feat: dp_finalizer — arbitrage Trackare vs CRH-only avec traçabilité audit
Nouveau module src/medical/dp_finalizer.py : - 5 règles d'arbitrage (R1-R5) : CRH CONFIRMED override, Trackare corroboré, symptôme R* override/review, ambigu REVIEW, Z-code/R-code interdits auto-confirm - Traçabilité : dp_trackare, dp_crh_only, dp_final sur DossierMedical - quality_flags dict (merge sans écraser) + alertes_codage (append) Modèles config.py : - DPCandidate, DPSelection (NUKE-3) - get_dp_ranker_llm_enabled(), check_adversarial_model_config() - Champs DossierMedical : dp_trackare, dp_crh_only, dp_final, quality_flags Intégration : - main.py : appel finalize_dp() après vetos/GHM (individuel + fusionné) - benchmark : finalizer dans _rebuild_and_select(), dp_final dans output Co-Authored-By: Claude Opus 4.6 <noreply@anthropic.com>
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src/medical/dp_finalizer.py
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src/medical/dp_finalizer.py
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"""DP Finalizer — arbitrage Trackare vs CRH-only.
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Dernière étape du pipeline DP : produit ``dp_final`` avec traçabilité
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complète (``dp_trackare``, ``dp_crh_only``) et ``quality_flags`` audit.
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Principes :
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- Clean architecture : logique métier isolée, pas de dépendance Ollama.
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- Traçabilité : chaque décision est justifiée (reason + evidence + flags).
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- Prudence : en cas de doute → REVIEW, jamais CONFIRMED.
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"""
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from __future__ import annotations
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from src.config import DossierMedical, DPSelection
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# Whitelist Z-codes admis en DP CONFIRMED (même que dp_selector)
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_Z_CODE_DP_WHITELIST = frozenset({
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"Z03", "Z04", "Z08", "Z09",
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"Z38", "Z43", "Z45", "Z50", "Z51", "Z54", "Z75",
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"Z99",
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})
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def _family3(code: str | None) -> str:
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"""Extrait le préfixe 3 caractères (family3) d'un code CIM-10."""
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if not code:
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return ""
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return code.split(".")[0].upper()
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def _code_in_candidates(code: str | None, selection: DPSelection) -> bool:
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"""Vérifie si *code* apparaît dans les candidats de *selection* (exact ou family3)."""
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if not code or not selection.candidates:
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return False
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code_up = code.upper()
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fam = _family3(code)
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for c in selection.candidates:
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c_code = (c.code or "").upper()
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if c_code == code_up or _family3(c_code) == fam:
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return True
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return False
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def _has_strong_evidence(sel: DPSelection) -> bool:
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"""Vérifie si la sélection a une evidence forte (non triviale)."""
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if not sel.evidence:
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return False
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# "Source: Trackare" seul n'est pas une preuve forte
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strong = [e for e in sel.evidence if "Trackare" not in e]
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return len(strong) > 0
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def _make_selection(
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code: str | None,
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term: str | None,
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verdict: str,
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confidence: str,
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evidence: list[str],
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reason: str,
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source_sel: DPSelection | None = None,
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) -> DPSelection:
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"""Construit un DPSelection final en préservant les candidats de la source."""
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return DPSelection(
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chosen_code=code,
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chosen_term=term,
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verdict=verdict,
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confidence=confidence,
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evidence=evidence,
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reason=reason,
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candidates=source_sel.candidates if source_sel else [],
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debug_scores=source_sel.debug_scores if source_sel else None,
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chosen_index=source_sel.chosen_index if source_sel else None,
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)
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# ── Règles R1-R5 ──────────────────────────────────────────────────────
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def decide_dp_final(
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trackare_dp: DPSelection | None,
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crh_dp: DPSelection | None,
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allow_symptom_dp: bool = False,
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) -> tuple[DPSelection, dict, list[str]]:
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"""Arbitrage Trackare vs CRH-only.
