@peopl-health/nexus 5.9.0-dev.921 → 6.0.0-dev.611

package/lib/clinical/config/subAgentsConfig.js

@@ -1,44 +0,0 @@
-const { Config_ID } = require('../../config/airtableConfig');
-
-const { getRecordByFilter } = require('../../services/airtableService');
-
-const MapCache = require('../../utils/MapCache');
-const { safeParse, isPlainObject } = require('../../utils/jsonUtils');
-
-const SUBAGENTS_CONFIG_TABLE = 'sub_agents';
-const CACHE_TTL = 5 * 60 * 1000;
-const CACHE_KEY = 'subAgentsConfig';
-const EXTRACTOR_DEFAULTS = { presetId: '' };
-const COMPOSER_DEFAULTS = { presetId: '' };
-
-const cache = new MapCache({ maxSize: 1, ttl: CACHE_TTL });
-
-async function load() {
-  const cached = cache.get(CACHE_KEY);
-  if (cached) return cached;
-
-  const records = await getRecordByFilter(Config_ID, SUBAGENTS_CONFIG_TABLE, 'TRUE()');
-  if (!records) throw new Error('subAgents config could not be read from the Config base');
-  const byKey = Object.fromEntries(records.map((r) => [r.config, r.value]));
-
-  const parsedExtractor = safeParse(byKey.EXTRACTOR, null);
-  if (byKey.EXTRACTOR && !isPlainObject(parsedExtractor)) throw new Error('subAgents config EXTRACTOR is not a JSON object');
-  const extractor = { ...EXTRACTOR_DEFAULTS, ...(parsedExtractor || {}) };
-
-  const parsedComposer = safeParse(byKey.COMPOSER, null);
-  if (byKey.COMPOSER && !isPlainObject(parsedComposer)) throw new Error('subAgents config COMPOSER is not a JSON object');
-  const composer = { ...COMPOSER_DEFAULTS, ...(parsedComposer || {}) };
-
-  const config = { EXTRACTOR: extractor, COMPOSER: composer };
-  cache.set(CACHE_KEY, config);
-  return config;
-}
-
-async function get(key) {
-  return (await load())[key];
-}
-
-module.exports = {
-  getExtractor: () => get('EXTRACTOR'),
-  getComposer: () => get('COMPOSER'),
-};

package/lib/clinical/flags/bridgeConfig.js

@@ -1,14 +0,0 @@
-const runtimeConfig = require('../../config/runtimeConfig');
-
-function isBridgeEnabled() {
-  return runtimeConfig.get('BRIDGE_ENABLED', 'false') === 'true';
-}
-
-function getBridgePresetId() {
-  return runtimeConfig.get('BRIDGE_PRESET_ID', 'clinical_agent');
-}
-
-module.exports = {
-  isBridgeEnabled,
-  getBridgePresetId,
-};

package/lib/clinical/flags/composerFlags.js

@@ -1,14 +0,0 @@
-const runtimeConfig = require('../../config/runtimeConfig');
-
-function isComposerEnabled() {
-  return runtimeConfig.get('COMPOSER_ENABLED', 'false') === 'true';
-}
-
-function isAgentSelfRenderEnabled() {
-  return runtimeConfig.get('CLINICAL_AGENT_SELF_RENDER', 'false') === 'true';
-}
-
-module.exports = {
-  isComposerEnabled,
-  isAgentSelfRenderEnabled,
-};

