@precisa-saude/fhir 0.18.0 → 0.20.0

package/dist/biomarkers.cjs

@@ -30,7 +30,7 @@
 
 
 
-var _chunkONRVND6Ucjs = require('./chunk-ONRVND6U.cjs');
+var _chunkNXOTXKVBcjs = require('./chunk-NXOTXKVB.cjs');
 
 
 
@@ -63,5 +63,5 @@ var _chunkONRVND6Ucjs = require('./chunk-ONRVND6U.cjs');
 
 
 
-exports.BIOMARKER_DEFINITIONS = _chunkONRVND6Ucjs.BIOMARKER_DEFINITIONS; exports.CAC_INDICATOR_CODES = _chunkONRVND6Ucjs.CAC_INDICATOR_CODES; exports.DEXA_CATEGORIES = _chunkONRVND6Ucjs.DEXA_CATEGORIES; exports.DEXA_INDICATOR_CODES = _chunkONRVND6Ucjs.DEXA_INDICATOR_CODES; exports.codeToLoinc = _chunkONRVND6Ucjs.codeToLoinc; exports.filterVisibleBiomarkers = _chunkONRVND6Ucjs.filterVisibleBiomarkers; exports.findCodeByName = _chunkONRVND6Ucjs.findCodeByName; exports.generateCacFullReference = _chunkONRVND6Ucjs.generateCacFullReference; exports.generateDexaFullReference = _chunkONRVND6Ucjs.generateDexaFullReference; exports.generateFilteredLLMReference = _chunkONRVND6Ucjs.generateFilteredLLMReference; exports.generateLLMReference = _chunkONRVND6Ucjs.generateLLMReference; exports.getAllCodes = _chunkONRVND6Ucjs.getAllCodes; exports.getAllDefinitions = _chunkONRVND6Ucjs.getAllDefinitions; exports.getAllLoincCodes = _chunkONRVND6Ucjs.getAllLoincCodes; exports.getAllSearchPatterns = _chunkONRVND6Ucjs.getAllSearchPatterns; exports.getBiomarkersByCategory = _chunkONRVND6Ucjs.getBiomarkersByCategory; exports.getBiomarkersForCategories = _chunkONRVND6Ucjs.getBiomarkersForCategories; exports.getDefinitionByCode = _chunkONRVND6Ucjs.getDefinitionByCode; exports.getDefinitionByLoinc = _chunkONRVND6Ucjs.getDefinitionByLoinc; exports.getDefinitionsBySex = _chunkONRVND6Ucjs.getDefinitionsBySex; exports.getSexForCode = _chunkONRVND6Ucjs.getSexForCode; exports.getVisibleDefinitions = _chunkONRVND6Ucjs.getVisibleDefinitions; exports.isBiomarkerVisible = _chunkONRVND6Ucjs.isBiomarkerVisible; exports.isCacDocument = _chunkONRVND6Ucjs.isCacDocument; exports.isDexaDocument = _chunkONRVND6Ucjs.isDexaDocument; exports.isValidCode = _chunkONRVND6Ucjs.isValidCode; exports.isValidLoinc = _chunkONRVND6Ucjs.isValidLoinc; exports.loincToCode = _chunkONRVND6Ucjs.loincToCode; exports.normalizeCode = _chunkONRVND6Ucjs.normalizeCode; exports.toBiomarkerTests = _chunkONRVND6Ucjs.toBiomarkerTests; exports.validateLoincNameMatch = _chunkONRVND6Ucjs.validateLoincNameMatch;
