@peopl-health/nexus 5.10.0-dev.1056 → 5.10.0-dev.1058

package/lib/clinical/flags/patternConsultFlags.js

@@ -0,0 +1,10 @@
+const runtimeConfig = require('../../config/runtimeConfig');
+
+function patternConsultLive() {
+  // Default off until the PATTERN_CONSULT Airtable preset and the swapped clinical_routing prose exist; the Python authority defaults true because those already exist there.
+  return String(runtimeConfig.get('PATTERN_CONSULT_LIVE', 'false')).trim().toLowerCase() === 'true';
+}
+
+module.exports = {
+  patternConsultLive,
+};

package/lib/clinical/tools/openClusterHypothesisTool.js

@@ -1,8 +1,10 @@
 const crypto = require('node:crypto');
 
+const { patternConsultStore } = require('../models/patternConsultModel');
 const { readSymptomCases, readClusters, storeCluster } = require('../../fhir');
 const { ClusterImpression } = require('../../shared/dtos/ClusterImpression');
 const { ClusterHistoryRecord } = require('../../shared/dtos/ClusterHistoryRecord');
+const { patternConsultLive } = require('../flags/patternConsultFlags');
 
 const HYPOTHESIS_TYPES = ['ae_profile', 'symptom_syndrome', 'disease_complication', 'relational_causal'];
 const CONFIDENCE_LEVELS = ['speculative', 'moderate', 'strong'];
@@ -95,10 +97,28 @@ async function handler(args = {}, context = {}) {
     if (!CONFIDENCE_LEVELS.includes(initialConfidence)) return fail(`invalid initial_confidence: '${initialConfidence}'. Must be one of ${CONFIDENCE_LEVELS.join(' | ')}.`, { initial_confidence: initialConfidence });
     if (!CLINICAL_SIGNIFICANCE.includes(clinicalSignificance)) return fail(`invalid clinical_significance: '${clinicalSignificance}'. Must be one of ${CLINICAL_SIGNIFICANCE.join(' | ')}.`, { clinical_significance: clinicalSignificance });
 
+    const consultationId = str(args?.consultation_id).trim() || null;
+
     if (requested.length < 2) return fail('cluster requires at least 2 member_case_ids (NCI symptom-cluster definition).', { member_case_ids: requested });
     const memberCaseIds = [...new Set(requested)];
     if (memberCaseIds.length < 2) return fail('after dedup, fewer than 2 unique member_case_ids remain');
 
+    if (patternConsultLive() && initialConfidence !== 'speculative') {
+      if (!consultationId) {
+        return fail('unanchored_hypothesis_must_start_speculative', {
+          initial_confidence: initialConfidence,
+          hint: 'open at speculative confidence, or anchor to a requestPatternConsult consultation_id',
+        });
+      }
+      const consult = await patternConsultStore().get(consultationId);
+      if (!consult || consult.patientCode !== runtime.patientCode) {
+        return fail('invalid_consultation_id', {
+          consultation_id: consultationId,
+          hint: 'anchor to a real requestPatternConsult consultation for this patient, or open at speculative confidence',
+        });
+      }
+    }
+
     const patientId = runtime.patientCode;
     const active = await readClusters({ patientId, label });
     const existing = active.find((c) => c.status === 'active');
@@ -119,7 +139,6 @@ async function handler(args = {}, context = {}) {
 
     const now = new Date().toISOString();
     const clusterId = `cluster_${crypto.randomUUID().replace(/-/g, '').slice(0, 12)}`;
-    const consultationId = str(args?.consultation_id).trim() || null;
     const cluster = new ClusterImpression({
       clusterId,
       patientId,

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "@peopl-health/nexus",
-  "version": "5.10.0-dev.1056",
+  "version": "5.10.0-dev.1058",
   "description": "Core messaging and assistant library for WhatsApp communication platforms",
   "keywords": [
     "whatsapp",