package/lib/clinical/helpers/clinicalFactsHelper.js

@@ -1,108 +0,0 @@
-const CATEGORY_TO_KIND = {
-  symptom: 'observation',
-  lab_value: 'observation',
-  emotion: 'observation',
-  medication: 'medication',
-  adherence: 'medication',
-  diagnosis: 'condition',
-  indication: 'condition',
-  treatment: 'procedure',
-  appointment: 'appointment',
-  allergy: 'allergy',
-};
-const LOW_CONFIDENCE = 0.7;
-
-function projectClinicalFacts({ clinicalMentions = [], safetyFlags = [], gradeScales = {} }) {
-  const clinicalFacts = clinicalMentions.map((m) => toClinicalFact(m, gradeScales)).filter(Boolean);
-
-  const symptoms = clinicalMentions.filter((m) => m?.fact?.category === 'symptom').length;
-  const agentHint = !clinicalMentions.length
-    ? 'Sin entidades clínicas extraíbles en este mensaje.'
-    : symptoms ? `${symptoms} síntoma(s) nuevo(s)` : `${clinicalMentions.length} mención(es) clínica(s)`;
-
-  return {
-    success: true,
-    data: {
-      agent_hint: agentHint,
-      safety_flags_received: [...safetyFlags],
-      degraded: false,
-      degraded_reasons: [],
-      clinical_facts: clinicalFacts,
-    },
-  };
-}
-
-function toClinicalFact(mention, gradeScales = {}) {
-  const fact = mention?.fact || {};
-  const prov = mention?.provenance || {};
-  if (!fact.mentionId || !fact.category || !fact.canonicalTerm) return null;
-
-  const kind = CATEGORY_TO_KIND[fact.category] || 'observation';
-  const out = { id: fact.mentionId, code: fact.canonicalTerm, kind };
-  if (fact.reportedAt) out.effective = fact.reportedAt;
-
-  const notes = Array.isArray(prov.verbatimQuotes) ? prov.verbatimQuotes.filter(Boolean) : [];
-  if (notes.length) out.notes = notes;
-
-  const assertion = fact.assertion;
-  if (assertion && typeof assertion === 'object') {
-    const interp = {
-      negated: Boolean(assertion.negated),
-      hedged: Boolean(assertion.hedged),
-      experiencer: assertion.experiencer || 'patient',
-      temporal: assertion.temporal || 'current',
-    };
-    const isDefault = !interp.negated && !interp.hedged
-      && interp.experiencer === 'patient' && interp.temporal === 'current';
-    if (!isDefault) out.interpretation = interp;
-  }
-
-  const confidence = prov.extractorConfidence;
-  if (typeof confidence === 'number' && confidence < LOW_CONFIDENCE) out.confidence = confidence;
-
-  if (kind === 'observation') {
-    if (fact.ctcaeTerm) out.code_ctcae = fact.ctcaeTerm;
-    const observed = Object.fromEntries(
-      Object.entries(fact.observedFields || {}).filter(([, v]) => v !== null && v !== undefined),
-    );
-    if (Object.keys(observed).length) out.value = { observed };
-    const gradeScale = fact.ctcaeTerm ? gradeScales[fact.ctcaeTerm] || null : null;
-    if (gradeScale) out.grade_scale = gradeScale;
-  } else if (kind === 'medication') {
-    out.adherence_status = fact.category === 'adherence' ? 'non_adherent' : 'unknown';
-  } else if (kind === 'condition') {
-    out.clinical_status = fact.category === 'diagnosis' ? 'active' : 'unknown';
-  }
-  return out;
-}
-
-function renderClinicalIntakeSummary({ clinicalMentions = [], safetyFlags = [] } = {}) {
-  const lines = clinicalMentions.map((mention) => {
-    const fact = mention?.fact || {};
-    const prov = mention?.provenance || {};
-    if (!fact.canonicalTerm) return null;
-    const parts = [`[${fact.category || 'mención'}] ${fact.canonicalTerm}`];
-    if (fact.ctcaeTerm && fact.ctcaeTerm !== fact.canonicalTerm) parts.push(`CTCAE: ${fact.ctcaeTerm}`);
-    const observed = Object.entries(fact.observedFields || {})
-      .filter(([, value]) => value !== null && value !== undefined)
-      .map(([key, value]) => `${key}=${value}`);
-    if (observed.length) parts.push(observed.join(', '));
-    const assertion = fact.assertion || {};
-    if (assertion.negated) parts.push('negado');
-    if (assertion.hedged) parts.push('con duda');
-    if (assertion.temporal && assertion.temporal !== 'current') parts.push(assertion.temporal);
-    if (assertion.experiencer && assertion.experiencer !== 'patient') parts.push(`de: ${assertion.experiencer}`);
-    const quote = (Array.isArray(prov.verbatimQuotes) ? prov.verbatimQuotes : []).find(Boolean);
-    if (quote) parts.push(`«${quote}»`);
-    return `- ${parts.join(' — ')}`;
-  }).filter(Boolean);
-  if (!lines.length) return '';
-  const flags = safetyFlags.map((flag) => (typeof flag === 'string' ? flag : flag?.type)).filter(Boolean);
-  const flagLine = flags.length ? `\nAlertas de seguridad: ${flags.join(', ')}` : '';
-  return `Extracción clínica (clinical-agent):\n${lines.join('\n')}${flagLine}`;
-}
-
-module.exports = {
-  projectClinicalFacts,
-  renderClinicalIntakeSummary,
-};