+exports.BIOMARKER_DEFINITIONS = _chunkNXOTXKVBcjs.BIOMARKER_DEFINITIONS; exports.CAC_INDICATOR_CODES = _chunkNXOTXKVBcjs.CAC_INDICATOR_CODES; exports.DEXA_CATEGORIES = _chunkNXOTXKVBcjs.DEXA_CATEGORIES; exports.DEXA_INDICATOR_CODES = _chunkNXOTXKVBcjs.DEXA_INDICATOR_CODES; exports.codeToLoinc = _chunkNXOTXKVBcjs.codeToLoinc; exports.filterVisibleBiomarkers = _chunkNXOTXKVBcjs.filterVisibleBiomarkers; exports.findCodeByName = _chunkNXOTXKVBcjs.findCodeByName; exports.generateCacFullReference = _chunkNXOTXKVBcjs.generateCacFullReference; exports.generateDexaFullReference = _chunkNXOTXKVBcjs.generateDexaFullReference; exports.generateFilteredLLMReference = _chunkNXOTXKVBcjs.generateFilteredLLMReference; exports.generateLLMReference = _chunkNXOTXKVBcjs.generateLLMReference; exports.getAllCodes = _chunkNXOTXKVBcjs.getAllCodes; exports.getAllDefinitions = _chunkNXOTXKVBcjs.getAllDefinitions; exports.getAllLoincCodes = _chunkNXOTXKVBcjs.getAllLoincCodes; exports.getAllSearchPatterns = _chunkNXOTXKVBcjs.getAllSearchPatterns; exports.getBiomarkersByCategory = _chunkNXOTXKVBcjs.getBiomarkersByCategory; exports.getBiomarkersForCategories = _chunkNXOTXKVBcjs.getBiomarkersForCategories; exports.getDefinitionByCode = _chunkNXOTXKVBcjs.getDefinitionByCode; exports.getDefinitionByLoinc = _chunkNXOTXKVBcjs.getDefinitionByLoinc; exports.getDefinitionsBySex = _chunkNXOTXKVBcjs.getDefinitionsBySex; exports.getSexForCode = _chunkNXOTXKVBcjs.getSexForCode; exports.getVisibleDefinitions = _chunkNXOTXKVBcjs.getVisibleDefinitions; exports.isBiomarkerVisible = _chunkNXOTXKVBcjs.isBiomarkerVisible; exports.isCacDocument = _chunkNXOTXKVBcjs.isCacDocument; exports.isDexaDocument = _chunkNXOTXKVBcjs.isDexaDocument; exports.isValidCode = _chunkNXOTXKVBcjs.isValidCode; exports.isValidLoinc = _chunkNXOTXKVBcjs.isValidLoinc; exports.loincToCode = _chunkNXOTXKVBcjs.loincToCode; exports.normalizeCode = _chunkNXOTXKVBcjs.normalizeCode; exports.toBiomarkerTests = _chunkNXOTXKVBcjs.toBiomarkerTests; exports.validateLoincNameMatch = _chunkNXOTXKVBcjs.validateLoincNameMatch;
 //# sourceMappingURL=biomarkers.cjs.map

