@erosolaraijs/cure 2.3.1 → 2.5.0

package/dist/capabilities/clinicalTrialMatchingModule.js

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+/**
+ * Clinical Trial Matching Engine
+ *
+ * ╔═══════════════════════════════════════════════════════════════════════════════╗
+ * ║  CLINICAL TRIAL MATCHING - CONNECTING PATIENTS TO NOVEL THERAPIES            ║
+ * ╠═══════════════════════════════════════════════════════════════════════════════╣
+ * ║  This module provides:                                                        ║
+ * ║  - Biomarker-to-trial mapping                                                ║
+ * ║  - Eligibility criteria assessment                                           ║
+ * ║  - Trial phase and mechanism matching                                        ║
+ * ║  - Geographic and logistical feasibility                                     ║
+ * ║  - Basket, umbrella, and platform trial navigation                           ║
+ * ╚═══════════════════════════════════════════════════════════════════════════════╝
+ */
+// ═══════════════════════════════════════════════════════════════════════════════
+// TRIAL DATABASE (REPRESENTATIVE EXAMPLES)
+// ═══════════════════════════════════════════════════════════════════════════════
+export const TRIAL_DATABASE = [
+    // EGFR-mutant NSCLC Trials
+    {
+        nctId: 'NCT04816214',
+        title: 'Amivantamab + Lazertinib vs Osimertinib in EGFR-Mutant NSCLC (MARIPOSA)',
+        phase: 'Phase 3',
+        status: 'Active, not recruiting',
+        trialType: 'Interventional',
+        sponsor: 'Janssen',
+        conditions: ['NSCLC', 'EGFR-mutant'],
+        interventions: [
+            { type: 'Combination', name: 'Amivantamab + Lazertinib', mechanism: 'EGFR-MET bispecific + EGFR TKI', novelty: 'Combination' }
+        ],
+        eligibilityCriteria: {
+            ageRange: { min: 18, max: 99 },
+            gender: 'All',
+            performanceStatus: { scale: 'ECOG', maxValue: 1 },
+            priorTherapyRequirements: [
+                { requirement: 'Excluded', therapyType: 'Prior EGFR TKI', details: 'No prior EGFR TKI for metastatic disease' }
+            ],
+            organFunctionRequirements: [
+                { organ: 'Renal', parameter: 'CrCl', requirement: '≥50 mL/min' },
+                { organ: 'Hepatic', parameter: 'AST/ALT', requirement: '≤3x ULN' }
+            ],
+            exclusionCriteria: ['Active brain metastases', 'Prior EGFR TKI', 'Interstitial lung disease'],
+            inclusionCriteria: ['EGFR exon 19 del or L858R', 'Metastatic NSCLC', 'Treatment-naive']
+        },
+        locations: [
+            { facility: 'MD Anderson Cancer Center', city: 'Houston', state: 'TX', country: 'USA', status: 'Recruiting' },
+            { facility: 'Memorial Sloan Kettering', city: 'New York', state: 'NY', country: 'USA', status: 'Recruiting' }
+        ],
+        biomarkerRequirements: [
+            { biomarker: 'EGFR exon 19 del or L858R', requirement: 'Required', testMethod: ['NGS', 'PCR', 'ctDNA'] }
+        ],
+        primaryEndpoint: 'Progression-free survival',
+        estimatedEnrollment: 1074,
+        studyStartDate: '2021-05',
+        estimatedCompletionDate: '2025-12'
+    },
+    // HER2+ Breast Cancer Trials
+    {
+        nctId: 'NCT04784715',
+        title: 'Trastuzumab Deruxtecan vs Physician Choice in HER2-low Breast Cancer (DESTINY-Breast06)',
+        phase: 'Phase 3',
+        status: 'Recruiting',
+        trialType: 'Interventional',
+        sponsor: 'Daiichi Sankyo',
+        conditions: ['Breast Cancer', 'HER2-low'],
+        interventions: [
+            { type: 'Biological', name: 'Trastuzumab Deruxtecan', mechanism: 'HER2-directed ADC', novelty: 'New indication' }
