@precisa-saude/fhir 0.1.0

package/dist/chunk-2X6MT5KE.cjs.map

@@ -0,0 +1 @@
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* Biomarker Reference Ranges\n *\n * Single source of truth for biomarker reference ranges used by both\n * web app (for display) and API (for fallback when LLM doesn't extract ranges).\n *\n * Data sources (priority order):\n * 1. Brazilian Government - SBPC/ML (Sociedade Brasileira de Patologia Clínica) guidelines\n * 2. International Standards - WHO, clinical laboratory guidelines\n * 3. Specific Labs - Fleury, Weinmann, Quest, LabCorp (when above unavailable)\n */\n\nimport { getCanonicalUnit as getCanonicalUnitForCode } from './units';\n\n// =============================================================================\n// TYPES\n// =============================================================================\n\n/**\n * Sex-specific key for reference ranges\n */\nexport type SexKey = 'M' | 'F' | 'all';\n\n/**\n * Reference range configuration for a biomarker\n */\nexport interface BiomarkerReferenceRange {\n  max?: number;\n  min?: number;\n  optimalMax?: number;\n  optimalMin?: number;\n  unit: string;\n  warningMax?: number;\n}\n\n/**\n * A variant of a reference range that applies to a specific sex and/or age group\n */\nexport interface RangeVariant {\n  ageMax?: number;\n  ageMin?: number;\n  range: BiomarkerReferenceRange;\n  sex: SexKey;\n}\n\n/**\n * Extended biomarker range definition with sex/age-specific variants\n */\n/**\n * Direction indicates whether exceeding the reference range on one side is benign.\n * - 'range': both above-max and below-min are abnormal (default)\n * - 'higher-better': above-max is normal (e.g., BMC, HDL)\n * - 'lower-better': below-min is normal (e.g., LDL, CRP)\n */\nexport type RangeDirection = 'range' | 'higher-better' | 'lower-better';\n\nexport interface BiomarkerRangeDefinition {\n  default: BiomarkerReferenceRange;\n  direction?: RangeDirection;\n  source?: string;\n  variants?: RangeVariant[];\n}\n\n/**\n * User context for personalized reference range lookup\n */\nexport interface ReferenceRangeContext {\n  age?: number;\n  biologicalSex?: 'M' | 'F';\n}\n\n// =============================================================================\n// BIOMARKER RANGE DEFINITIONS\n// =============================================================================\n\n/**\n * Comprehensive biomarker reference range definitions with sex/age-specific variants\n *\n * Each marker has a default range (used as fallback) and optional variants\n * for sex/age-specific ranges.\n */\nexport const biomarkerRangeDefinitions: Record<string, BiomarkerRangeDefinition> = {\n  // =============================================================================\n  // LIPIDS\n  // =============================================================================\n\n  Albumin_Creatinine_Ratio: {\n    default: { max: 30, min: 0, optimalMax: 20, optimalMin: 0, unit: 'mg/g' },\n  },\n\n  Adiponectin: {\n    default: { max: 26, min: 4, optimalMax: 20, optimalMin: 8, unit: 'mcg/mL' },\n  },\n\n  ADMA: {\n    default: { max: 0.7, min: 0.3, optimalMax: 0.55, optimalMin: 0.3, unit: 'umol/L' },\n  },\n\n  AFP: {\n    default: { max: 10, min: 0, optimalMax: 8, optimalMin: 0, unit: 'ng/mL' },\n  },\n\n  Albumin_Globulin_Ratio: {\n    default: { max: 2.5, min: 1.0, optimalMax: 2.2, optimalMin: 1.2, unit: '' },\n  },\n\n  Albumin: {\n    default: { max: 5.0, min: 3.5, optimalMax: 4.8, optimalMin: 4.0, unit: 'g/dL' },\n    source: 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[\n      {\n        ageMax: 24,\n        ageMin: 18,\n        range: { max: 13.0, min: 1.5, optimalMax: 10.0, optimalMin: 3.0, unit: 'ng/mL' },\n        sex: 'F',\n      },\n      {\n        ageMax: 30,\n        ageMin: 25,\n        range: { max: 10.0, min: 1.5, optimalMax: 8.0, optimalMin: 2.5, unit: 'ng/mL' },\n        sex: 'F',\n      },\n      {\n        ageMax: 35,\n        ageMin: 31,\n        range: { max: 8.0, min: 1.0, optimalMax: 6.0, optimalMin: 2.0, unit: 'ng/mL' },\n        sex: 'F',\n      },\n      {\n        ageMax: 40,\n        ageMin: 36,\n        range: { max: 6.0, min: 0.5, optimalMax: 4.0, optimalMin: 1.0, unit: 'ng/mL' },\n        sex: 'F',\n      },\n      {\n        ageMin: 41,\n        range: { max: 3.0, min: 0.1, optimalMax: 2.0, optimalMin: 0.5, unit: 'ng/mL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Ammonia: {\n    default: { max: 45, min: 15, optimalMax: 40, optimalMin: 20, unit: 'umol/L' },\n  },\n\n  AntiThyroglobulin: {\n    default: { max: 115, min: 0, optimalMax: 40, optimalMin: 0, unit: 'IU/mL' },\n  },\n\n  AntiTPO: {\n    default: { max: 34, min: 0, optimalMax: 9, optimalMin: 0, unit: 'IU/mL' },\n  },\n\n  // Aortic valve calcium — no standardized clinical threshold; use mild cutoff\n  AorticValveCalcium: {\n    default: { max: 99, min: 0, optimalMax: 0, optimalMin: 0, unit: 'AU' },\n    direction: 'lower-better',\n  },\n\n  ApoA1: {\n    default: { max: 200, min: 100, optimalMax: 180, optimalMin: 120, unit: 'mg/dL' },\n  },\n\n  ApoB: {\n    default: { max: 90, min: 0, optimalMax: 70, optimalMin: 0, unit: 'mg/dL' },\n    direction: 'lower-better',\n  },\n\n  ApoCIII: {\n    default: { max: 10, min: 0, optimalMax: 7, optimalMin: 0, unit: 'mg/dL' },\n  },\n\n  ApoCIII_ApoA1_Ratio: {\n    default: { max: 0.15, min: 0, optimalMax: 0.1, optimalMin: 0, unit: '' },\n  },\n\n  // =============================================================================\n  // THYROID\n  // =============================================================================\n\n  Omega6_AA: {\n    default: { max: 15.0, min: 5.0, optimalMax: 12.0, optimalMin: 7.0, unit: '%' },\n  },\n\n  AA_EPA_Ratio: {\n    default: { max: 15.0, min: 1.0, optimalMax: 5.0, optimalMin: 1.5, unit: '' },\n    direction: 'lower-better',\n  },\n\n  Arsenic: {\n    default: { max: 35, min: 0, optimalMax: 20, optimalMin: 0, unit: 'mcg/L' },\n  },\n\n  AST: {\n    default: { max: 35, min: 0, optimalMax: 25, optimalMin: 0, unit: 'U/L' },\n    source: 'sbpc-ml-2021',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 40, min: 10, optimalMax: 30, optimalMin: 10, unit: 'U/L' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 32, min: 9, optimalMax: 25, optimalMin: 10, unit: 'U/L' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Basophils: {\n    default: { max: 1, min: 0, optimalMax: 0.5, optimalMin: 0, unit: '%' },\n  },\n\n  Basophils_Abs: {\n    default: { max: 0.1, min: 0, optimalMax: 0.05, optimalMin: 0, unit: 'K/uL' },\n  },\n\n  // =============================================================================\n  // HEMATOLOGY - CBC\n  // =============================================================================\n\n  Bicarbonate: {\n    default: { max: 29, min: 23, optimalMax: 28, optimalMin: 24, unit: 'mEq/L' },\n  },\n\n  BilirubinDirect: {\n    default: { max: 0.3, min: 0, optimalMax: 0.2, optimalMin: 0, unit: 'mg/dL' },\n  },\n\n  BilirubinIndirect: {\n    default: { max: 0.8, min: 0, optimalMax: 0.6, optimalMin: 0, unit: 'mg/dL' },\n  },\n\n  BilirubinTotal: {\n    default: { max: 1.2, min: 0.1, optimalMax: 0.9, optimalMin: 0.2, unit: 'mg/dL' },\n  },\n\n  BNP: {\n    default: { max: 100, min: 0, optimalMax: 50, optimalMin: 0, unit: 'pg/mL' },\n  },\n\n  BUN_Creatinine_Ratio: {\n    default: { max: 20, min: 10, optimalMax: 18, optimalMin: 12, unit: '' },\n  },\n\n  CA125: {\n    default: { max: 35, min: 0, optimalMax: 25, optimalMin: 0, unit: 'U/mL' },\n  },\n\n  CA199: {\n    default: { max: 37, min: 0, optimalMax: 30, optimalMin: 0, unit: 'U/mL' },\n  },\n\n  // CAC: Agatston classification — 0=none, 1-99=mild, 100-399=moderate, 400+=severe\n  // max=99 so only moderate+ scores (≥100) flag as ANORMAL; optimalMax=0 (zero is ideal)\n  CAC: {\n    default: { max: 99, min: 0, optimalMax: 0, optimalMin: 0, unit: 'AU' },\n    direction: 'lower-better',\n  },\n\n  // Per-vessel scores (hidden) — no standardized thresholds, use same mild cutoff\n  CAC_LAD: {\n    default: { max: 99, min: 0, optimalMax: 0, optimalMin: 0, unit: 'AU' },\n    direction: 'lower-better',\n  },\n\n  CAC_LCX: {\n    default: { max: 99, min: 0, optimalMax: 0, optimalMin: 0, unit: 'AU' },\n    direction: 'lower-better',\n  },\n\n  CAC_LMA: {\n    default: { max: 99, min: 0, optimalMax: 0, optimalMin: 0, unit: 'AU' },\n    direction: 'lower-better',\n  },\n\n  CAC_Percentile: {\n    default: { max: 50, min: 0, optimalMax: 25, optimalMin: 0, unit: '%', warningMax: 75 },\n    direction: 'lower-better',\n  },\n\n  CAC_RCA: {\n    default: { max: 99, min: 0, optimalMax: 0, optimalMin: 0, unit: 'AU' },\n    direction: 'lower-better',\n  },\n\n  Cadmium: {\n    default: { max: 1.2, min: 0, optimalMax: 0.5, optimalMin: 0, unit: 'mcg/L' },\n  },\n\n  Calcium: {\n    default: { max: 10.5, min: 8.5, optimalMax: 10.0, optimalMin: 9.0, unit: 'mg/dL' },\n  },\n\n  CEA: {\n    default: { max: 3.0, min: 0, optimalMax: 2.5, optimalMin: 0, unit: 'ng/mL' },\n  },\n\n  CK: {\n    default: { max: 190, min: 30, optimalMax: 170, optimalMin: 40, unit: 'U/L' },\n    variants: [\n      { sex: 'F', range: { max: 170, min: 30, optimalMax: 150, optimalMin: 40, unit: 'U/L' } },\n    ],\n  },\n\n  Chloride: {\n    default: { max: 106, min: 98, optimalMax: 105, optimalMin: 100, unit: 'mEq/L' },\n  },\n\n  Cholesterol: {\n    default: { max: 200, min: 0, optimalMax: 180, optimalMin: 0, unit: 'mg/dL' },\n    source: 'sbc-lipids-2017',\n  },\n\n  Cholesterol_HDL_Ratio: {\n    // Lower is better - Function Health reference: <= 3.5\n    default: { max: 5.0, min: 0, optimalMax: 3.5, optimalMin: 0, unit: '' },\n    direction: 'lower-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 5.0, min: 0, optimalMax: 4.0, optimalMin: 0, unit: '' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 4.5, min: 0, optimalMax: 3.5, optimalMin: 0, unit: '' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  CO2: {\n    default: { max: 29, min: 23, optimalMax: 28, optimalMin: 24, unit: 'mEq/L' },\n  },\n\n  Copper: {\n    default: { max: 175, min: 70, optimalMax: 150, optimalMin: 85, unit: 'mcg/dL' },\n  },\n\n  CoQ10: {\n    default: { max: 1.5, min: 0.5, optimalMax: 1.3, optimalMin: 0.7, unit: 'mg/L' },\n  },\n\n  Cortisol: {\n    default: { max: 25, min: 5, optimalMax: 20, optimalMin: 10, unit: 'mcg/dL' },\n  },\n\n  CortisolFree: {\n    default: { max: 2.5, min: 0.5, optimalMax: 2.0, optimalMin: 0.8, unit: 'mcg/dL' },\n  },\n\n  CPeptide: {\n    default: { max: 3.9, min: 0.8, optimalMax: 3.0, optimalMin: 1.0, unit: 'ng/mL' },\n  },\n\n  Creatinine: {\n    default: { max: 1.2, min: 0.6, optimalMax: 1.0, optimalMin: 0.7, unit: 'mg/dL' },\n    source: 'sbpc-ml-2021',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 1.3, min: 0.7, optimalMax: 1.1, optimalMin: 0.8, unit: 'mg/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 1.1, min: 0.5, optimalMax: 0.9, optimalMin: 0.6, unit: 'mg/dL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  CRP: {\n    default: { max: 3.0, min: 0, optimalMax: 1.0, optimalMin: 0, unit: 'mg/L' },\n    direction: 'lower-better',\n  },\n\n  CystatinC: {\n    default: { max: 1.0, min: 0.5, optimalMax: 0.9, optimalMin: 0.6, unit: 'mg/L' },\n  },\n\n  DDimer: {\n    default: { max: 500, min: 0, optimalMax: 250, optimalMin: 0, unit: 'ng/mL' },\n  },\n\n  // =============================================================================\n  // METABOLIC PANEL\n  // =============================================================================\n\n  Omega3_DHA: {\n    default: { max: 8.0, min: 2.0, optimalMax: 6.5, optimalMin: 3.5, unit: '%' },\n  },\n\n  DHEAS: {\n    default: { max: 500, min: 100, optimalMax: 400, optimalMin: 150, unit: 'mcg/dL' },\n    variants: [\n      {\n        ageMax: 39,\n        ageMin: 18,\n        range: { max: 640, min: 280, optimalMax: 500, optimalMin: 300, unit: 'mcg/dL' },\n        sex: 'M',\n      },\n      {\n        ageMax: 59,\n        ageMin: 40,\n        range: { max: 520, min: 120, optimalMax: 400, optimalMin: 150, unit: 'mcg/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 60,\n        range: { max: 290, min: 42, optimalMax: 220, optimalMin: 80, unit: 'mcg/dL' },\n        sex: 'M',\n      },\n      {\n        ageMax: 39,\n        ageMin: 18,\n        range: { max: 380, min: 65, optimalMax: 300, optimalMin: 100, unit: 'mcg/dL' },\n        sex: 'F',\n      },\n      {\n        ageMax: 59,\n        ageMin: 40,\n        range: { max: 240, min: 32, optimalMax: 180, optimalMin: 60, unit: 'mcg/dL' },\n        sex: 'F',\n      },\n      {\n        ageMin: 60,\n        range: { max: 140, min: 18, optimalMax: 100, optimalMin: 30, unit: 'mcg/dL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Omega3_DPA: {\n    default: { max: 2.0, min: 0.3, optimalMax: 1.5, optimalMin: 0.5, unit: '%' },\n  },\n\n  eGFR: {\n    default: { max: 120, min: 90, optimalMax: 120, optimalMin: 90, unit: 'mL/min/1.73m²' },\n    variants: [\n      {\n        ageMin: 60,\n        range: { max: 90, min: 60, optimalMax: 90, optimalMin: 60, unit: 'mL/min/1.73m²' },\n        sex: 'all',\n      },\n    ],\n  },\n\n  Eosinophils: {\n    default: { max: 5, min: 0, optimalMax: 4, optimalMin: 1, unit: '%' },\n    direction: 'lower-better',\n  },\n\n  Eosinophils_Abs: {\n    default: { max: 0.5, min: 0, optimalMax: 0.3, optimalMin: 0, unit: 'K/uL' },\n  },\n\n  Omega3_EPA: {\n    