package/dist/biomarkers.js

@@ -30,7 +30,7 @@ import {
   normalizeCode,
   toBiomarkerTests,
   validateLoincNameMatch
-} from "./chunk-7O6VUA2B.js";
+} from "./chunk-3KIJIRCI.js";
 export {
   BIOMARKER_DEFINITIONS,
   CAC_INDICATOR_CODES,

package/dist/{chunk-NP4YZFUI.cjs → chunk-2KDLOCD2.cjs}

@@ -1,6 +1,6 @@
 "use strict";Object.defineProperty(exports, "__esModule", {value: true});
 
-var _chunkONRVND6Ucjs = require('./chunk-ONRVND6U.cjs');
+var _chunkNXOTXKVBcjs = require('./chunk-NXOTXKVB.cjs');
 
 
 
@@ -30,7 +30,7 @@ function interpretationDisplay(flag) {
   }
 }
 function labObservationToFHIR(observation, patientId, laboratoryName) {
-  const loincCode = _chunkONRVND6Ucjs.codeToLoinc.call(void 0, observation.biomarkerCode) || "99999-9";
+  const loincCode = _chunkNXOTXKVBcjs.codeToLoinc.call(void 0, observation.biomarkerCode) || "99999-9";
   const sourceUnit = observation.unit || _chunkMJ254F5Kcjs.getDefaultUnit.call(void 0, observation.biomarkerCode) || observation.unit;
   const ucumUnit = _chunkMJ254F5Kcjs.unitToUCUM.call(void 0, sourceUnit);
   const isQualitative = observation.isQualitative || typeof observation.value === "string";
@@ -248,4 +248,4 @@ function labResultToFHIRBundle(report, observations, userProfile) {
 
 
 exports.labObservationToFHIR = labObservationToFHIR; exports.labReportToFHIR = labReportToFHIR; exports.userProfileToFHIR = userProfileToFHIR; exports.labResultToFHIRBundle = labResultToFHIRBundle;
-//# sourceMappingURL=chunk-NP4YZFUI.cjs.map
+//# sourceMappingURL=chunk-2KDLOCD2.cjs.map