package/lib/clinical/helpers/clinicalMentionHelper.js

@@ -1,68 +0,0 @@
-const { ClinicalMention } = require('../../shared/dtos/ClinicalMention');
-
-function buildExtractorInput(text, detectedTags, curated, template) {
-  const payload = JSON.stringify({ raw_message: text, detected_tags: detectedTags }, null, 2);
-  const tpl = curated.length ? template.symptom : template.default;
-  return tpl
-    .replace('{{curated}}', () => JSON.stringify(curated, null, 2))
-    .replace('{{payload}}', () => payload);
-}
-
-function readOutputText(result) {
-  if (result?.output_text) return result.output_text;
-  const output = Array.isArray(result?.output) ? result.output : [];
-  const message = output.find((item) => item.type === 'message');
-  const content = Array.isArray(message?.content) ? message.content : [];
-  const part = content.find((c) => typeof c?.text === 'string');
-  return part?.text || '';
-}
-
-function toClinicalMention(raw, { code, turnId, index, now, intakeSource, responseFormat, spanishByTerm = {} }) {
-  const rawTerm = (raw.ctcae_term || '').trim().toLowerCase();
-  const ctcaeTerm = !rawTerm || rawTerm === 'other' ? null : rawTerm;
-  const canonicalTerm = deriveCanonicalTerm(raw, ctcaeTerm, spanishByTerm);
-  if (!canonicalTerm) return null;
-
-  const mentionId = `men_${turnId}_${index}`;
-  const verbatim = raw.verbatim_quote ? [raw.verbatim_quote] : (raw.verbatim_quotes || []);
-  const observed = raw.observed_fields || {};
-  return new ClinicalMention({
-    fact: {
-      mentionId,
-      patientId: code,
-      category: raw.category,
-      canonicalTerm,
-      reportedAt: now,
-      assertion: raw.assertion || {},
-      ctcaeTerm,
-      temporality: raw.temporality || null,
-      observedFields: responseFormat === 'router'
-        ? Object.fromEntries(Object.entries(observed).filter(([, v]) => v != null))
-        : observed,
-    },
-    provenance: {
-      mentionId,
-      patientId: code,
-      turnId,
-      recordedAt: now,
-      source: intakeSource || 'self',
-      verbatimQuotes: verbatim,
-      extractorConfidence: raw.extractor_confidence ?? raw.confidence ?? raw.assertion?.confidence ?? 1,
-    },
-  });
-}
-
-function deriveCanonicalTerm(raw, ctcaeTerm, spanishByTerm) {
-  const emitted = (raw.canonical_term || '').trim().toLowerCase();
-  if (emitted) return emitted;
-  if (raw.category === 'symptom' && ctcaeTerm) {
-    return ((spanishByTerm[ctcaeTerm] || ctcaeTerm) || '').toLowerCase() || null;
-  }
-  return null;
-}
-
-module.exports = {
-  buildExtractorInput,
-  readOutputText,
-  toClinicalMention,
-};

