@precisa-saude/fhir 0.10.0 → 0.11.0

package/dist/index.js.map

@@ -1 +1 @@
-{"version":3,"sources":["../src/intervention-converter.ts","../src/dexa-zone-data.ts","../src/screening-intervals.ts","../src/i18n.ts","../src/identifiers.ts"],"sourcesContent":["/**\n * FHIR Intervention Converter\n *\n * Converts interventions (medication, supplement, diet, exercise, sleep)\n * to FHIR R4 MedicationStatement and Observation resources.\n */\n\nimport { userProfileToFHIR } from './converter';\nimport type { FHIRBundle, FHIRMedicationStatement, FHIRObservation } from './fhir-types';\nimport type { InterventionData, UserProfileData } from './types';\n\n/**\n * Determine MedicationStatement/Observation status based on end date\n */\nfunction interventionStatus(endDate?: string): 'active' | 'completed' {\n  if (!endDate) return 'active';\n  return new Date(endDate) < new Date() ? 'completed' : 'active';\n}\n\n/**\n * LOINC-like codes for lifestyle observation types\n */\nconst LIFESTYLE_CODES: Record<string, { code: string; display: string }> = {\n  diet: { code: '81259-4', display: 'Diet' },\n  exercise: { code: '73985-4', display: 'Exercise activity' },\n  sleep: { code: '93832-4', display: 'Sleep duration' },\n};\n\n/**\n * Convert medication/supplement intervention to FHIR MedicationStatement\n */\nexport function interventionToFHIRMedicationStatement(\n  intervention: InterventionData,\n  patientId: string,\n): FHIRMedicationStatement {\n  const statement: FHIRMedicationStatement = {\n    category: {\n      coding: [\n        {\n          code: 'patientspecified',\n          display: 'Patient Specified',\n          system: 'http://terminology.hl7.org/CodeSystem/medication-statement-category',\n        },\n      ],\n    },\n    dateAsserted: intervention.startDate,\n    effectivePeriod: {\n      end: intervention.endDate,\n      start: intervention.startDate,\n    },\n    id: `intervention-${intervention.interventionId}`,\n    medicationCodeableConcept: {\n      text: intervention.name,\n    },\n    resourceType: 'MedicationStatement',\n    status: interventionStatus(intervention.endDate),\n    subject: {\n      reference: `Patient/${patientId}`,\n    },\n  };\n\n  if (intervention.notes) {\n    statement.note = [{ text: intervention.notes }];\n  }\n\n  return statement;\n}\n\n/**\n * Convert diet/exercise/sleep intervention to FHIR Observation (social-history)\n */\nexport function interventionToFHIRObservation(\n  intervention: InterventionData,\n  patientId: string,\n): FHIRObservation {\n  const lifestyleCode = LIFESTYLE_CODES[intervention.type];\n\n  const observation: FHIRObservation = {\n    category: [\n      {\n        coding: [\n          {\n            code: 'social-history',\n            display: 'Social History',\n            system: 'http://terminology.hl7.org/CodeSystem/observation-category',\n          },\n        ],\n      },\n    ],\n    code: {\n      coding: lifestyleCode\n        ? [\n            {\n              code: lifestyleCode.code,\n              display: lifestyleCode.display,\n              system: 'http://loinc.org',\n            },\n          ]\n        : [],\n      text: intervention.name,\n    },\n    effectivePeriod: {\n      end: intervention.endDate,\n      start: intervention.startDate,\n    },\n    id: `intervention-${intervention.interventionId}`,\n    resourceType: 'Observation',\n    status: 'final',\n    subject: {\n      reference: `Patient/${patientId}`,\n    },\n    valueString: intervention.name,\n  };\n\n  if (intervention.notes) {\n    observation.note = [{ text: intervention.notes }];\n  }\n\n  return observation;\n}\n\n/**\n * Convert all interventions to a FHIR Bundle\n */\nexport function interventionsToFHIRBundle(\n  interventions: InterventionData[],\n  userProfile: UserProfileData,\n): FHIRBundle {\n  const patientId = userProfile.userId;\n  const fhirPatient = userProfileToFHIR(userProfile);\n\n  const entries = interventions.map((intervention) => {\n    const isMedication = intervention.type === 'medication' || intervention.type === 'supplement';\n    const resource = isMedication\n      ? interventionToFHIRMedicationStatement(intervention, patientId)\n      : interventionToFHIRObservation(intervention, patientId);\n\n    return {\n      fullUrl: `urn:uuid:intervention-${intervention.interventionId}`,\n      resource,\n    };\n  });\n\n  return {\n    entry: [\n      {\n        fullUrl: `urn:uuid:${patientId}`,\n        resource: fhirPatient,\n      },\n      ...entries,\n    ],\n    resourceType: 'Bundle',\n    type: 'collection',\n  };\n}\n","/**\n * Structured zone data for DEXA body composition and bone density charts.\n *\n * Body fat zones derived from Gallagher et al. Am J Clin Nutr 2000;72:694-701 (PMID: 10966886)\n * and ACSM Guidelines for Exercise Testing, 11th Ed (2021).\n *\n * T-Score zones from WHO criteria (Kanis JA, Osteoporos Int, PMID: 7696835).