t2a_v2/tests/test_ghm.py

"""Tests pour le module d'estimation GHM."""

import pytest

from src.config import ActeCCAM, Diagnostic, DossierMedical
from src.medical.ghm import estimate_ghm, find_cmd, _detect_type_ghm, _compute_severity


class TestFindCMD:
    def test_k85_hepatobilaire(self):
        cmd, libelle = find_cmd("K85.1")
        assert cmd == "07"
        assert "hépatobiliaire" in libelle.lower() or "pancréat" in libelle.lower()

    def test_j18_respiratoire(self):
        cmd, _ = find_cmd("J18")
        assert cmd == "04"

    def test_n17_renal(self):
        cmd, _ = find_cmd("N17")
        assert cmd == "11"

    def test_n40_genital_masculin(self):
        cmd, _ = find_cmd("N40")
        assert cmd == "12"

    def test_f10_toxicomanie(self):
        cmd, _ = find_cmd("F10")
        assert cmd == "20"

    def test_z00_facteurs(self):
        cmd, _ = find_cmd("Z00")
        assert cmd == "23"

    def test_k40_digestif(self):
        cmd, _ = find_cmd("K40")
        assert cmd == "06"

    def test_b20_vih(self):
        cmd, _ = find_cmd("B20")
        assert cmd == "25"

    def test_t25_brulures(self):
        cmd, _ = find_cmd("T25")
        assert cmd == "22"

    def test_s72_traumatismes(self):
        cmd, _ = find_cmd("S72")
        assert cmd == "21"

    def test_code_with_dot(self):
        cmd, _ = find_cmd("K85.1")
        assert cmd == "07"

    def test_code_lowercase(self):
        cmd, _ = find_cmd("k85.1")
        assert cmd == "07"

    def test_empty_code(self):
        cmd, libelle = find_cmd("")
        assert cmd is None
        assert libelle is None

    def test_none_code(self):
        cmd, libelle = find_cmd(None)
        assert cmd is None
        assert libelle is None

    def test_short_code(self):
        cmd, libelle = find_cmd("K8")
        assert cmd is None


class TestDetectTypeGHM:
    def test_chirurgical(self):
        actes = [ActeCCAM(texte="Cholécystectomie", code_ccam_suggestion="HMFC004")]
        assert _detect_type_ghm(actes) == "C"

    def test_interventionnel(self):
        actes = [ActeCCAM(texte="Échographie", code_ccam_suggestion="ZCQM001")]
        assert _detect_type_ghm(actes) == "K"

    def test_medical_no_actes(self):
        assert _detect_type_ghm([]) == "M"

    def test_medical_no_code(self):
        actes = [ActeCCAM(texte="Biopsie", code_ccam_suggestion=None)]
        assert _detect_type_ghm(actes) == "M"

    def test_chirurgical_overrides_interventionnel(self):
        actes = [
            ActeCCAM(texte="Écho", code_ccam_suggestion="ZCQM001"),
            ActeCCAM(texte="Cholécystectomie", code_ccam_suggestion="HMFC004"),
        ]
        assert _detect_type_ghm(actes) == "C"


class TestSeverityLevels:
    def test_no_cma_level_1(self):
        das = [Diagnostic(texte="HTA", cim10_suggestion="I10")]
        niveau, cma, cms = _compute_severity(das)
        assert niveau == 1

    def test_two_cma_level_2(self):
        das = [
            Diagnostic(texte="FA", cim10_suggestion="I48.9", est_cma=True),
            Diagnostic(texte="IRA", cim10_suggestion="N17.9", est_cma=True),
        ]
        niveau, cma, cms = _compute_severity(das)
        assert niveau == 2
        assert cma == 2

    def test_one_cms_level_3(self):
        das = [
            Diagnostic(texte="Sepsis sévère", cim10_suggestion="A41.9", est_cma=True, est_cms=True),
        ]
        niveau, cma, cms = _compute_severity(das)
        assert niveau == 3
        assert cms == 1

    def test_two_cms_level_4(self):
        das = [
            Diagnostic(texte="Sepsis", cim10_suggestion="A41.9", est_cma=True, est_cms=True),
            Diagnostic(texte="IRA", cim10_suggestion="N17.9", est_cma=True, est_cms=True),
        ]
        niveau, cma, cms = _compute_severity(das)
        assert niveau == 4
        assert cms == 2

    def test_three_cma_level_3(self):
        das = [
            Diagnostic(texte="FA", cim10_suggestion="I48.9", est_cma=True),
            Diagnostic(texte="IRA", cim10_suggestion="N17.9", est_cma=True),
            Diagnostic(texte="Diabète", cim10_suggestion="E11.9", est_cma=True),
        ]
        niveau, cma, cms = _compute_severity(das)
        assert niveau == 3
        assert cma == 3


class TestEstimateGHM:
    def test_chirurgical_with_cma(self):
        dossier = DossierMedical(
            diagnostic_principal=Diagnostic(texte="Cholécystite", cim10_suggestion="K80.1"),
            actes_ccam=[ActeCCAM(texte="Cholécystectomie", code_ccam_suggestion="HMFC004")],
            diagnostics_associes=[
                Diagnostic(texte="FA", cim10_suggestion="I48.9", est_cma=True),
                Diagnostic(texte="IRA", cim10_suggestion="N17.9", est_cma=True),
            ],
        )
        ghm = estimate_ghm(dossier)
        assert ghm.cmd == "07"
        assert ghm.type_ghm == "C"
        assert ghm.severite == 2
        assert ghm.ghm_approx == "07C??2"
        assert ghm.cma_count == 2

    def test_medical_sans_actes(self):
        dossier = DossierMedical(
            diagnostic_principal=Diagnostic(texte="Pneumonie", cim10_suggestion="J18.9"),
        )
        ghm = estimate_ghm(dossier)
        assert ghm.cmd == "04"
        assert ghm.type_ghm == "M"
        assert ghm.severite == 1
        assert ghm.ghm_approx == "04M??1"

    def test_dp_absent(self):
        dossier = DossierMedical()
        ghm = estimate_ghm(dossier)
        assert ghm.cmd is None
        assert ghm.ghm_approx is None
        assert any("DP absent" in a for a in ghm.alertes)

    def test_dp_sans_code(self):
        dossier = DossierMedical(
            diagnostic_principal=Diagnostic(texte="Douleur thoracique"),
        )
        ghm = estimate_ghm(dossier)
        assert ghm.cmd is None
        assert any("sans code" in a for a in ghm.alertes)

    def test_dp_symptomatique(self):
        dossier = DossierMedical(
            diagnostic_principal=Diagnostic(texte="Douleur thoracique", cim10_suggestion="R07.4"),
        )
        ghm = estimate_ghm(dossier)
        assert ghm.cmd == "23"
        assert any("symptomatique" in a for a in ghm.alertes)