choices.keys() - ] + symptoms = [] + for symptom in self.consultation.symptoms: + if symptom == Symptom.OTHERS: + symptoms.append(self.consultation.other_symptoms) + else: + symptoms.append(symptom) + + return symptoms @property def date_of_onset_of_symptoms(self): - return ( - self.consultation.symptoms_onset_date.date() - if self.consultation and self.consultation.symptoms_onset_date - else None - ) + if symptom := self.consultation.symptoms.first(): + return symptom.onset_date.date() class PatientConsultationICMR(PatientConsultation): diff --git a/care/facility/tests/test_encounter_symptom_api.py b/care/facility/tests/test_encounter_symptom_api.py new file mode 100644 index 0000000000..efff7fb6d2 --- /dev/null +++ b/care/facility/tests/test_encounter_symptom_api.py @@ -0,0 +1,431 @@ +from datetime import timedelta + +from django.utils.timezone import now +from rest_framework import status +from rest_framework.test import APITestCase + +from care.facility.models.encounter_symptom import ( + ClinicalImpressionStatus, + EncounterSymptom, + Symptom, +) +from care.facility.models.icd11_diagnosis import ( + ConditionVerificationStatus, + ICD11Diagnosis, +) +from care.utils.tests.test_utils import TestUtils + + +class TestEncounterSymptomInConsultation(TestUtils, APITestCase): + @classmethod + def setUpTestData(cls) -> None: + cls.state = cls.create_state() + cls.district = cls.create_district(cls.state) + cls.local_body = cls.create_local_body(cls.district) + cls.super_user = cls.create_super_user("su", cls.district) + cls.facility = cls.create_facility(cls.super_user, cls.district, cls.local_body) + cls.location = cls.create_asset_location(cls.facility) + cls.user = cls.create_user("staff1", cls.district, home_facility=cls.facility) + cls.doctor = cls.create_user( + "doctor", cls.district, home_facility=cls.facility, user_type=15 + ) + cls.patient = cls.create_patient(cls.district, cls.facility) + cls.consultation_data = cls.get_consultation_data() + cls.consultation_data.update( + { + "patient": cls.patient.external_id, + "consultation": cls.facility.external_id, + "treating_physician": cls.doctor.id, + "create_diagnoses": [ + { + "diagnosis": ICD11Diagnosis.objects.first().id, + "is_principal": False, + "verification_status": ConditionVerificationStatus.CONFIRMED, + } + ], + "create_symptoms": [ + { + "symptom": Symptom.COUGH, + "onset_date": now(), + }, + { + "symptom": Symptom.FEVER, + "onset_date": now(), + }, + ], + } + ) + + def test_create_consultation(self): + data = self.consultation_data.copy() + + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_201_CREATED) + self.assertEqual(EncounterSymptom.objects.count(), 2) + + def test_create_consultation_with_duplicate_symptoms(self): + data = self.consultation_data.copy() + data["create_symptoms"] = [ + { + "symptom": Symptom.FEVER, + "onset_date": now(), + }, + { + "symptom": Symptom.FEVER, + "onset_date": now(), + }, + ] + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + {"create_symptoms": ["Duplicate symptoms are not allowed"]}, + ) + + data["create_symptoms"] = [ + { + "symptom": Symptom.OTHERS, + "other_symptom": "Other Symptom", + "onset_date": now(), + }, + { + "symptom": Symptom.OTHERS, + "other_symptom": "Other Symptom", + "onset_date": now(), + }, + ] + + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + {"create_symptoms": ["Duplicate symptoms are not allowed"]}, + ) + + def test_create_consultation_with_no_symptom(self): + data = self.consultation_data.copy() + + data["create_symptoms"] = [] + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_201_CREATED) + self.assertEqual(EncounterSymptom.objects.count(), 0) + + def test_create_consultation_with_invalid_symptom(self): + data = self.consultation_data.copy() + data["create_symptoms"] = [ + { + "symptom": 100, + "onset_date": now(), + }, + ] + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + {"create_symptoms": [{"symptom": ['"100" is not a valid choice.']