cancer_registry_reporting_test_kit 0.9.0

data/lib/cancer_registry_reporting_test_kit/search_test.rb

@@ -0,0 +1,897 @@
+# frozen_string_literal: true
+
+require_relative 'fhir_resource_navigation'
+require_relative 'search_test_properties'
+
+module CancerRegistryReportingTestKit
+  module SearchTest
+    extend Forwardable
+    include FHIRResourceNavigation
+
+    def_delegators 'self.class', :metadata, :provenance_metadata, :properties
+    def_delegators 'properties',
+                   :resource_type,
+                   :search_param_names,
+                   :saves_delayed_references?,
+                   :first_search?,
+                   :fixed_value_search?,
+                   :manual_search_params?,
+                   :possible_status_search?,
+                   :test_medication_inclusion?,
+                   :test_post_search?,
+                   :token_search_params,
+                   :test_reference_variants?,
+                   :params_with_comparators,
+                   :multiple_or_search_params
+
+    attr_accessor :manual_search_params
+
+    def all_search_params
+      @all_search_params ||=
+        patient_id_list.each_with_object({}) do |patient_id, params|
+          params[patient_id] ||= []
+          new_params =
+            if manual_search_params
+              manual_search_param_hash(patient_id)
+            elsif fixed_value_search?
+              fixed_value_search_param_values.map { |value| fixed_value_search_params(value, patient_id) }
+            else
+              [search_params_with_values(search_param_names, patient_id)]
+            end
+          new_params.reject! do |params|
+            params.any? { |_key, value| value.blank? }
+          end
+
+          params[patient_id].concat(new_params)
+        end
+    end
+
+    def all_provenance_revinclude_search_params
+      @all_provenance_revinclude_search_params ||=
+        all_search_params.transform_values! do |params_list|
+          params_list.map { |params| params.merge(_revinclude: 'Provenance:target') }
+        end
+    end
+
+    def any_valid_search_params?(search_params)
+      search_params.any? { |_patient_id, params| params.present? }
+    end
+
+    def run_provenance_revinclude_search_test
+      # TODO: skip if not supported?
+      skip_if !any_valid_search_params?(all_provenance_revinclude_search_params), unable_to_resolve_params_message
+
+      provenance_resources =
+        all_provenance_revinclude_search_params.flat_map do |_patient_id, params_list|
+          params_list.flat_map do |params|
+            fhir_search resource_type, params:, tags: tags(params)
+
+            perform_search_with_status(params, patient_id) if response[:status] == 400 && possible_status_search?
+
+            check_search_response
+
+            # TODO: check that only provenance resources for resources matching
+            # granular scopes returned
+            fetch_all_bundled_resources(additional_resource_types: ['Provenance'], params:)
+              .select { |resource| resource.resourceType == 'Provenance' }
+          end
+        end
+
+      scratch_provenance_resources[:all] ||= []
+      scratch_provenance_resources[:all].concat(provenance_resources)
+
+      save_delayed_references(provenance_resources, 'Provenance')
+
+      skip_if provenance_resources.empty?, no_resources_skip_message('Provenance')
+    end
+
+    def run_search_test
+      # TODO: skip if not supported?
+      skip_if !any_valid_search_params?(all_search_params), unable_to_resolve_params_message
+
+      resources_returned =
+        all_search_params.flat_map do |patient_id, params_list|
+          params_list.flat_map { |params| perform_search(params, patient_id) }
+        end
+
+      skip_if resources_returned.empty?, no_resources_skip_message
+
+      perform_multiple_or_search_test if multiple_or_search_params.present?
+    end
+
+    def perform_search(params, patient_id)
+      params.each do |key, value|
+        if key == "date" || key == "effective-time"
+          params[key] = ["ge#{value}", "le#{value}"]
+        end
+      end
+
+      fhir_search resource_type, params:, tags: tags(params)
+
+      perform_search_with_status(params, patient_id) if response[:status] == 400 && possible_status_search?
