@precisa-saude/fhir 0.19.0 → 0.20.0

package/dist/biomarkers.cjs

@@ -30,7 +30,7 @@
 
 
 
-var _chunkZ5VH5QGCcjs = require('./chunk-Z5VH5QGC.cjs');
+var _chunkNXOTXKVBcjs = require('./chunk-NXOTXKVB.cjs');
 
 
 
@@ -63,5 +63,5 @@ var _chunkZ5VH5QGCcjs = require('./chunk-Z5VH5QGC.cjs');
 
 
 
-exports.BIOMARKER_DEFINITIONS = _chunkZ5VH5QGCcjs.BIOMARKER_DEFINITIONS; exports.CAC_INDICATOR_CODES = _chunkZ5VH5QGCcjs.CAC_INDICATOR_CODES; exports.DEXA_CATEGORIES = _chunkZ5VH5QGCcjs.DEXA_CATEGORIES; exports.DEXA_INDICATOR_CODES = _chunkZ5VH5QGCcjs.DEXA_INDICATOR_CODES; exports.codeToLoinc = _chunkZ5VH5QGCcjs.codeToLoinc; exports.filterVisibleBiomarkers = _chunkZ5VH5QGCcjs.filterVisibleBiomarkers; exports.findCodeByName = _chunkZ5VH5QGCcjs.findCodeByName; exports.generateCacFullReference = _chunkZ5VH5QGCcjs.generateCacFullReference; exports.generateDexaFullReference = _chunkZ5VH5QGCcjs.generateDexaFullReference; exports.generateFilteredLLMReference = _chunkZ5VH5QGCcjs.generateFilteredLLMReference; exports.generateLLMReference = _chunkZ5VH5QGCcjs.generateLLMReference; exports.getAllCodes = _chunkZ5VH5QGCcjs.getAllCodes; exports.getAllDefinitions = _chunkZ5VH5QGCcjs.getAllDefinitions; exports.getAllLoincCodes = _chunkZ5VH5QGCcjs.getAllLoincCodes; exports.getAllSearchPatterns = _chunkZ5VH5QGCcjs.getAllSearchPatterns; exports.getBiomarkersByCategory = _chunkZ5VH5QGCcjs.getBiomarkersByCategory; exports.getBiomarkersForCategories = _chunkZ5VH5QGCcjs.getBiomarkersForCategories; exports.getDefinitionByCode = _chunkZ5VH5QGCcjs.getDefinitionByCode; exports.getDefinitionByLoinc = _chunkZ5VH5QGCcjs.getDefinitionByLoinc; exports.getDefinitionsBySex = _chunkZ5VH5QGCcjs.getDefinitionsBySex; exports.getSexForCode = _chunkZ5VH5QGCcjs.getSexForCode; exports.getVisibleDefinitions = _chunkZ5VH5QGCcjs.getVisibleDefinitions; exports.isBiomarkerVisible = _chunkZ5VH5QGCcjs.isBiomarkerVisible; exports.isCacDocument = _chunkZ5VH5QGCcjs.isCacDocument; exports.isDexaDocument = _chunkZ5VH5QGCcjs.isDexaDocument; exports.isValidCode = _chunkZ5VH5QGCcjs.isValidCode; exports.isValidLoinc = _chunkZ5VH5QGCcjs.isValidLoinc; exports.loincToCode = _chunkZ5VH5QGCcjs.loincToCode; exports.normalizeCode = _chunkZ5VH5QGCcjs.normalizeCode; exports.toBiomarkerTests = _chunkZ5VH5QGCcjs.toBiomarkerTests; exports.validateLoincNameMatch = _chunkZ5VH5QGCcjs.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-MTWOF55H.js";
+} from "./chunk-3KIJIRCI.js";
 export {
   BIOMARKER_DEFINITIONS,
   CAC_INDICATOR_CODES,

package/dist/{chunk-J3QVVVVH.cjs → chunk-2KDLOCD2.cjs}

@@ -1,6 +1,6 @@
 "use strict";Object.defineProperty(exports, "__esModule", {value: true});
 
-var _chunkZ5VH5QGCcjs = require('./chunk-Z5VH5QGC.cjs');
+var _chunkNXOTXKVBcjs = require('./chunk-NXOTXKVB.cjs');
 
 
 
@@ -30,7 +30,7 @@ function interpretationDisplay(flag) {
   }
 }
 function labObservationToFHIR(observation, patientId, laboratoryName) {
-  const loincCode = _chunkZ5VH5QGCcjs.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-J3QVVVVH.cjs.map
+//# sourceMappingURL=chunk-2KDLOCD2.cjs.map

package/dist/{chunk-J3QVVVVH.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 ? [{ 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-MTWOF55H.js → chunk-3KIJIRCI.js}

@@ -2198,8 +2198,9 @@ var BIOMARKER_DEFINITIONS = [
   // múltiplas formulações: "total body water" não devolve nada, "body water"
   // devolve os dois códigos abaixo.
   //
-  // As 12 entradas sem código, e o motivo de cada uma:
+  // 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
@@ -2249,6 +2250,35 @@ var BIOMARKER_DEFINITIONS = [
     },
     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",
@@ -2350,6 +2380,18 @@ var BIOMARKER_DEFINITIONS = [
     },
     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",
@@ -3203,4 +3245,4 @@ export {
   getBiomarkersByCategory,
   getBiomarkersForCategories
 };
-//# sourceMappingURL=chunk-MTWOF55H.js.map
+//# sourceMappingURL=chunk-3KIJIRCI.js.map