package/dist/{chunk-NP4YZFUI.cjs.map → chunk-2KDLOCD2.cjs.map}

@@ -1 +1 @@
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[{ system: 'phone' as const, value: profile.phone }] : []),\n      ].length > 0\n        ? [\n            ...(profile.email ? [{ system: 'email' as const, value: profile.email }] : []),\n            ...(profile.phone ? 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[{ display: laboratoryName }] : undefined,\n    resourceType: 'Observation',\n    status: 'final',\n    subject: {\n      reference: `Patient/${patientId}`,\n    },\n  };\n\n  // Add value based on type (qualitative = string, quantitative = number)\n  if (isQualitative) {\n    fhirObs.valueString = String(observation.value);\n  } else {\n    fhirObs.valueQuantity = {\n      code: ucumUnit,\n      system: 'http://unitsofmeasure.org',\n      unit: sourceUnit,\n      value: observation.value as number,\n    };\n\n    // Reference range only applies to quantitative values\n    if (observation.referenceMin !== undefined && observation.referenceMax !== undefined) {\n      fhirObs.referenceRange = [\n        {\n          high: {\n            code: ucumUnit,\n            system: 'http://unitsofmeasure.org',\n            unit: sourceUnit,\n            value: observation.referenceMax,\n          },\n          low: {\n            code: ucumUnit,\n            system: 'http://unitsofmeasure.org',\n            unit: sourceUnit,\n            value: observation.referenceMin,\n          },\n        },\n      ];\n    }\n  }\n\n  return fhirObs;\n}\n\n/**\n * Convert generic lab report to FHIR DiagnosticReport\n */\nexport function labReportToFHIR(\n  report: LabReportData,\n  patientId: string,\n  observationIds: string[],\n): FHIRDiagnosticReport {\n  // Map processing status to FHIR status\n  let status: FHIRDiagnosticReport['status'];\n  switch (report.processingStatus) {\n    case 'complete':\n      status = 'final';\n      break;\n    case 'partial':\n      status = 'partial';\n      break;\n    case 'pending_review':\n      status = 'preliminary';\n      break;\n    default:\n      status = 'final';\n  }\n\n  return {\n    category: [\n      {\n        coding: [\n          {\n            code: 'LAB',\n            display: 'Laboratory',\n            system: 'http://terminology.hl7.org/CodeSystem/v2-0074',\n          },\n        ],\n      },\n    ],\n    code: {\n      coding: [\n        {\n          code: '11502-2', // Laboratory report\n          display: 'Laboratory report',\n          system: 'http://loinc.org',\n        },\n      ],\n      text: 'Laboratory Results',\n    },\n    conclusion:\n      report.overallStatus === 'NORMAL'\n        ? 'All results within normal limits'\n        : 'One or more abnormal results detected',\n    conclusionCode:\n      report.overallStatus === 'ANORMAL'\n        ? [\n            {\n              coding: [\n                {\n                  code: 'A',\n                  display: 'Abnormal',\n                  system: 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation',\n                },\n              ],\n            },\n          ]\n        : undefined,\n    effectiveDateTime: report.collectionDate,\n    id: report.reportId,\n    issued: report.createdAt,\n    performer: report.laboratoryName ? [{ display: report.laboratoryName }] : undefined,\n    resourceType: 'DiagnosticReport',\n    result: observationIds.map((id) => ({ reference: `Observation/${id}` })),\n    status,\n    subject: {\n      reference: `Patient/${patientId}`,\n    },\n  };\n}\n\n/**\n * Convert user profile to FHIR Patient\n * NOTE: CPF is intentionally excluded for privacy (LGPD compliance)\n */\nexport function userProfileToFHIR(profile: UserProfileData): FHIRPatient {\n  const nameParts = profile.name.split(' ');\n  const given = nameParts.slice(0, -1);\n  const family = nameParts[nameParts.length - 1] || '';\n\n  return {\n    address: profile.address\n      ? 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[{ system: 'phone' as const, value: profile.phone }] : []),\n      ].length > 0\n        ? [\n            ...(profile.email ? [{ system: 'email' as const, value: profile.email }] : []),\n            ...(profile.phone ? [{ system: 'phone' as const, value: profile.phone }] : []),\n          ]\n        : undefined,\n  };\n}\n\n/**\n * Convert complete lab result to FHIR Bundle\n * This is the main function for exporting lab results to FHIR R4 format\n */\nexport function labResultToFHIRBundle(\n  report: LabReportData,\n  observations: LabObservationData[],\n  userProfile: UserProfileData,\n): FHIRBundle {\n  const patientId = userProfile.userId;\n\n  // Convert observations\n  const fhirObservations = observations.map((obs) => ({\n    fullUrl: `urn:uuid:observation-${obs.reportId}-${obs.biomarkerCode}`,\n    resource: labObservationToFHIR(\n      { ...obs, collectionDate: report.collectionDate },\n      patientId,\n      report.laboratoryName,\n    ),\n  }));\n\n  const observationIds = observations.map(\n    (obs) => `observation-${obs.reportId}-${obs.biomarkerCode}`,\n  );\n\n  // Convert report\n  const diagnosticReport = labReportToFHIR(report, patientId, observationIds);\n\n  // Convert patient\n  const fhirPatient = userProfileToFHIR(userProfile);\n\n  return {\n    entry: [\n      {\n        fullUrl: `urn:uuid:${patientId}`,\n        resource: fhirPatient,\n      },\n      {\n        fullUrl: `urn:uuid:diagnostic-report-${report.reportId}`,\n        resource: diagnosticReport,\n      },\n      ...fhirObservations,\n    ],\n    resourceType: 'Bundle',\n    type: 'collection',\n  };\n}\n"]}