+        ],
+        eligibilityCriteria: {
+            ageRange: { min: 18, max: 99 },
+            gender: 'All',
+            performanceStatus: { scale: 'ECOG', maxValue: 1 },
+            priorTherapyRequirements: [
+                { requirement: 'Required', therapyType: 'Prior endocrine therapy', details: 'For HR+ patients' },
+                { requirement: 'Allowed', therapyType: 'Prior chemotherapy', details: '1-2 prior lines allowed' }
+            ],
+            organFunctionRequirements: [
+                { organ: 'Cardiac', parameter: 'LVEF', requirement: '≥50%' }
+            ],
+            exclusionCriteria: ['HER2-positive (IHC 3+)', 'History of ILD', 'Uncontrolled brain mets'],
+            inclusionCriteria: ['HER2-low (IHC 1+ or 2+/FISH-)', 'HR+ or HR-', 'Metastatic breast cancer']
+        },
+        locations: [
+            { facility: 'Dana-Farber Cancer Institute', city: 'Boston', state: 'MA', country: 'USA', status: 'Recruiting' }
+        ],
+        biomarkerRequirements: [
+            { biomarker: 'HER2-low', requirement: 'Required', testMethod: ['IHC', 'FISH'] }
+        ],
+        primaryEndpoint: 'Progression-free survival',
+        estimatedEnrollment: 850,
+        studyStartDate: '2021-03',
+        estimatedCompletionDate: '2026-06'
+    },
+    // KRAS G12C Trials
+    {
+        nctId: 'NCT04685135',
+        title: 'Sotorasib + Anti-EGFR in KRAS G12C CRC (CodeBreaK 300)',
+        phase: 'Phase 3',
+        status: 'Recruiting',
+        trialType: 'Interventional',
+        sponsor: 'Amgen',
+        conditions: ['Colorectal Cancer', 'KRAS G12C'],
+        interventions: [
+            { type: 'Combination', name: 'Sotorasib + Panitumumab', mechanism: 'KRAS G12C inhibitor + anti-EGFR', novelty: 'Combination' }
+        ],
+        eligibilityCriteria: {
+            ageRange: { min: 18, max: 99 },
+            gender: 'All',
+            performanceStatus: { scale: 'ECOG', maxValue: 1 },
+            priorTherapyRequirements: [
+                { requirement: 'Required', therapyType: 'Prior chemotherapy', details: '1-2 prior lines for metastatic disease' }
+            ],
+            organFunctionRequirements: [],
+            exclusionCriteria: ['Prior KRAS G12C inhibitor', 'Symptomatic brain mets'],
+            inclusionCriteria: ['KRAS G12C mutation', 'Metastatic CRC', 'Prior fluoropyrimidine, oxaliplatin, irinotecan']
+        },
+        locations: [
+            { facility: 'Multiple sites', city: 'Various', state: 'Various', country: 'USA', status: 'Recruiting' }
+        ],
+        biomarkerRequirements: [
+            { biomarker: 'KRAS G12C', requirement: 'Required', testMethod: ['NGS', 'PCR'] }
+        ],
+        primaryEndpoint: 'Overall survival',
+        estimatedEnrollment: 160,
+        studyStartDate: '2021-01',
+        estimatedCompletionDate: '2025-06'
+    },
+    // Basket Trial Example
+    {
+        nctId: 'NCT02465060',
+        title: 'NCI-MATCH: Targeted Therapy Directed by Genetic Testing (Basket Trial)',
+        phase: 'Phase 2',
+        status: 'Active, not recruiting',
+        trialType: 'Basket',
+        sponsor: 'NCI',
+        conditions: ['Solid Tumors', 'Lymphoma'],
+        interventions: [
+            { type: 'Drug', name: 'Multiple targeted agents', mechanism: 'Various - based on molecular alteration', novelty: 'First-in-class' }
+        ],
+        eligibilityCriteria: {
+            ageRange: { min: 18, max: 99 },
+            gender: 'All',
+            performanceStatus: { scale: 'ECOG', maxValue: 1 },
+            priorTherapyRequirements: [