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Returns:
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(dp_final, quality_flags_additions, alertes)
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"""
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flags: dict = {}
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alertes: list[str] = []
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# ── Cas dégénérés ──────────────────────────────────────────────
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if not trackare_dp and not crh_dp:
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return (
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DPSelection(verdict="REVIEW", reason="Aucun DP disponible"),
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{"no_dp_source": True},
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["Aucun DP extrait (ni Trackare ni CRH)"],
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)
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if not trackare_dp and crh_dp:
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# CRH-only mode — pass-through
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dp = crh_dp.model_copy(deep=True)
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flags["crh_only_mode"] = True
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# Appliquer R5 post-hoc
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dp, r5_flags, r5_alertes = _apply_r5(dp, crh_dp, allow_symptom_dp)
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flags.update(r5_flags)
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alertes.extend(r5_alertes)
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return dp, flags, alertes
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if trackare_dp and not crh_dp:
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# Trackare-only mode
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code = trackare_dp.chosen_code or ""
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# R5 : Z-code → REVIEW
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if code.startswith("Z") and _family3(code) not in _Z_CODE_DP_WHITELIST:
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dp = _make_selection(
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code=trackare_dp.chosen_code,
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term=trackare_dp.chosen_term,
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verdict="REVIEW",
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confidence="medium",
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evidence=trackare_dp.evidence + ["Z-code en DP : vérification DIM requise"],
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reason="R5 — Z-code non whitelisté en DP",
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source_sel=trackare_dp,
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)
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flags["trackare_only_mode"] = True
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flags["z_code_dp_review"] = True
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return dp, flags, ["DP Trackare Z-code non whitelisté → REVIEW"]
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dp = trackare_dp.model_copy(deep=True)
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# Respecter un REVIEW déjà posé par le garde-fou dp_selector
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if not dp.evidence:
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dp.evidence = ["Source: Trackare (codage établissement)"]
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flags["trackare_only_mode"] = True
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return dp, flags, alertes
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# ── Les deux sources existent ──────────────────────────────────
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assert trackare_dp is not None and crh_dp is not None
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t_code = (trackare_dp.chosen_code or "").upper()
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c_code = (crh_dp.chosen_code or "").upper()
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t_fam = _family3(t_code)
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c_fam = _family3(c_code)
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# ── R3 — Trackare symptôme (R*) + CRH étiologique ─────────────
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# (évalué avant R1 : cas spécifique > cas général)
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if t_code.startswith("R"):
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if crh_dp.verdict == "CONFIRMED" and not c_code.startswith("R") and _has_strong_evidence(crh_dp):
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# Override : CRH étiologique CONFIRMED
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dp = crh_dp.model_copy(deep=True)
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dp.reason = "R3 — Trackare symptôme écarté au profit du CRH étiologique CONFIRMED"
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flags["trackare_symptom_overridden"] = True
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alertes.append(
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f"Trackare symptôme ({t_code}) remplacé par CRH ({c_code}) — "
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f"diagnostic étiologique CONFIRMED"
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)
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# R5 post-hoc
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dp, r5_flags, r5_alertes = _apply_r5(dp, crh_dp, allow_symptom_dp)
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flags.update(r5_flags)
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alertes.extend(r5_alertes)
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return dp, flags, alertes
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else:
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# REVIEW prudent
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dp = _make_selection(
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code=trackare_dp.chosen_code,
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term=trackare_dp.chosen_term,
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verdict="REVIEW",
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confidence="medium",
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evidence=[
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"Source: Trackare (codage établissement)",
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"Alerte: Trackare code un symptôme (R*) mais le CRH mentionne un diagnostic étiologique",
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],
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reason="R3 — Trackare symptôme vs CRH diagnostic : vérification DIM requise",
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source_sel=trackare_dp,
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)
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flags["trackare_symptom_vs_crh_diagnosis"] = True
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alertes.append(
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f"Trackare symptôme ({t_code}) vs CRH ({c_code}) — vérification DIM requise"
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)
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return dp, flags, alertes
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# ── R1 — CRH CONFIRMED avec evidence forte → CRH prime ────────
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if crh_dp.verdict == "CONFIRMED" and _has_strong_evidence(crh_dp):
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dp = crh_dp.model_copy(deep=True)
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dp.reason = "R1 — CRH-only CONFIRMED avec preuves fortes"
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if t_code and t_code != c_code and t_fam != c_fam:
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flags["override_trackare_by_crh_confirmed"] = True
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alertes.append(
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f"DP final basé CRH-only CONFIRMED ({c_code}) — "
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f"Trackare ({t_code}) écarté (preuves CRH supérieures)"
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)
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else:
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flags["crh_confirmed_coherent"] = True
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# R5 post-hoc
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dp, r5_flags, r5_alertes = _apply_r5(dp, crh_dp, allow_symptom_dp)
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flags.update(r5_flags)
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alertes.extend(r5_alertes)
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return dp, flags, alertes
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# ── R2 — Trackare non-symptôme, cohérent CRH → confirmer ──────
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if (
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not t_code.startswith("R")
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and not t_code.startswith("Z")
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and (t_code == c_code or t_fam == c_fam or _code_in_candidates(t_code, crh_dp))
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):