package/dist/{chunk-7O6VUA2B.js → chunk-3KIJIRCI.js}

@@ -1984,10 +1984,20 @@ var BIOMARKER_DEFINITIONS = [
     },
     unit: "kg"
   },
+  // Sem `loinc` de propósito. A entrada apontava para 73964-9, cujo nome
+  // oficial é "Body muscle mass Calculated", e massa magra não é massa
+  // muscular: em DEXA, massa magra é tudo que não é gordura nem mineral
+  // ósseo, incluindo órgãos, água e tecido conjuntivo. Massa muscular é um
+  // subconjunto dela.
+  //
+  // O campo sai em bundle FHIR, então a aproximação não ficava só aqui — um
+  // consumidor externo leria massa muscular onde escrevemos massa magra. Não
+  // há LOINC para massa magra (busca por "lean body mass" só devolve códigos
+  // de urina ajustados por LBM), então o certo é não ter código, como já se
+  // faz com FatFreeMass. Quem quer massa muscular usa MuscleMass, abaixo.
   {
     category: "composicao-corporal",
     code: "LeanMass",
-    loinc: "73964-9",
     names: {
       en: ["Lean Mass", "Lean Body Mass", "Lean Tissue Mass", "Total Lean Mass", "LBM"],
       pt: ["Massa Magra", "Massa Corporal Magra", "Tecido Magro", "Massa Magra Total"]
@@ -2156,6 +2166,323 @@ var BIOMARKER_DEFINITIONS = [
     },
     unit: "kg"
   },
+  // ===========================================================================
+  // Composição corporal por bioimpedância, adipometria e antropometria
+  // ===========================================================================
+  //
+  // POLÍTICA DE `loinc` AUSENTE, e o que ela custa
+  //
+  // Várias entradas abaixo não têm `loinc`. Isso não é pendência esquecida: é
+  // o resultado de procurar e não achar, e a decisão tem consequência que
+  // vale enunciar uma vez.
+  //
+  // O que muda sem o código: a observação continua sendo exportada em FHIR e
+  // continua aparecendo para o usuário, mas o `Observation.code` sai só com o
+  // nosso código interno, sem identificador interoperável. Um consumidor
+  // externo consegue ler o valor e a unidade, e não consegue mapear a medida
+  // para o vocabulário dele sem acordo bilateral. Na prática: exibível
+  // sempre, comparável entre sistemas só quando há LOINC.
+  //
+  // Por que ainda assim é o certo: código errado é pior que código ausente.
+  // Ausente o consumidor sabe que precisa perguntar; errado ele integra com
+  // confiança e erra em silêncio. Esta mesma PR corrige um caso desses, em
+  // que `LeanMass` apontava para "Body muscle mass" e o IG publicava massa
+  // muscular sob o rótulo de massa magra.
+  //
+  // Como preencher depois: quando a LOINC publicar o conceito, basta somar o
+  // campo `loinc` — o código interno não muda, e as observações já gravadas
+  // não precisam ser reescritas, porque a chave é o nosso código.
+  //
+  // Todos os códigos aqui foram conferidos na API pública da NLM (Clinical
+  // Table Search Service), e a ausência só foi registrada depois de tentar
+  // múltiplas formulações: "total body water" não devolve nada, "body water"
+  // devolve os dois códigos abaixo.
+  //
+  // As 13 entradas sem código, e o motivo de cada uma:
+  //
+  //   MuscleMassIndex       corte publicado é sobre massa apendicular, não total
+  //   VisceralFatLevel      índice de 1 a 20; 73707-2 é área, outra grandeza
+  //   ResidualMass          conceito de fracionamento antropométrico, não LOINC
+  //   BasalMetabolicRate    candidatos são índice ou RMR medido, ver nota local