+
+      check_search_response
+
+      resources_returned =
+        fetch_all_bundled_resources(params:).select { |resource| resource.resourceType == resource_type }
+
+      return [] if resources_returned.blank?
+
+      perform_comparator_searches(params, patient_id) if params_with_comparators.present?
+
+      filter_conditions(resources_returned) if resource_type == 'Condition'
+      filter_devices(resources_returned) if resource_type == 'Device'
+
+      if first_search?
+        all_scratch_resources.concat(resources_returned).uniq!
+        scratch_resources_for_patient(patient_id).concat(resources_returned).uniq!
+      end
+
+      # resources_returned.each do |resource|
+      #   check_resource_against_params(resource, params)
+      # end
+
+      save_delayed_references(resources_returned) if saves_delayed_references?
+
+      return resources_returned if all_search_variants_tested?
+
+      perform_post_search(resources_returned, params) if test_post_search?
+      test_medication_inclusion(resources_returned, params, patient_id) if test_medication_inclusion?
+      perform_reference_with_type_search(params, resources_returned.count) if test_reference_variants?
+      perform_search_with_system(params, patient_id) if token_search_params.present?
+
+      resources_returned
+    end
+
+    def perform_post_search(get_search_resources, params)
+      fhir_search resource_type, params:, search_method: :post
+
+      check_search_response
+
+      post_search_resources = fetch_all_bundled_resources.select { |resource| resource.resourceType == resource_type }
+
+      filter_conditions(post_search_resources) if resource_type == 'Condition'
+      filter_devices(post_search_resources) if resource_type == 'Device'
+
+      get_resource_count = get_search_resources.length
+      post_resource_count = post_search_resources.length
+
+      search_variant_test_records[:post_variant] = true
+
+      assert get_resource_count == post_resource_count,
+             'Expected search by POST to return the same results as search by GET, ' \
+             "but GET search returned #{get_resource_count} resources, and POST search " \
+             "returned #{post_resource_count} resources."
+    end
+
+    def filter_devices(resources)
+      codes_to_include = implantable_device_codes&.split(',')&.map(&:strip)
+      return resources if codes_to_include.blank?
+
+      resources.select! do |resource|
+        resource&.type&.coding&.any? { |coding| codes_to_include.include?(coding.code) }
+      end
+    end
+
+    def filter_conditions(resources)
+      # HL7 JIRA FHIR-37917. US Core v5.0.1 does not required patient+category.
+      # In order to distinguish which resources matches the current profile, Inferno has to manually filter
+      # the result of first search, which is searching by patient.
+      selected_categories = []
+        all_search_params.each do |key, array_of_param_hashes|
+          categories = array_of_param_hashes.map { |param_hash| param_hash['category']}
+          selected_categories.concat categories
+        end
+        selected_categories.uniq!
+
+        resources.select! do |resource|
+          resource.category.any? do |category|
+            category.coding.any? do |coding|
+              selected_categories.include? coding.code
+            end
+          end
+        end
+    end
+
+    def search_and_check_response(params, resource_type = self.resource_type)
+      fhir_search resource_type, params:, tags: tags(params)
+
+      check_search_response
+    end
+
+    def check_search_response
+      assert_response_status(200)
+      assert_resource_type(:bundle)
+      # NOTE: how do we want to handle validating Bundles?
+    end
+
+    def search_variant_test_records
+      @search_variant_test_records ||= initial_search_variant_test_records
+    end
+
+    def initial_search_variant_test_records
+      {}.tap do |records|
+        records[:post_variant] = false if test_post_search?
+        records[:medication_inclusion] = false if test_medication_inclusion?
+        records[:reference_variants] = false if test_reference_variants?
+        records[:token_variants] = false if token_search_params.present?
+        records[:comparator_searches] = Set.new if params_with_comparators.present?
+      end
+    end
+
+    def all_search_variants_tested?
+      search_variant_test_records.all? { |_variant, tested| tested.present? } &&
+        all_comparator_searches_tested?