package/lib/clinical/helpers/cohortHelper.js

@@ -1,22 +0,0 @@
-const { isInCohort } = require('../config/cohortConfig');
-const { Thread } = require('../../models/threadModel');
-
-const runtimeConfig = require('../../config/runtimeConfig');
-const { logger } = require('../../utils/logger');
-
-async function overlayCohortPreset(thread) {
-  const enrolled = await isInCohort(thread.code, 'preset');
-  if (!enrolled) return thread;
-  try {
-    const base = thread.toObject();
-    delete base._id;
-    const cohortThread = new Thread({ ...base, preset_id: runtimeConfig.get('COHORT_PRESET_ID', 'clinical_agent'), preset_version: null });
-    cohortThread.isInCohort = true;
-    return cohortThread;
-  } catch (error) {
-    logger.error('[cohortHelper] overlay failed; patient stays on the control path', { code: thread.code, error: error.message });
-    return thread;
-  }
-}
-
-module.exports = { overlayCohortPreset };

package/lib/clinical/helpers/gradeEstimateHelper.js

@@ -1,29 +0,0 @@
-const GRADE_MIN = 1;
-const GRADE_MAX = 5;
-const inGradeRange = (value) => Number.isInteger(value) && value >= GRADE_MIN && value <= GRADE_MAX;
-
-function parseGradeEstimate(raw) {
-  const grade = { bestEstimate: null, confidence: null, possibleRange: null, reasoning: '' };
-  if (!raw || typeof raw !== 'object') return grade;
-  if (raw.best_estimate !== null && raw.best_estimate !== undefined) {
-    if (!inGradeRange(raw.best_estimate)) return { error: 'grade_out_of_range' };
-    grade.bestEstimate = raw.best_estimate;
-  }
-  if (['low', 'moderate', 'high'].includes(raw.confidence)) grade.confidence = raw.confidence;
-  if (raw.possible_range !== null && raw.possible_range !== undefined) {
-    const range = raw.possible_range;
-    if (!Array.isArray(range) || range.length !== 2 || !inGradeRange(range[0]) || !inGradeRange(range[1]) || range[0] > range[1]) {
-      return { error: 'grade_out_of_range' };
-    }
-    grade.possibleRange = [range[0], range[1]];
-  }
-  if (typeof raw.reasoning === 'string') grade.reasoning = raw.reasoning;
-  return grade;
-}
-
-module.exports = {
-  GRADE_MIN,
-  GRADE_MAX,
-  inGradeRange,
-  parseGradeEstimate,
-};

package/lib/clinical/helpers/resultsHelper.js

@@ -1,34 +0,0 @@
-const DEGRADED_NUMERIC_REASON = 'observations_should_have_been_passed_text_contains_numbers — patient_verbatim contains a numeric+unit pattern (e.g. \'8.5 g/dL\'); pass these as `observations: [{code, value, unit, effective}]` so the audit lane emits FHIR Observation + Provenance per fact.';
-
-const NUMERIC_VALUE_PATTERN = new RegExp(
-  '\\d+(?:\\.\\d+)?\\s*(?:'
-  + 'g/dL|mg/dL|mmol/L|umol/L|mEq/L|ng/mL|pg/mL|ug/mL|ug/dL'
-  + '|10\\^?\\*?[0-9]+/[a-zA-Z]+'
-  + '|K/uL|/uL|/mm3'
-  + '|U/L|IU/L'
-  + '|mmHg|cmH2O'
-  + '|bpm|/min|rpm'
-  + '|°C|°F|Cel'
-  + '|(?:kg|mg|ug|mL|dL|cm|mm)\\b'
-  + '|%'
-  + ')',
-  'i',
-);
-
-function patientVerbatimHasNumericValues(text) {
-  if (!text || typeof text !== 'string') return false;
-  return NUMERIC_VALUE_PATTERN.test(text);
-}
-
-function slugify(value, maxLen = 32) {
-  if (!value) return '';
-  const stripped = value.normalize('NFKD').replace(/[̀-ͯ]/g, '');
-  const hyphenated = stripped.replace(/[^a-zA-Z0-9]+/g, '-').replace(/^-+|-+$/g, '').toLowerCase();
-  return hyphenated.slice(0, maxLen).replace(/^-+|-+$/g, '');
-}
-
-module.exports = {
-  DEGRADED_NUMERIC_REASON,
-  patientVerbatimHasNumericValues,
-  slugify,
-};