+  //   ExtracellularWater    "extracellular water" não devolve nada
+  //   IntracellularWater    "intracellular water" não devolve nada
+  //   ECWToTBWRatio         razão derivada, sem conceito próprio
+  //   WaistToHeightRatio    "waist to height" não devolve nada
+  //   ConicityIndex         índice derivado, sem conceito próprio
+  //   SkinfoldSubscapular   LOINC só tem tríceps, coxa e cintura
+  //   SkinfoldSuprailiac    idem
+  //   SkinfoldChest         idem
+  //   SkinfoldMidaxillary   idem
+  // Bioimpedância (BIA)
+  {
+    category: "composicao-corporal",
+    code: "TotalBodyWater",
+    loinc: "101683-1",
+    names: {
+      en: ["Total Body Water", "Body Water", "TBW", "Total Water"],
+      pt: ["\xC1gua Corporal Total", "\xC1gua Corporal", "ACT", "\xC1gua Total"]
+    },
+    unit: "L"
+  },
+  {
+    category: "composicao-corporal",
+    code: "BodyWaterPct",
+    loinc: "101684-9",
+    names: {
+      en: ["Body Water Percentage", "Percentage of Body Water", "% Body Water", "Water %"],
+      pt: ["Percentual de \xC1gua Corporal", "% \xC1gua Corporal", "\xC1gua Corporal %"]
+    },
+    unit: "%"
+  },
+  {
+    category: "composicao-corporal",
+    code: "MuscleMass",
+    loinc: "73964-9",
+    names: {
+      en: ["Muscle Mass", "Skeletal Muscle Mass", "SMM", "Body Muscle Mass"],
+      pt: [
+        "Massa Muscular",
+        "Massa Muscular Esquel\xE9tica",
+        "MME",
+        "Massa Muscular Corporal",
+        "M\xFAsculo"
+      ]
+    },
+    unit: "kg"
+  },
+  // Derivado, não extraído: `MuscleMass / altura²`, calculado pelo
+  // `calculadoras-clinicas` a partir da altura que o usuário informa no
+  // cadastro. Mesmo ajuste que o IMC faz com o peso, e serve para a medida
+  // ser comparável entre estaturas diferentes e ao longo do tempo.
+  //
+  // Sem `loinc` e sem faixa, e agora com fonte para a decisão em vez de só
+  // cautela. O EWGSOP2 (Age and Ageing, 2019, DOI 10.1093/ageing/afy169)
+  // separa explicitamente "total body Skeletal Muscle Mass (SMM)" de
+  // "Appendicular Skeletal Muscle Mass (ASM)", e os cortes publicados são
+  // sobre ASM. `MuscleMass` aqui é total, então o corte não se aplica.
+  //
+  // O mesmo consenso ainda diz, sobre ajustar por tamanho corporal: "The
+  // authors make no recommendation to adjust for body size, but adjustment
+  // can be made if data are available for a relevant normative population."
+  // Não temos população normativa brasileira para bioimpedância, e o
+  // consenso registra que a equação de Sergi, padrão do método, foi
+  // derivada em europeus idosos.
+  //
+  // Por isso o índice existe para acompanhar a própria evolução, e não para
+  // classificar.
+  {
+    category: "composicao-corporal",
+    code: "MuscleMassIndex",
+    names: {
+      en: ["Muscle Mass Index", "Skeletal Muscle Mass Index", "SMI", "SMMI"],
+      pt: ["\xCDndice de Massa Muscular", "IMM", "\xCDndice de Massa Muscular Esquel\xE9tica"]
+    },
+    unit: "kg/m2"
+  },
+  {
+    category: "composicao-corporal",
+    code: "PhaseAngle",
+    loinc: "107160-4",
+    names: {
+      en: ["Phase Angle", "Whole Body Phase Angle", "PhA", "AnglePhase"],
+      pt: ["\xC2ngulo de Fase", "\xC2ngulo de Fase Corporal"]
+    },
+    unit: "deg"
+  },
+  // O nível de gordura visceral do InBody e similares é um índice