+    end
+
+    def all_comparator_searches_tested?
+      return true if params_with_comparators.blank?
+
+      Set.new(params_with_comparators) == search_variant_test_records[:comparator_searches]
+    end
+
+    def date_comparator_value(comparator, date)
+      date = date.start || date.end if date.is_a? FHIR::Period
+      case comparator
+      when 'lt', 'le'
+        comparator + (DateTime.xmlschema(date) + 1).xmlschema
+      when 'gt', 'ge'
+        comparator + (DateTime.xmlschema(date) - 1).xmlschema
+      else
+        # ''
+        raise "Unsupported comparator '#{comparator}'"
+      end
+    end
+
+    def required_comparators(name)
+      metadata
+        .search_definitions
+        .dig(name.to_sym, :comparators)
+        .select { |_comparator, expectation| expectation == 'SHALL' }
+        .keys
+        .map(&:to_s)
+    end
+
+    def perform_comparator_searches(params, patient_id)
+      params_with_comparators.each do |name|
+        next if search_variant_test_records[:comparator_searches].include? name
+
+        required_comparators(name).each do |comparator|
+          paths = search_param_paths(name).first
+          date_element = find_a_value_at(scratch_resources_for_patient(patient_id), paths)
+          params_with_comparator = params.merge(name => date_comparator_value(comparator, date_element))
+
+          search_and_check_response(params_with_comparator)
+
+          fetch_all_bundled_resources(params: params_with_comparator).each do |resource|
+            check_resource_against_params(resource, params_with_comparator) if resource.resourceType == resource_type
+          end
+        end
+
+        search_variant_test_records[:comparator_searches] << name
+      end
+    end
+
+    def perform_reference_with_type_search(params, resource_count)
+      return if resource_count.zero?
+      return if search_variant_test_records[:reference_variants]
+
+      new_search_params = params.merge('patient' => "Patient/#{params['patient']}")
+      search_and_check_response(new_search_params)
+
+      reference_with_type_resources =
+        fetch_all_bundled_resources(params: new_search_params)
+          .select { |resource| resource.resourceType == resource_type }
+
+      filter_conditions(reference_with_type_resources) if resource_type == 'Condition' && metadata.version == 'v5.0.1'
+      filter_devices(reference_with_type_resources) if resource_type == 'Device'
+
+      new_resource_count = reference_with_type_resources.count
+
+      assert new_resource_count == resource_count,
+             "Expected search by `#{params['patient']}` to to return the same results as searching " \
+             "by `#{new_search_params['patient']}`, but found #{resource_count} resources with " \
+             "`#{params['patient']}` and #{new_resource_count} with `#{new_search_params['patient']}`"
+
+      search_variant_test_records[:reference_variants] = true
+    end
+
+    def perform_search_with_system(params, patient_id)
+      return if search_variant_test_records[:token_variants]
+
+      new_search_params = search_params_with_values(token_search_params, patient_id, include_system: true)
+      return if new_search_params.any? { |_name, value| value.blank? }
+
+      search_params = params.merge(new_search_params)
+      search_and_check_response(search_params)
+
+      resources_returned =
+        fetch_all_bundled_resources(params: search_params)
+          .select { |resource| resource.resourceType == resource_type }
+
+      assert resources_returned.present?, 'No resources were returned when searching by `system|code`'
+
+      search_variant_test_records[:token_variants] = true
+    end
+
+    def perform_search_with_status(
+      original_params,
+      _patient_id,
+      status_search_values: self.status_search_values,
+      resource_type: self.resource_type
+    )
+      assert resource.is_a?(FHIR::OperationOutcome), 'Server returned a status of 400 without an OperationOutcome'
+      # TODO: warn about documenting status requirements
+      status_search_values.flat_map do |status_value|
+        search_params = original_params.merge("#{status_search_param_name}": status_value)
+
+        search_and_check_response(search_params)
+
+        entries = resource.entry.select { |entry| entry.resource.resourceType == resource_type }
+
+        if entries.present?
