#!/usr/bin/env python
# camcops_server/tasks/ciwa.py
"""
===============================================================================
Copyright (C) 2012-2018 Rudolf Cardinal (rudolf@pobox.com).
This file is part of CamCOPS.
CamCOPS is free software: you can redistribute it and/or modify
it under the terms of the GNU General Public License as published by
the Free Software Foundation, either version 3 of the License, or
(at your option) any later version.
CamCOPS is distributed in the hope that it will be useful,
but WITHOUT ANY WARRANTY; without even the implied warranty of
MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
GNU General Public License for more details.
You should have received a copy of the GNU General Public License
along with CamCOPS. If not, see <http://www.gnu.org/licenses/>.
===============================================================================
"""
from typing import Any, Dict, List, Tuple, Type
from cardinal_pythonlib.stringfunc import strseq
from sqlalchemy.ext.declarative import DeclarativeMeta
from sqlalchemy.sql.schema import Column
from sqlalchemy.sql.sqltypes import Float, Integer
from camcops_server.cc_modules.cc_constants import CssClass
from camcops_server.cc_modules.cc_ctvinfo import CTV_INCOMPLETE, CtvInfo
from camcops_server.cc_modules.cc_db import add_multiple_columns
from camcops_server.cc_modules.cc_html import (
answer,
subheading_spanning_two_columns,
tr,
tr_qa,
)
from camcops_server.cc_modules.cc_request import CamcopsRequest
from camcops_server.cc_modules.cc_sqla_coltypes import (
CamcopsColumn,
MIN_ZERO_CHECKER,
PermittedValueChecker,
SummaryCategoryColType,
)
from camcops_server.cc_modules.cc_summaryelement import SummaryElement
from camcops_server.cc_modules.cc_task import (
get_from_dict,
Task,
TaskHasClinicianMixin,
TaskHasPatientMixin,
)
from camcops_server.cc_modules.cc_trackerhelpers import (
TrackerLabel,
TrackerInfo,
)
# =============================================================================
# CIWA
# =============================================================================
class CiwaMetaclass(DeclarativeMeta):
# noinspection PyInitNewSignature
def __init__(cls: Type['Ciwa'],
name: str,
bases: Tuple[Type, ...],
classdict: Dict[str, Any]) -> None:
add_multiple_columns(
cls, "q", 1, cls.NSCOREDQUESTIONS - 1,
minimum=0, maximum=7,
comment_fmt="Q{n}, {s} (0-7, higher worse)",
comment_strings=[
"nausea/vomiting", "tremor", "paroxysmal sweats", "anxiety",
"agitation", "tactile disturbances", "auditory disturbances",
"visual disturbances", "headache/fullness in head"
]
)
super().__init__(name, bases, classdict)
[docs]class Ciwa(TaskHasPatientMixin, TaskHasClinicianMixin, Task,
metaclass=CiwaMetaclass):
__tablename__ = "ciwa"
shortname = "CIWA-Ar"
longname = ("Clinical Institute Withdrawal Assessment for Alcohol "
"Scale, Revised")
provides_trackers = True
NSCOREDQUESTIONS = 10
SCORED_QUESTIONS = strseq("q", 1, NSCOREDQUESTIONS)
q10 = CamcopsColumn(
"q10", Integer,
permitted_value_checker=PermittedValueChecker(minimum=0, maximum=4),
comment="Q10, orientation/clouding of sensorium (0-4, higher worse)"
)
t = Column(
"t", Float,
comment="Temperature (degrees C)"
)
hr = CamcopsColumn(
"hr", Integer,
permitted_value_checker=MIN_ZERO_CHECKER,
comment="Heart rate (beats/minute)"
)
sbp = CamcopsColumn(
"sbp", Integer,