\n */\n\nexport interface BodyFatZone {\n  ageMax: number;\n  ageMin: number;\n  color: string;\n  fatPctMax: number;\n  fatPctMin: number;\n  label: string;\n  sex: 'F' | 'M';\n}\n\ninterface AgeBracket {\n  ageMax: number;\n  ageMin: number;\n  label: string;\n}\n\nconst AGE_BRACKETS: AgeBracket[] = [\n  { ageMax: 25, ageMin: 18, label: '18-25' },\n  { ageMax: 35, ageMin: 26, label: '26-35' },\n  { ageMax: 45, ageMin: 36, label: '36-45' },\n  { ageMax: 55, ageMin: 46, label: '46-55' },\n  { ageMax: 99, ageMin: 56, label: '56+' },\n];\n\n// Zone boundaries per age bracket for men: [essential, athletic, fitness, average, obese]\n// Each value is the upper bound of the zone\nconst MALE_ZONES: number[][] = [\n  [5, 10, 20, 25, 40],\n  [5, 11, 21, 26, 40],\n  [5, 12, 22, 27, 40],\n  [5, 13, 23, 28, 40],\n  [5, 14, 24, 29, 40],\n];\n\nconst FEMALE_ZONES: number[][] = [\n  [13, 18, 28, 32, 45],\n  [13, 18, 29, 33, 45],\n  [13, 19, 30, 34, 45],\n  [13, 20, 31, 35, 45],\n  [13, 20, 32, 36, 45],\n];\n\ninterface ZoneDefinition {\n  color: string;\n  label: string;\n}\n\nconst ZONE_DEFS: ZoneDefinition[] = [\n  { color: '#3b82f6', label: 'Essencial' },\n  { color: '#06b6d4', label: 'Atlético' },\n  { color: '#22c55e', label: 'Fitness' },\n  { color: '#eab308', label: 'Média' },\n  { color: '#ef4444', label: 'Obeso' },\n];\n\nfunction buildZones(sex: 'F' | 'M', zoneData: number[][]): BodyFatZone[] {\n  const zones: BodyFatZone[] = [];\n  for (let i = 0; i < AGE_BRACKETS.length; i++) {\n    const bracket = AGE_BRACKETS[i]!;\n    const b = zoneData[i]!;\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[0]!.color,\n      fatPctMax: b[0]!,\n      fatPctMin: 0,\n      label: ZONE_DEFS[0]!.label,\n      sex,\n    });\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[1]!.color,\n      fatPctMax: b[1]!,\n      fatPctMin: b[0]!,\n      label: ZONE_DEFS[1]!.label,\n      sex,\n    });\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[2]!.color,\n      fatPctMax: b[2]!,\n      fatPctMin: b[1]!,\n      label: ZONE_DEFS[2]!.label,\n      sex,\n    });\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[3]!.color,\n      fatPctMax: b[3]!,\n      fatPctMin: b[2]!,\n      label: ZONE_DEFS[3]!.label,\n      sex,\n    });\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[4]!.color,\n      fatPctMax: b[4]!,\n      fatPctMin: b[3]!,\n      label: ZONE_DEFS[4]!.label,\n      sex,\n    });\n  }\n  return zones;\n}\n\nexport const BODY_FAT_ZONES: BodyFatZone[] = [\n  ...buildZones('M', MALE_ZONES),\n  ...buildZones('F', FEMALE_ZONES),\n];\n\nexport { AGE_BRACKETS, ZONE_DEFS };\n\nexport interface TScoreZone {\n  color: string;\n  label: string;\n  max: number;\n  min: number;\n}\n\nexport const T_SCORE_ZONES: TScoreZone[] = [\n  { color: '#22c55e', label: 'Normal', max: 4, min: -1.0 },\n  { color: '#eab308', label: 'Osteopenia', max: -1.0, min: -2.5 },\n  { color: '#ef4444', label: 'Osteoporose', max: -2.5, min: -5 },\n];\n","/**\n * Screening Intervals Configuration\n *\n * Defines recommended screening intervals for different biomarker categories\n * based on clinical guidelines and best practices.\n */\n\n/**\n * Screening interval in months\n */\nexport type ScreeningIntervalMonths = 3 | 6 | 12;\n\n/**\n * Biomarker category with its recommended screening interval\n */\nexport interface CategoryScreeningInterval {\n  category: string;\n  intervalMonths: ScreeningIntervalMonths;\n  nameEn: string;\n  namePt: string;\n}\n\n/**\n * Screening interval configuration for each category\n *\n * Categories are grouped by their recommended screening intervals:\n * - 3 months: Body composition and bone density (frequently changing metrics)\n * - 6 months: Metabolic panel and nutrients (moderate change rate)\n * - 12 months: Standard blood panels (stable long-term markers)\n */\nexport const CATEGORY_SCREENING_INTERVALS: CategoryScreeningInterval[] = [\n  // 3-month intervals - Body composition (frequently changing)\n  {\n    category: 'composicao-corporal',\n    intervalMonths: 3,\n    nameEn: 'Body Composition',\n    namePt: 'Composição Corporal',\n  },\n  {\n    category: 'densidade-ossea',\n    intervalMonths: 3,\n    nameEn: 'Bone Density',\n    namePt: 'Densidade Óssea',\n  },\n\n  // 6-month intervals - Metabolic and nutrients\n  {\n    category: 'metabolico',\n    intervalMonths: 6,\n    nameEn: 'Metabolic Panel',\n    namePt: 'Painel Metabólico',\n  },\n  {\n    category: 'nutrientes',\n    intervalMonths: 6,\n    nameEn: 'Nutrients',\n    namePt: 'Nutrientes',\n  },\n  {\n    category: 'pancreas',\n    intervalMonths: 6,\n    nameEn: 'Pancreas',\n    namePt: 'Pâncreas',\n  },\n\n  // 12-month intervals - Standard blood panels\n  {\n    category: 'coracao',\n    intervalMonths: 12,\n    nameEn: 'Heart Health',\n    namePt: 'Saúde Cardiovascular',\n  },\n  {\n    category: 'tireoide',\n    intervalMonths: 12,\n    nameEn: 'Thyroid',\n    namePt: 'Tireoide',\n  },\n  {\n    category: 'sangue',\n    intervalMonths: 12,\n    nameEn: 'Blood Count',\n    namePt: 'Hemograma',\n  },\n  {\n    category: 'figado',\n    intervalMonths: 12,\n    nameEn: 'Liver Function',\n    namePt: 'Função Hepática',\n  },\n  {\n    category: 'rins',\n    intervalMonths: 12,\n    nameEn: 'Kidney Function',\n    namePt: 'Função Renal',\n  },\n  {\n    category: 'saude-feminina',\n    intervalMonths: 12,\n    nameEn: \"Women's Health\",\n    namePt: 'Saúde Feminina',\n  },\n  {\n    category: 'saude-masculina',\n    intervalMonths: 12,\n    nameEn: \"Men's Health\",\n    namePt: 'Saúde Masculina',\n  },\n  {\n    category: 'eletrolitos',\n    intervalMonths: 12,\n    nameEn: 'Electrolytes',\n    namePt: 'Eletrólitos',\n  },\n  {\n    category: 'estresse-envelhecimento',\n    intervalMonths: 12,\n    nameEn: 'Stress & Aging',\n    namePt: 'Estresse e Envelhecimento',\n  },\n  {\n    category: 'autoimunidade',\n    intervalMonths: 12,\n    nameEn: 'Autoimmunity',\n    namePt: 'Autoimunidade',\n  },\n  {\n    category: 'regulacao-imunologica',\n    intervalMonths: 12,\n    nameEn: 'Immune Regulation',\n    namePt: 'Regulação Imunológica',\n  },\n  {\n    category: 'toxinas-ambientais',\n    intervalMonths: 12,\n    nameEn: 'Environmental Toxins',\n    namePt: 'Toxinas Ambientais',\n  },\n  {\n    category: 'urina',\n    intervalMonths: 12,\n    nameEn: 'Urinalysis',\n    namePt: 'Urina',\n  },\n];\n\n/**\n * Get screening interval for a category\n */\nexport const getScreeningInterval = (category: string): CategoryScreeningInterval | undefined => {\n  return CATEGORY_SCREENING_INTERVALS.find((c) => c.category === category);\n};\n\n/**\n * Get all categories with a specific interval\n */\nexport const getCategoriesByInterval = (\n  intervalMonths: ScreeningIntervalMonths,\n): CategoryScreeningInterval[] => {\n  return CATEGORY_SCREENING_INTERVALS.filter((c) => c.intervalMonths === intervalMonths);\n};\n\n/**\n * Calculate next screening date based on last test date and category\n */\nexport const calculateNextScreeningDate = (lastTestDate: Date, category: string): Date | null => {\n  const interval = getScreeningInterval(category);\n  if (!interval) return null;\n\n  const nextDate = new Date(lastTestDate);\n  nextDate.setMonth(nextDate.getMonth() + interval.intervalMonths);\n  return nextDate;\n};\n\n/**\n * Check if a category is due for screening\n */\nexport const isScreeningDue = (\n  lastTestDate: Date,\n  category: string,\n  referenceDate: Date = new Date(),\n): boolean => {\n  const nextDate = calculateNextScreeningDate(lastTestDate, category);\n  if (!nextDate) return false;\n  return referenceDate >= nextDate;\n};\n\n/**\n * Get categories that are due for screening based on last test dates\n */\nexport const getDueCategories = (\n  lastTestDates: Record<string, Date>,\n  referenceDate: Date = new Date(),\n): CategoryScreeningInterval[] => {\n  return CATEGORY_SCREENING_INTERVALS.filter((interval) => {\n    const lastDate = lastTestDates[interval.category];\n    if (!lastDate) return true; // Never tested = due\n    return isScreeningDue(lastDate, interval.category, referenceDate);\n  });\n};\n\n/**\n * Get days until next screening for a category\n */\nexport const getDaysUntilScreening = (\n  lastTestDate: Date,\n  category: string,\n  referenceDate: Date = new Date(),\n): number | null => {\n  const nextDate = calculateNextScreeningDate(lastTestDate, category);\n  if (!nextDate) return null;\n\n  const diffTime = nextDate.getTime() - referenceDate.getTime();\n  return Math.ceil(diffTime / (1000 * 60 * 60 * 24));\n};\n","/**\n * Portuguese pluralization utility using native Intl.PluralRules\n * Provides automatic pluralization for common words used in the app\n */\n\nconst pluralRules = new Intl.PluralRules('pt-BR');\n\n/**\n * Dictionary of Portuguese words with their plural forms\n * Key is the singular form, value is the plural form\n */\nconst dictionary: Record<string, string> = {\n  // Common nouns\n  arquivo: 'arquivos',\n  biomarcador: 'biomarcadores',\n  // Past participles (masculine)\n  cadastrado: 'cadastrados',\n  // Past participles (feminine)\n  concluída: 'concluídas',\n  confirmado: 'confirmados',\n  convertido: 'convertidos',\n  convidado: 'convidados',\n  convite: 'convites',\n  disponível: 'disponíveis',\n  documento: 'documentos',\n  enviado: 'enviados',\n  exame: 'exames',\n  excluída: 'excluídas',\n\n  excluído: 'excluídos',\n  // Verbs (3rd person)\n  falhou: 'falharam',\n  falta: 'faltam',\n  ignorado: 'ignorados',\n  item: 'itens',\n  outro: 'outros',\n  página: 'páginas',\n  pendente: 'pendentes',\n  registro: 'registros',\n  removido: 'removidos',\n\n  resultado: 'resultados',\n  revisão: 'revisões',\n\n  revogado: 'revogados',\n  usuário: 'usuários',\n};\n\n/**\n * Get the plural form of a word from the dictionary\n * Falls back to adding 's' if word is not in dictionary\n */\nconst getPluralForm = (singular: string): string => {\n  return dictionary[singular] ?? `${singular}s`;\n};\n\n/**\n * Returns the correct singular or plural form based on count\n * Uses Intl.PluralRules for proper locale-aware pluralization\n *\n * @example\n * plural(1, 'usuário') // 'usuário'\n * plural(3, 'usuário') // 'usuários'\n * plural(0, 'registro') // 'registros'\n */\nexport const plural = (count: number, word: string): string => {\n  const rule = pluralRules.select(count);\n  return rule === 'one' ? word : getPluralForm(word);\n};\n\n/**\n * Returns count with the correct singular or plural form\n *\n * @example\n * pluralCount(1, 'usuário') // '1 usuário'\n * pluralCount(3, 'usuário') // '3 usuários'\n */\nexport const pluralCount = (count: number, word: string): string => {\n  return `${count} ${plural(count, word)}`;\n};\n\n/**\n * Returns the correct form for compound phrases (noun + adjective)\n * Both words are pluralized together\n *\n * @example\n * pluralPhrase(1, 'usuário', 'cadastrado') // 'usuário cadastrado'\n * pluralPhrase(3, 'usuário', 'cadastrado') // 'usuários cadastrados'\n * pluralPhrase(2, 'revisão', 'excluída') // 'revisões excluídas'\n */\nexport const pluralPhrase = (count: number, noun: string, adjective: string): string => {\n  const rule = pluralRules.select(count);\n  if (rule === 'one') {\n    return `${noun} ${adjective}`;\n  }\n  return `${getPluralForm(noun)} ${getPluralForm(adjective)}`;\n};\n\n/**\n * Returns count with the correct compound phrase form\n *\n * @example\n * pluralPhraseCount(1, 'usuário', 'cadastrado') // '1 usuário cadastrado'\n * pluralPhraseCount(3, 'convite', 'enviado') // '3 convites enviados'\n */\nexport const pluralPhraseCount = (count: number, noun: string, adjective: string): string => {\n  return `${count} ${pluralPhrase(count, noun, adjective)}`;\n};\n","/**\n * Helpers para identificadores brasileiros — CPF e CNS\n *\n * Validação, formatação e conversão para FHIR Identifier.