+          original_params.merge!("#{status_search_param_name}": status_value)
+          break
+        end
+      end
+    end
+
+    def status_search_param_name
+      @status_search_param_name ||=
+        metadata.search_definitions.keys.find { |key| key.to_s.include? 'status' }
+    end
+
+    def status_search_values
+      default_search_values(status_search_param_name)
+    end
+
+    def default_search_values(param_name)
+      definition = metadata.search_definitions[param_name]
+      return [] if definition.blank?
+
+      definition[:multiple_or] == 'SHALL' ? [definition[:values].join(',')] : Array.wrap(definition[:values])
+    end
+
+    def perform_multiple_or_search_test
+      resolved_one = false
+
+      all_search_params.each do |patient_id, params_list|
+        next unless params_list.present?
+
+        search_params = params_list.first
+        existing_values = {}
+        missing_values = {}
+
+        multiple_or_search_params.each do |param_name|
+          search_value = default_search_values(param_name.to_sym)
+          search_params = search_params.merge(param_name.to_s => search_value)
+          existing_values[param_name.to_sym] =
+            scratch_resources_for_patient(patient_id).map(&param_name.to_sym).compact.uniq
+        end
+
+        # skip patient without multiple-or values
+        next if existing_values.values.any?(&:empty?)
+
+        resolved_one = true
+
+        search_and_check_response(search_params)
+
+        resources_returned =
+          fetch_all_bundled_resources(params: search_params)
+            .select { |resource| resource.resourceType == resource_type }
+
+        multiple_or_search_params.each do |param_name|
+          missing_values[param_name.to_sym] =
+            existing_values[param_name.to_sym] - resources_returned.map(&param_name.to_sym)
+        end
+
+        missing_value_message = missing_values
+          .reject { |_param_name, missing_value| missing_value.empty? }
+          .map { |param_name, missing_value| "#{missing_value.join(',')} values from #{param_name}" }
+          .join(' and ')
+
+        assert missing_value_message.blank?,
+               "Could not find #{missing_value_message} in any of the resources returned for Patient/#{patient_id}"
+
+        break if resolved_one
+      end
+    end
+
+    def test_medication_inclusion(base_resources, params, patient_id)
+      return if search_variant_test_records[:medication_inclusion]
+
+      scratch[:medication_resources] ||= {}
+      scratch[:medication_resources][:all] ||= []
+      scratch[:medication_resources][patient_id] ||= []
+      scratch[:medication_resources][:contained] ||= []
+
+      base_resources_with_external_reference =
+        base_resources
+          .select { |request| request&.medicationReference&.present? }
+          .reject { |request| request&.medicationReference&.reference&.start_with? '#' }
+
+      contained_medications =
+        base_resources
+          .select { |request| request&.medicationReference&.reference&.start_with? '#' }
+          .flat_map(&:contained)
+          .select { |resource| resource.resourceType == 'Medication' }
+
+      scratch[:medication_resources][:all] += contained_medications
+      scratch[:medication_resources][patient_id] += contained_medications
+      scratch[:medication_resources][:contained] += contained_medications
+
+      return if base_resources_with_external_reference.blank?
+
+      search_params = params.merge(_include: "#{resource_type}:medication")
+
+      search_and_check_response(search_params)
+
+      medications =
+        fetch_all_bundled_resources(params: search_params)
+          .select { |resource| resource.resourceType == 'Medication' }
+      assert medications.present?, 'No Medications were included in the search results'
+
+      included_medications = medications.map { |medication| "#{medication.resourceType}/#{medication.id}" }
+
+      matched_base_resources = base_resources_with_external_reference.select do |base_resource|
+        included_medications.any? do |medication_reference|
+          is_reference_match?(base_resource.medicationReference.reference, medication_reference)
+        end
+      end
+
+      not_matched_included_medications = included_medications.select do |medication_reference|
+        matched_base_resources.none? do |base_resource|
+          is_reference_match?(base_resource.medicationReference.reference, medication_reference)
+        end
+      end
+
+      not_matched_included_medications_string = not_matched_included_medications.join(',')
+      assert not_matched_included_medications.empty?,
+             "No #{resource_type} references #{not_matched_included_medications_string} in the search result."