package/lib/clinical/helpers/safetyFlagsHelper.js

@@ -1,10 +0,0 @@
-function detectSafetyFlags(text, catalog) {
-  const flags = new Set();
-  if (!text) return [];
-  for (const { flag, re } of catalog) {
-    if (re.test(text)) flags.add(flag);
-  }
-  return [...flags];
-}
-
-module.exports = { detectSafetyFlags };

package/lib/clinical/services/bridgeService.js

@@ -1,55 +0,0 @@
-const { logger } = require('../../utils/logger');
-const MapCache = require('../../utils/MapCache');
-const { isBridgeEnabled } = require('../flags/bridgeConfig');
-
-const MAX_WORDS = 25;
-const BRIDGE_RATE_LIMIT_MS = 60000;
-const CONTEXT_MARKER_PREFIX_RX = /^\s*(\[\s*(?:puente|sistema)\b[^\]]*\]\s*)+/i;
-
-const bridgeTimestamps = new MapCache({ maxSize: 1000, ttl: BRIDGE_RATE_LIMIT_MS });
-
-function sanitizeBridgeText(text) {
-  const trimmed = (text || '').replace(CONTEXT_MARKER_PREFIX_RX, '').trim();
-  if (trimmed.length < 2) return null;
-  if (trimmed.split(/\s+/).length > MAX_WORDS) return null;
-  return trimmed;
-}
-
-function buildDedupNote(bridgeText) {
-  return '[sistema] Ya enviaste la siguiente burbuja al paciente como mensaje puente: ' +
-    `"${bridgeText}". Tu mensaje final NO debe repetir saludo, nombre del paciente, ` +
-    'ni acuse del inbound — eso ya fue entregado. Empieza directo con el contenido ' +
-    'clínico. El mensaje final es la SEGUNDA burbuja que verá el paciente, no la primera.';
-}
-
-function maybeSendBridge({ narrationText, hasToolCalls, code, turnId = null, traceId = null, shouldContinue, sendMessage }) {
-  if (!isBridgeEnabled()) return { sent: false };
-
-  const skip = (reason) => {
-    logger.info('[bridge] skipped', { code, reason });
-    return { sent: false };
-  };
-
-  if (typeof shouldContinue === 'function' && !shouldContinue()) return skip('superseded');
-  if (!hasToolCalls) return skip('text_only_iter1_would_duplicate_final');
-
-  const text = sanitizeBridgeText(narrationText);
-  if (!text) return skip('no_usable_narration');
-
-  if (bridgeTimestamps.get(code) !== undefined) return skip('recent_bridge_in_thread');
-
-  bridgeTimestamps.set(code, true);
-  try {
-    Promise.resolve(sendMessage({ code, body: text, processed: true, origin: 'assistant', raw: { bridge: true }, turnId, traceId }))
-      .catch(err => logger.warn('[bridge] send failed', { code, error: err.message }));
-  } catch (err) {
-    logger.warn('[bridge] send failed', { code, error: err.message });
-  }
-
-  logger.info('[bridge] sent', { code });
-  return { sent: true, text, dedupNote: buildDedupNote(text) };
-}
-
-module.exports = {
-  maybeSendBridge,
-};