\n * Algoritmos de validação baseados nas especificações oficiais:\n * - CPF: Receita Federal (mod-11, dois dígitos verificadores)\n * - CNS: Ministério da Saúde (mod-11 para definitivos, soma ponderada para provisórios)\n */\n\nimport type { FHIRIdentifier } from './fhir-types';\n\nconst CPF_SYSTEM = 'http://rnds.saude.gov.br/fhir/r4/NamingSystem/cpf';\nconst CNS_SYSTEM = 'http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns';\n\n/**\n * Remove caracteres não-numéricos de uma string.\n */\nfunction digitsOnly(value: string): string {\n  return value.replace(/\\D/g, '');\n}\n\n/**\n * Valida um CPF brasileiro usando algoritmo mod-11.\n *\n * @param cpf — CPF com ou sem formatação (ex: \"123.456.789-09\" ou \"12345678909\")\n * @returns true se o CPF é estruturalmente válido\n */\nexport function validateCPF(cpf: string): boolean {\n  const digits = digitsOnly(cpf);\n\n  if (digits.length !== 11) return false;\n\n  // Rejeitar sequências de dígitos iguais (ex: 111.111.111-11)\n  if (/^(\\d)\\1{10}$/.test(digits)) return false;\n\n  // Primeiro dígito verificador\n  let sum = 0;\n  for (let i = 0; i < 9; i++) {\n    sum += Number(digits[i]) * (10 - i);\n  }\n  let remainder = (sum * 10) % 11;\n  if (remainder === 10) remainder = 0;\n  if (remainder !== Number(digits[9])) return false;\n\n  // Segundo dígito verificador\n  sum = 0;\n  for (let i = 0; i < 10; i++) {\n    sum += Number(digits[i]) * (11 - i);\n  }\n  remainder = (sum * 10) % 11;\n  if (remainder === 10) remainder = 0;\n  if (remainder !== Number(digits[10])) return false;\n\n  return true;\n}\n\n/**\n * Valida um CNS (Cartão Nacional de Saúde) brasileiro.\n *\n * CNS definitivos começam com 1 ou 2 (mod-11).\n * CNS provisórios começam com 7, 8 ou 9 (soma ponderada mod-11 = 0).\n *\n * @param cns — CNS com 15 dígitos\n * @returns true se o CNS é estruturalmente válido\n */\nexport function validateCNS(cns: string): boolean {\n  const digits = digitsOnly(cns);\n\n  if (digits.length !== 15) return false;\n\n  const firstDigit = digits[0]!;\n\n  // CNS deve começar com 1, 2 (definitivo) ou 7, 8, 9 (provisório)\n  if (!['1', '2', '7', '8', '9'].includes(firstDigit)) return false;\n\n  // Ambos os tipos usam soma ponderada mod-11 = 0\n  let sum = 0;\n  for (let i = 0; i < 15; i++) {\n    sum += Number(digits[i]) * (15 - i);\n  }\n  return sum % 11 === 0;\n}\n\n/**\n * Formata um CPF como XXX.XXX.XXX-XX.\n *\n * @param cpf — CPF com 11 dígitos (com ou sem formatação)\n * @returns CPF formatado ou a string original se inválido\n */\nexport function formatCPF(cpf: string): string {\n  const digits = digitsOnly(cpf);\n  if (digits.length !== 11) return cpf;\n  return `${digits.slice(0, 3)}.${digits.slice(3, 6)}.${digits.slice(6, 9)}-${digits.slice(9)}`;\n}\n\n/**\n * Formata um CNS como XXX XXXX XXXX XXXX.\n *\n * @param cns — CNS com 15 dígitos\n * @returns CNS formatado ou a string original se inválido\n */\nexport function formatCNS(cns: string): string {\n  const digits = digitsOnly(cns);\n  if (digits.length !== 15) return cns;\n  return `${digits.slice(0, 3)} ${digits.slice(3, 7)} ${digits.slice(7, 11)} ${digits.slice(11)}`;\n}\n\n/**\n * Converte um CPF para um FHIR Identifier.\n *\n * @param cpf — CPF com 11 dígitos (com ou sem formatação)\n * @returns FHIR Identifier com sistema RNDS para CPF\n * @throws Error se o CPF for inválido\n */\nexport function cpfToFHIRIdentifier(cpf: string): FHIRIdentifier {\n  if (!validateCPF(cpf)) {\n    throw new Error('CPF inválido');\n  }\n  return {\n    system: CPF_SYSTEM,\n    use: 'official',\n    value: digitsOnly(cpf),\n  };\n}\n\n/**\n * Converte um CNS para um FHIR Identifier.\n *\n * @param cns — CNS com 15 dígitos\n * @returns FHIR Identifier com sistema RNDS para CNS\n * @throws Error se o CNS for inválido\n */\nexport function cnsToFHIRIdentifier(cns: string): FHIRIdentifier {\n  if (!validateCNS(cns)) {\n    throw new Error('CNS inválido');\n  }\n  return {\n    system: CNS_SYSTEM,\n    use: 'official',\n    value: digitsOnly(cns),\n  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+{"version":3,"sources":["../src/category-groups.ts","../src/intervention-converter.ts","../src/dexa-zone-data.ts","../src/screening-intervals.ts","../src/i18n.ts","../src/identifiers.ts"],"sourcesContent":["/**\n * Agrupamento de categorias clínicas em 10 grupos de alto nível.\n *\n * `BiomarkerDefinition.category` armazena 20 sub-categorias (granularidade\n * fina, ex: `tireoide`, `pancreas`). Este módulo agrupa essas\n * sub-categorias em 10 buckets clínicos amplos para apresentação no\n * site, na API pública e em material de divulgação.\n *\n * As sub-categorias permanecem como fonte da verdade nos dados; este\n * agrupamento é uma camada derivada.