+                { requirement: 'Required', therapyType: 'Prior standard therapy', details: 'Progressed on standard options' }
+            ],
+            organFunctionRequirements: [],
+            exclusionCriteria: ['Matched targeted therapy previously received'],
+            inclusionCriteria: ['Actionable genomic alteration', 'No standard treatment options']
+        },
+        locations: [
+            { facility: 'ECOG-ACRIN Network Sites', city: 'Multiple', state: 'Multiple', country: 'USA', status: 'Recruiting' }
+        ],
+        biomarkerRequirements: [
+            { biomarker: 'Actionable mutation per NCI-MATCH arms', requirement: 'Required', testMethod: ['NGS'] }
+        ],
+        primaryEndpoint: 'Overall response rate',
+        estimatedEnrollment: 6000,
+        studyStartDate: '2015-08',
+        estimatedCompletionDate: '2025-12'
+    },
+    // Immunotherapy Combination
+    {
+        nctId: 'NCT03899610',
+        title: 'Nivolumab + Relatlimab vs Nivolumab in Melanoma (RELATIVITY-047)',
+        phase: 'Phase 3',
+        status: 'Active, not recruiting',
+        trialType: 'Interventional',
+        sponsor: 'Bristol-Myers Squibb',
+        conditions: ['Melanoma'],
+        interventions: [
+            { type: 'Combination', name: 'Nivolumab + Relatlimab', mechanism: 'Anti-PD-1 + Anti-LAG-3', novelty: 'First-in-class' }
+        ],
+        eligibilityCriteria: {
+            ageRange: { min: 18, max: 99 },
+            gender: 'All',
+            performanceStatus: { scale: 'ECOG', maxValue: 1 },
+            priorTherapyRequirements: [
+                { requirement: 'Excluded', therapyType: 'Prior anti-PD-1/PD-L1', details: 'No prior checkpoint inhibitor' }
+            ],
+            organFunctionRequirements: [],
+            exclusionCriteria: ['Active autoimmune disease', 'Prior immunotherapy'],
+            inclusionCriteria: ['Unresectable or metastatic melanoma', 'Treatment-naive for metastatic disease']
+        },
+        locations: [
+            { facility: 'Multiple sites', city: 'Various', state: 'Various', country: 'USA', status: 'Recruiting' }
+        ],
+        biomarkerRequirements: [],
+        primaryEndpoint: 'Progression-free survival',
+        estimatedEnrollment: 714,
+        studyStartDate: '2019-04',
+        estimatedCompletionDate: '2024-12'
+    },
+    // CAR-T Trial
+    {
+        nctId: 'NCT04503278',
+        title: 'Cilta-cel vs Standard of Care in Multiple Myeloma (CARTITUDE-4)',
+        phase: 'Phase 3',
+        status: 'Active, not recruiting',
+        trialType: 'Interventional',
+        sponsor: 'Janssen',
+        conditions: ['Multiple Myeloma'],
+        interventions: [
+            { type: 'Biological', name: 'Ciltacabtagene autoleucel (Cilta-cel)', mechanism: 'BCMA-directed CAR-T', novelty: 'Next-generation' }
+        ],
+        eligibilityCriteria: {
+            ageRange: { min: 18, max: 99 },
+            gender: 'All',
+            performanceStatus: { scale: 'ECOG', maxValue: 1 },
+            priorTherapyRequirements: [
+                { requirement: 'Required', therapyType: 'Prior lenalidomide and PI', details: '1-3 prior lines including lenalidomide and a PI' }
+            ],
+            organFunctionRequirements: [
+                { organ: 'Cardiac', parameter: 'LVEF', requirement: '≥45%' },
+                { organ: 'Pulmonary', parameter: 'O2 sat', requirement: '≥92% on room air' }
+            ],
+            exclusionCriteria: ['Prior BCMA-targeted therapy', 'Active CNS involvement', 'Uncontrolled infection'],
+            inclusionCriteria: ['Relapsed/refractory MM', 'Lenalidomide-refractory', '1-3 prior lines']
+        },
+        locations: [
