feat: BIO_NORMALS 33 analytes + interprétations cliniques + cohérence DAS/bio étendue
- BIO_NORMALS passe de 13 à 33 tests (cardio, infectio, métabo, thyroïde, hémato, hépatique) - _BIO_INTERPRETATION synchronisé (33 entrées, 3 clés high/low/normal chacune) - _DAS_BIO_CHECKS étendu de 13 à 38 patterns (sepsis, infarctus, EP, diabète, thyroïde, etc.) - lab_value_sanity.yaml étendu avec 20 garde-fous plausibilité nouveaux tests - tests/test_bio_normals.py : 32 tests (complétude, concordance, _is_abnormal) Co-Authored-By: Claude Opus 4.6 <noreply@anthropic.com>
This commit is contained in:
dom
@@ -165,18 +165,48 @@ def _build_tagged_context(dossier: DossierMedical) -> tuple[str, dict[str, str]]
|
||||
|
||||
# Interprétations cliniques pour le résumé bio déterministe
|
||||
_BIO_INTERPRETATION: dict[str, dict[str, str]] = {
|
||||
"CRP": {"high": "infection/inflammation active", "low": "normal", "normal": "pas d'inflammation"},
|
||||
"Hémoglobine": {"high": "polyglobulie", "low": "anémie", "normal": "pas d'anémie"},
|
||||
"Plaquettes": {"high": "thrombocytose", "low": "thrombopénie", "normal": "numération normale"},
|
||||
"Leucocytes": {"high": "hyperleucocytose", "low": "leucopénie", "normal": "numération normale"},
|
||||
"Créatinine": {"high": "insuffisance rénale", "low": "normal", "normal": "fonction rénale conservée"},
|
||||
"Potassium": {"high": "hyperkaliémie", "low": "hypokaliémie", "normal": "kaliémie normale"},
|
||||
"Sodium": {"high": "hypernatrémie", "low": "hyponatrémie", "normal": "natrémie normale"},
|
||||
# --- Hépatique / digestif ---
|
||||
"Lipasémie": {"high": "pancréatite probable", "low": "normal", "normal": "pas de pancréatite"},
|
||||
"ASAT": {"high": "cytolyse hépatique", "low": "normal", "normal": "pas de cytolyse"},
|
||||
"ALAT": {"high": "cytolyse hépatique", "low": "normal", "normal": "pas de cytolyse"},
|
||||
"GGT": {"high": "cholestase/atteinte hépatique", "low": "normal", "normal": "pas de cholestase"},
|
||||
"PAL": {"high": "cholestase/atteinte osseuse", "low": "normal", "normal": "pas de cholestase"},
|
||||
"Bilirubine totale": {"high": "ictère/cholestase", "low": "normal", "normal": "pas d'ictère"},
|
||||
"Bilirubine directe": {"high": "cholestase/obstruction biliaire", "low": "normal", "normal": "pas de cholestase"},
|
||||
"LDH": {"high": "cytolyse/hémolyse", "low": "normal", "normal": "pas de cytolyse"},
|
||||
# --- Inflammatoire ---
|
||||
"CRP": {"high": "infection/inflammation active", "low": "normal", "normal": "pas d'inflammation"},
|
||||
"VS": {"high": "inflammation", "low": "normal", "normal": "pas d'inflammation"},
|
||||
# --- Ionogramme ---
|
||||
"Sodium": {"high": "hypernatrémie", "low": "hyponatrémie", "normal": "natrémie normale"},
|
||||
"Potassium": {"high": "hyperkaliémie", "low": "hypokaliémie", "normal": "kaliémie normale"},
|
||||
# --- Hématologie ---
|
||||
"Hémoglobine": {"high": "polyglobulie", "low": "anémie", "normal": "pas d'anémie"},
|
||||
"Plaquettes": {"high": "thrombocytose", "low": "thrombopénie", "normal": "numération normale"},
|
||||
"Leucocytes": {"high": "hyperleucocytose", "low": "leucopénie", "normal": "numération normale"},
|
||||
"TP": {"high": "normal", "low": "insuffisance hépatique/CIVD", "normal": "coagulation normale"},
|
||||
"TCA": {"high": "hypocoagulabilité", "low": "normal", "normal": "coagulation normale"},
|
||||
"Ferritine": {"high": "surcharge en fer/inflammation", "low": "carence en fer", "normal": "réserves en fer normales"},
|
||||
# --- Rénal ---
|
||||
"Créatinine": {"high": "insuffisance rénale", "low": "normal", "normal": "fonction rénale conservée"},
|
||||
"Urée": {"high": "insuffisance rénale/catabolisme", "low": "normal", "normal": "fonction rénale conservée"},
|
||||