\n */\n\nexport type CategoryGroup =\n  | 'cardiovascular'\n  | 'metabolico-endocrino'\n  | 'renal-eletrolitico'\n  | 'hepatico-biliar'\n  | 'hematologico'\n  | 'imunologico'\n  | 'oncologico'\n  | 'nutricional-ambiental'\n  | 'saude-reprodutiva'\n  | 'composicao-envelhecimento';\n\nexport interface CategoryGroupInfo {\n  /** Rótulo em inglês */\n  en: string;\n  /** Rótulo em português */\n  pt: string;\n  /** Slug (kebab-case, sem acento) */\n  slug: CategoryGroup;\n  /** Sub-categorias da fonte agrupadas neste bucket */\n  subcategories: readonly string[];\n}\n\nexport const CATEGORY_GROUPS: Record<CategoryGroup, CategoryGroupInfo> = {\n  cardiovascular: {\n    en: 'Cardiovascular',\n    pt: 'Cardiovascular',\n    slug: 'cardiovascular',\n    subcategories: ['coracao'],\n  },\n  'composicao-envelhecimento': {\n    en: 'Body Composition & Aging',\n    pt: 'Composição Corporal e Envelhecimento',\n    slug: 'composicao-envelhecimento',\n    subcategories: ['composicao-corporal', 'densidade-ossea', 'estresse-envelhecimento'],\n  },\n  hematologico: {\n    en: 'Hematology',\n    pt: 'Hematológico',\n    slug: 'hematologico',\n    subcategories: ['sangue'],\n  },\n  'hepatico-biliar': {\n    en: 'Hepatic & Biliary',\n    pt: 'Hepático e Biliar',\n    slug: 'hepatico-biliar',\n    subcategories: ['figado'],\n  },\n  imunologico: {\n    en: 'Immunology',\n    pt: 'Imunológico',\n    slug: 'imunologico',\n    subcategories: ['autoimunidade', 'regulacao-imunologica'],\n  },\n  'metabolico-endocrino': {\n    en: 'Metabolic & Endocrine',\n    pt: 'Metabólico e Endócrino',\n    slug: 'metabolico-endocrino',\n    subcategories: ['metabolico', 'pancreas', 'hormonios', 'tireoide'],\n  },\n  'nutricional-ambiental': {\n    en: 'Nutrition & Environmental Exposure',\n    pt: 'Nutricional e Exposição Ambiental',\n    slug: 'nutricional-ambiental',\n    subcategories: ['nutrientes', 'toxinas-ambientais'],\n  },\n  oncologico: {\n    en: 'Oncology',\n    pt: 'Oncológico',\n    slug: 'oncologico',\n    subcategories: ['marcadores-tumorais'],\n  },\n  'renal-eletrolitico': {\n    en: 'Renal & Electrolytes',\n    pt: 'Renal e Eletrolítico',\n    slug: 'renal-eletrolitico',\n    subcategories: ['rins', 'urina', 'eletrolitos'],\n  },\n  'saude-reprodutiva': {\n    en: 'Reproductive Health',\n    pt: 'Saúde Reprodutiva',\n    slug: 'saude-reprodutiva',\n    subcategories: ['saude-feminina', 'saude-masculina'],\n  },\n};\n\nconst SUBCATEGORY_TO_GROUP = new Map<string, CategoryGroup>();\nfor (const group of Object.values(CATEGORY_GROUPS)) {\n  for (const sub of group.subcategories) {\n    SUBCATEGORY_TO_GROUP.set(sub, group.slug);\n  }\n}\n\n/**\n * Resolve a sub-categoria (granular) para o grupo de alto nível (10 buckets).\n */\nexport function getCategoryGroup(subcategory: string): CategoryGroup | undefined {\n  return SUBCATEGORY_TO_GROUP.get(subcategory);\n}\n\n/**\n * Lista todas as sub-categorias mapeadas em algum grupo.\n */\nexport function listMappedSubcategories(): readonly string[] {\n  return [...SUBCATEGORY_TO_GROUP.keys()];\n}\n","/**\n * FHIR Intervention Converter\n *\n * Converts interventions (medication, supplement, diet, exercise, sleep)\n * to FHIR R4 MedicationStatement and Observation resources.\n */\n\nimport { userProfileToFHIR } from './converter';\nimport type { FHIRBundle, FHIRMedicationStatement, FHIRObservation } from './fhir-types';\nimport type { InterventionData, UserProfileData } from './types';\n\n/**\n * Determine MedicationStatement/Observation status based on end date\n */\nfunction interventionStatus(endDate?: string): 'active' | 'completed' {\n  if (!endDate) return 'active';\n  return new Date(endDate) < new Date() ? 'completed' : 'active';\n}\n\n/**\n * LOINC-like codes for lifestyle observation types\n */\nconst LIFESTYLE_CODES: Record<string, { code: string; display: string }> = {\n  diet: { code: '81259-4', display: 'Diet' },\n  exercise: { code: '73985-4', display: 'Exercise activity' },\n  sleep: { code: '93832-4', display: 'Sleep duration' },\n};\n\n/**\n * Convert medication/supplement intervention to FHIR MedicationStatement\n */\nexport function interventionToFHIRMedicationStatement(\n  intervention: InterventionData,\n  patientId: string,\n): FHIRMedicationStatement {\n  const statement: FHIRMedicationStatement = {\n    category: {\n      coding: [\n        {\n          code: 'patientspecified',\n          display: 'Patient Specified',\n          system: 'http://terminology.hl7.org/CodeSystem/medication-statement-category',\n        },\n      ],\n    },\n    dateAsserted: intervention.startDate,\n    effectivePeriod: {\n      end: intervention.endDate,\n      start: intervention.startDate,\n    },\n    id: `intervention-${intervention.interventionId}`,\n    medicationCodeableConcept: {\n      text: intervention.name,\n    },\n    resourceType: 'MedicationStatement',\n    status: interventionStatus(intervention.endDate),\n    subject: {\n      reference: `Patient/${patientId}`,\n    },\n  };\n\n  if (intervention.notes) {\n    statement.note = [{ text: intervention.notes }];\n  }\n\n  return statement;\n}\n\n/**\n * Convert diet/exercise/sleep intervention to FHIR Observation (social-history)\n */\nexport function interventionToFHIRObservation(\n  intervention: InterventionData,\n  patientId: string,\n): FHIRObservation {\n  const lifestyleCode = LIFESTYLE_CODES[intervention.type];\n\n  const observation: FHIRObservation = {\n    category: [\n      {\n        coding: [\n          {\n            code: 'social-history',\n            display: 'Social History',\n            system: 'http://terminology.hl7.org/CodeSystem/observation-category',\n          },\n        ],\n      },\n    ],\n    code: {\n      coding: lifestyleCode\n        ? [\n            {\n              code: lifestyleCode.code,\n              display: lifestyleCode.display,\n              system: 'http://loinc.org',\n            },\n          ]\n        : [],\n      text: intervention.name,\n    },\n    effectivePeriod: {\n      end: intervention.endDate,\n      