@precisa-saude/fhir 0.20.0 → 0.20.2

package/dist/biomarkers.cjs

@@ -30,7 +30,7 @@
 
 
 
-var _chunkNXOTXKVBcjs = require('./chunk-NXOTXKVB.cjs');
+var _chunkS6LWF5M4cjs = require('./chunk-S6LWF5M4.cjs');
 
 
 
@@ -63,5 +63,5 @@ var _chunkNXOTXKVBcjs = require('./chunk-NXOTXKVB.cjs');
 
 
 
-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;
+exports.BIOMARKER_DEFINITIONS = _chunkS6LWF5M4cjs.BIOMARKER_DEFINITIONS; exports.CAC_INDICATOR_CODES = _chunkS6LWF5M4cjs.CAC_INDICATOR_CODES; exports.DEXA_CATEGORIES = _chunkS6LWF5M4cjs.DEXA_CATEGORIES; exports.DEXA_INDICATOR_CODES = _chunkS6LWF5M4cjs.DEXA_INDICATOR_CODES; exports.codeToLoinc = _chunkS6LWF5M4cjs.codeToLoinc; exports.filterVisibleBiomarkers = _chunkS6LWF5M4cjs.filterVisibleBiomarkers; exports.findCodeByName = _chunkS6LWF5M4cjs.findCodeByName; exports.generateCacFullReference = _chunkS6LWF5M4cjs.generateCacFullReference; exports.generateDexaFullReference = _chunkS6LWF5M4cjs.generateDexaFullReference; exports.generateFilteredLLMReference = _chunkS6LWF5M4cjs.generateFilteredLLMReference; exports.generateLLMReference = _chunkS6LWF5M4cjs.generateLLMReference; exports.getAllCodes = _chunkS6LWF5M4cjs.getAllCodes; exports.getAllDefinitions = _chunkS6LWF5M4cjs.getAllDefinitions; exports.getAllLoincCodes = _chunkS6LWF5M4cjs.getAllLoincCodes; exports.getAllSearchPatterns = _chunkS6LWF5M4cjs.getAllSearchPatterns; exports.getBiomarkersByCategory = _chunkS6LWF5M4cjs.getBiomarkersByCategory; exports.getBiomarkersForCategories = _chunkS6LWF5M4cjs.getBiomarkersForCategories; exports.getDefinitionByCode = _chunkS6LWF5M4cjs.getDefinitionByCode; exports.getDefinitionByLoinc = _chunkS6LWF5M4cjs.getDefinitionByLoinc; exports.getDefinitionsBySex = _chunkS6LWF5M4cjs.getDefinitionsBySex; exports.getSexForCode = _chunkS6LWF5M4cjs.getSexForCode; exports.getVisibleDefinitions = _chunkS6LWF5M4cjs.getVisibleDefinitions; exports.isBiomarkerVisible = _chunkS6LWF5M4cjs.isBiomarkerVisible; exports.isCacDocument = _chunkS6LWF5M4cjs.isCacDocument; exports.isDexaDocument = _chunkS6LWF5M4cjs.isDexaDocument; exports.isValidCode = _chunkS6LWF5M4cjs.isValidCode; exports.isValidLoinc = _chunkS6LWF5M4cjs.isValidLoinc; exports.loincToCode = _chunkS6LWF5M4cjs.loincToCode; exports.normalizeCode = _chunkS6LWF5M4cjs.normalizeCode; exports.toBiomarkerTests = _chunkS6LWF5M4cjs.toBiomarkerTests; exports.validateLoincNameMatch = _chunkS6LWF5M4cjs.validateLoincNameMatch;
 //# sourceMappingURL=biomarkers.cjs.map

package/dist/biomarkers.js

@@ -30,7 +30,7 @@ import {
   normalizeCode,
   toBiomarkerTests,
   validateLoincNameMatch
-} from "./chunk-3KIJIRCI.js";
+} from "./chunk-ZT5XBA5S.js";
 export {
   BIOMARKER_DEFINITIONS,
   CAC_INDICATOR_CODES,