+            { facility: 'Multiple academic centers', city: 'Various', state: 'Various', country: 'USA', status: 'Recruiting' }
+        ],
+        biomarkerRequirements: [],
+        primaryEndpoint: 'Progression-free survival',
+        estimatedEnrollment: 400,
+        studyStartDate: '2020-06',
+        estimatedCompletionDate: '2026-01'
+    },
+    // Pediatric Trial
+    {
+        nctId: 'NCT03155620',
+        title: 'Larotrectinib in Pediatric Solid Tumors with NTRK Fusion (SCOUT)',
+        phase: 'Phase 1/2',
+        status: 'Recruiting',
+        trialType: 'Basket',
+        sponsor: 'Bayer',
+        conditions: ['Pediatric Solid Tumors', 'NTRK Fusion'],
+        interventions: [
+            { type: 'Drug', name: 'Larotrectinib', mechanism: 'TRK inhibitor', novelty: 'First-in-class' }
+        ],
+        eligibilityCriteria: {
+            ageRange: { min: 0, max: 21 },
+            gender: 'All',
+            performanceStatus: { scale: 'Karnofsky', maxValue: 50 },
+            priorTherapyRequirements: [
+                { requirement: 'Allowed', therapyType: 'Prior therapy', details: 'No limit on prior therapies' }
+            ],
+            organFunctionRequirements: [],
+            exclusionCriteria: ['Prior TRK inhibitor', 'Primary CNS tumor'],
+            inclusionCriteria: ['NTRK gene fusion', 'Relapsed or refractory solid tumor', 'Age ≤21']
+        },
+        locations: [
+            { facility: "Children's Hospital of Philadelphia", city: 'Philadelphia', state: 'PA', country: 'USA', status: 'Recruiting' },
+            { facility: 'Texas Childrens Hospital', city: 'Houston', state: 'TX', country: 'USA', status: 'Recruiting' }
+        ],
+        biomarkerRequirements: [
+            { biomarker: 'NTRK1/2/3 fusion', requirement: 'Required', testMethod: ['NGS', 'FISH', 'IHC'] }
+        ],
+        primaryEndpoint: 'Overall response rate',
+        estimatedEnrollment: 150,
+        studyStartDate: '2017-07',
+        estimatedCompletionDate: '2025-12'
+    }
+];
+// ═══════════════════════════════════════════════════════════════════════════════
+// TRIAL MATCHING ENGINE
+// ═══════════════════════════════════════════════════════════════════════════════
+export class ClinicalTrialMatchingEngine {
+    trials = TRIAL_DATABASE;
+    findMatchingTrials(patient) {
+        const matches = [];
+        for (const trial of this.trials) {
+            if (trial.status === 'Withdrawn' || trial.status === 'Terminated')
+                continue;
+            const matchResult = this.evaluateTrialMatch(patient, trial);
+            if (matchResult.matchScore > 0) {
+                matches.push(matchResult);
+            }
+        }
+        return matches.sort((a, b) => b.matchScore - a.matchScore);
+    }
+    evaluateTrialMatch(patient, trial) {
+        const matchDetails = [];
+        const barriers = [];
+        let score = 0;
+        // Check cancer type match
+        const cancerMatch = trial.conditions.some(c => c.toLowerCase().includes(patient.cancerType.toLowerCase()) ||
+            patient.cancerType.toLowerCase().includes(c.toLowerCase()));
+        if (cancerMatch) {
+            score += 30;
+            matchDetails.push({ criterion: 'Cancer type', status: 'Met', explanation: 'Cancer type matches trial conditions' });
+        }
+        else {
+            matchDetails.push({ criterion: 'Cancer type', status: 'Not Met', explanation: 'Cancer type does not match' });
+        }
+        // Check biomarker requirements
+        for (const bioReq of trial.biomarkerRequirements) {
+            const patientBiomarker = patient.biomarkers.find(b => b.name.toLowerCase().includes(bioReq.biomarker.toLowerCase()) ||