start: intervention.startDate,\n    },\n    id: `intervention-${intervention.interventionId}`,\n    resourceType: 'Observation',\n    status: 'final',\n    subject: {\n      reference: `Patient/${patientId}`,\n    },\n    valueString: intervention.name,\n  };\n\n  if (intervention.notes) {\n    observation.note = [{ text: intervention.notes }];\n  }\n\n  return observation;\n}\n\n/**\n * Convert all interventions to a FHIR Bundle\n */\nexport function interventionsToFHIRBundle(\n  interventions: InterventionData[],\n  userProfile: UserProfileData,\n): FHIRBundle {\n  const patientId = userProfile.userId;\n  const fhirPatient = userProfileToFHIR(userProfile);\n\n  const entries = interventions.map((intervention) => {\n    const isMedication = intervention.type === 'medication' || intervention.type === 'supplement';\n    const resource = isMedication\n      ? interventionToFHIRMedicationStatement(intervention, patientId)\n      : interventionToFHIRObservation(intervention, patientId);\n\n    return {\n      fullUrl: `urn:uuid:intervention-${intervention.interventionId}`,\n      resource,\n    };\n  });\n\n  return {\n    entry: [\n      {\n        fullUrl: `urn:uuid:${patientId}`,\n        resource: fhirPatient,\n      },\n      ...entries,\n    ],\n    resourceType: 'Bundle',\n    type: 'collection',\n  };\n}\n","/**\n * Structured zone data for DEXA body composition and bone density charts.\n *\n * Body fat zones derived from Gallagher et al. Am J Clin Nutr 2000;72:694-701 (PMID: 10966886)\n * and ACSM Guidelines for Exercise Testing, 11th Ed (2021).\n *\n * T-Score zones from WHO criteria (Kanis JA, Osteoporos Int, PMID: 7696835).\n */\n\nexport interface BodyFatZone {\n  ageMax: number;\n  ageMin: number;\n  color: string;\n  fatPctMax: number;\n  fatPctMin: number;\n  label: string;\n  sex: 'F' | 'M';\n}\n\ninterface AgeBracket {\n  ageMax: number;\n  ageMin: number;\n  label: string;\n}\n\nconst AGE_BRACKETS: AgeBracket[] = [\n  { ageMax: 25, ageMin: 18, label: '18-25' },\n  { ageMax: 35, ageMin: 26, label: '26-35' },\n  { ageMax: 45, ageMin: 36, label: '36-45' },\n  { ageMax: 55, ageMin: 46, label: '46-55' },\n  { ageMax: 99, ageMin: 56, label: '56+' },\n];\n\n// Zone boundaries per age bracket for men: [essential, athletic, fitness, average, obese]\n// Each value is the upper bound of the zone\nconst MALE_ZONES: number[][] = [\n  [5, 10, 20, 25, 40],\n  [5, 11, 21, 26, 40],\n  [5, 12, 22, 27, 40],\n  [5, 13, 23, 28, 40],\n  [5, 14, 24, 29, 40],\n];\n\nconst FEMALE_ZONES: number[][] = [\n  [13, 18, 28, 32, 45],\n  [13, 18, 29, 33, 45],\n  [13, 19, 30, 34, 45],\n  [13, 20, 31, 35, 45],\n  [13, 20, 32, 36, 45],\n];\n\ninterface ZoneDefinition {\n  color: string;\n  label: string;\n}\n\nconst ZONE_DEFS: ZoneDefinition[] = [\n  { color: '#3b82f6', label: 'Essencial' },\n  { color: '#06b6d4', label: 'Atlético' },\n  { color: '#22c55e', label: 'Fitness' },\n  { color: '#eab308', label: 'Média' },\n  { color: '#ef4444', label: 'Obeso' },\n];\n\nfunction buildZones(sex: 'F' | 'M', zoneData: number[][]): BodyFatZone[] {\n  const zones: BodyFatZone[] = [];\n  for (let i = 0; i < AGE_BRACKETS.length; i++) {\n    const bracket = AGE_BRACKETS[i]!;\n    const b = zoneData[i]!;\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[0]!.color,\n      fatPctMax: b[0]!,\n      fatPctMin: 0,\n      label: ZONE_DEFS[0]!.label,\n      sex,\n    });\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[1]!.color,\n      fatPctMax: b[1]!,\n      fatPctMin: b[0]!,\n      label: ZONE_DEFS[1]!.label,\n      sex,\n    });\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[2]!.color,\n      fatPctMax: b[2]!,\n      fatPctMin: b[1]!,\n      label: ZONE_DEFS[2]!.label,\n      sex,\n    });\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[3]!.color,\n      fatPctMax: b[3]!,\n      fatPctMin: b[2]!,\n      label: ZONE_DEFS[3]!.label,\n      sex,\n    });\n    zones.push({\n      ...bracket,\n      color: ZONE_DEFS[4]!.color,\n      fatPctMax: b[4]!,\n      fatPctMin: b[3]!,\n      label: ZONE_DEFS[4]!.label,\n      sex,\n    });\n  }\n  return zones;\n}\n\nexport const BODY_FAT_ZONES: BodyFatZone[] = [\n  ...buildZones('M', MALE_ZONES),\n  ...buildZones('F', FEMALE_ZONES),\n];\n\nexport { AGE_BRACKETS, ZONE_DEFS };\n\nexport interface TScoreZone {\n  color: string;\n  label: string;\n  max: number;\n  min: number;\n}\n\nexport const T_SCORE_ZONES: TScoreZone[] = [\n  { color: '#22c55e', label: 'Normal', max: 4, min: -1.0 },\n  { color: '#eab308', label: 'Osteopenia', max: -1.0, min: -2.5 },\n  { color: '#ef4444', label: 'Osteoporose', max: -2.5, min: -5 },\n];\n","/**\n * Screening Intervals Configuration\n *\n * Defines recommended screening intervals for different biomarker categories\n * based on clinical guidelines and best practices.\n */\n\n/**\n * Screening interval in months\n */\nexport type ScreeningIntervalMonths = 3 | 6 | 12;\n\n/**\n * Biomarker category with its recommended screening interval\n */\nexport interface CategoryScreeningInterval {\n  category: string;\n  intervalMonths: ScreeningIntervalMonths;\n  nameEn: string;\n  namePt: string;\n}\n\n/**\n * Screening interval configuration for each category\n *\n * Categories are grouped by their recommended screening intervals:\n * - 3 months: Body composition and bone density (frequently changing metrics)\n * - 6 months: Metabolic panel and nutrients (moderate change rate)\n * 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package/dist/reference-ranges.cjs