default: { max: 3.5, min: 0.5, optimalMax: 2.5, optimalMin: 1.0, unit: '%' },\n  },\n\n  EPADPADHA: {\n    default: { max: 10.0, min: 3.0, optimalMax: 9.0, optimalMin: 5.0, unit: '%' },\n  },\n\n  ESR: {\n    default: { max: 20, min: 0, optimalMax: 10, optimalMin: 0, unit: 'mm/hr' },\n  },\n\n  Estradiol: {\n    default: { max: 40, min: 10, optimalMax: 35, optimalMin: 15, unit: 'pg/mL' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 40, min: 10, optimalMax: 30, optimalMin: 15, unit: 'pg/mL' },\n        sex: 'M',\n      },\n      {\n        ageMax: 50,\n        ageMin: 18,\n        range: { max: 400, min: 30, optimalMax: 300, optimalMin: 50, unit: 'pg/mL' },\n        sex: 'F',\n      },\n      {\n        ageMin: 51,\n        range: { max: 30, min: 0, optimalMax: 20, optimalMin: 0, unit: 'pg/mL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  F2Isoprostanes: {\n    default: { max: 86, min: 0, optimalMax: 60, optimalMin: 0, unit: 'pg/mL' },\n  },\n\n  Ferritin: {\n    default: { max: 300, min: 20, optimalMax: 150, optimalMin: 50, unit: 'ng/mL' },\n    source: 'sbpc-ml-2021',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 400, min: 30, optimalMax: 200, optimalMin: 50, unit: 'ng/mL' },\n        sex: 'M',\n      },\n      {\n        ageMax: 50,\n        ageMin: 18,\n        range: { max: 150, min: 15, optimalMax: 100, optimalMin: 30, unit: 'ng/mL' },\n        sex: 'F',\n      },\n      {\n        ageMin: 51,\n        range: { max: 300, min: 30, optimalMax: 150, optimalMin: 50, unit: 'ng/mL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Fibrinogen: {\n    default: { max: 400, min: 200, optimalMax: 350, optimalMin: 250, unit: 'mg/dL' },\n  },\n\n  FolicAcid: {\n    default: { max: 20, min: 3, optimalMax: 15, optimalMin: 5, unit: 'ng/mL' },\n  },\n\n  // =============================================================================\n  // LIVER FUNCTION\n  // =============================================================================\n\n  FSH: {\n    default: { max: 12.4, min: 1.5, optimalMax: 10.0, optimalMin: 3.0, unit: 'mIU/mL' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 12.4, min: 1.5, optimalMax: 8.0, optimalMin: 1.5, unit: 'mIU/mL' },\n        sex: 'M',\n      },\n      {\n        ageMax: 50,\n        ageMin: 18,\n        range: { max: 12.5, min: 3.5, optimalMax: 10.0, optimalMin: 3.5, unit: 'mIU/mL' },\n        sex: 'F',\n      },\n      {\n        ageMin: 51,\n        range: { max: 134.8, min: 25.8, optimalMax: 80.0, optimalMin: 25.8, unit: 'mIU/mL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  GGT: {\n    default: { max: 55, min: 0, optimalMax: 30, optimalMin: 0, unit: 'U/L' },\n    direction: 'lower-better',\n    source: 'sbpc-ml-2021',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 61, min: 8, optimalMax: 40, optimalMin: 10, unit: 'U/L' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 36, min: 5, optimalMax: 25, optimalMin: 8, unit: 'U/L' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Ghrelin: {\n    default: { max: 1000, min: 300, optimalMax: 800, optimalMin: 400, unit: 'pg/mL' },\n  },\n\n  Globulin: {\n    default: { max: 3.5, min: 2.0, optimalMax: 3.2, optimalMin: 2.3, unit: 'g/dL' },\n  },\n\n  Glucose: {\n    default: { max: 100, min: 70, optimalMax: 90, optimalMin: 70, unit: 'mg/dL' },\n    source: 'sbd-diabetes-2024',\n  },\n\n  GlycoMark: {\n    default: { max: 40, min: 10, optimalMax: 35, optimalMin: 15, unit: 'mcg/mL' },\n  },\n\n  GrowthHormone: {\n    default: { max: 5, min: 0, optimalMax: 3, optimalMin: 0, unit: 'ng/mL' },\n  },\n\n  HbA1c: {\n    default: { max: 5.7, min: 4.0, optimalMax: 5.3, optimalMin: 4.5, unit: '%' },\n    source: 'sbd-diabetes-2024',\n  },\n\n  Hct: {\n    default: { max: 50, min: 36, optimalMax: 48, optimalMin: 40, unit: '%' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 54, min: 40, optimalMax: 50, optimalMin: 42, unit: '%' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 48, min: 36, optimalMax: 45, optimalMin: 38, unit: '%' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  HDL: {\n    default: { max: 60, min: 40, optimalMax: 60, optimalMin: 50, unit: 'mg/dL' },\n    direction: 'higher-better',\n    source: 'sbc-lipids-2017',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 60, min: 40, optimalMax: 60, optimalMin: 45, unit: 'mg/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 60, min: 50, optimalMax: 60, optimalMin: 55, unit: 'mg/dL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  HDL_Large: {\n    // HDL Large: higher is better\n    // Quest Ion Mobility reference: Male 4334-10815, Female 5038-17886 nmol/L, optimal >6729\n    default: { max: 17886, min: 4334, optimalMax: 17886, optimalMin: 6729, unit: 'nmol/L' },\n    direction: 'higher-better',\n  },\n\n  // =============================================================================\n  // INFLAMMATION\n  // =============================================================================\n\n  Hgb: {\n    default: { max: 17.5, min: 12.0, optimalMax: 16.0, optimalMin: 13.5, unit: 'g/dL' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 17.5, min: 13.5, optimalMax: 16.5, optimalMin: 14.0, unit: 'g/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 15.5, min: 12.0, optimalMax: 14.5, optimalMin: 12.5, unit: 'g/dL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  HOMA_IR: {\n    default: { max: 2.5, min: 0, optimalMax: 1.5, optimalMin: 0, unit: '' },\n    direction: 'lower-better',\n  },\n\n  Homocysteine: {\n    default: { max: 15, min: 4, optimalMax: 10, optimalMin: 5, unit: 'umol/L' },\n    direction: 'lower-better',\n  },\n\n  IGF1: {\n    default: { max: 350, min: 100, optimalMax: 300, optimalMin: 150, unit: 'ng/mL' },\n  },\n\n  // =============================================================================\n  // METABOLIC\n  // =============================================================================\n\n  ImmatureGranulocytes: {\n    default: { max: 1.0, min: 0, optimalMax: 0.5, optimalMin: 0, unit: '%' },\n  },\n\n  Insulin: {\n    default: { max: 25, min: 2, optimalMax: 8, optimalMin: 3, unit: 'µIU/mL' },\n  },\n\n  Iron: {\n    default: { max: 170, min: 60, optimalMax: 140, optimalMin: 80, unit: 'mcg/dL' },\n    source: 'sbpc-ml-2021',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 175, min: 65, optimalMax: 150, optimalMin: 80, unit: 'mcg/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 170, min: 50, optimalMax: 130, optimalMin: 60, unit: 'mcg/dL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Lactate: {\n    default: { max: 2.2, min: 0.5, optimalMax: 1.8, optimalMin: 0.7, unit: 'mmol/L' },\n  },\n\n  LDL: {\n    default: { max: 100, min: 0, optimalMax: 