+                bioReq.biomarker.toLowerCase().includes(b.name.toLowerCase()));
+            if (bioReq.requirement === 'Required') {
+                if (patientBiomarker?.status === 'Positive') {
+                    score += 25;
+                    matchDetails.push({ criterion: `Biomarker: ${bioReq.biomarker}`, status: 'Met', explanation: 'Required biomarker is positive' });
+                }
+                else if (patientBiomarker?.status === 'Negative') {
+                    score -= 50;
+                    barriers.push(`Required biomarker ${bioReq.biomarker} is negative`);
+                    matchDetails.push({ criterion: `Biomarker: ${bioReq.biomarker}`, status: 'Not Met', explanation: 'Required biomarker is negative' });
+                }
+                else {
+                    matchDetails.push({ criterion: `Biomarker: ${bioReq.biomarker}`, status: 'Unknown', explanation: 'Biomarker status not tested' });
+                }
+            }
+            else if (bioReq.requirement === 'Excluded') {
+                if (patientBiomarker?.status === 'Positive') {
+                    score -= 50;
+                    barriers.push(`Excluded biomarker ${bioReq.biomarker} is positive`);
+                    matchDetails.push({ criterion: `Biomarker: ${bioReq.biomarker}`, status: 'Not Met', explanation: 'Excluded biomarker is positive' });
+                }
+            }
+        }
+        // Check age eligibility
+        const ageElig = trial.eligibilityCriteria.ageRange;
+        if (patient.age >= ageElig.min && patient.age <= ageElig.max) {
+            score += 10;
+            matchDetails.push({ criterion: 'Age', status: 'Met', explanation: `Age ${patient.age} within range ${ageElig.min}-${ageElig.max}` });
+        }
+        else {
+            barriers.push(`Age ${patient.age} outside eligible range ${ageElig.min}-${ageElig.max}`);
+            matchDetails.push({ criterion: 'Age', status: 'Not Met', explanation: 'Age outside eligible range' });
+        }
+        // Check performance status
+        const psReq = trial.eligibilityCriteria.performanceStatus;
+        if (patient.performanceStatus <= psReq.maxValue) {
+            score += 10;
+            matchDetails.push({ criterion: 'Performance status', status: 'Met', explanation: `PS ${patient.performanceStatus} meets requirement ≤${psReq.maxValue}` });
+        }
+        else {
+            barriers.push(`Performance status ${patient.performanceStatus} exceeds maximum ${psReq.maxValue}`);
+            matchDetails.push({ criterion: 'Performance status', status: 'Not Met', explanation: 'Performance status too high' });
+        }
+        // Check phase preference
+        if (patient.preferences.preferredPhases.includes(trial.phase)) {
+            score += 5;
+        }
+        // Check location
+        const matchingLocation = trial.locations.find(loc => loc.country === patient.location.country &&
+            loc.status === 'Recruiting');
+        if (matchingLocation) {
+            score += 10;
+            matchDetails.push({ criterion: 'Location', status: 'Met', explanation: `Trial available in ${matchingLocation.city}, ${matchingLocation.state}` });
+        }
+        else if (patient.willingToTravel) {
+            score += 5;
+            matchDetails.push({ criterion: 'Location', status: 'Partial', explanation: 'Patient willing to travel' });
+        }
+        else {
+            barriers.push('No recruiting sites in patient location');
+            matchDetails.push({ criterion: 'Location', status: 'Not Met', explanation: 'No local sites; travel required' });
+        }
+        // Determine eligibility status
+        let eligibilityStatus;
+        if (barriers.length === 0 && score > 50) {
