chore: add .gitignore
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dom
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output/structured/88_23034958/BACTERIO_23034958_cim10.json
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output/structured/88_23034958/BACTERIO_23034958_cim10.json
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{
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"source_file": "BACTERIO 23034958.pdf",
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"document_type": "crh",
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"sejour": {},
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"diagnostic_principal": {
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"texte": "Candidurie",
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"cim10_suggestion": "N39.0",
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"cim10_confidence": "high",
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"cim10_final": "N39.0",
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"cim10_decision": {
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"action": "PROMOTE_DP",
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"final_code": "N39.0",
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"reason": "DAS promu en DP (score (2, 3, 4))",
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"needs_info": [],
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"applied_rules": [
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"RULE-DAS-TO-DP"
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]
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},
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"justification": "La présence de Candida albicans dans l'ECBU indique une candidurie, nécessitant potentiellement un traitement antifongique et une surveillance, mobilisant des ressources supplémentaires.",
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"sources_rag": [],
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"preuves_cliniques": [],
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"source": "llm_das",
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"source_page": 1,
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"source_excerpt": "...Vitek2, gélose chromogène ou agglutination\n1.10*4 UFC/mL Candida albicans\nConclusion\nPrésence d'une candidurie.\nRésultat à confronter au contexte clinique.\nPrélèvement de contrôle nécessaire pour étayer le diag..."
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},
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"dp_selection": {
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"chosen_index": 0,
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"chosen_term": "Candidurie",
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"chosen_code": "N39.0",
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"verdict": "CONFIRMED",
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"evidence": [
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"Score 3.0 — source: llm_das",
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"Conclusion: «Présence d'une candidurie.\nRésultat à confronter au contexte clinique.\nPrélèvement de contrôle nécessaire pour étayer le diagnostic.\nCompte-rendu : Complet (1) analyse référencée sous\nACCREDITATION COFRAC Page 1/1\nValidé et diffusé sous la »"
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],
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"reason": "Candidat unique",
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"candidates": [
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{
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"index": 0,
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"term": "Candidurie",
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"code": "N39.0",
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"source": "llm_das",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": false,
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"section_strength": 1,
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"num_occurrences": 1,
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"score": 3.0,
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"score_details": {
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"section": 1,
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"confidence": 0,
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"diag_section_bonus": 2
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}
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}
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],
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"debug_scores": {
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"top1": 3.0
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}
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},
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"dp_crh_only": {
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"chosen_index": 0,
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"chosen_term": "Candidurie",
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"chosen_code": "N39.0",
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"verdict": "CONFIRMED",
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"evidence": [
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"Score 3.0 — source: llm_das",
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"Conclusion: «Présence d'une candidurie.\nRésultat à confronter au contexte clinique.\nPrélèvement de contrôle nécessaire pour étayer le diagnostic.\nCompte-rendu : Complet (1) analyse référencée sous\nACCREDITATION COFRAC Page 1/1\nValidé et diffusé sous la »"
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],
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"reason": "Candidat unique",
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"candidates": [
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{
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"index": 0,
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"term": "Candidurie",
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"code": "N39.0",
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"source": "llm_das",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": false,
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"section_strength": 1,
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"num_occurrences": 1,
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"score": 3.0,
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"score_details": {
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"section": 1,
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"confidence": 0,
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"diag_section_bonus": 2
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}
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}
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],
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"debug_scores": {
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"top1": 3.0
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}
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},
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"dp_final": {
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"chosen_index": 0,
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"chosen_term": "Candidurie",
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"chosen_code": "N39.0",
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"verdict": "CONFIRMED",
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"evidence": [
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"Score 3.0 — source: llm_das",
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"Conclusion: «Présence d'une candidurie.\nRésultat à confronter au contexte clinique.\nPrélèvement de contrôle nécessaire pour étayer le diagnostic.\nCompte-rendu : Complet (1) analyse référencée sous\nACCREDITATION COFRAC Page 1/1\nValidé et diffusé sous la »"
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],
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"reason": "Candidat unique",
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"candidates": [
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{
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"index": 0,
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"term": "Candidurie",
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"code": "N39.0",
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"source": "llm_das",
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"is_comorbidity_like": false,
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"is_symptom_like": false,
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"is_act_only": false,
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"section_strength": 1,
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"num_occurrences": 1,
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"score": 3.0,
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"score_details": {
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"section": 1,
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"confidence": 0,
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"diag_section_bonus": 2
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}
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}
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],
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"debug_scores": {
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"top1": 3.0
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}
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},
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"quality_flags": {
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"crh_only_mode": true
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},
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"diagnostics_associes": [],
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"actes_ccam": [],
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"antecedents": [],
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"traitements_sortie": [],
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"biologie_cle": [
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{
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"test": "Leucocytes",
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"valeur": "5",
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"valeur_num": 5.0,
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"anomalie": false,
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"quality": "ok",
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"source_page": 1,
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"source_excerpt": "...ie ci-dessous rendu(s) sous accréditation (1) sauf mention contraire\nECBU - Milieu de jet\nCytologie\nLeucocytes 5 /µL <10\nAutomate Iris IQ 200 Select (Beckman-Coulter)\nHématies 12 /µL <10\nAutomate Iris IQ 200 Se..."
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}
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],
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"biologie_discarded": [],
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"imagerie": [],
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"complications": [],
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"alertes_codage": [
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"CMA niveau 2 : 'Candidurie' (N39.0) — sévérité non_evalue",
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"QC: DAS N39.0 (Candidurie) à reconsidérer — Le dossier clinique ne mentionne pas la présence de Candida albicans dans l'ECBU. Un taux de leucocytes normal (5) ne justifie pas le codage N39.0 (Candidurie). Il n'y a aucune preuve clinique pour soutenir ce code. La justification fournie est incorrecte car elle suppose une candidurie qui n'est pas documentée.",
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"QC: Le dossier clinique est incomplet pour justifier le codage N39.0. Une ECBU positive pour Candida albicans est nécessaire pour ce diagnostic.",
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"RULE-DAS-TO-DP: DP absent → DAS N39.0 (Candidurie) promu en DP",
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"DECISIONS[PDF]: 1 ligne(s)",
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"DECISION: diagnostic_principal N39.0 promu en DP (RULE-DAS-TO-DP)"
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],
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"source_files": [],
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"ghm_estimation": {
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"cmd": "11",
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"cmd_libelle": "Affections du rein et des voies urinaires",
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"type_ghm": "M",
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"severite": 1,
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"ghm_approx": "11M??1",
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"cma_count": 0,
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"cms_count": 0,
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"alertes": []
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},
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"controles_cpam": [],
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"processing_time_s": 9.69,
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"metrics": {
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"das_total": 0,
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"das_active": 0,
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"das_excluded": 0,
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"das_removed": 0,
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"das_ruled_out": 0,
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"das_no_code": 0,
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"actes_total": 0,
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"actes_with_code": 0,
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"dp_has_code": true
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},
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"rules_runtime": {
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"router_version": 1,
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"mode": "strict",
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"enabled_packs": [
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"decisions_core",
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"vetos_core"
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],
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"always_on_rules": [],
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"triggers_fired": []
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}
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}
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