70, optimalMin: 0, unit: 'mg/dL' },\n    direction: 'lower-better',\n    source: 'sbc-lipids-2017',\n  },\n\n  LDL_Medium: {\n    // LDL Medium (LDL Média): lower is better\n    // Quest Ion Mobility reference: Male 167-485, Female 121-397 nmol/L, optimal <215\n    default: { max: 485, min: 121, optimalMax: 215, optimalMin: 121, unit: 'nmol/L' },\n    direction: 'lower-better',\n  },\n\n  LDL_ParticleNumber: {\n    // LDL Particle Number: lower is better\n    // Quest Ion Mobility reference: 1016-2185 nmol/L, optimal <1138\n    default: { max: 2185, min: 1016, optimalMax: 1138, optimalMin: 1016, unit: 'nmol/L' },\n    direction: 'lower-better',\n  },\n\n  LDL_Peak_Size: {\n    // LDL Peak Size: higher is better (larger particles less atherogenic)\n    // Quest Ion Mobility reference: optimal >222.9 Å (22.29 nm)\n    default: { max: 250.0, min: 217.4, optimalMax: 250.0, optimalMin: 222.9, unit: 'Å' },\n    direction: 'higher-better',\n  },\n\n  // =============================================================================\n  // IRON STUDIES\n  // =============================================================================\n\n  LDL_Small: {\n    // LDL Small (LDL Pequena): lower is better (small dense LDL is most atherogenic)\n    // Quest Ion Mobility reference: Male 123-441, Female 126-382 nmol/L, optimal <142\n    default: { max: 441, min: 123, optimalMax: 142, optimalMin: 123, unit: 'nmol/L' },\n    direction: 'lower-better',\n  },\n\n  Lead: {\n    default: { max: 5, min: 0, optimalMax: 2, optimalMin: 0, unit: 'mcg/dL' },\n  },\n\n  Leptin: {\n    default: { max: 15, min: 2, optimalMax: 12, optimalMin: 3, unit: 'ng/mL' },\n    direction: 'lower-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 10, min: 1, optimalMax: 8, optimalMin: 2, unit: 'ng/mL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 25, min: 4, optimalMax: 18, optimalMin: 5, unit: 'ng/mL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  LH: {\n    default: { max: 8.6, min: 1.7, optimalMax: 8.0, optimalMin: 2.0, unit: 'mIU/mL' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 8.6, min: 1.7, optimalMax: 6.0, optimalMin: 1.7, unit: 'mIU/mL' },\n        sex: 'M',\n      },\n      {\n        ageMax: 50,\n        ageMin: 18,\n        range: { max: 12.6, min: 2.4, optimalMax: 10.0, optimalMin: 2.4, unit: 'mIU/mL' },\n        sex: 'F',\n      },\n      {\n        ageMin: 51,\n        range: { max: 58.5, min: 7.7, optimalMax: 40.0, optimalMin: 10.0, unit: 'mIU/mL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Omega6_LA: {\n    default: { max: 35.0, min: 15.0, optimalMax: 28.0, optimalMin: 18.0, unit: '%' },\n  },\n\n  // =============================================================================\n  // VITAMINS\n  // =============================================================================\n\n  Lipoprotein_a: {\n    default: { max: 75, min: 0, optimalMax: 30, optimalMin: 0, unit: 'nmol/L' },\n    direction: 'lower-better',\n  },\n\n  Lymphocytes: {\n    default: { max: 40, min: 20, optimalMax: 35, optimalMin: 25, unit: '%' },\n  },\n\n  Lymphocytes_Abs: {\n    default: { max: 4.0, min: 1.0, optimalMax: 3.0, optimalMin: 1.5, unit: 'K/uL' },\n  },\n\n  Magnesium: {\n    default: { max: 2.2, min: 1.7, optimalMax: 2.1, optimalMin: 1.9, unit: 'mg/dL' },\n  },\n\n  Magnesium_RBC: {\n    default: { max: 6.8, min: 4.0, optimalMax: 6.0, optimalMin: 4.5, unit: 'mg/dL' },\n  },\n\n  MCH: {\n    default: { max: 33, min: 27, optimalMax: 32, optimalMin: 28, unit: 'pg' },\n  },\n\n  MCHC: {\n    default: { max: 36, min: 32, optimalMax: 35, optimalMin: 33, unit: 'g/dL' },\n  },\n\n  MCV: {\n    default: { max: 100, min: 80, optimalMax: 98, optimalMin: 82, unit: 'fL' },\n  },\n\n  Mercury: {\n    default: { max: 10, min: 0, optimalMax: 5, optimalMin: 0, unit: 'mcg/L' },\n  },\n\n  Microalbumin: {\n    default: { max: 30, min: 0, optimalMax: 20, optimalMin: 0, unit: 'mg/L' },\n  },\n\n  // =============================================================================\n  // HORMONES\n  // =============================================================================\n\n  MMA: {\n    default: { max: 378, min: 0, optimalMax: 270, optimalMin: 0, unit: 'nmol/L' },\n  },\n\n  Monocytes: {\n    default: { max: 8, min: 2, optimalMax: 7, optimalMin: 3, unit: '%' },\n  },\n\n  Monocytes_Abs: {\n    default: { max: 0.8, min: 0.2, optimalMax: 0.7, optimalMin: 0.3, unit: 'K/uL' },\n  },\n\n  MPV: {\n    default: { max: 11.5, min: 7.5, optimalMax: 10.5, optimalMin: 8.0, unit: 'fL' },\n  },\n\n  Myeloperoxidase: {\n    default: { max: 420, min: 0, optimalMax: 300, optimalMin: 0, unit: 'pmol/L' },\n  },\n\n  // WBC Differential (%)\n  Neutrophils: {\n    default: { max: 70, min: 40, optimalMax: 65, optimalMin: 50, unit: '%' },\n  },\n\n  // WBC Differential (Absolute)\n  Neutrophils_Abs: {\n    default: { max: 8.0, min: 1.5, optimalMax: 6.0, optimalMin: 2.0, unit: 'K/uL' },\n  },\n\n  NonHDL_Cholesterol: {\n    default: { max: 130, min: 0, optimalMax: 100, optimalMin: 0, unit: 'mg/dL' },\n    direction: 'lower-better',\n  },\n\n  NRBC: {\n    default: { max: 0, min: 0, optimalMax: 0, optimalMin: 0, unit: '/100WBC' },\n  },\n\n  NTproBNP: {\n    default: { max: 125, min: 0, optimalMax: 75, optimalMin: 0, unit: 'pg/mL' },\n  },\n\n  Oleic_Acid: {\n    default: { max: 25.0, min: 15.0, optimalMax: 22.0, optimalMin: 18.0, unit: '%' },\n  },\n\n  Omega3_Index: {\n    default: { max: 8.0, min: 4.0, optimalMax: 8.0, optimalMin: 5.5, unit: '%' },\n  },\n\n  Omega3_Total: {\n    default: { max: 12.0, min: 3.0, optimalMax: 10.0, optimalMin: 5.5, unit: '%' },\n  },\n\n  Omega6_Total: {\n    default: { max: 40.0, min: 20.0, optimalMax: 35.0, optimalMin: 25.0, unit: '%' },\n  },\n\n  Omega6_Omega3_Ratio: {\n    default: { max: 10.0, min: 1.0, optimalMax: 4.0, optimalMin: 1.0, unit: '' },\n    direction: 'lower-better',\n  },\n\n  // =============================================================================\n  // TUMOR MARKERS\n  // =============================================================================\n\n  OmegaCheck: {\n    default: { max: 8.0, min: 4.0, optimalMax: 8.0, optimalMin: 5.5, unit: '%' },\n  },\n\n  Palmitic_Acid: {\n    default: { max: 30.0, min: 20.0, optimalMax: 27.0, optimalMin: 22.0, unit: '%' },\n  },\n\n  Phosphorus: {\n    default: { max: 4.5, min: 2.5, optimalMax: 4.0, optimalMin: 3.0, unit: 'mg/dL' },\n  },\n\n  Platelets: {\n    default: { max: 400, min: 150, optimalMax: 350, optimalMin: 180, unit: 'K/uL' },\n  },\n\n  Potassium: {\n    default: { max: 5.0, min: 3.5, optimalMax: 4.6, optimalMin: 3.8, unit: 'mEq/L' },\n  },\n\n  // =============================================================================\n  // CARDIAC MARKERS\n  // =============================================================================\n\n  Prealbumin: {\n    default: { max: 38, min: 18, optimalMax: 35, optimalMin: 20, unit: 'mg/dL' },\n  },\n\n  Progesterone: {\n    default: { max: 0.9, min: 0.1, optimalMax: 0.7, optimalMin: 0.2, unit: 'ng/mL' },\n  },\n\n  Prolactin: {\n    default: { max: 18, min: 2, optimalMax: 15, optimalMin: 4, unit: 'ng/mL' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 18, min: 2, optimalMax: 15, optimalMin: 4, unit: 'ng/mL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 29, min: 2, optimalMax: 23, optimalMin: 4, unit: 'ng/mL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  PSA: {\n    default: { max: 4.0, min: 0, optimalMax: 2.5, optimalMin: 0, unit: 'ng/mL' },\n    variants: [\n      {\n        ageMax: 49,\n        ageMin: 18,\n        range: { max: 2.5, min: 0, optimalMax: 1.5, optimalMin: 0, unit: 'ng/mL' },\n        sex: 'M',\n      },\n      {\n        ageMax: 59,\n        ageMin: 50,\n        range: { max: 3.5, min: 0, optimalMax: 2.5, optimalMin: 0, unit: 'ng/mL' },\n        sex: 'M',\n      },\n      {\n        ageMax: 69,\n        ageMin: 60,\n        range: { max: 4.5, min: 0, optimalMax: 3.0, optimalMin: 0, unit: 'ng/mL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 70,\n        range: { max: 6.5, min: 0, optimalMax: 4.0, optimalMin: 0, unit: 'ng/mL' },\n        sex: 'M',\n      },\n    ],\n  },\n\n  RBC: {\n    default: { max: 5.5, min: 4.0, optimalMax: 5.2, optimalMin: 4.3, unit: 'M/uL' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 5.9, min: 4.5, optimalMax: 5.5, optimalMin: 4.7, unit: 'M/uL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 5.2, min: 4.0, optimalMax: 5.0, optimalMin: 4.2, unit: 'M/uL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  // =============================================================================\n  // URINALYSIS\n  // =============================================================================\n\n  RDW: {\n    default: { max: 14.5, min: 11.5, optimalMax: 14.0, optimalMin: 12.0, unit: '%' },\n  },\n\n  Reticulocytes: {\n    default: { max: 2.5, min: 0.5, optimalMax: 2.0, optimalMin: 0.8, unit: '%' },\n  },\n\n  SDMA: {\n    default: { max: 0.6, min: 0.3, optimalMax: 0.5, optimalMin: 0.3, unit: 'umol/L' },\n  },\n\n  Selenium: {\n    default: { max: 150, min: 70, optimalMax: 125, optimalMin: 85, unit: 'mcg/L' },\n  },\n\n  SHBG: {\n    default: { max: 54, min: 18, optimalMax: 50, optimalMin: 20, unit: 'nmol/L' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 54, min: 18, optimalMax: 45, optimalMin: 20, unit: 'nmol/L' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 122, min: 24, optimalMax: 90, optimalMin: 30, unit: 'nmol/L' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Sodium: {\n    default: { max: 145, min: 136, optimalMax: 143, optimalMin: 138, unit: 'mEq/L' },\n  },\n\n  // =============================================================================\n  // KIDNEY FUNCTION\n  // =============================================================================\n\n  SpecificGravity_Urine: {\n    default: { max: 1.03, min: 1.005, optimalMax: 1.025, optimalMin: 1.01, unit: 'SG' },\n  },\n\n  Stearic_Acid: {\n    default: { max: 14.0, min: 8.0, optimalMax: 12.0, optimalMin: 10.0, unit: '%' },\n  },\n\n  T3Free: {\n    default: { max: 4.2, min: 2.3, optimalMax: 3.8, optimalMin: 2.8, unit: 'pg/mL' },\n  },\n\n  // =============================================================================\n  // OMEGA FATTY ACIDS\n  // =============================================================================\n\n  T3Reverse: {\n    default: { max: 27, min: 9, optimalMax: 22, optimalMin: 12, unit: 'ng/dL' },\n  },\n\n  T4Free: {\n    default: { max: 1.8, min: 0.8, optimalMax: 1.5, optimalMin: 1.0, unit: 'ng/dL' },\n  },\n\n  T4Total: {\n    default: { max: 12.0, min: 4.5, optimalMax: 10.0, optimalMin: 6.0, unit: 'ug/dL' },\n  },\n\n  Testosterone: {\n    default: { max: 1000, min: 300, optimalMax: 800, optimalMin: 500, unit: 'ng/dL' },\n    variants: [\n      {\n        ageMax: 49,\n        ageMin: 18,\n        range: { max: 1000, min: 300, optimalMax: 800, optimalMin: 500, unit: 'ng/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 50,\n        range: { max: 800, min: 200, optimalMax: 650, optimalMin: 400, unit: 'ng/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 70, min: 15, optimalMax: 50, optimalMin: 20, unit: 'ng/dL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  TestosteroneBioavailable: {\n    default: { max: 200, min: 50, optimalMax: 150, optimalMin: 80, unit: 'ng/dL' },\n  },\n\n  // TestosteroneFree - using direct immunoassay ranges (Quest/LabCorp standard)\n  // Previous values (9.3-26.5 pg/mL) were based on equilibrium dialysis method\n  TestosteroneFree: {\n    default: { max: 155, min: 35, optimalMax: 120, optimalMin: 50, unit: 'pg/mL' },\n    variants: [\n      {\n        ageMax: 49,\n        ageMin: 18,\n        range: { max: 155, min: 35, optimalMax: 120, optimalMin: 50, unit: 'pg/mL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 50,\n        range: { max: 130, min: 30, optimalMax: 100, optimalMin: 40, unit: 'pg/mL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 5.0, min: 0.2, optimalMax: 3.0, optimalMin: 0.5, unit: 'pg/mL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  TIBC: {\n    default: { max: 400, min: 250, optimalMax: 370, optimalMin: 280, unit: 'mcg/dL' },\n  },\n\n  TotalProtein: {\n    default: { max: 8.3, min: 6.0, optimalMax: 7.8, optimalMin: 6.5, unit: 'g/dL' },\n  },\n\n  Trans_Fat_Index: {\n    default: { max: 1.0, min: 0, optimalMax: 0.5, optimalMin: 0, unit: '%' },\n  },\n\n  Transferrin: {\n    default: { max: 360, min: 200, optimalMax: 340, optimalMin: 220, unit: 'mg/dL' },\n  },\n\n  TransferrinSaturation: {\n    default: { max: 50, min: 20, optimalMax: 45, optimalMin: 25, unit: '%' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 55, min: 20, optimalMax: 45, optimalMin: 25, unit: '%' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 50, min: 15, optimalMax: 40, optimalMin: 20, unit: '%' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Triglycerides: {\n    default: { max: 150, min: 0, optimalMax: 100, optimalMin: 0, unit: 'mg/dL' },\n    direction: 'lower-better',\n    source: 'sbc-lipids-2017',\n  },\n\n  TroponinI: {\n    default: { max: 0.04, min: 0, optimalMax: 0.02, optimalMin: 0, unit: 'ng/mL' },\n  },\n\n  TroponinT: {\n    default: { max: 14, min: 0, optimalMax: 10, optimalMin: 0, unit: 'ng/L' },\n  },\n\n  TSH: {\n    default: { max: 4.0, min: 0.4, optimalMax: 2.5, optimalMin: 1.0, unit: 