+
+      medications.uniq!(&:id)
+
+      scratch[:medication_resources][:all] += medications
+      scratch[:medication_resources][patient_id] += medications
+
+      search_variant_test_records[:medication_inclusion] = true
+    end
+
+    def is_reference_match?(reference, local_reference)
+      regex_pattern = %r{^(#{Regexp.escape(local_reference)}|\S+/#{Regexp.escape(local_reference)}(?:[/|]\S+)*)$}
+      reference.match?(regex_pattern)
+    end
+
+    def all_scratch_resources
+      scratch_resources[:all] ||= []
+    end
+
+    def scratch_resources_for_patient(patient_id)
+      return all_scratch_resources if patient_id.nil?
+
+      scratch_resources[patient_id] ||= []
+    end
+
+    def references_to_save(resource_type = nil)
+      reference_metadata = resource_type == 'Provenance' ? provenance_metadata : metadata
+      reference_metadata.delayed_references
+    end
+
+    def fixed_value_search_param_name
+      (search_param_names - ['patient']).first
+    end
+
+    def manual_search_param_hash(patient_id)
+      single_patient_manual_search_params = [patient_id] + manual_search_params
+      split_values = single_patient_manual_search_params.map { |value| value.split(',') }
+
+      combinations = split_values[0].product(*split_values[1..])
+
+      combinations.map do |combination|
+        search_param_names.zip(combination).to_h
+      end
+    end
+
+    def fixed_value_search_param_values
+      metadata.search_definitions[fixed_value_search_param_name.to_sym][:values]
+    end
+
+    def fixed_value_search_params(value, patient_id)
+      search_param_names.each_with_object({}) do |name, params|
+        params[name] = patient_id_param?(name) ? patient_id : value
+      end
+    end
+
+    def manual_search_param_name
+      (search_param_names - ['patient']).first
+    end
+
+    def manual_search_param_values
+      metadata.search_definitions[manual_search_param_name.to_sym][:values]
+    end
+
+    def manual_search_params_full(value, patient_id)
+      search_param_names.each_with_object({}) do |name, params|
+        params[name] = patient_id_param?(name) ? patient_id : value
+      end
+    end
+
+    def search_params_with_values(search_param_names, patient_id, include_system: false)
+      resources = scratch_resources_for_patient(patient_id)
+
+      if resources.empty?
+        return search_param_names.each_with_object({}) do |name, params|
+          value = patient_id_param?(name) ? patient_id : nil
+          params[name] = value
+        end
+      end
+
+      resources.each_with_object({}) do |resource, outer_params|
+        results_from_one_resource = search_param_names.each_with_object({}) do |name, params|
+          value = if patient_id_param?(name)
+                    patient_id
+                  else
+                    search_param_value(name, resource,
+                                       include_system: include_system)
+                  end
+          params[name] = value
+        end
+
+        outer_params.merge!(results_from_one_resource)
+
+        # stop if all parameter values are found
+        return outer_params if outer_params.all? { |_key, value| value.present? }
+      end
+    end
+
+    def patient_id_list
+      return [nil] unless respond_to? :patient_ids
+
+      patient_ids.split(',').map(&:strip)
+    end
+
+    def patient_search?