package/dist/{chunk-OZGOBYLX.js → chunk-3XFDQQAP.js}

@@ -1,7 +1,14 @@
 import {
-  getDefinitionByLoinc,
-  loincToCode
-} from "./chunk-3KIJIRCI.js";
+  BIOMARKER_CODE_SYSTEM,
+  LOINC_SYSTEM
+} from "./chunk-A6HR4XDK.js";
+import {
+  codeToLoinc,
+  getDefinitionByCode,
+  isValidCode,
+  loincToCode,
+  normalizeCode
+} from "./chunk-ZT5XBA5S.js";
 import {
   validateFHIRImportBundle
 } from "./chunk-N3ZCOLG2.js";
@@ -9,10 +16,30 @@ import {
 // src/importer.ts
 var MAX_OBSERVATIONS = 5e3;
 var MAX_FILE_SIZE = 15 * 1024 * 1024;
-function extractLoincCode(observation) {
-  if (!observation.code?.coding) return void 0;
-  const loincCoding = observation.code.coding.find((c) => c.system === "http://loinc.org");
-  return loincCoding?.code;
+function resolveBiomarkerCode(observation) {
+  const coding = observation.code?.coding ?? [];
+  const loincCode = coding.find((c) => c.system === LOINC_SYSTEM)?.code;
+  const declaredCode = coding.find((c) => c.system === BIOMARKER_CODE_SYSTEM)?.code;
+  const seenCodes = [
+    ...loincCode ? [`LOINC ${loincCode}`] : [],
+    ...declaredCode ? [`biomarker code ${declaredCode}`] : []
+  ];
+  let reason;
+  if (seenCodes.length > 0) {
+    reason = `Unknown code: ${seenCodes.join(", ")}`;
+  } else if (coding.length > 0) {
+    const systems = [...new Set(coding.map((c) => c.system ?? "(sem system)"))];
+    reason = `No code in a supported system (found: ${systems.join(", ")})`;
+  } else {
+    reason = "No code found in observation coding";
+  }
+  const fromLoinc = loincCode ? loincToCode(loincCode) : void 0;
+  if (fromLoinc) return { internalCode: fromLoinc, loincCode, reason };
+  if (declaredCode && isValidCode(declaredCode)) {
+    const canonical = normalizeCode(declaredCode);
+    return { internalCode: canonical, loincCode: codeToLoinc(canonical), reason };
+  }
+  return { loincCode, reason };
 }
 function extractFlag(observation) {
   const code = observation.interpretation?.[0]?.coding?.[0]?.code;
@@ -41,28 +68,13 @@ function extractObservationsFromBundle(bundle) {
   return { observations, skipped };
 }
 function mapFHIRObservationToInternal(observation, index) {
-  const loincCode = extractLoincCode(observation);
-  if (!loincCode) {
-    return {
-      skipped: {
-        index,
-        reason: "No LOINC code found in observation coding",
-        resourceType: "Observation"
-      }
-    };
-  }
-  const internalCode = loincToCode(loincCode);
+  const { internalCode, loincCode, reason } = resolveBiomarkerCode(observation);
   if (!internalCode) {
     return {
-      skipped: {
-        index,
-        loincCode,
-        reason: `Unknown LOINC code: ${loincCode}`,
-        resourceType: "Observation"
-      }
+      skipped: { index, loincCode, reason, resourceType: "Observation" }
     };
   }
-  const definition = getDefinitionByLoinc(loincCode);
+  const definition = getDefinitionByCode(internalCode);
   let value;
   let unit = "";
   let isQualitative = false;
@@ -150,4 +162,4 @@ export {
   mapFHIRObservationToInternal,
   processImportBundle
 };
-//# sourceMappingURL=chunk-OZGOBYLX.js.map
+//# sourceMappingURL=chunk-3XFDQQAP.js.map