}]}, + ) + + data["create_symptoms"] = [ + { + "symptom": Symptom.OTHERS, + "onset_date": now(), + }, + ] + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + { + "create_symptoms": { + "other_symptom": "Other symptom should not be empty when symptom type is OTHERS" + } + }, + ) + + def test_create_consultation_with_no_symptom_onset_date(self): + data = self.consultation_data.copy() + data["create_symptoms"] = [ + { + "symptom": Symptom.FEVER, + }, + ] + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + {"create_symptoms": [{"onset_date": ["This field is required."]}]}, + ) + + def test_create_consultation_with_symptom_onset_date_in_future(self): + data = self.consultation_data.copy() + data["create_symptoms"] = [ + { + "symptom": Symptom.FEVER, + "onset_date": now() + timedelta(days=1), + }, + ] + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + {"create_symptoms": {"onset_date": "Onset date cannot be in the future"}}, + ) + + def test_create_consultation_with_cure_date_before_onset_date(self): + data = self.consultation_data.copy() + data["create_symptoms"] = [ + { + "symptom": Symptom.FEVER, + "onset_date": now(), + "cure_date": now() - timedelta(days=1), + }, + ] + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + {"create_symptoms": {"cure_date": "Cure date should be after onset date"}}, + ) + + def test_create_consultation_with_correct_cure_date(self): + data = self.consultation_data.copy() + data["create_symptoms"] = [ + { + "symptom": Symptom.FEVER, + "onset_date": now() - timedelta(days=1), + "cure_date": now(), + }, + ] + response = self.client.post( + "/api/v1/consultation/", + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_201_CREATED) + self.assertEqual(EncounterSymptom.objects.count(), 1) + self.assertEqual( + EncounterSymptom.objects.first().clinical_impression_status, + ClinicalImpressionStatus.COMPLETED, + ) + + +class TestEncounterSymptomApi(TestUtils, APITestCase): + @classmethod + def setUpTestData(cls) -> None: + cls.state = cls.create_state() + cls.district = cls.create_district(cls.state) + cls.local_body = cls.create_local_body(cls.district) + cls.super_user = cls.create_super_user("su", cls.district) + cls.facility = cls.create_facility(cls.super_user, cls.district, cls.local_body) + cls.location = cls.create_asset_location(cls.facility) + cls.user = cls.create_user("staff1", cls.district, home_facility=cls.facility) + cls.doctor = cls.create_user( + "doctor", cls.district, home_facility=cls.facility, user_type=15 + ) + cls.patient = cls.create_patient(cls.district, cls.facility) + cls.consultation = cls.create_consultation( + cls.patient, cls.facility, cls.doctor + ) + + def get_url(self, symptom=None): + if symptom: + return f"/api/v1/consultation/{self.consultation.external_id}/symptoms/{symptom.external_id}/" + return f"/api/v1/consultation/{self.consultation.external_id}/symptoms/" + + def test_create_new_symptom(self): + data = { + "symptom": Symptom.FEVER, + "onset_date": now(), + } + response = self.client.post( + self.get_url(), + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_201_CREATED) + self.assertEqual(EncounterSymptom.objects.count(), 1) + + def test_create_static_symptom_with_other_symptom(self): + data = { + "symptom": Symptom.FEVER, + "other_symptom": "Other Symptom", + "onset_date": now(), + } + response = self.client.post( + self.get_url(), + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + { + "other_symptom": [ + "Other symptom should be empty when symptom type is not OTHERS" + ] + }, + ) + + def test_create_others_symptom(self): + data = { + "symptom": Symptom.OTHERS, + "other_symptom": "Other Symptom", + "onset_date": now(), + } + response = self.client.post( + self.get_url(), + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_201_CREATED) + self.assertEqual(EncounterSymptom.objects.count(), 1) + + def test_create_other_symptom_without_other_symptom(self): + data = { + "symptom": Symptom.OTHERS, + "onset_date": now(), + } + response = self.client.post( + self.get_url(), + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + { + "other_symptom": [ + "Other symptom should not be empty when symptom type is OTHERS" + ] + }, + ) + + def test_create_duplicate_symptoms(self): + EncounterSymptom.objects.create( + consultation=self.consultation, + symptom=Symptom.FEVER, + onset_date=now(), + created_by=self.user, + ) + data = { + "symptom": Symptom.FEVER, + "onset_date": now(), + } + response = self.client.post( + self.get_url(), + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + {"symptom": ["An active symptom with the same details already exists"]}, + ) + + def test_update_symptom(self): + symptom = EncounterSymptom.objects.create( + consultation=self.consultation, + symptom=Symptom.FEVER, + onset_date=now(), + created_by=self.user, + ) + data = { + "cure_date": now(), + } + response = self.client.patch( + self.get_url(symptom), + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_200_OK) + self.assertEqual(EncounterSymptom.objects.count(), 1) + + def test_create_onset_date_in_future(self): + data = { + "symptom": Symptom.FEVER, + "onset_date": now() + timedelta(days=1), + } + response = self.client.post( + self.get_url(), + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + {"onset_date": ["Onset date cannot be in the future"]}, + ) + + def test_cure_date_before_onset_date(self): + symptom = EncounterSymptom.objects.create( + consultation=self.consultation, + symptom=Symptom.FEVER, + onset_date=now(), + created_by=self.user, + ) + data = { + "cure_date": now() - timedelta(days=1), + } + response = self.client.patch( + self.get_url(symptom), + data, + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_400_BAD_REQUEST) + self.assertEqual( + response.json(), + {"cure_date": ["Cure date should be after onset date"]}, + ) + + def test_mark_symptom_as_error(self): + symptom = EncounterSymptom.objects.create( + consultation=self.consultation, + symptom=Symptom.FEVER, + onset_date=now(), + created_by=self.user, + ) + response = self.client.delete( + self.get_url(symptom), + format="json", + ) + self.assertEqual(response.status_code, status.HTTP_204_NO_CONTENT) + self.assertEqual( + EncounterSymptom.objects.get(id=symptom.id).clinical_impression_status, + ClinicalImpressionStatus.ENTERED_IN_ERROR, + ) diff --git a/care/facility/tests/test_patient_consultation_api.py b/care/facility/tests/test_patient_consultation_api.py index 5a4104b1ec..270cff9157 100644 --- a/care/facility/tests/test_patient_consultation_api.py +++ b/care/facility/tests/test_patient_consultation_api.py @@ -1,11 +1,12 @@ import datetime from unittest.mock import patch -from django.utils.timezone import make_aware +from django.utils.timezone import make_aware, now from rest_framework import status from rest_framework.test import APITestCase from care.facility.api.serializers.patient_consultation import MIN_ENCOUNTER_DATE +from care.facility.models.encounter_symptom import Symptom from care.facility.models.file_upload import FileUpload from care.facility.models.icd11_diagnosis import ( ConditionVerificationStatus, @@ -37,7 +38,6 @@ def setUpTestData(cls) -> None: def get_default_data(self): return { "route_to_facility": 10, - "symptoms": [1], "category": CATEGORY_CHOICES[0][0], "examination_details": "examination_details", "history_of_present_illness": "history_of_present_illness", @@ -51,6 +51,17 @@ def get_default_data(self): "verification_status": ConditionVerificationStatus.CONFIRMED, } ], + "create_symptoms": [ + { + "symptom": Symptom.FEVER, + "onset_date": now(), + }, + { + "symptom": Symptom.OTHERS, + "other_symptom": "Other Symptom", + "onset_date": now(), + }, + ], "patient_no": datetime.datetime.now().timestamp(), } @@ -419,9 +430,7 @@ def test_update_consultation_after_discharge(self): ) self.assertEqual(res.status_code, status.HTTP_200_OK) - res = self.update_consultation( - consultation, symptoms=[1, 2], category="MILD", suggestion="A" - ) + res = self.update_consultation(consultation, category="MILD", suggestion="A") self.assertEqual(res.status_code, status.HTTP_400_BAD_REQUEST) def test_add_diagnoses_and_duplicate_diagnoses(self): diff --git a/care/facility/utils/reports/discharge_summary.py b/care/facility/utils/reports/discharge_summary.py index ac3afd1665..acec25ea20 100644 --- a/care/facility/utils/reports/discharge_summary.py +++ b/care/facility/utils/reports/discharge_summary.py @@ -14,6 +14,7 @@ from care.facility.models import ( DailyRound, Disease, + EncounterSymptom, InvestigationValue, PatientConsultation, PatientSample, @@ -21,6 +22,7 @@ PrescriptionDosageType, PrescriptionType, ) +from care.facility.models.encounter_symptom import ClinicalImpressionStatus from care.facility.models.file_upload import FileUpload from care.facility.models.icd11_diagnosis import ( ACTIVE_CONDITION_VERIFICATION_STATUSES, @@ -97,6 +99,9 @@ def get_discharge_summary_data(consultation: PatientConsultation): ) hcx = Policy.objects.filter(patient=consultation.patient) daily_rounds = DailyRound.objects.filter(consultation=consultation) + symptoms = EncounterSymptom.objects.filter(consultation=consultation).exclude( + clinical_impression_status=ClinicalImpressionStatus.ENTERED_IN_ERROR + ) diagnoses = get_diagnoses_data(consultation) investigations = InvestigationValue.objects.filter( Q(consultation=consultation.id) @@ -133,6 +138,7 @@ def get_discharge_summary_data(consultation: PatientConsultation): "patient": consultation.patient, "samples": samples, "hcx": hcx, + "symptoms": symptoms, "principal_diagnoses": diagnoses["principal"], "unconfirmed_diagnoses": diagnoses["unconfirmed"], "provisional_diagnoses": diagnoses["provisional"], diff --git a/care/templates/reports/patient_discharge_summary_pdf.html b/care/templates/reports/patient_discharge_summary_pdf.html index 48c05155b1..06c7969b10 100644 --- a/care/templates/reports/patient_discharge_summary_pdf.html +++ b/care/templates/reports/patient_discharge_summary_pdf.html @@ -133,18 +133,6 @@