+            eligibilityStatus = 'Likely Eligible';
+        }
+        else if (barriers.length === 0) {
+            eligibilityStatus = 'Need More Info';
+        }
+        else if (barriers.some(b => b.includes('Required biomarker') || b.includes('Age'))) {
+            eligibilityStatus = 'Likely Ineligible';
+        }
+        else {
+            eligibilityStatus = 'Possibly Eligible';
+        }
+        // Generate next steps
+        const nextSteps = [];
+        if (eligibilityStatus === 'Likely Eligible' || eligibilityStatus === 'Possibly Eligible') {
+            nextSteps.push('Discuss with oncologist');
+            nextSteps.push(`Contact trial site: ${trial.locations[0]?.facility || 'See ClinicalTrials.gov'}`);
+            nextSteps.push(`Search ClinicalTrials.gov for NCT: ${trial.nctId}`);
+        }
+        if (matchDetails.some(m => m.status === 'Unknown')) {
+            nextSteps.push('Complete biomarker testing');
+        }
+        return {
+            trial,
+            matchScore: Math.max(0, score),
+            matchDetails,
+            eligibilityStatus,
+            barriers,
+            nextSteps
+        };
+    }
+    findTrialsByBiomarker(biomarker) {
+        return this.trials.filter(trial => trial.biomarkerRequirements.some(b => b.biomarker.toLowerCase().includes(biomarker.toLowerCase())));
+    }
+    findTrialsByMechanism(mechanism) {
+        return this.trials.filter(trial => trial.interventions.some(i => i.mechanism.toLowerCase().includes(mechanism.toLowerCase())));
+    }
+    findBasketTrials() {
+        return this.trials.filter(trial => trial.trialType === 'Basket');
+    }
+    findPediatricTrials() {
+        return this.trials.filter(trial => trial.eligibilityCriteria.ageRange.min < 18 ||
+            trial.conditions.some(c => c.toLowerCase().includes('pediatric')));
+    }
+    getTrialById(nctId) {
+        return this.trials.find(t => t.nctId === nctId);
+    }
+    generateTrialSearchStrategy(patient) {
+        const searchTerms = [
+            patient.cancerType,
+            patient.histology,
+            ...patient.biomarkers.filter(b => b.status === 'Positive').map(b => b.name)
+        ];
+        return {
+            searchTerms,
+            recommendedDatabases: [
+                'ClinicalTrials.gov (clinicaltrials.gov)',
+                'NCI Cancer Clinical Trials (cancer.gov/clinicaltrials)',
+                'TrialMatch (lls.org/support/information-specialists)',
+                'EmergingMed Navigator (emergingmed.com)'
+            ],
+            searchTips: [
+                'Use condition + biomarker for targeted searches',
+                'Filter by "Recruiting" status',
+                'Check Phase 1/2 trials for novel mechanisms',
+                'Consider basket trials if you have an actionable mutation',
+                'Contact trial coordinators directly for eligibility questions'
+            ]
+        };
+    }
+}
+// Export singleton
+export const clinicalTrialMatchingEngine = new ClinicalTrialMatchingEngine();
+//# sourceMappingURL=clinicalTrialMatchingModule.js.map

package/dist/capabilities/clinicalTrialMatchingModule.js.map

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package/dist/capabilities/emergencyOncology.d.ts

@@ -0,0 +1,97 @@
+/**
+ * Emergency Oncology and Oncologic Emergencies Protocols
+ *
+ * ╔═══════════════════════════════════════════════════════════════════════════════╗
+ * ║  EMERGENCY ONCOLOGY - LIFE-SAVING INTERVENTIONS FOR CANCER EMERGENCIES       ║
+ * ╠═══════════════════════════════════════════════════════════════════════════════╣
+ * ║  This module provides protocols for:                                          ║
