refactor: fetch risk assessment 'risk level'

- Gets the patients risk level with the provided encounter id and the type of screening

Signed-off-by: Kathurima Kimathi <kathurimakimathi415@gmail.com>

pkg/clinical/domain/complex_types.go

@@ -3126,3 +3126,68 @@ func (e *DiagnosticReportStatusEnum) UnmarshalGQL(v interface{}) error {
 func (e DiagnosticReportStatusEnum) MarshalGQL(w io.Writer) {
 	fmt.Fprint(w, strconv.Quote(e.String()))
 }
+
+// ScreeningTypeEnum is used to define the type of Screening
+type ScreeningTypeEnum string
+
+const (
+	// CervicalCancerScreeningTypeEnum is cervical Screening type
+	CervicalCancerScreeningTypeEnum ScreeningTypeEnum = "CERVICAL_CANCER_SCREENING"
+
+	// BreastCancerScreeningTypeEnum is represents the breast Screening type
+	BreastCancerScreeningTypeEnum ScreeningTypeEnum = "BREAST_CANCER_SCREENING"
+)
+
+// AllScreeningTypeEnum is a list of all possible Screening types
+var AllScreeningTypeEnum = []ScreeningTypeEnum{
+	CervicalCancerScreeningTypeEnum,
+	BreastCancerScreeningTypeEnum,
+}
+
+// IsValid ...
+func (e ScreeningTypeEnum) IsValid() bool {
+	switch e {
+	case CervicalCancerScreeningTypeEnum,
+		BreastCancerScreeningTypeEnum:
+		return true
+	}
+
+	return false
+}
+
+// String ...
+func (e ScreeningTypeEnum) String() string {
+	return string(e)
+}
+
+// UnmarshalGQL ...
+func (e *ScreeningTypeEnum) UnmarshalGQL(v interface{}) error {
+	str, ok := v.(string)
+	if !ok {
+		return fmt.Errorf("enums must be strings")
+	}
+
+	*e = ScreeningTypeEnum(str)
+	if !e.IsValid() {
+		return fmt.Errorf("%s is not a valid Screening type enum", str)
+	}
+
+	return nil
+}
+
+// MarshalGQL writes the Screening type to the supplied writer as a quoted string
+func (e ScreeningTypeEnum) MarshalGQL(w io.Writer) {
+	fmt.Fprint(w, strconv.Quote(e.String()))
+}
+
+// Text returns a human friendly representation of the screening type
+func (screeningType ScreeningTypeEnum) Text() string {
+	switch screeningType {
+	case BreastCancerScreeningTypeEnum:
+		return "Breast Cancer Screening"
+	case CervicalCancerScreeningTypeEnum:
+		return "Cervical Cancer Screening"
+	}
+
+	return "unknown screening type"
+}

pkg/clinical/presentation/graph/clinical.graphql

@@ -135,7 +135,7 @@ extend type Query {
     pagination: Pagination!
   ): QuestionnaireConnection!
 
-  getQuestionnaireResponseRiskLevel(questionnaireResponseID: String!): String!
+  getQuestionnaireResponseRiskLevel(encounterID: String!, screeningType: ScreeningTypeEnum!): String!
 }
 
 extend type Mutation {

pkg/clinical/presentation/graph/enums.graphql

@@ -121,3 +121,8 @@ enum QuantityComparatorEnum{
 enum QuestionnaireResponseStatusEnum{
   completed
 }
+
+enum ScreeningTypeEnum{
+  BREAST_CANCER_SCREENING
+  CERVICAL_CANCER_SCREENING
+}

pkg/clinical/usecases/clinical/questionnaire_response.go

@@ -30,6 +30,8 @@ func (u *UseCasesClinicalImpl) CreateQuestionnaireResponse(ctx context.Context,
 		return "", fmt.Errorf("cannot create a questionnaire response in a finished encounter")
 	}
 
+	// TODO: Ensure user cannot submit the same risk assessment twice in the same encounter
+
 	patientID := encounter.Resource.Subject.ID
 	patientReference := fmt.Sprintf("Patient/%s", *patientID)
 