permitted_value_checker=MIN_ZERO_CHECKER,
comment="Systolic blood pressure (mmHg)"
)
dbp = CamcopsColumn(
"dbp", Integer,
permitted_value_checker=MIN_ZERO_CHECKER,
comment="Diastolic blood pressure (mmHg)"
)
rr = CamcopsColumn(
"rr", Integer,
permitted_value_checker=MIN_ZERO_CHECKER,
comment="Respiratory rate (breaths/minute)"
)
MAX_SCORE = 67
[docs] def get_trackers(self, req: CamcopsRequest) -> List[TrackerInfo]:
return [TrackerInfo(
value=self.total_score(),
plot_label="CIWA total score",
axis_label="Total score (out of {})".format(self.MAX_SCORE),
axis_min=-0.5,
axis_max=self.MAX_SCORE + 0.5,
horizontal_lines=[14.5, 7.5],
horizontal_labels=[
TrackerLabel(17, req.wappstring("severe")),
TrackerLabel(11, req.wappstring("moderate")),
TrackerLabel(3.75, req.wappstring("mild")),
]
)]
[docs] def get_clinical_text(self, req: CamcopsRequest) -> List[CtvInfo]:
if not self.is_complete():
return CTV_INCOMPLETE
return [CtvInfo(
content="CIWA total score: {}/{}".format(self.total_score(),
self.MAX_SCORE)
)]
[docs] def get_summaries(self, req: CamcopsRequest) -> List[SummaryElement]:
return self.standard_task_summary_fields() + [
SummaryElement(name="total",
coltype=Integer(),
value=self.total_score(),
comment="Total score (/{})".format(self.MAX_SCORE)),
SummaryElement(name="severity",
coltype=SummaryCategoryColType,
value=self.severity(req),
comment="Likely severity"),
]
[docs] def is_complete(self) -> bool:
return (self.are_all_fields_complete(self.SCORED_QUESTIONS) and
self.field_contents_valid())
def total_score(self) -> int:
return self.sum_fields(self.SCORED_QUESTIONS)
def severity(self, req: CamcopsRequest) -> str:
score = self.total_score()
if score >= 15:
severity = self.wxstring(req, "category_severe")
elif score >= 8:
severity = self.wxstring(req, "category_moderate")
else:
severity = self.wxstring(req, "category_mild")
return severity
[docs] def get_task_html(self, req: CamcopsRequest) -> str:
score = self.total_score()
severity = self.severity(req)
answer_dicts_dict = {}
for q in self.SCORED_QUESTIONS:
d = {None: None}
for option in range(0, 8):
if option > 4 and q == "q10":
continue
d[option] = self.wxstring(req, q + "_option" + str(option))
answer_dicts_dict[q] = d
q_a = ""
for q in range(1, Ciwa.NSCOREDQUESTIONS + 1):
q_a += tr_qa(
self.wxstring(req, "q" + str(q) + "_s"),
get_from_dict(answer_dicts_dict["q" + str(q)],
getattr(self, "q" + str(q)))
)
h = """
<div class="{CssClass.SUMMARY}">
<table class="{CssClass.SUMMARY}">
{tr_is_complete}
{total_score}
{severity}
</table>
</div>
<table class="{CssClass.TASKDETAIL}">
<tr>
<th width="35%">Question</th>
<th width="65%">Answer</th>
</tr>
{q_a}
{subhead_vitals}
{t}
{hr}
{bp}
{rr}
</table>
<div class="{CssClass.FOOTNOTES}">
[1] Total score ≥15 severe, ≥8 moderate, otherwise
mild/minimal.
</div>
""".format(
CssClass=CssClass,
tr_is_complete=self.get_is_complete_tr(req),
total_score=tr(
req.wappstring("total_score"),
answer(score) + " / {}".format(self.MAX_SCORE)
),
severity=tr_qa(
self.wxstring(req, "severity") + " <sup>[1]</sup>",
severity
),
q_a=q_a,
subhead_vitals=subheading_spanning_two_columns(
self.wxstring(req, "vitals_title")),
t=tr_qa(self.wxstring(req, "t"), self.t),
hr=tr_qa(self.wxstring(req, "hr"), self.hr),
bp=tr(self.wxstring(req, "bp"),
answer(self.sbp) + " / " + answer(self.dbp)),
rr=tr_qa(self.wxstring(req, "rr"), self.rr),
)
return h