'µIU/mL' },\n    source: 'sbem-thyroid-2013',\n    variants: [\n      {\n        ageMin: 65,\n        range: { max: 6.0, min: 0.4, optimalMax: 4.0, optimalMin: 1.0, unit: 'µIU/mL' },\n        sex: 'all',\n      },\n    ],\n  },\n\n  Urea: {\n    default: { max: 20, min: 7, optimalMax: 16, optimalMin: 10, unit: 'mg/dL' },\n  },\n\n  UricAcid: {\n    default: { max: 7.0, min: 2.5, optimalMax: 5.5, optimalMin: 3.0, unit: 'mg/dL' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 7.0, min: 3.4, optimalMax: 6.0, optimalMin: 4.0, unit: 'mg/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 6.0, min: 2.4, optimalMax: 5.0, optimalMin: 3.0, unit: 'mg/dL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  Urobilinogen_Urine: {\n    default: { max: 1.0, min: 0.1, optimalMax: 1.0, optimalMin: 0.1, unit: 'mg/dL' },\n  },\n\n  // =============================================================================\n  // ADVANCED CARDIOVASCULAR\n  // =============================================================================\n\n  pH_Urine: {\n    default: { max: 8.0, min: 4.5, optimalMax: 7.0, optimalMin: 5.5, unit: 'pH' },\n  },\n\n  HyalineCasts_Urine: {\n    default: { max: 2, min: 0, optimalMax: 1, optimalMin: 0, unit: '/LPF' },\n  },\n\n  RBC_Urine: {\n    default: { max: 3, min: 0, optimalMax: 1, optimalMin: 0, unit: '/HPF' },\n  },\n\n  SquamousEpithelial_Urine: {\n    default: { max: 15, min: 0, optimalMax: 5, optimalMin: 0, unit: '/HPF' },\n  },\n\n  Leukocytes_Urine: {\n    default: { max: 5, min: 0, optimalMax: 2, optimalMin: 0, unit: '/HPF' },\n  },\n\n  Folate: {\n    default: { max: 20, min: 3.9, optimalMax: 17, optimalMin: 5, unit: 'ng/mL' },\n  },\n\n  VitaminA: {\n    default: { max: 100, min: 20, optimalMax: 80, optimalMin: 30, unit: 'mcg/dL' },\n  },\n\n  // =============================================================================\n  // MINERALS\n  // =============================================================================\n\n  VitaminB1: {\n    default: { max: 180, min: 70, optimalMax: 150, optimalMin: 80, unit: 'nmol/L' },\n  },\n\n  VitaminB12: {\n    default: { max: 900, min: 200, optimalMax: 800, optimalMin: 400, unit: 'pg/mL' },\n    source: 'sbpc-ml-2021',\n  },\n\n  VitaminB6: {\n    default: { max: 50, min: 5, optimalMax: 40, optimalMin: 10, unit: 'ng/mL' },\n  },\n\n  VitaminC: {\n    default: { max: 2.0, min: 0.4, optimalMax: 1.5, optimalMin: 0.6, unit: 'mg/dL' },\n  },\n\n  // =============================================================================\n  // HEAVY METALS\n  // =============================================================================\n\n  VitaminD: {\n    default: { max: 100, min: 30, optimalMax: 70, optimalMin: 40, unit: 'ng/mL' },\n    source: 'sbem-thyroid-2013',\n  },\n\n  VitaminD_1_25: {\n    default: { max: 72, min: 18, optimalMax: 60, optimalMin: 25, unit: 'pg/mL' },\n  },\n\n  VitaminE: {\n    default: { max: 17, min: 5.5, optimalMax: 14, optimalMin: 7, unit: 'mg/L' },\n  },\n\n  VLDL: {\n    default: { max: 40, min: 5, optimalMax: 30, optimalMin: 10, unit: 'mg/dL' },\n  },\n\n  // =============================================================================\n  // OTHER\n  // =============================================================================\n\n  WBC: {\n    default: { max: 11.0, min: 4.0, optimalMax: 8.0, optimalMin: 5.0, unit: 'K/uL' },\n  },\n\n  Zinc: {\n    default: { max: 120, min: 60, optimalMax: 100, optimalMin: 70, unit: 'mcg/dL' },\n  },\n\n  // =============================================================================\n  // BODY COMPOSITION (DXA)\n  // =============================================================================\n\n  AndroidFatPct: {\n    default: { max: 35, min: 10, optimalMax: 25, optimalMin: 15, unit: '%' },\n    direction: 'lower-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 30, min: 10, optimalMax: 22, optimalMin: 12, unit: '%' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 42, min: 15, optimalMax: 32, optimalMin: 20, unit: '%' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  AndroidGynoidRatio: {\n    default: { max: 1.2, min: 0.5, optimalMax: 1.0, optimalMin: 0.6, unit: '' },\n    direction: 'lower-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 1.2, min: 0.6, optimalMax: 1.0, optimalMin: 0.7, unit: '' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 1.0, min: 0.4, optimalMax: 0.8, optimalMin: 0.5, unit: '' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  BMC: {\n    default: { max: 3.5, min: 2.0, optimalMax: 3.2, optimalMin: 2.3, unit: 'kg' },\n    direction: 'higher-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 4.0, min: 2.5, optimalMax: 3.5, optimalMin: 2.8, unit: 'kg' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 3.0, min: 1.8, optimalMax: 2.7, optimalMin: 2.0, unit: 'kg' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  // BodyFatPct — Age-bracketed ranges from Gallagher et al. Am J Clin Nutr 2000;72:694-701\n  // (PMID: 10966886) and ACSM Guidelines for Exercise Testing, 11th Ed (2021)\n  BodyFatPct: {\n    default: { max: 30, min: 10, optimalMax: 25, optimalMin: 15, unit: '%' },\n    direction: 'lower-better',\n    variants: [\n      // Men — age brackets\n      {\n        ageMax: 25,\n        ageMin: 18,\n        range: { max: 25, min: 5, optimalMax: 20, optimalMin: 10, unit: '%' },\n        sex: 'M',\n      },\n      {\n        ageMax: 35,\n        ageMin: 26,\n        range: { max: 26, min: 5, optimalMax: 21, optimalMin: 11, unit: '%' },\n        sex: 'M',\n      },\n      {\n        ageMax: 45,\n        ageMin: 36,\n        range: { max: 27, min: 5, optimalMax: 22, optimalMin: 12, unit: '%' },\n        sex: 'M',\n      },\n      {\n        ageMax: 55,\n        ageMin: 46,\n        range: { max: 28, min: 5, optimalMax: 23, optimalMin: 13, unit: '%' },\n        sex: 'M',\n      },\n      {\n        ageMin: 56,\n        range: { max: 29, min: 5, optimalMax: 24, optimalMin: 14, unit: '%' },\n        sex: 'M',\n      },\n      // Women — age brackets\n      {\n        ageMax: 25,\n        ageMin: 18,\n        range: { max: 32, min: 13, optimalMax: 28, optimalMin: 18, unit: '%' },\n        sex: 'F',\n      },\n      {\n        ageMax: 35,\n        ageMin: 26,\n        range: { max: 33, min: 13, optimalMax: 29, optimalMin: 18, unit: '%' },\n        sex: 'F',\n      },\n      {\n        ageMax: 45,\n        ageMin: 36,\n        range: { max: 34, min: 13, optimalMax: 30, optimalMin: 19, unit: '%' },\n        sex: 'F',\n      },\n      {\n        ageMax: 55,\n        ageMin: 46,\n        range: { max: 35, min: 13, optimalMax: 31, optimalMin: 20, unit: '%' },\n        sex: 'F',\n      },\n      {\n        ageMin: 