package/lib/clinical/services/clinicalAirtableService.js

@@ -1,162 +0,0 @@
-const { Monitoreo_ID, Estado_General_ID } = require('../../config/airtableConfig');
-const airtableService = require('../../services/airtableService');
-const { logger } = require('../../utils/logger');
-
-const MEDICAL_URGENCY_TO_EMERGENCY_LEVEL = {
-  stat: 'Alta',
-  asap: 'Alta',
-  urgent: 'Media',
-};
-
-// The Airtable reminder.type singleSelect predates the clinical-agent enum.
-const REMINDER_TYPE_TO_AIRTABLE = {
-  examen: 'exámen',
-  check_in: 'otros',
-};
-
-// intake.source only offers self|doctor; team_relay carries "según médico" authority.
-const INTAKE_SOURCE_TO_AIRTABLE = {
-  self: 'self',
-  caregiver: 'self',
-  team_relay: 'doctor',
-};
-
-async function auditedWrite({ trace, code, table, write }) {
-  const entry = { table, at: new Date().toISOString(), ok: false };
-  try {
-    const result = await write();
-    entry.ok = true;
-    const record = Array.isArray(result) ? result[0] : result;
-    if (record?.id) entry.recordId = record.id;
-  } catch (err) {
-    entry.error = err?.message || String(err);
-    logger.error('[clinicalAirtableService] Airtable write failed', { table, code, error: entry.error });
-  }
-  if (trace?.setSignals) {
-    const existing = Array.isArray(trace.signals?.airtableWrites) ? trace.signals.airtableWrites : [];
-    trace.setSignals({ airtableWrites: [...existing, entry] });
-  }
-  return entry.ok;
-}
-
-async function findMonitoreoPatientRecordId(code) {
-  const patient = await airtableService.getRecordByFilter(Monitoreo_ID, 'estado_general', `{whatsapp_id} = "${code}"`);
-  return patient?.[0]?.recordID || null;
-}
-
-async function findIntakePatientRecordId(code) {
-  const patient = await airtableService.getRecordByFilter(Estado_General_ID, 'estado_general', `{whatsapp_id} = "${code}"`);
-  return patient?.[0]?.monitoreo_record_id || null;
-}
-
-async function recordUnresolvedRequest({ code, trace, question, details, resolutionAttempted = false, category = null, urgency = null }) {
-  return auditedWrite({
-    trace,
-    code,
-    table: 'unresolved_questions',
-    write: async () => {
-      const patientId = await findMonitoreoPatientRecordId(code);
-      const fields = {
-        customer_id: patientId ? [patientId] : [],
-        question: question || '',
-        details: details || '',
-        resolution_attempted: Boolean(resolutionAttempted),
-        message_tag: 'request',
-      };
-      if (category) fields.category = category;
-      if (urgency) fields.urgency = urgency;
-      return airtableService.addRecord(Monitoreo_ID, 'unresolved_questions', [{ fields }], code);
-    },
-  });
-}
-
-async function recordEmergency({ code, trace, symptom, suspectedCondition = '', recommendedAction = '', urgencyFhir = null, urgencyLevel = null, documentation = '' }) {