+  // adimensional de 1 a 20, e NÃO é o mesmo que VATMass ou VATVolume, que
+  // vêm de DEXA em massa e volume. LOINC 73707-2 é "Visceral fat [Area]", em
+  // área, então também não serve. Fica sem código, com unidade vazia, para
+  // não ser confundido com nenhum dos três.
+  {
+    category: "composicao-corporal",
+    code: "VisceralFatLevel",
+    names: {
+      en: ["Visceral Fat Level", "Visceral Fat Index", "VFL"],
+      pt: ["N\xEDvel de Gordura Visceral", "\xCDndice de Gordura Visceral", "Gordura Visceral N\xEDvel"]
+    },
+    unit: ""
+  },
+  // Compartimentos de água. Sem LOINC: busca por "extracellular water" e
+  // "intracellular water" não devolve nada, ao contrário de "body water",
+  // que rendeu os dois códigos usados acima.
+  {
+    category: "composicao-corporal",
+    code: "ExtracellularWater",
+    names: {
+      en: ["Extracellular Water", "ECW"],
+      pt: ["\xC1gua Extracelular", "AEC"]
+    },
+    unit: "L"
+  },
+  {
+    category: "composicao-corporal",
+    code: "IntracellularWater",
+    names: {
+      en: ["Intracellular Water", "ICW"],
+      pt: ["\xC1gua Intracelular", "AIC"]
+    },
+    unit: "L"
+  },
+  // Razão entre água extracelular e total. É o marcador de retenção hídrica
+  // e de estado inflamatório que os aparelhos de bioimpedância reportam, e
+  // vem adimensional.
+  {
+    category: "composicao-corporal",
+    code: "ECWToTBWRatio",
+    names: {
+      en: ["ECW/TBW", "ECW_TBW", "ECW to TBW Ratio", "Extracellular Water Ratio"],
+      pt: ["Rela\xE7\xE3o AEC/ACT", "Raz\xE3o \xC1gua Extracelular"]
+    },
+    unit: ""
+  },
+  {
+    category: "composicao-corporal",
+    code: "ResidualMass",
+    names: {
+      en: ["Residual Mass", "Residual Weight"],
+      pt: ["Massa Residual", "Peso Residual"]
+    },
+    unit: "kg"
+  },
+  // Sem `loinc` até alguém decidir com a definição completa em mãos. Os
+  // candidatos não servem como estão: 50042-1 é "Basal metabolic rate
+  // index", um índice e não kcal/dia; 82278-3 é "Measured RMR", medido por
+  // calorimetria indireta, enquanto o aparelho de bioimpedância *estima* a
+  // partir da massa magra; 82286-6 "Predicted RMR" é o mais próximo, mas
+  // ainda é RMR e não TMB. Colocar qualquer um deles repetiria o erro que
+  // esta mesma PR corrige em LeanMass.
+  {
+    category: "composicao-corporal",
+    code: "BasalMetabolicRate",
+    names: {
+      en: ["Basal Metabolic Rate", "BMR"],
+      pt: ["Taxa Metab\xF3lica Basal", "TMB", "Metabolismo Basal", "Gasto Energ\xE9tico Basal"]
+    },
+    unit: "kcal/d"
+  },
+  // Antropometria
+  {
+    category: "composicao-corporal",
+    code: "WaistCircumference",
+    // 8280-0 é a medida em si. 56086-2, que parecia o óbvio pela busca, é
+    // "Adult Waist Circumference Protocol", um protocolo PhenX e não um
+    // resultado.
+    loinc: "8280-0",
+    names: {
+      en: ["Waist Circumference", "Abdominal Circumference", "Waist"],
+      pt: [
+        "Circunfer\xEAncia de Cintura",
+        "Circunfer\xEAncia Abdominal",
+        "Per\xEDmetro Abdominal",
+        "Cintura"
+      ]
+    },
+    unit: "cm"
+  },
+  // O EWGSOP2 usa a panturrilha como proxy de massa muscular onde não há
+  // outro método disponível, o que a torna útil em consulta sem aparelho.
+  {
+    category: "composicao-corporal",
+    code: "CalfCircumference",
+    loinc: "107112-5",