{{consultation.height}} cm

- {% if consultation.route_to_facility %} -
-

- Symptoms at admission: - {{consultation.get_symptoms_display|title}} -

-

- From: - {{consultation.symptoms_onset_date.date}} -

-
- {% endif %} {% if hcx %} @@ -193,6 +181,49 @@

{% endif %} + {% if symptoms %} +

+ Symptoms: +

+
+ + + + + + + + + + {% for symptom in symptoms %} + + + + + + {% endfor %} + +
+ Name + + Onset Date + + Cure Date +
+ {% if symptom.symptom == 9 %} + {{symptom.other_symptom}} + {% else %} + {{symptom.get_symptom_display}} + {% endif %} + + {{symptom.onset_date.date}} + + {{symptom.cure_date.date}} +
+
+ {% endif %} + {% if principal_diagnosis %}

Principal Diagnosis (as per ICD-11 recommended by WHO): @@ -765,14 +796,6 @@

{{daily_round.other_details}} -
-
- Symptoms -
-
- {{daily_round.additional_symptoms}} -
-
diff --git a/care/utils/tests/test_utils.py b/care/utils/tests/test_utils.py index acb286f043..465fa74c87 100644 --- a/care/utils/tests/test_utils.py +++ b/care/utils/tests/test_utils.py @@ -12,7 +12,6 @@ from care.facility.models import ( CATEGORY_CHOICES, DISEASE_CHOICES_MAP, - SYMPTOM_CHOICES, Ambulance, Disease, DiseaseStatusEnum, @@ -307,13 +306,8 @@ def create_patient(cls, district: District, facility: Facility, **kwargs): return patient @classmethod - def get_consultation_data(cls): + def get_consultation_data(cls) -> dict: return { - "patient": cls.patient, - "facility": cls.facility, - "symptoms": [SYMPTOM_CHOICES[0][0], SYMPTOM_CHOICES[1][0]], - "other_symptoms": "No other symptoms", - "symptoms_onset_date": make_aware(datetime(2020, 4, 7, 15, 30)), "category": CATEGORY_CHOICES[0][0], "examination_details": "examination_details", "history_of_present_illness": "history_of_present_illness", @@ -321,14 +315,12 @@ def get_consultation_data(cls): "suggestion": PatientConsultation.SUGGESTION_CHOICES[0][ 0 ], # HOME ISOLATION - "referred_to": None, "encounter_date": make_aware(datetime(2020, 4, 7, 15, 30)), "discharge_date": None, "consultation_notes": "", "course_in_facility": "", - "created_date": mock_equal, - "modified_date": mock_equal, "patient_no": int(datetime.now().timestamp() * 1000), + "route_to_facility": 10, } @classmethod @@ -336,6 +328,7 @@ def create_consultation( cls, patient: PatientRegistration, facility: Facility, + doctor: User | None = None, referred_to=None, **kwargs, ) -> PatientConsultation: @@ -345,6 +338,7 @@ def create_consultation( "patient": patient, "facility": facility, "referred_to": referred_to, + "treating_physician": doctor, } ) data.update(kwargs) diff --git a/config/api_router.py b/config/api_router.py index 70512b97c0..ab8787fcc2 100644 --- a/config/api_router.py +++ b/config/api_router.py @@ -33,6 +33,7 @@ ConsultationDiagnosisViewSet, ) from care.facility.api.viewsets.daily_round import DailyRoundsViewSet +from care.facility.api.viewsets.encounter_symptom import EncounterSymptomViewSet from care.facility.api.viewsets.events import ( EventTypeViewSet, PatientConsultationEventViewSet, @@ -227,6 +228,7 @@ ) consultation_nested_router.register(r"daily_rounds", DailyRoundsViewSet) consultation_nested_router.register(r"diagnoses", ConsultationDiagnosisViewSet) +consultation_nested_router.register(r"symptoms", EncounterSymptomViewSet) consultation_nested_router.register(r"investigation", InvestigationValueViewSet) consultation_nested_router.register(r"prescriptions", ConsultationPrescriptionViewSet) consultation_nested_router.register( diff --git a/data/dummy/facility.json b/data/dummy/facility.json index 9976ca3646..7b7485df8c 100644 --- a/data/dummy/facility.json +++ b/data/dummy/facility.json @@ -1952,9 +1952,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "3", - "other_symptoms": "", - "symptoms_onset_date": "2022-09-27T07:19:53.380Z", "deprecated_covid_category": null, "category": "Moderate", "examination_details": "", @@ -2023,9 +2020,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2094,9 +2088,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2165,9 +2156,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2236,9 +2224,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2307,9 +2292,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2378,9 +2360,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2449,9 +2428,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2520,9 +2496,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2591,9 +2564,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2662,9 +2632,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2733,9 +2700,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2804,9 +2768,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2875,9 +2836,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -2946,9 +2904,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3017,9 +2972,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3088,9 +3040,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3159,9 +3108,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3230,9 +3176,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3301,9 +3244,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3372,9 +3312,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3443,9 +3380,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3514,9 +3448,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3585,9 +3516,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3656,9 +3584,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions", @@ -3727,9 +3652,6 @@ "deprecated_icd11_provisional_diagnoses": "[]", "deprecated_icd11_diagnoses": "[]", "deprecated_icd11_principal_diagnosis": "", - "symptoms": "1", - "other_symptoms": "", - "symptoms_onset_date": null, "deprecated_covid_category": null, "category": "Stable", "examination_details": "Examination details and Clinical conditions",