56,\n        range: { max: 36, min: 13, optimalMax: 32, optimalMin: 20, unit: '%' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  FatFreeMass: {\n    default: { max: 80, min: 40, optimalMax: 70, optimalMin: 45, unit: 'kg' },\n    direction: 'higher-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 90, min: 50, optimalMax: 80, optimalMin: 55, unit: 'kg' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 60, min: 35, optimalMax: 52, optimalMin: 38, unit: 'kg' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  FatMass: {\n    default: { max: 30, min: 5, optimalMax: 20, optimalMin: 8, unit: 'kg' },\n    direction: 'lower-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 25, min: 5, optimalMax: 18, optimalMin: 7, unit: 'kg' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 30, min: 8, optimalMax: 22, optimalMin: 10, unit: 'kg' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  GynoidFatPct: {\n    default: { max: 45, min: 15, optimalMax: 35, optimalMin: 20, unit: '%' },\n    direction: 'lower-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 35, min: 12, optimalMax: 28, optimalMin: 15, unit: '%' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 50, min: 20, optimalMax: 40, optimalMin: 25, unit: '%' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  LeanMass: {\n    default: { max: 75, min: 35, optimalMax: 65, optimalMin: 40, unit: 'kg' },\n    direction: 'higher-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 85, min: 45, optimalMax: 75, optimalMin: 50, unit: 'kg' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 55, min: 30, optimalMax: 48, optimalMin: 35, unit: 'kg' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  TotalMass: {\n    default: { max: 100, min: 50, optimalMax: 85, optimalMin: 55, unit: 'kg' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 100, min: 55, optimalMax: 90, optimalMin: 60, unit: 'kg' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 85, min: 45, optimalMax: 75, optimalMin: 50, unit: 'kg' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  VATMass: {\n    default: { max: 1.5, min: 0, optimalMax: 0.8, optimalMin: 0, unit: 'kg' },\n    direction: 'lower-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 1.5, min: 0, optimalMax: 1.0, optimalMin: 0, unit: 'kg' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 1.0, min: 0, optimalMax: 0.5, optimalMin: 0, unit: 'kg' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  VATVolume: {\n    default: { max: 1500, min: 0, optimalMax: 800, optimalMin: 0, unit: 'cm³' },\n    direction: 'lower-better',\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 1500, min: 0, optimalMax: 1000, optimalMin: 0, unit: 'cm³' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 1000, min: 0, optimalMax: 500, optimalMin: 0, unit: 'cm³' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  // =============================================================================\n  // BONE DENSITOMETRY (DXA)\n  // =============================================================================\n\n  BMD_Total: {\n    default: { max: 1.4, min: 0.9, optimalMax: 1.3, optimalMin: 1.0, unit: 'g/cm²' },\n    direction: 'higher-better',\n  },\n\n  TScore_Total: {\n    default: { max: 4.0, min: -1.0, optimalMax: 2.0, optimalMin: -0.5, unit: '' },\n    direction: 'higher-better',\n  },\n\n  ZScore_Total: {\n    default: { max: 2.0, min: -2.0, optimalMax: 1.0, optimalMin: -1.0, unit: '' },\n    direction: 'higher-better',\n  },\n\n  // =============================================================================\n  // MISSING LAB RANGES\n  // =============================================================================\n\n  Amylase: {\n    default: { max: 100, min: 28, optimalMax: 90, optimalMin: 35, unit: 'U/L' },\n  },\n\n  Creatinine_Urine: {\n    default: { max: 300, min: 20, optimalMax: 250, optimalMin: 40, unit: 'mg/dL' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 300, min: 40, optimalMax: 260, optimalMin: 60, unit: 'mg/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 220, min: 20, optimalMax: 180, optimalMin: 40, unit: 'mg/dL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  IgA: {\n    default: { max: 400, min: 70, optimalMax: 350, optimalMin: 100, unit: 'mg/dL' },\n  },\n\n  Lipase: {\n    default: { max: 60, min: 0, optimalMax: 50, optimalMin: 10, unit: 'U/L' },\n  },\n\n  Microalbumin_Urine: {\n    default: { max: 30, min: 0, optimalMax: 20, optimalMin: 0, unit: 'mg/L' },\n  },\n\n  PSA_Free: {\n    default: { max: 1.5, min: 0, optimalMax: 1.0, optimalMin: 0, unit: 'ng/mL' },\n  },\n\n  PSA_FreeRatio: {\n    default: { max: 100, min: 25, optimalMax: 100, optimalMin: 30, unit: '%' },\n  },\n\n  // BMI - WHO classification: 18.5–24.9 normal, 25–29.9 overweight, ≥30 obese\n  BMI: {\n    default: { max: 30, min: 18.5, optimalMax: 24.9, optimalMin: 18.5, unit: 'kg/m2' },\n  },\n\n  // eAG - Estimated Average Glucose, derived from HbA1c (ADAG study)\n  eAG: {\n    default: { max: 154, min: 70, optimalMax: 126, optimalMin: 70, unit: 'mg/dL' },\n  },\n\n  // INR - International Normalized Ratio (non-anticoagulated patients)\n  INR: {\n    default: { max: 1.2, min: 0.8, optimalMax: 1.1, optimalMin: 0.9, unit: 'ratio' },\n  },\n\n  // Prothrombin Time\n  ProthrombinTime: {\n    default: { max: 13.5, min: 11, optimalMax: 13, optimalMin: 11, unit: 'seconds' },\n  },\n\n  // DHT - Dihydrotestosterone (adult male reference; female values are much lower)\n  DHT: {\n    default: { max: 85, min: 30, optimalMax: 85, optimalMin: 30, unit: 'ng/dL' },\n    variants: [\n      {\n        ageMin: 18,\n        range: { max: 85, min: 30, optimalMax: 85, optimalMin: 30, unit: 'ng/dL' },\n        sex: 'M',\n      },\n      {\n        ageMin: 18,\n        range: { max: 22, min: 4, optimalMax: 22, optimalMin: 4, unit: 'ng/dL' },\n        sex: 'F',\n      },\n    ],\n  },\n\n  // Total IgE - higher values suggest atopy/allergic sensitization\n  IgE_Total: {\n    default: { max: 100, min: 0, optimalMax: 100, optimalMin: 0, unit: 'IU/mL' },\n    direction: 'lower-better',\n  },\n\n  // IgG - Immunoglobulin G\n  IgG: {\n    default: { max: 1600, min: 700, optimalMax: 1600, optimalMin: 700, unit: 'mg/dL' },\n  },\n\n  // IgE E1 Cat Dander - Class 0 (≤0.35 kU/L) = negative\n  IgE_E1_CatDander: {\n    default: { max: 0.35, min: 0, optimalMax: 0.35, optimalMin: 0, unit: 'kU/L' },\n    direction: 'lower-better',\n  },\n\n  // IgE GX1 Grasses - Class 0 (≤0.35 kU/L) = negative\n  IgE_GX1_Grasses: {\n    default: { max: 0.35, min: 0, optimalMax: 0.35, optimalMin: 0, unit: 'kU/L' },\n    direction: 'lower-better',\n  },\n};\n\n// =============================================================================\n// HELPER