+    names: {
+      en: ["Calf Circumference", "Calf Girth"],
+      pt: ["Circunfer\xEAncia da Panturrilha", "Per\xEDmetro da Panturrilha", "Panturrilha"]
+    },
+    unit: "cm"
+  },
+  {
+    category: "composicao-corporal",
+    code: "WaistToHeightRatio",
+    names: {
+      en: ["Waist to Height Ratio", "Waist-to-Height Ratio", "WHtR"],
+      pt: ["Raz\xE3o Cintura-Altura", "Rela\xE7\xE3o Cintura-Estatura", "RCEst"]
+    },
+    unit: ""
+  },
+  {
+    category: "composicao-corporal",
+    code: "ConicityIndex",
+    names: {
+      en: ["Conicity Index", "C Index"],
+      pt: ["\xCDndice de Conicidade", "\xCDndice C"]
+    },
+    unit: ""
+  },
+  // Dobras cutâneas (adipometria)
+  //
+  // A LOINC tem apenas três sítios: tríceps, coxa e cintura. Os outros quatro
+  // que os protocolos brasileiros medem ficam sem código, e é por ausência
+  // confirmada, não por falta de busca. Entram individualmente porque o
+  // protocolo de somatório varia (Pollock 3 ou 7 dobras, Faulkner, Guedes) e
+  // guardar só a soma perderia o dado de origem.
+  {
+    category: "composicao-corporal",
+    code: "SkinfoldTriceps",
+    loinc: "8354-3",
+    names: {
+      en: ["Triceps Skinfold", "Tricipital Skinfold", "Skin Fold Thickness Triceps"],
+      pt: ["Dobra Tricipital", "Dobra Cut\xE2nea Tricipital", "Tricipital", "DCT"]
+    },
+    unit: "mm"
+  },
+  {
+    category: "composicao-corporal",
+    code: "SkinfoldThigh",
+    loinc: "8353-5",
+    names: {
+      en: ["Thigh Skinfold", "Skin Fold Thickness Thigh"],
+      pt: ["Dobra da Coxa", "Dobra Cut\xE2nea Coxa", "Coxa"]
+    },
+    unit: "mm"
+  },
+  {
+    category: "composicao-corporal",
+    code: "SkinfoldAbdominal",
+    loinc: "8355-0",
+    names: {
+      en: ["Abdominal Skinfold", "Waist Skinfold", "Skin Fold Thickness Waist"],
+      pt: ["Dobra Abdominal", "Dobra Cut\xE2nea Abdominal", "Abdominal"]
+    },
+    unit: "mm"
+  },
+  {
+    category: "composicao-corporal",
+    code: "SkinfoldSubscapular",
+    names: {
+      en: ["Subscapular Skinfold"],
+      pt: ["Dobra Subescapular", "Dobra Cut\xE2nea Subescapular", "Subescapular"]
+    },
+    unit: "mm"
+  },
+  {
+    category: "composicao-corporal",
+    code: "SkinfoldSuprailiac",
+    names: {
+      en: ["Suprailiac Skinfold", "Supra-iliac Skinfold"],
+      pt: ["Dobra Supra-il\xEDaca", "Dobra Cut\xE2nea Supra-il\xEDaca", "Supra-il\xEDaca", "Suprailiaca"]
+    },
+    unit: "mm"
+  },
+  {
+    category: "composicao-corporal",
+    code: "SkinfoldChest",
+    names: {
+      en: ["Chest Skinfold", "Pectoral Skinfold"],
+      pt: ["Dobra Peitoral", "Dobra Cut\xE2nea Peitoral", "Peitoral", "Dobra Tor\xE1cica"]
+    },
+    unit: "mm"
+  },
+  {
+    category: "composicao-corporal",
+    code: "SkinfoldMidaxillary",
+    names: {
+      en: ["Midaxillary Skinfold", "Mid-axillary Skinfold"],
+      pt: ["Dobra Axilar M\xE9dia", "Dobra Cut\xE2nea Axilar M\xE9dia", "Axilar M\xE9dia"]
+    },
+    unit: "mm"
+  },
   // Regional Body Composition (DEXA)
   // Note: No official LOINC codes exist for regional lean/fat mass measurements
   // Hidden from UI for now - may be shown in future regional breakdown view
@@ -2918,4 +3245,4 @@ export {
   getBiomarkersByCategory,
   getBiomarkersForCategories
 };
-//# sourceMappingURL=chunk-7O6VUA2B.js.map
+//# sourceMappingURL=chunk-3KIJIRCI.js.map