package/dist/chunk-3XFDQQAP.js.map

@@ -0,0 +1 @@
+{"version":3,"sources":["../src/importer.ts"],"sourcesContent":["/**\n * FHIR Importer\n *\n * Parses FHIR R4 Bundles and extracts Observation resources with known LOINC codes,\n * mapping them to internal biomarker codes for storage as lab results.\n */\n\nimport {\n  codeToLoinc,\n  getDefinitionByCode,\n  isValidCode,\n  loincToCode,\n  normalizeCode,\n} from './biomarkers';\nimport { BIOMARKER_CODE_SYSTEM, LOINC_SYSTEM } from './code-systems';\nimport type { FHIRBundle, FHIRObservation } from './fhir-types';\nimport { validateFHIRImportBundle } from './validators';\n\nexport interface ImportedObservation {\n  biomarkerCode: string;\n  biomarkerName: string;\n  collectionDate: string;\n  flag: 'H' | 'L' | '';\n  isQualitative: boolean;\n  /** Ausente nos biomarcadores sem LOINC publicado, como composição corporal. */\n  loincCode?: string;\n  referenceMax?: number;\n  referenceMin?: number;\n  unit: string;\n  value: number | string;\n}\n\nexport interface SkippedEntry {\n  index: number;\n  loincCode?: string;\n  reason: string;\n  resourceType?: string;\n}\n\nexport interface ImportError {\n  details: string;\n  field: string;\n}\n\nexport interface FHIRImportResult {\n  errors: ImportError[];\n  imported: ImportedObservation[];\n  skipped: SkippedEntry[];\n  totalProcessed: number;\n}\n\n/**\n * Limites de importação.\n *\n * Uma Observation exportada ocupa cerca de 1,25KB em JSON compacto e 2,75KB\n * quando o arquivo vem indentado, medido sobre um histórico real de 998\n * Observations em 61 laudos. Nesse tamanho, 5000 Observations dão 6,0MB\n * compactos ou 13,1MB indentados, e por isso o teto de arquivo é 15MB: cobre\n * as duas formas com folga.\n *\n * Na densidade desse mesmo histórico (16 Observations por laudo), 5000\n * equivalem a cerca de 300 laudos.\n */\nconst MAX_OBSERVATIONS = 5000;\nconst MAX_FILE_SIZE = 15 * 1024 * 1024; // 15MB\n\n/**\n * Resolve o código interno do biomarcador a partir do `code.coding`.\n *\n * LOINC primeiro, que é o vocabulário que arquivos de terceiros usam. Quando\n * não resolve, cai para o coding de códigos internos, presente nos arquivos\n * exportados pela própria plataforma.\n *\n * O fallback cobre dois casos: biomarcadores sem LOINC publicado (composição\n * corporal, densidade óssea, escore de cálcio) e arquivos antigos, exportados\n * quando esses biomarcadores saíam com o placeholder `99999-9`, que não\n * resolve para nada.\n */\nfunction resolveBiomarkerCode(observation: FHIRObservation): {\n  internalCode?: string;\n  loincCode?: string;\n  reason: string;\n} {\n  const coding = observation.code?.coding ?? [];\n  const loincCode = coding.find((c) => c.system === LOINC_SYSTEM)?.code;\n  const declaredCode = coding.find((c) => c.system === BIOMARKER_CODE_SYSTEM)?.code;\n\n  const seenCodes = [\n    ...(loincCode ? [`LOINC ${loincCode}`] : []),\n    ...