+      search_param_names.any? { |name| patient_id_param? name }
+    end
+
+    def patient_id_param?(name)
+      name == 'patient' || (name == '_id' && resource_type == 'Patient')
+    end
+
+    def search_param_paths(name)
+      paths = metadata.search_definitions[name.to_sym][:paths]
+      if paths.first == 'class'
+        paths[0] = 'local_class'
+      elsif paths.first == 'method'
+        paths[0] = 'local_method'
+      end
+
+      paths
+    end
+
+    def all_search_params_present?(params)
+      params.all? { |_name, value| value.present? }
+    end
+
+    def array_of_codes(array)
+      array.map { |name| "`#{name}`" }.join(', ')
+    end
+
+    def unable_to_resolve_params_message
+      "Could not find values for all search params #{array_of_codes(search_param_names)}"
+    end
+
+    def empty_search_params_message(empty_search_params)
+      "Could not find values for the search parameters #{array_of_codes(empty_search_params.keys)}"
+    end
+
+    def no_resources_skip_message(resource_type = self.resource_type)
+      msg = "No #{resource_type} resources appear to be available"
+
+      if resource_type == 'Device' && implantable_device_codes.present?
+        msg.concat(" with the following Device Type Code filter: #{implantable_device_codes}")
+      end
+
+      "#{msg}. Please use patients with more information"
+    end
+
+    def fetch_all_bundled_resources(
+      reply_handler: nil,
+      max_pages: 20,
+      additional_resource_types: [],
+      resource_type: self.resource_type,
+      params: nil
+    )
+      page_count = 1
+      resources = []
+      bundle = resource
+
+      until bundle.nil? || page_count == max_pages
+        resources += bundle&.entry&.map { |entry| entry&.resource }
+        next_bundle_link = bundle&.link&.find { |link| link.relation == 'next' }&.url
+        reply_handler&.call(response)
+
+        break if next_bundle_link.blank?
+
+        reply = fhir_client.raw_read_url(next_bundle_link)
+
+        store_request('outgoing', tags: tags(params)) { reply }
+        error_message = cant_resolve_next_bundle_message(next_bundle_link)
+
+        assert_response_status(200)
+        assert_valid_json(reply.body, error_message)
+
+        bundle = fhir_client.parse_reply(FHIR::Bundle, fhir_client.default_format, reply)
+
+        page_count += 1
+      end
+
+      valid_resource_types = [resource_type, 'OperationOutcome'].concat(additional_resource_types)
+      valid_resource_types << 'Medication' if %w[MedicationRequest MedicationDispense].include?(resource_type)
+
+      invalid_resource_types =
+        resources.reject { |entry| valid_resource_types.include? entry.resourceType }
+          .map(&:resourceType)
+          .uniq
+
+      if invalid_resource_types.any?
+        info "Received resource type(s) #{invalid_resource_types.join(', ')} in search bundle, " \
+             "but only expected resource types #{valid_resource_types.join(', ')}. " \
+             'This is unusual but allowed if the server believes additional resource types are relevant.'
+      end
+
+      resources
+    end
+
+    def cant_resolve_next_bundle_message(link)
+      "Could not resolve next bundle: #{link}"
+    end
+
+    def search_param_value(name, resource, include_system: false)
+      paths = search_param_paths(name)
+      search_value = nil
+      paths.each do |path|
+        element = find_a_value_at(resource, path) { |element| element_has_valid_value?(element, include_system) }
+
+        search_value =
+          case element
+          when FHIR::Period
+            if element.start.present?
+              "gt#{(DateTime.xmlschema(element.start) - 1).xmlschema}"
+            else
+              end_datetime = get_fhir_datetime_range(element.end)[:end]
+              "lt#{(end_datetime + 1).xmlschema}"
+            end
+          when FHIR::Reference
+            element.reference
+          when FHIR::CodeableConcept
+            if include_system
+              coding =
+                find_a_value_at(element, 'coding') { |coding| coding.code.present? && coding.system.present? }
+              "#{coding.system}|#{coding.code}"
+            else
+              find_a_value_at(element, 'coding.code')
+            end
+          when FHIR::Identifier
+            include_system ? "#{element.system}|#{element.value}" : element.value
+          when FHIR::Coding
+            include_system ? "#{element.system}|#{element.code}" : element.code
+          when FHIR::HumanName
+            element.family || element.given&.first || element.text
+          when FHIR::Address
+            element.text || element.city || element.state || element.postalCode || element.country
+          when CancerRegistryReportingTestKit::PrimitiveType
+            element.value
+          else
+            if metadata.version != 'v3.1.1' &&
+               metadata.search_definitions[name.to_sym][:type] == 'date' &&
+               params_with_comparators&.include?(name)
+              # convert date search to greath-than comparator search with correct precision
+              # For all date search parameters:
+              #   Patient.birthDate does not mandate comparators so cannot be converted
+              #   Goal.target-date has day precision
+              #   All others have second + time offset precision
+              if /^\d{4}(-\d{2})?$/.match?(element) || # YYYY or YYYY-MM
+                 (/^\d{4}-\d{2}-\d{2}$/.match?(element) && resource_type != 'Goal') # YYY-MM-DD AND Resource is NOT Goal
+                "gt#{(DateTime.xmlschema(element) - 1).xmlschema}"
+              else
+                element
+              end
+            else
+              element
+            end
+          end
+
+        break if search_value.present?