@@ -141,6 +143,7 @@ func (u *UseCasesClinicalImpl) generateQuestionnaireReviewSummary(
 				questionnaireResponseID,
 				common.HighRiskCIELCode,
 				"High Risk",
+				domain.CervicalCancerScreeningTypeEnum.Text(), // TODO: This is TEMPORARY. A follow up PR is to follow supplying the value from params
 			)
 			if err != nil {
 				return "", err
@@ -153,6 +156,7 @@ func (u *UseCasesClinicalImpl) generateQuestionnaireReviewSummary(
 				questionnaireResponseID,
 				common.LowRiskCIELCode,
 				"Low Risk",
+				domain.CervicalCancerScreeningTypeEnum.Text(),
 			)
 			if err != nil {
 				return "", err
@@ -168,8 +172,8 @@ func (u *UseCasesClinicalImpl) generateQuestionnaireReviewSummary(
 func (u *UseCasesClinicalImpl) recordRiskAssessment(
 	ctx context.Context,
 	encounter *domain.FHIREncounterRelayPayload,
-	questionnaireResponseID string,
-	outcomeCode, outcomeDisplay string,
+	questionnaireResponseID, outcomeCode string,
+	outcomeDisplay, usageContext string,
 ) (string, error) {
 	CIELTerminologySystem := scalarutils.URI(common.CIELTerminologySystem)
 	codingCode := scalarutils.Code(outcomeCode)
@@ -194,6 +198,7 @@ func (u *UseCasesClinicalImpl) recordRiskAssessment(
 
 	instant := scalarutils.Instant(time.Now().Format(time.RFC3339))
 
+	textStatus := domain.NarrativeStatusEnumAdditional
 	riskAssessment := domain.FHIRRiskAssessmentInput{
 		Status: domain.ObservationStatusEnumFinal,
 		Code:   &domain.FHIRCodeableConceptInput{},
@@ -218,6 +223,10 @@ func (u *UseCasesClinicalImpl) recordRiskAssessment(
 				Reference: &questionnaireResponseReference,
 			},
 		},
+		Text: &domain.FHIRNarrativeInput{
+			Status: &textStatus,
+			Div:    scalarutils.XHTML(usageContext),
+		},
 	}
 
 	tags, err := u.GetTenantMetaTags(ctx)
@@ -241,20 +250,21 @@ func (u *UseCasesClinicalImpl) recordRiskAssessment(
 
 // GetQuestionnaireResponseRiskLevel fetches the risk level associated with a questionnaire response. This is based off the scoring
 // of the questionnaire response. Outcome: High Risk / Low Risk
-func (u *UseCasesClinicalImpl) GetQuestionnaireResponseRiskLevel(ctx context.Context, questionnaireResponseID string) (string, error) {
-	questionnaireResponse, err := u.infrastructure.FHIR.GetFHIRQuestionnaireResponse(ctx, questionnaireResponseID)
+func (u *UseCasesClinicalImpl) GetQuestionnaireResponseRiskLevel(ctx context.Context, encounterID string, screeningType domain.ScreeningTypeEnum) (string, error) {
+	encounter, err := u.infrastructure.FHIR.GetFHIREncounter(ctx, encounterID)
 	if err != nil {
 		return "", err
 	}
 
-	encounterReference := questionnaireResponse.Resource.Encounter.Reference
-	patientReference := questionnaireResponse.Resource.Source.Reference
+	patientID := encounter.Resource.Subject.ID
+	encounterReference := fmt.Sprintf("Encounter/%s", *encounter.Resource.ID)
+	patientReference := fmt.Sprintf("Patient/%s", *patientID)
 
 	riskAssessmentSearchParams := map[string]interface{}{
-		"patient":   *patientReference,
-		"encounter": *encounterReference,
+		"patient":   patientReference,
+		"encounter": encounterReference,
+		"_text":     screeningType.Text(),
 		"_sort":     "date",
-		"_count":    "1",
 	}
 
 	identifiers, err := u.infrastructure.BaseExtension.GetTenantIdentifiers(ctx)