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dp = _make_selection(
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code=trackare_dp.chosen_code,
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term=trackare_dp.chosen_term,
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verdict="CONFIRMED",
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confidence="high",
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evidence=[
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"Source: Trackare (codage établissement)",
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f"Trackare {t_code} corroboré par CRH (candidat {c_code})",
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],
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reason="R2 — Trackare non-symptôme corroboré par CRH",
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source_sel=crh_dp,
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)
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flags["trackare_confirmed_by_crh"] = True
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return dp, flags, alertes
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# ── R4 — Ambigu / preuves faibles → REVIEW ────────────────────
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if trackare_dp:
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base = trackare_dp
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base_label = "Trackare"
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else:
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base = crh_dp
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base_label = "CRH"
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dp = _make_selection(
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code=base.chosen_code,
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term=base.chosen_term,
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verdict="REVIEW",
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confidence="medium",
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evidence=base.evidence[:2] + ["Preuves insuffisantes pour confirmation automatique"],
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reason="R4 — Ambigu / preuves faibles",
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source_sel=crh_dp,
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)
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flags["review_ambiguous"] = True
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alertes.append(f"DP ambigu ({base_label} {base.chosen_code or '?'}) — REVIEW")
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return dp, flags, alertes
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# ── R5 — Interdits auto-confirm (post-hoc) ────────────────────────
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def _apply_r5(
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dp: DPSelection,
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crh_dp: DPSelection | None,
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allow_symptom_dp: bool,
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) -> tuple[DPSelection, dict, list[str]]:
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"""Applique R5 : Z-code et R-code jamais auto-CONFIRMED (sauf whitelist)."""
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flags: dict = {}
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alertes: list[str] = []
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code = (dp.chosen_code or "").upper()
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# Z-code non whitelisté → forcer REVIEW
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if code.startswith("Z") and _family3(code) not in _Z_CODE_DP_WHITELIST:
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if dp.verdict == "CONFIRMED":
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dp.verdict = "REVIEW"
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dp.confidence = "medium"
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dp.evidence.append("R5 — Z-code non whitelisté en DP → REVIEW")
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dp.reason = (dp.reason or "") + " | R5 Z-code"
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flags["z_code_dp_review"] = True
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alertes.append(f"Z-code {code} en DP → REVIEW (R5)")
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# R-code avec candidat non-R disponible → REVIEW si allow_symptom_dp=false
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if (
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code.startswith("R")
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and not allow_symptom_dp
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and crh_dp
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and any(
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not (c.code or "").upper().startswith("R")
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for c in crh_dp.candidates
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if c.code
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)
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):
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if dp.verdict == "CONFIRMED":
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dp.verdict = "REVIEW"
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dp.confidence = "medium"
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dp.evidence.append("R5 — Symptôme R-code en DP avec candidat non-R disponible → REVIEW")
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dp.reason = (dp.reason or "") + " | R5 R-code"
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flags["r_code_dp_with_non_r_candidate"] = True
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alertes.append(f"R-code {code} en DP avec alternative non-R → REVIEW (R5)")
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return dp, flags, alertes
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# ── Fonction publique ──────────────────────────────────────────────
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def finalize_dp(dossier: DossierMedical) -> DossierMedical:
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"""Point d'entrée unique du finalizer.
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Lit ``dp_selection`` et ``document_type``, produit :
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- ``dp_trackare`` (si Trackare)
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- ``dp_crh_only`` (si CRH)
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- ``dp_final`` (arbitrage)
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- ``quality_flags`` (merge sans écraser)
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- ``alertes_codage`` (append)
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"""
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# ── 1. Identifier les sources DP ───────────────────────────────
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trackare_dp: DPSelection | None = None
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crh_dp: DPSelection | None = None
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if dossier.dp_selection:
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sel = dossier.dp_selection
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reason = (sel.reason or "").lower()
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is_trackare_source = (
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dossier.document_type == "trackare"
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or "trackare" in reason
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or any("Trackare" in e for e in sel.evidence)
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)
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if is_trackare_source:
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trackare_dp = sel
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else:
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crh_dp = sel
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# ── 2. Stocker les sources pour traçabilité ────────────────────
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dossier.dp_trackare = trackare_dp
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dossier.dp_crh_only = crh_dp
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# ── 3. Arbitrage ───────────────────────────────────────────────
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dp_final, flags, alertes = decide_dp_final(trackare_dp, crh_dp)
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# ── 4. Écrire les résultats ────────────────────────────────────
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dossier.dp_final = dp_final
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# Merge quality_flags (ne pas écraser les flags existants)
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for k, v in flags.items():
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dossier.quality_flags[k] = v
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# Append alertes_codage
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for alerte in alertes:
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if alerte not in dossier.alertes_codage:
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dossier.alertes_codage.append(alerte)
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return dossier
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