+      end
+
+      search_value&.gsub(',', '\\,')
+    end
+
+    def element_has_valid_value?(element, include_system)
+      case element
+      when FHIR::Reference
+        element.reference.present?
+      when FHIR::CodeableConcept
+        if include_system
+          coding =
+            find_a_value_at(element, 'coding') { |coding| coding.code.present? && coding.system.present? }
+          coding.present?
+        else
+          find_a_value_at(element, 'coding.code').present?
+        end
+      when FHIR::Identifier
+        include_system ? element.value.present? && element.system.present? : element.value.present?
+      when FHIR::Coding
+        include_system ? element.code.present? && element.system.present? : element.code.present?
+      when FHIR::HumanName
+        (element.family || element.given&.first || element.text).present?
+      when FHIR::Address
+        (element.text || element.city || element.state || element.postalCode || element.country).present?
+      when CancerRegistryReportingTestKit::PrimitiveType
+        element.value.present?
+      else
+        true
+      end
+    end
+
+    def save_resource_reference(resource_type, reference)
+      scratch[:references] ||= {}
+      scratch[:references][resource_type] ||= Set.new
+      scratch[:references][resource_type] << reference
+    end
+
+    def save_delayed_references(resources, containing_resource_type = resource_type)
+      resources.each do |resource|
+        references_to_save(containing_resource_type).each do |reference_to_save|
+          resolve_path(resource, reference_to_save[:path])
+            .select do |reference|
+            reference.is_a?(FHIR::Reference) &&
+              !reference.contained? && reference.reference.present?
+          end
+            .each do |reference|
+              resource_type = reference.resource_class.name.demodulize
+              need_to_save = reference_to_save[:resources].include?(resource_type)
+              next unless need_to_save
+
+              save_resource_reference(resource_type, reference)
+            end
+        end
+      end
+    end
+
+    #### RESULT CHECKING ####
+
+    def check_resource_against_params(resource, params)
+      params.each do |name, escaped_search_value|
+        values_found = []
+        search_value = unescape_search_value(escaped_search_value)
+
+        match_found = resource_matches_param?(resource, name, escaped_search_value, values_found)
+
+        assert match_found,
+               "#{resource_type}/#{resource.id} did not match the search parameters:\n" \
+               "* Expected: #{unescape_search_value(search_value)}\n" \
+               "* Found: #{values_found.map(&:inspect).join(', ')}"
+      end
+    end
+
+    def unescape_search_value(value)
+      value&.gsub('\\,', ',')
+    end
+
+    def resource_matches_param?(resource, search_param_name, escaped_search_value, values_found = [])
+      search_value = unescape_search_value(escaped_search_value)
+      paths = search_param_paths(search_param_name)
+
+      match_found = false
+
+      paths.each do |path|
+        type = metadata.search_definitions[search_param_name.to_sym][:type]
+
+        resolve_path(resource, path).each do |value|
+          values_found <<
+            if value.is_a? FHIR::Reference
+              value.reference
+            elsif value.is_a? CancerRegistryReportingTestKit::PrimitiveType
+              value.value
+            else
+              value
+            end
+        end
+
+        values_found.compact!