@@ -5,7 +5,7 @@
 
 
 
-var _chunkD6XKCRS2cjs = require('./chunk-D6XKCRS2.cjs');
+var _chunkT22Q6ML7cjs = require('./chunk-T22Q6ML7.cjs');
 require('./chunk-MJ254F5K.cjs');
 
 
@@ -14,5 +14,5 @@ require('./chunk-MJ254F5K.cjs');
 
 
 
-exports.applyFallbackReferenceRanges = _chunkD6XKCRS2cjs.applyFallbackReferenceRanges; exports.biomarkerRangeDefinitions = _chunkD6XKCRS2cjs.biomarkerRangeDefinitions; exports.defaultReferenceRanges = _chunkD6XKCRS2cjs.defaultReferenceRanges; exports.getFallbackReferenceRange = _chunkD6XKCRS2cjs.getFallbackReferenceRange; exports.getRangeDirection = _chunkD6XKCRS2cjs.getRangeDirection; exports.getReferenceRange = _chunkD6XKCRS2cjs.getReferenceRange;
+exports.applyFallbackReferenceRanges = _chunkT22Q6ML7cjs.applyFallbackReferenceRanges; exports.biomarkerRangeDefinitions = _chunkT22Q6ML7cjs.biomarkerRangeDefinitions; exports.defaultReferenceRanges = _chunkT22Q6ML7cjs.defaultReferenceRanges; exports.getFallbackReferenceRange = _chunkT22Q6ML7cjs.getFallbackReferenceRange; exports.getRangeDirection = _chunkT22Q6ML7cjs.getRangeDirection; exports.getReferenceRange = _chunkT22Q6ML7cjs.getReferenceRange;
 //# sourceMappingURL=reference-ranges.cjs.map

package/dist/reference-ranges.d.cts

@@ -13,10 +13,24 @@
  * Sex-specific key for reference ranges
  */
 type SexKey = 'M' | 'F' | 'all';
+/**
+ * Pré-condição de jejum para a faixa de referência.
+ *
+ * - `strict`: coleta exige jejum mínimo (ex.: glicemia de jejum, insulina).
+ * - `preferred`: jejum recomendado, mas faixa aplicável em não-jejum
+ *   (ex.: perfil lipídico pós-SBC 2017, com corte de triglicérides distinto).
+ * - `not-required`: valor independe do estado prandial (ex.: HbA1c, TSH).
+ */
+type FastingRequirement = 'strict' | 'preferred' | 'not-required';
 /**
  * Reference range configuration for a biomarker
  */
 interface BiomarkerReferenceRange {
+    /**
+     * Pré-condição de jejum para a interpretação da faixa. Opcional;
+     * consumidores devem aplicar sinalização adequada quando `strict`.
+     */
+    fastingRequired?: FastingRequirement;
     max?: number;
     min?: number;
     optimalMax?: number;
@@ -25,11 +39,27 @@ interface BiomarkerReferenceRange {
     warningMax?: number;
 }
 /**
- * A variant of a reference range that applies to a specific sex and/or age group
+ * Trimestre gestacional. Usado em variantes e no contexto de consulta
+ * para matching de faixas específicas da gestação.
+ */
+type PregnancyTrimester = 1 | 2 | 3;
+/**
+ * A variant of a reference range that applies to a specific sex, age group,
+ * and/or pregnancy state.
+ *
+ * Ordem de avaliação: variantes são processadas na ordem em que aparecem.
+ * Para que usuárias gestantes recebam a variante gestacional correta,
+ * essas variantes devem ser listadas **antes** das variantes por idade/sexo.
  */
 interface RangeVariant {
     ageMax?: number;
     ageMin?: number;
+    pregnancyTrimester?: PregnancyTrimester;
+    /**
+     * Quando `true`, a variante só se aplica a contextos de gestação.
+     * Se `pregnancyTrimester` estiver definido, o trimestre deve coincidir.
+     */
+    pregnant?: boolean;
     range: BiomarkerReferenceRange;
     sex: SexKey;
 }
@@ -63,11 +93,16 @@ interface BiomarkerRangeDefinition {
     variants?: RangeVariant[];
 }
 /**
- * User context for personalized reference range lookup
+ * User context for personalized reference range lookup.
+ *
+ * Para gestação, defina `pregnant: true` e, quando disponível,
+ * `pregnancyTrimester` para obter a variante trimestre-específica.
  */
 interface ReferenceRangeContext {
     age?: number;
     biologicalSex?: 'M' | 'F';
+    pregnancyTrimester?: PregnancyTrimester;
+    pregnant?: boolean;
 }
 /**
  * Comprehensive biomarker reference range definitions with sex/age-specific variants
@@ -116,4 +151,4 @@ declare function applyFallbackReferenceRanges<T extends {
     unit?: string;
 }>(biomarkers: T[]): number;
 