-  const level = urgencyLevel || MEDICAL_URGENCY_TO_EMERGENCY_LEVEL[urgencyFhir] || 'Alta';
-  return auditedWrite({
-    trace,
-    code,
-    table: 'emergencies',
-    write: async () => {
-      const patientId = await findMonitoreoPatientRecordId(code);
-      const fields = {
-        patient: patientId ? [patientId] : [],
-        symptom: symptom || '',
-        suspectedCondition: suspectedCondition || '',
-        urgencyLevel: level,
-        recommendedAction: recommendedAction || '',
-      };
-      if (urgencyFhir) fields.urgency_fhir = urgencyFhir;
-      if (documentation) fields['Documentación_emergencia'] = documentation;
-      return airtableService.addRecord(Monitoreo_ID, 'emergencies', [{ fields }], code);
-    },
-  });
-}
-
-async function recordClinicalIntake({ code, trace, messageRaw, source = 'self' }) {
-  return auditedWrite({
-    trace,
-    code,
-    table: 'intake',
-    write: async () => {
-      const patientId = await findIntakePatientRecordId(code);
-      return airtableService.addRecord(Estado_General_ID, 'intake', [{
-        fields: {
-          patient: patientId ? [patientId] : [],
-          message_raw: messageRaw || '',
-          source: INTAKE_SOURCE_TO_AIRTABLE[source] || 'self',
-        },
-      }], code);
-    },
-  });
-}
-
-async function recordReminder({ code, trace, actionType, reminderId, reminderDateUtc, reminderType, description }) {
-  const type = REMINDER_TYPE_TO_AIRTABLE[reminderType] || reminderType;
-  if (actionType === 'update') {
-    return auditedWrite({
-      trace,
-      code,
-      table: 'reminder',
-      write: async () => {
-        const updated = await airtableService.updateRecordByFilter(
-          Monitoreo_ID,
-          'reminder',
-          `AND({schedule_id} = "${reminderId}", IF({is_active}, "true", "false") = "true", IF({is_sent}, "true", "false") = "false")`,
-          { reminder_date: reminderDateUtc, type, description },
-          code,
-        );
-        if (!updated?.length) throw new Error(`no active unsent reminder found for reminder_id ${reminderId}`);
-        return updated;
-      },
-    });
-  }
-  return auditedWrite({
-    trace,
-    code,
-    table: 'reminder',
-    write: () => airtableService.addLinkedRecord(
-      Monitoreo_ID,
-      'reminder',
-      {
-        schedule_id: reminderId || '',
-        whatsapp_id: code,
-        reminder_date: reminderDateUtc,
-        type,
-        description,
-      },
-      {
-        referenceTable: 'estado_general',
-        referenceFilter: `{whatsapp_id} = "${code}"`,
-        linkFieldName: 'patient_id',
-      },
-      code,
-    ),
-  });
-}
-
-module.exports = {
-  recordUnresolvedRequest,
-  recordEmergency,
-  recordClinicalIntake,
-  recordReminder,
-};