(declaredCode ? [`biomarker code ${declaredCode}`] : []),\n  ];\n\n  // Três motivos distintos de descarte, que antes se confundiam num só. Sem\n  // essa separação, um arquivo em SNOMED relatava \"nenhum código encontrado\",\n  // sugerindo `coding` vazio quando na verdade o código existia e estava num\n  // system que não tratamos. Para importação de terceiros, é a diferença entre\n  // um diagnóstico acionável e um enigma.\n  let reason: string;\n  if (seenCodes.length > 0) {\n    reason = `Unknown code: ${seenCodes.join(', ')}`;\n  } else if (coding.length > 0) {\n    const systems = [...new Set(coding.map((c) => c.system ?? '(sem system)'))];\n    reason = `No code in a supported system (found: ${systems.join(', ')})`;\n  } else {\n    reason = 'No code found in observation coding';\n  }\n\n  const fromLoinc = loincCode ? loincToCode(loincCode) : undefined;\n  if (fromLoinc) return { internalCode: fromLoinc, loincCode, reason };\n\n  if (declaredCode && isValidCode(declaredCode)) {\n    // `isValidCode` aceita alias, mas alias não serve como código armazenado:\n    // 49 definições têm um, e tanto `codeToLoinc` quanto as faixas de\n    // referência são indexadas só pelo canônico. Sem normalizar, `VLDL_Cholesterol`\n    // entraria no lugar de `VLDL` e perderia o LOINC 13458-5 que ele tem.\n    // Importar um Bundle é fronteira de dados, que é onde `normalizeCode` deve\n    // ser aplicado.\n    const canonical = normalizeCode(declaredCode);\n\n    // `codeToLoinc` devolve undefined para quem não tem LOINC, que é o caso\n    // esperado aqui. O campo fica de fora em vez de receber um valor inventado.\n    return { internalCode: canonical, loincCode: codeToLoinc(canonical), reason };\n  }\n\n  return { loincCode, reason };\n}\n\n/**\n * Extract interpretation flag from Observation\n */\nfunction extractFlag(observation: FHIRObservation): 'H' | 'L' | '' {\n  const code = observation.interpretation?.[0]?.coding?.[0]?.code;\n  if (code === 'H' || code === 'HH') return 'H';\n  if (code === 'L' || code === 'LL') return 'L';\n  return '';\n}\n\n/**\n * Extract Observation resources from a FHIR Bundle\n */\nexport function extractObservationsFromBundle(bundle: FHIRBundle): {\n  observations: FHIRObservation[];\n  skipped: SkippedEntry[];\n} {\n  const observations: FHIRObservation[] = [];\n  const skipped: SkippedEntry[] = [];\n\n  for (let i = 0; i < bundle.entry.length; i++) {\n    const entry = bundle.entry[i]!;\n    if (!entry.resource) {\n      skipped.push({ index: i, reason: 'Entry has no resource' });\n      continue;\n    }\n\n    if (entry.resource.resourceType !== 'Observation') {\n      // Non-observation resources are silently skipped (Patient, DiagnosticReport, etc.)