-export { type BiomarkerRangeDefinition, type BiomarkerReferenceRange, type RangeDirection, type RangeVariant, type ReferenceRangeContext, type SexKey, applyFallbackReferenceRanges, biomarkerRangeDefinitions, defaultReferenceRanges, getFallbackReferenceRange, getRangeDirection, getReferenceRange };
+export { type BiomarkerRangeDefinition, type BiomarkerReferenceRange, type FastingRequirement, type PregnancyTrimester, type RangeDirection, type RangeVariant, type ReferenceRangeContext, type SexKey, applyFallbackReferenceRanges, biomarkerRangeDefinitions, defaultReferenceRanges, getFallbackReferenceRange, getRangeDirection, getReferenceRange };

package/dist/reference-ranges.d.ts

@@ -13,10 +13,24 @@
  * Sex-specific key for reference ranges
  */
 type SexKey = 'M' | 'F' | 'all';
+/**
+ * Pré-condição de jejum para a faixa de referência.
+ *
+ * - `strict`: coleta exige jejum mínimo (ex.: glicemia de jejum, insulina).
+ * - `preferred`: jejum recomendado, mas faixa aplicável em não-jejum
+ *   (ex.: perfil lipídico pós-SBC 2017, com corte de triglicérides distinto).
+ * - `not-required`: valor independe do estado prandial (ex.: HbA1c, TSH).
+ */
+type FastingRequirement = 'strict' | 'preferred' | 'not-required';
 /**
  * Reference range configuration for a biomarker
  */
 interface BiomarkerReferenceRange {
+    /**
+     * Pré-condição de jejum para a interpretação da faixa. Opcional;
+     * consumidores devem aplicar sinalização adequada quando `strict`.
+     */
+    fastingRequired?: FastingRequirement;
     max?: number;
     min?: number;
     optimalMax?: number;
@@ -25,11 +39,27 @@ interface BiomarkerReferenceRange {
     warningMax?: number;
 }
 /**
- * A variant of a reference range that applies to a specific sex and/or age group
+ * Trimestre gestacional. Usado em variantes e no contexto de consulta
+ * para matching de faixas específicas da gestação.
+ */
+type PregnancyTrimester = 1 | 2 | 3;
+/**
+ * A variant of a reference range that applies to a specific sex, age group,
+ * and/or pregnancy state.
+ *
+ * Ordem de avaliação: variantes são processadas na ordem em que aparecem.
+ * Para que usuárias gestantes recebam a variante gestacional correta,
+ * essas variantes devem ser listadas **antes** das variantes por idade/sexo.
  */
 interface RangeVariant {
     ageMax?: number;
     ageMin?: number;
+    pregnancyTrimester?: PregnancyTrimester;
+    /**
+     * Quando `true`, a variante só se aplica a contextos de gestação.
+     * Se `pregnancyTrimester` estiver definido, o trimestre deve coincidir.
+     */
+    pregnant?: boolean;
     range: BiomarkerReferenceRange;
     sex: SexKey;
 }
@@ -63,11 +93,16 @@ interface BiomarkerRangeDefinition {
     variants?: RangeVariant[];
 }
 /**
- * User context for personalized reference range lookup
+ * User context for personalized reference range lookup.
+ *
+ * Para gestação, defina `pregnant: true` e, quando disponível,
+ * `pregnancyTrimester` para obter a variante trimestre-específica.
  */
 interface ReferenceRangeContext {
     age?: number;
     biologicalSex?: 'M' | 'F';
+    pregnancyTrimester?: PregnancyTrimester;
+    pregnant?: boolean;
 }
 /**
  * Comprehensive biomarker reference range definitions with sex/age-specific variants
@@ -116,4 +151,4 @@ declare function applyFallbackReferenceRanges<T extends {
     unit?: string;
 }>(biomarkers: T[]): number;
 
-export { type BiomarkerRangeDefinition, type BiomarkerReferenceRange, type RangeDirection, type RangeVariant, type ReferenceRangeContext, type SexKey, applyFallbackReferenceRanges, biomarkerRangeDefinitions, defaultReferenceRanges, getFallbackReferenceRange, getRangeDirection, getReferenceRange };
+export { type BiomarkerRangeDefinition, type BiomarkerReferenceRange, type FastingRequirement, type PregnancyTrimester, type RangeDirection, type RangeVariant, type ReferenceRangeContext, type SexKey, applyFallbackReferenceRanges, biomarkerRangeDefinitions, defaultReferenceRanges, getFallbackReferenceRange, getRangeDirection, getReferenceRange };

package/dist/reference-ranges.js

@@ -5,7 +5,7 @@ import {
   getFallbackReferenceRange,
   getRangeDirection,
   getReferenceRange
-} from "./chunk-GTKRPCZB.js";
+} from "./chunk-WTAXN4BF.js";
 import "./chunk-R4MUCMO3.js";
 export {
   applyFallbackReferenceRanges,

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "@precisa-saude/fhir",
-  "version": "0.10.0",
+  "version": "0.11.0",
   "description": "Tipos FHIR R4, definições de biomarcadores, faixas de referência e conversores para o ecossistema de saúde brasileiro",
   "keywords": [
     "fhir",