# --- Cardiologie ---
|
||||
"Troponine": {"high": "nécrose myocardique (SCA/IDM)", "low": "normal", "normal": "pas de souffrance myocardique"},
|
||||
"BNP": {"high": "insuffisance cardiaque", "low": "normal", "normal": "pas d'insuffisance cardiaque"},
|
||||
"NT-proBNP": {"high": "insuffisance cardiaque", "low": "normal", "normal": "pas d'insuffisance cardiaque"},
|
||||
"D-dimères": {"high": "activation coagulation (EP/TVP possible)", "low": "normal", "normal": "EP/TVP peu probable"},
|
||||
"INR": {"high": "hypocoagulabilité/surdosage AVK", "low": "hypercoagulabilité", "normal": "coagulation normale"},
|
||||
"Fibrinogène": {"high": "inflammation/risque thrombotique", "low": "CIVD/insuffisance hépatique", "normal": "normal"},
|
||||
# --- Infectiologie ---
|
||||
"Procalcitonine": {"high": "infection bactérienne", "low": "normal", "normal": "pas d'infection bactérienne"},
|
||||
"Lactate": {"high": "hypoperfusion/choc", "low": "normal", "normal": "pas d'hypoperfusion"},
|
||||
# --- Métabolisme ---
|
||||
"Glycémie": {"high": "hyperglycémie/diabète", "low": "hypoglycémie", "normal": "glycémie normale"},
|
||||
"HbA1c": {"high": "diabète mal équilibré", "low": "normal", "normal": "équilibre glycémique correct"},
|
||||
"Albumine": {"high": "déshydratation", "low": "dénutrition/insuffisance hépatique", "normal": "état nutritionnel conservé"},
|
||||
"Acide urique": {"high": "hyperuricémie/goutte", "low": "normal", "normal": "uricémie normale"},
|
||||
# --- Thyroïde ---
|
||||
"TSH": {"high": "hypothyroïdie", "low": "hyperthyroïdie", "normal": "fonction thyroïdienne normale"},
|
||||
}
|
||||
|
||||
|
||||
@@ -243,6 +273,7 @@ def _check_das_bio_coherence(dossier: DossierMedical) -> list[str]:
|
||||
|
||||
# Patterns DAS → (test bio attendu, direction attendue)
|
||||
_DAS_BIO_CHECKS: dict[str, tuple[str, str]] = {
|
||||
# Hématologie
|
||||
"leucocytose": ("Leucocytes", "high"),
|
||||
"leucopénie": ("Leucocytes", "low"),
|
||||
"leucopenie": ("Leucocytes", "low"),
|
||||
@@ -254,8 +285,42 @@ def _check_das_bio_coherence(dossier: DossierMedical) -> list[str]:
|
||||
"anémie": ("Hémoglobine", "low"),
|
||||
"anemie": ("Hémoglobine", "low"),
|
||||
"polyglobulie": ("Hémoglobine", "high"),
|
||||
"carence en fer": ("Ferritine", "low"),
|
||||
"carence martiale": ("Ferritine", "low"),
|
||||
# Ionogramme
|
||||
"hyperkaliémie": ("Potassium", "high"),
|
||||
"hypokaliémie": ("Potassium", "low"),
|
||||
"hypernatrémie": ("Sodium", "high"),
|
||||
"hyponatrémie": ("Sodium", "low"),
|
||||
"hyponatremie": ("Sodium", "low"),
|
||||
# Rénal
|
||||
"insuffisance rénale": ("Créatinine", "high"),
|
||||
"insuffisance renale": ("Créatinine", "high"),
|
||||
# Digestif
|
||||
"pancréatite": ("Lipasémie", "high"),
|
||||
"pancreatite": ("Lipasémie", "high"),
|
||||
# Infectiologie
|
||||
"sepsis": ("CRP", "high"),
|
||||
"choc septique": ("Lactate", "high"),
|
||||
# Cardiologie
|
||||
"infarctus": ("Troponine", "high"),
|
||||
"syndrome coronarien": ("Troponine", "high"),
|
||||
"embolie pulmonaire": ("D-dimères", "high"),
|
||||
"insuffisance cardiaque": ("BNP", "high"),
|
||||
# Métabolisme / nutrition
|
||||
"dénutrition": ("Albumine", "low"),
|
||||
"denutrition": ("Albumine", "low"),
|
||||
"diabète": ("Glycémie", "high"),
|
||||
"diabete": ("Glycémie", "high"),
|
||||
"hyperuricémie": ("Acide urique", "high"),
|
||||
"goutte": ("Acide urique", "high"),
|
||||
# Thyroïde
|
||||
"hypothyroïdie": ("TSH", "high"),
|
||||
"hypothyroidie": ("TSH", "high"),
|
||||
"hyperthyroïdie": ("TSH", "low"),
|
||||
"hyperthyroidie": ("TSH", "low"),
|
||||
# Coagulation
|
||||
"civd": ("Fibrinogène", "low"),
|
||||
}
|
||||
|
||||
# Indexer les valeurs bio disponibles
|
||||
|
||||
Reference in New Issue
Block a user