\n      continue;\n    }\n\n    if (observations.length >= MAX_OBSERVATIONS) {\n      skipped.push({ index: i, reason: `Maximum of ${MAX_OBSERVATIONS} observations exceeded` });\n      continue;\n    }\n\n    observations.push(entry.resource as FHIRObservation);\n  }\n\n  return { observations, skipped };\n}\n\n/**\n * Map a FHIR Observation to internal format using LOINC→biomarker code lookup\n */\nexport function mapFHIRObservationToInternal(\n  observation: FHIRObservation,\n  index: number,\n): { observation: ImportedObservation } | { skipped: SkippedEntry } {\n  const { internalCode, loincCode, reason } = resolveBiomarkerCode(observation);\n\n  if (!internalCode) {\n    return {\n      skipped: { index, loincCode, reason, resourceType: 'Observation' },\n    };\n  }\n\n  const definition = getDefinitionByCode(internalCode);\n\n  // Extract value\n  let value: number | string;\n  let unit = '';\n  let isQualitative = false;\n\n  if (observation.valueQuantity?.value !== undefined) {\n    value = observation.valueQuantity.value;\n    unit = observation.valueQuantity.unit || observation.valueQuantity.code || '';\n  } else if (observation.valueString) {\n    value = observation.valueString;\n    isQualitative = true;\n  } else {\n    return {\n      skipped: {\n        index,\n        loincCode,\n        reason: 'Observation has no value (valueQuantity or valueString)',\n        resourceType: 'Observation',\n      },\n    };\n  }\n\n  // Extract collection date (effectiveDateTime or effectivePeriod.start)\n  const collectionDate = observation.effectiveDateTime || observation.effectivePeriod?.start || '';\n  if (!collectionDate) {\n    return {\n      skipped: {\n        index,\n        loincCode,\n        reason: 'Observation has no effectiveDateTime or effectivePeriod.start',\n        resourceType: 'Observation',\n      },\n    };\n  }\n\n  // Extract reference ranges\n  let referenceMin: number | undefined;\n  let referenceMax: number | undefined;\n  if (observation.referenceRange?.[0]) {\n    referenceMin = observation.referenceRange[0].low?.value;\n    referenceMax = observation.referenceRange[0].high?.value;\n  }\n\n  const imported: ImportedObservation = {\n    biomarkerCode: internalCode,\n    biomarkerName:\n      definition?.names.pt[0] || definition?.names.en[0] || observation.code.text || internalCode,\n    collectionDate,\n    flag: extractFlag(observation),\n    isQualitative,\n    loincCode,\n    referenceMax,\n    referenceMin,\n    unit: unit || definition?.unit || '',\n    value,\n  };\n\n  return { observation: imported };\n}\n\n/**\n * Process a complete FHIR Bundle for import\n */\nexport function processImportBundle(data: unknown): FHIRImportResult {\n  // Structural validation\n  const validationErrors = validateFHIRImportBundle(data);\n  if (validationErrors.length > 0) {\n    return {\n      errors: validationErrors,\n      imported: [],\n      skipped: [],\n      totalProcessed: 0,\n    };\n  }\n\n  const bundle = data as FHIRBundle;\n\n  // Extract observations\n  const { observations, skipped } = extractObservationsFromBundle(bundle);\n\n  // Map each observation to internal format\n  const imported: ImportedObservation[] = [];\n  