+        match_found =
+          case type
+          when 'Period', 'date', 'instant', 'dateTime'
+            values_found.any? { |date| validate_date_search(search_value, date) }
+          when 'HumanName'
+            # When a string search parameter refers to the types HumanName and Address,
+            # the search covers the elements of type string, and does not cover elements such as use and period
+            # https://www.hl7.org/fhir/search.html#string
+            search_value_downcase = search_value.downcase
+            values_found.any? do |name|
+              name&.text&.downcase&.start_with?(search_value_downcase) ||
+                name&.family&.downcase&.start_with?(search_value_downcase) ||
+                name&.given&.any? { |given| given.downcase.start_with?(search_value_downcase) } ||
+                name&.prefix&.any? { |prefix| prefix.downcase.start_with?(search_value_downcase) } ||
+                name&.suffix&.any? { |suffix| suffix.downcase.start_with?(search_value_downcase) }
+            end
+          when 'Address'
+            search_value_downcase = search_value.downcase
+            values_found.any? do |address|
+              address&.text&.downcase&.start_with?(search_value_downcase) ||
+                address&.city&.downcase&.start_with?(search_value_downcase) ||
+                address&.state&.downcase&.start_with?(search_value_downcase) ||
+                address&.postalCode&.downcase&.start_with?(search_value_downcase) ||
+                address&.country&.downcase&.start_with?(search_value_downcase)
+            end
+          when 'CodeableConcept'
+            # FHIR token search (https://www.hl7.org/fhir/search.html#token): "When in doubt, servers SHOULD
+            # treat tokens in a case-insensitive manner, on the grounds that including undesired data has
+            # less safety implications than excluding desired behavior".
+            codings = values_found.flat_map(&:coding)
+            if search_value.include? '|'
+              system = search_value.split('|').first
+              code = search_value.split('|').last
+              codings&.any? { |coding| coding.system == system && coding.code&.casecmp?(code) }
+            else
+              codings&.any? { |coding| coding.code&.casecmp?(search_value) }
+            end
+          when 'Coding'
+            if search_value.include? '|'
+              system = search_value.split('|').first
+              code = search_value.split('|').last
+              values_found.any? { |coding| coding.system == system && coding.code&.casecmp?(code) }
+            else
+              values_found.any? { |coding| coding.code&.casecmp?(search_value) }
+            end
+          when 'Identifier'
+            if search_value.include? '|'
+              values_found.any? { |identifier| "#{identifier.system}|#{identifier.value}" == search_value }
+            else
+              values_found.any? { |identifier| identifier.value == search_value }
+            end
+          when 'string'
+            searched_values = search_value.downcase.split(/(?<!\\\\),/).map { |string| string.gsub('\\,', ',') }
+            values_found.any? do |value_found|
+              searched_values.any? { |searched_value| value_found.downcase.starts_with? searched_value }
+            end
+          else
+            # searching by patient requires special case because we are searching by a resource identifier
+            # references can also be URLs, so we may need to resolve those URLs
+            if %w[subject patient].include? search_param_name.to_s
+              id = search_value.split('Patient/').last
+              possible_values = [id, "Patient/#{id}", "#{url}/Patient/#{id}"]
+              values_found.any? do |reference|
+                possible_values.include? reference
+              end
+            else
+              search_values = search_value.split(/(?<!\\\\),/).map { |string| string.gsub('\\,', ',') }
+              values_found.any? { |value_found| search_values.include? value_found }
+            end
+          end
+
+        break if match_found
+      end
+
+      match_found
+    end
+
+    def tags(params)
+      return nil unless config.options[:tag_requests]
+
+      return nil if params.blank?
+
+      if %w[Condition DiagnosticReport DocumentReference Observation ServiceRequest].include? resource_type
+        return [search_params_tag(params)]
+      end
+
+      nil
+    end
+
+    def search_params_tag(params)
+      "#{resource_type}?#{params.keys.join('&')}"
+    end
+  end
+end