FUNCTIONS\n// =============================================================================\n\n/**\n * Legacy flat reference ranges for backward compatibility\n * This is derived from biomarkerRangeDefinitions defaults\n */\nexport const defaultReferenceRanges: Record<string, BiomarkerReferenceRange> = Object.fromEntries(\n  Object.entries(biomarkerRangeDefinitions).map(([code, def]) => [code, def.default]),\n);\n\n/**\n * Get the reference range for a biomarker code, optionally personalized for user context\n * @param testCode - The biomarker code (e.g., \"HDL\", \"Testosterone\")\n * @param context - Optional user context for personalized ranges\n * @returns Reference range or undefined if not found\n */\nexport function getReferenceRange(\n  testCode: string,\n  context?: ReferenceRangeContext,\n): BiomarkerReferenceRange | undefined {\n  const definition = biomarkerRangeDefinitions[testCode];\n  if (!definition) return undefined;\n\n  // If no context or no variants, return default\n  if (!context || !definition.variants || definition.variants.length === 0) {\n    return definition.default;\n  }\n\n  const { age, biologicalSex } = context;\n\n  // Find matching variant (first match wins - more specific variants should be listed first)\n  for (const variant of definition.variants) {\n    // Check sex match ('all' matches everyone)\n    if (variant.sex !== 'all' && variant.sex !== biologicalSex) {\n      continue;\n    }\n\n    // Check age range\n    if (variant.ageMin !== undefined && (age === undefined || age < variant.ageMin)) {\n      continue;\n    }\n    if (variant.ageMax !== undefined && (age === undefined || age > variant.ageMax)) {\n      continue;\n    }\n\n    return variant.range;\n  }\n\n  // No matching variant found - return default\n  return definition.default;\n}\n\n/**\n * Get the range direction for a biomarker code.\n * Returns 'range' (default) if not specified.\n */\nexport function getRangeDirection(testCode: string): RangeDirection {\n  return biomarkerRangeDefinitions[testCode]?.direction ?? 'range';\n}\n\n/**\n * Get fallback reference range for a biomarker code (default only, no personalization)\n * Used by API when LLM doesn't extract reference values\n * @param biomarkerCode - The biomarker code\n * @returns Reference range with min/max/unit or undefined\n */\nexport function getFallbackReferenceRange(\n  biomarkerCode: string,\n): { min: number; max: number; unit: string } | undefined {\n  const definition = biomarkerRangeDefinitions[biomarkerCode];\n  if (!definition || definition.default.min === undefined || definition.default.max === undefined) {\n    return undefined;\n  }\n  return {\n    max: definition.default.max,\n    min: definition.default.min,\n    unit: definition.default.unit,\n  };\n}\n\n/**\n * Apply fallback reference ranges to biomarkers that are missing them\n * @param biomarkers - Array of parsed biomarkers\n * @returns Count of biomarkers that received fallback references\n */\nexport function applyFallbackReferenceRanges<\n  T extends {\n    code: string;\n    referenceMin?: number | null;\n    referenceMax?: number | null;\n    unit?: string;\n  },\n>(biomarkers: T[]): number {\n  let fallbackCount = 0;\n\n  for (const biomarker of biomarkers) {\n    // Skip if already has reference values\n    if (biomarker.referenceMin != null && biomarker.referenceMax != null) {\n      continue;\n    }\n\n    const fallback = getFallbackReferenceRange(biomarker.code);\n    if (fallback) {\n      // Only apply if units are compatible or biomarker has no unit\n      const canonicalUnit = getCanonicalUnitForCode(biomarker.code);\n      const unitsMatch =\n        !biomarker.unit ||\n        biomarker.unit.toLowerCase() === fallback.unit.toLowerCase() ||\n        (canonicalUnit && biomarker.unit.toLowerCase() === canonicalUnit.toLowerCase()) ||\n        // Handle common unit variations\n        (biomarker.unit === '%' && fallback.unit === '%');\n\n      if (unitsMatch) {\n        if (biomarker.referenceMin == null) {\n          biomarker.referenceMin = fallback.min;\n        }\n        if (biomarker.referenceMax == null) {\n          biomarker.referenceMax = fallback.max;\n        }\n        fallbackCount++;\n      }\n    }\n  }\n\n  return fallbackCount;\n}\n"]}

package/dist/chunk-3ILBFLVQ.cjs

@@ -0,0 +1,63 @@
+"use strict";Object.defineProperty(exports, "__esModule", {value: true});// src/validators.ts
+function validateFHIRDiagnosticReport(report) {
+  const errors = [];
+  if (!report.resourceType || report.resourceType !== "DiagnosticReport") {
+    errors.push("Invalid resourceType");
+  }
+  if (!report.status) {
+    errors.push("Missing status");
+  }
+  if (!report.code || !report.code.coding || report.code.coding.length === 0) {
+    errors.push("Missing or invalid code");
+  }
+  if (!report.subject || !report.subject.reference) {
+    errors.push("Missing subject reference");
+  }
+  return errors;
+}
+function validateFHIRObservation(observation) {
+  const errors = [];
+  if (!observation.resourceType || observation.resourceType !== "Observation") {
+    errors.push("Invalid resourceType");
+  }
+  if (!observation.status) {
+    errors.push("Missing status");
+  }
+  if (!observation.code || !observation.code.coding || observation.code.coding.length === 0) {
+    errors.push("Missing or invalid code");
+  }
+  if (!observation.subject || !observation.subject.reference) {
+    errors.push("Missing subject reference");
+  }
+  if (!observation.valueQuantity && !observation.valueString) {
+    errors.push("Missing value (valueQuantity or valueString)");
+  }
+  return errors;
+}
+function validateFHIRImportBundle(data) {
+  const errors = [];
+  if (!data || typeof data !== "object") {
+    errors.push({ details: "Input must be a JSON object", field: "root" });
+    return errors;
+  }
+  const bundle = data;
+  if (bundle.resourceType !== "Bundle") {
+    errors.push({
+      details: `Expected resourceType "Bundle", got "${String(bundle.resourceType)}"`,
+      field: "resourceType"
+    });
+  }
+  if (!Array.isArray(bundle.entry)) {
+    errors.push({ details: 'Bundle must contain an "entry" array', field: "entry" });
+  } else if (bundle.entry.length === 0) {
+    errors.push({ details: "Bundle entry array is empty", field: "entry" });
+  }
+  return errors;
+}
+
+
+
+
+
+exports.validateFHIRDiagnosticReport = validateFHIRDiagnosticReport; exports.validateFHIRObservation = validateFHIRObservation; exports.validateFHIRImportBundle = validateFHIRImportBundle;
+//# sourceMappingURL=chunk-3ILBFLVQ.cjs.map

package/dist/chunk-3ILBFLVQ.cjs.map

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