+ * ║  - Structural emergencies (SVC syndrome, spinal cord compression, etc.)      ║
+ * ║  - Metabolic emergencies (TLS, hypercalcemia, SIADH, etc.)                   ║
+ * ║  - Treatment-related emergencies (febrile neutropenia, CRS, irAEs)           ║
+ * ║  - Extravasation and infusion reactions                                       ║
+ * ║  - Hemorrhagic and thrombotic emergencies                                    ║
+ * ║  - Rapid-onset symptoms requiring immediate intervention                      ║
+ * ╚═══════════════════════════════════════════════════════════════════════════════╝
+ */
+export interface OncologicEmergency {
+    id: string;
+    name: string;
+    category: EmergencyCategory;
+    urgency: 'Immediate' | 'Urgent' | 'Semi-urgent';
+    timeToIntervention: string;
+    recognition: RecognitionCriteria;
+    initialManagement: EmergencyManagement[];
+    definitiveManagement: DefinitiveManagement[];
+    monitoring: MonitoringProtocol;
+    outcomes: OutcomeExpectations;
+    preventionStrategies: string[];
+}
+export type EmergencyCategory = 'Structural' | 'Metabolic' | 'Hematologic' | 'Treatment-Related' | 'Infectious' | 'Neurologic' | 'Cardiovascular' | 'Respiratory';
+export interface RecognitionCriteria {
+    symptoms: string[];
+    signs: string[];
+    diagnosticCriteria: string[];
+    labFindings?: string[];
+    imagingFindings?: string[];
+    riskFactors: string[];
+}
+export interface EmergencyManagement {
+    step: number;
+    action: string;
+    timing: string;
+    details: string;
+    medications?: MedicationOrder[];
+    contraindications?: string[];
+}
+export interface MedicationOrder {
+    drug: string;
+    dose: string;
+    route: string;
+    frequency: string;
+    duration: string;
+    monitoring?: string;
+}
+export interface DefinitiveManagement {
+    intervention: string;
+    indication: string;
+    timing: string;
+    expectedOutcome: string;
+    alternatives?: string[];
+}
+export interface MonitoringProtocol {
+    parameters: string[];
+    frequency: string;
+    escalationCriteria: string[];
+    deescalationCriteria: string[];
+}
+export interface OutcomeExpectations {
+    withTreatment: string;
+    withoutTreatment: string;
+    longTermPrognosis: string;
+}
+export declare const STRUCTURAL_EMERGENCIES: OncologicEmergency[];
+export declare const METABOLIC_EMERGENCIES: OncologicEmergency[];
+export declare const TREATMENT_RELATED_EMERGENCIES: OncologicEmergency[];
+export declare const HEMATOLOGIC_EMERGENCIES: OncologicEmergency[];
+export declare class EmergencyOncologyEngine {
+    private emergencies;
+    constructor();
+    private initializeEmergencies;
+    getEmergency(id: string): OncologicEmergency | undefined;
+    getEmergenciesByCategory(category: EmergencyCategory): OncologicEmergency[];
+    getEmergenciesByUrgency(urgency: 'Immediate' | 'Urgent' | 'Semi-urgent'): OncologicEmergency[];
+    identifyPotentialEmergency(symptoms: string[], labValues?: Record<string, number>): OncologicEmergency[];
+    generateEmergencyProtocol(emergencyId: string, patientFactors?: {
+        weight?: number;
+        renalFunction?: string;
+        allergies?: string[];
+    }): {
+        emergency: OncologicEmergency;
+        prioritizedSteps: EmergencyManagement[];
+        contraindicatedSteps: EmergencyManagement[];
+        criticalTimepoints: string[];
+    } | undefined;
+    getAllEmergencies(): OncologicEmergency[];
+}
+export declare const emergencyOncologyEngine: EmergencyOncologyEngine;
+//# sourceMappingURL=emergencyOncology.d.ts.map

package/dist/capabilities/emergencyOncology.d.ts.map

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