pkg/clinical/usecases/clinical/questionnaire_response_test.go

@@ -360,8 +360,9 @@ func TestUseCasesClinicalImpl_CreateQuestionnaireResponse(t *testing.T) {
 func TestUseCasesClinicalImpl_GetQuestionnaireResponseRiskLevel(t *testing.T) {
 	ctx := context.Background()
 	type args struct {
-		ctx                     context.Context
-		questionnaireResponseID string
+		ctx           context.Context
+		encounterID   string
+		screeningType domain.ScreeningTypeEnum
 	}
 	tests := []struct {
 		name    string
@@ -372,32 +373,36 @@ func TestUseCasesClinicalImpl_GetQuestionnaireResponseRiskLevel(t *testing.T) {
 		{
 			name: "Happy Case - Successfully get risk level",
 			args: args{
-				ctx:                     ctx,
-				questionnaireResponseID: gofakeit.UUID(),
+				ctx:           ctx,
+				encounterID:   gofakeit.UUID(),
+				screeningType: domain.CervicalCancerScreeningTypeEnum,
 			},
 			wantErr: false,
 		},
 		{
-			name: "Sad Case - Fail to get fhir questionnaire response",
+			name: "Sad Case - Fail to get fhir encounter",
 			args: args{
-				ctx:                     ctx,
-				questionnaireResponseID: gofakeit.UUID(),
+				ctx:           ctx,
+				encounterID:   gofakeit.UUID(),
+				screeningType: domain.CervicalCancerScreeningTypeEnum,
 			},
 			wantErr: true,
 		},
 		{
 			name: "Sad Case - Fail to get tenant identifiers",
 			args: args{
-				ctx:                     ctx,
-				questionnaireResponseID: gofakeit.UUID(),
+				ctx:           ctx,
+				encounterID:   gofakeit.UUID(),
+				screeningType: domain.CervicalCancerScreeningTypeEnum,
 			},
 			wantErr: true,
 		},
 		{
 			name: "Sad Case - Fail to search risk assessment",
 			args: args{
-				ctx:                     ctx,
-				questionnaireResponseID: gofakeit.UUID(),
+				ctx:           ctx,
+				encounterID:   gofakeit.UUID(),
+				screeningType: domain.CervicalCancerScreeningTypeEnum,
 			},
 			wantErr: true,
 		},
@@ -414,9 +419,9 @@ func TestUseCasesClinicalImpl_GetQuestionnaireResponseRiskLevel(t *testing.T) {
 			infra := infrastructure.NewInfrastructureInteractor(fakeExt, fakeFHIR, fakeOCL, fakeUpload, fakePubSub)
 			u := clinicalUsecase.NewUseCasesClinicalImpl(infra)
 
-			if tt.name == "Sad Case - Fail to get fhir questionnaire response" {
-				fakeFHIR.MockGetFHIRQuestionnaireResponseFn = func(ctx context.Context, id string) (*domain.FHIRQuestionnaireResponseRelayPayload, error) {
-					return nil, fmt.Errorf("failed to get questionnaire response")
+			if tt.name == "Sad Case - Fail to get fhir encounter" {
+				fakeFHIR.MockGetFHIREncounterFn = func(ctx context.Context, id string) (*domain.FHIREncounterRelayPayload, error) {
+					return nil, fmt.Errorf("failed to get encounter")
 				}
 			}
 
@@ -432,7 +437,7 @@ func TestUseCasesClinicalImpl_GetQuestionnaireResponseRiskLevel(t *testing.T) {
 				}
 			}
 
-			got, err := u.GetQuestionnaireResponseRiskLevel(tt.args.ctx, tt.args.questionnaireResponseID)
+			got, err := u.GetQuestionnaireResponseRiskLevel(tt.args.ctx, tt.args.encounterID, tt.args.screeningType)
 			if (err != nil) != tt.wantErr {
 				t.Errorf("UseCasesClinicalImpl.GetQuestionnaireResponseRiskLevel() error = %v, wantErr %v", err, tt.wantErr)
 				return

pkg/clinical/usecases/usecases.go

@@ -112,7 +112,7 @@ type Clinical interface {
 	ListQuestionnaires(ctx context.Context, searchParam *string, pagination *dto.Pagination) (*dto.QuestionnaireConnection, error)
 	RecordConsent(ctx context.Context, input dto.ConsentInput) (*dto.ConsentOutput, error)
 
-	GetQuestionnaireResponseRiskLevel(ctx context.Context, questionnaireResponseID string) (string, error)
+	GetQuestionnaireResponseRiskLevel(ctx context.Context, encounterID string, screeningType domain.ScreeningTypeEnum) (string, error)
 	RecordMammographyResult(ctx context.Context, input dto.DiagnosticReportInput) (*dto.DiagnosticReport, error)
 }