package/lib/clinical/services/clinicalExtractionService.js

@@ -1,112 +0,0 @@
-const { getSafetyFlagPatterns } = require('../config/divergenceConfig');
-const { getExtractor } = require('../config/subAgentsConfig');
-const { getCtcaeCatalog } = require('../stores/CtcaeCatalog');
-const { storeClinicalMentions } = require('../../fhir');
-
-const { Config_ID } = require('../../config/airtableConfig');
-const { getRecordByFilter } = require('../../services/airtableService');
-const MapCache = require('../../utils/MapCache');
-const { safeParse, safeParseArray } = require('../../utils/jsonUtils');
-const { logger } = require('../../utils/logger');
-const { detectSafetyFlags } = require('../helpers/safetyFlagsHelper');
-const { buildExtractorInput, readOutputText, toClinicalMention } = require('../helpers/clinicalMentionHelper');
-
-const CONFIG_TABLE = 'registry';
-const CACHE_TTL = 5 * 60 * 1000;
-const CONFIG_CACHE_KEY = 'clinicalExtractorConfig';
-
-const extractorConfigCache = new MapCache({ maxSize: 1, ttl: CACHE_TTL });
-
-async function extractClinicalMentions({ text, turnId, code, provider, detectedTags = [], intakeSource = 'self', responseFormat = 'router' }) {
-  const [patterns, { presetId }] = await Promise.all([
-    getSafetyFlagPatterns(),
-    getExtractor(),
-  ]);
-
-  const flags = new Set(detectSafetyFlags(text || '', patterns));
-
-  if (!text || !text.trim() || !presetId || !provider?.runStructured) {
-    return { clinicalMentions: [], safetyFlags: [...flags] };
-  }
-
-  try {
-    const template = await getExtractorInputTemplate();
-    const curated = detectedTags.includes('symptom') ? getCtcaeCatalog().getCuratedSymptomsByTerm() : new Map();
-    const curatedRows = [...curated.values()].map(toExtractorRow);
-    const spanishByTerm = Object.fromEntries(curatedRows.filter((row) => row.ctcae_term).map((row) => [row.ctcae_term, row.spanish_label]));
-
-    const result = await provider.runStructured({
-      presetId,
-      input: [{ role: 'user', content: buildExtractorInput(text, detectedTags, curatedRows, template) }],
-      metadata: { extractor: 'clinical-mention', turnId },
-    });
-
-    if (result?.status && result.status !== 'completed') throw new Error(`clinical extraction incomplete: status=${result.status}`);
-
-    const outputText = readOutputText(result);
-    const parsed = safeParse(outputText, null);
-    if (outputText && outputText.trim() && parsed === null) {
-      logger.warn('[clinicalExtraction] model output did not parse as JSON; no mentions extracted', { turnId });
-    }
-    const rawMentions = Array.isArray(parsed?.mentions) ? parsed.mentions : [];
-
-    const now = new Date().toISOString();
-    const clinicalMentions = [];
-    rawMentions.forEach((raw, index) => {
-      if (!raw || typeof raw !== 'object') return;
-      const mention = toClinicalMention(raw, { code, turnId, index, now, intakeSource, responseFormat, spanishByTerm });
-      if (mention) clinicalMentions.push(mention);
-      for (const f of raw.safety_flags || []) flags.add(f);
-    });
-
-    const patientMentions = clinicalMentions.filter((mention) => mention.fact.assertion.experiencer === 'patient');
-    if (patientMentions.length) {
-      await storeClinicalMentions({ patientId: code, mentions: patientMentions });
-    }
-
-    return { clinicalMentions, safetyFlags: [...flags] };
-  } catch (err) {
-    logger.error('[clinicalExtraction] extraction failed; returning deterministic safety flags only', { turnId, error: err?.message });
-    return { clinicalMentions: [], safetyFlags: [...flags] };
-  }
-}
-
-function toExtractorRow(symptom) {
-  return {
-    ctcae_term: symptom.ctcaeTerm,
-    spanish_label: symptom.spanishLabel,
-    patient_phrases_validated: symptom.patientPhrasesValidated,
-    observed_fields_schema: symptom.observedFieldsSchema,
-    critical_field: symptom.criticalField,
-    grades: symptom.grades,
-  };
-}
-
-async function loadExtractorConfig() {
-  const cached = extractorConfigCache.get(CONFIG_CACHE_KEY);
-  if (cached) return cached;
-
-  const records = await getRecordByFilter(Config_ID, CONFIG_TABLE, 'TRUE()');
-  if (!records) throw new Error('extractor config could not be read from the Config base');
-  const config = Object.fromEntries(records.map((r) => [r.config, r.value]));
-  extractorConfigCache.set(CONFIG_CACHE_KEY, config);
-  return config;
-}
-
-async function getExtractorInputTemplate() {
-  const config = await loadExtractorConfig();
-  return {
-    default: config.EXTRACTOR_INPUT_TEMPLATE_DEFAULT || '',
-    symptom: config.EXTRACTOR_INPUT_TEMPLATE_SYMPTOM || '',
-  };
-}
-
-async function getConversationalTokens() {
-  const config = await loadExtractorConfig();
-  return safeParseArray(config.CONVERSATIONAL_TOKENS) || [];
-}
-
-module.exports = {
-  extractClinicalMentions,
-  getConversationalTokens,
-};