const allSkipped: SkippedEntry[] = [...skipped];\n\n  for (let i = 0; i < observations.length; i++) {\n    const result = mapFHIRObservationToInternal(observations[i]!, i);\n\n    if ('observation' in result) {\n      imported.push(result.observation);\n    } else {\n      allSkipped.push(result.skipped);\n    }\n  }\n\n  return {\n    errors: [],\n    imported,\n    skipped: allSkipped,\n    totalProcessed: observations.length,\n  };\n}\n\nexport { MAX_FILE_SIZE, MAX_OBSERVATIONS };\n"],"mappings":";;;;;;;;;;;;;;;;AA+DA,IAAM,mBAAmB;AACzB,IAAM,gBAAgB,KAAK,OAAO;AAclC,SAAS,qBAAqB,aAI5B;AACA,QAAM,SAAS,YAAY,MAAM,UAAU,CAAC;AAC5C,QAAM,YAAY,OAAO,KAAK,CAAC,MAAM,EAAE,WAAW,YAAY,GAAG;AACjE,QAAM,eAAe,OAAO,KAAK,CAAC,MAAM,EAAE,WAAW,qBAAqB,GAAG;AAE7E,QAAM,YAAY;AAAA,IAChB,GAAI,YAAY,CAAC,SAAS,SAAS,EAAE,IAAI,CAAC;AAAA,IAC1C,GAAI,eAAe,CAAC,kBAAkB,YAAY,EAAE,IAAI,CAAC;AAAA,EAC3D;AAOA,MAAI;AACJ,MAAI,UAAU,SAAS,GAAG;AACxB,aAAS,iBAAiB,UAAU,KAAK,IAAI,CAAC;AAAA,EAChD,WAAW,OAAO,SAAS,GAAG;AAC5B,UAAM,UAAU,CAAC,GAAG,IAAI,IAAI,OAAO,IAAI,CAAC,MAAM,EAAE,UAAU,cAAc,CAAC,CAAC;AAC1E,aAAS,yCAAyC,QAAQ,KAAK,IAAI,CAAC;AAAA,EACtE,OAAO;AACL,aAAS;AAAA,EACX;AAEA,QAAM,YAAY,YAAY,YAAY,SAAS,IAAI;AACvD,MAAI,UAAW,QAAO,EAAE,cAAc,WAAW,WAAW,OAAO;AAEnE,MAAI,gBAAgB,YAAY,YAAY,GAAG;AAO7C,UAAM,YAAY,cAAc,YAAY;AAI5C,WAAO,EAAE,cAAc,WAAW,WAAW,YAAY,SAAS,GAAG,OAAO;AAAA,EAC9E;AAEA,SAAO,EAAE,WAAW,OAAO;AAC7B;AAKA,SAAS,YAAY,aAA8C;AACjE,QAAM,OAAO,YAAY,iBAAiB,CAAC,GAAG,SAAS,CAAC,GAAG;AAC3D,MAAI,SAAS,OAAO,SAAS,KAAM,QAAO;AAC1C,MAAI,SAAS,OAAO,SAAS,KAAM,QAAO;AAC1C,SAAO;AACT;AAKO,SAAS,8BAA8B,QAG5C;AACA,QAAM,eAAkC,CAAC;AACzC,QAAM,UAA0B,CAAC;AAEjC,WAAS,IAAI,GAAG,IAAI,OAAO,MAAM,QAAQ,KAAK;AAC5C,UAAM,QAAQ,OAAO,MAAM,CAAC;AAC5B,QAAI,CAAC,MAAM,UAAU;AACnB,cAAQ,KAAK,EAAE,OAAO,GAAG,QAAQ,wBAAwB,CAAC;AAC1D;AAAA,IACF;AAEA,QAAI,MAAM,SAAS,iBAAiB,eAAe;AAEjD;AAAA,IACF;AAEA,QAAI,aAAa,UAAU,kBAAkB;AAC3C,cAAQ,KAAK,EAAE,OAAO,GAAG,QAAQ,cAAc,gBAAgB,yBAAyB,CAAC;AACzF;AAAA,IACF;AAEA,iBAAa,KAAK,MAAM,QAA2B;AAAA,EACrD;AAEA,SAAO,EAAE,cAAc,QAAQ;AACjC;AAKO,SAAS,6BACd,aACA,OACkE;AAClE,QAAM,EAAE,cAAc,WAAW,OAAO,IAAI,qBAAqB,WAAW;AAE5E,MAAI,CAAC,cAAc;AACjB,WAAO;AAAA,MACL,SAAS,EAAE,OAAO,WAAW,QAAQ,cAAc,cAAc;AAAA,IACnE;AAAA,EACF;AAEA,QAAM,aAAa,oBAAoB,YAAY;AAGnD,MAAI;AACJ,MAAI,OAAO;AACX,MAAI,gBAAgB;AAEpB,MAAI,YAAY,eAAe,UAAU,QAAW;AAClD,YAAQ,YAAY,cAAc;AAClC,WAAO,YAAY,cAAc,QAAQ,YAAY,cAAc,QAAQ;AAAA,EAC7E,WAAW,YAAY,aAAa;AAClC,YAAQ,YAAY;AACpB,oBAAgB;AAAA,EAClB,OAAO;AACL,WAAO;AAAA,MACL,SAAS;AAAA,QACP;AAAA,QACA;AAAA,QACA,QAAQ;AAAA,QACR,cAAc;AAAA,MAChB;AAAA,IACF;AAAA,EACF;AAGA,QAAM,iBAAiB,YAAY,qBAAqB,YAAY,iBAAiB,SAAS;AAC9F,MAAI,CAAC,gBAAgB;AACnB,WAAO;AAAA,MACL,SAAS;AAAA,QACP;AAAA,QACA;AAAA,QACA,QAAQ;AAAA,QACR,cAAc;AAAA,MAChB;AAAA,IACF;AAAA,EACF;AAGA,MAAI;AACJ,MAAI;AACJ,MAAI,YAAY,iBAAiB,CAAC,GAAG;AACnC,mBAAe,YAAY,eAAe,CAAC,EAAE,KAAK;AAClD,mBAAe,YAAY,eAAe,CAAC,EAAE,MAAM;AAAA,EACrD;AAEA,QAAM,WAAgC;AAAA,IACpC,eAAe;AAAA,IACf,eACE,YAAY,MAAM,GAAG,CAAC,KAAK,YAAY,MAAM,GAAG,CAAC,KAAK,YAAY,KAAK,QAAQ;AAAA,IACjF;AAAA,IACA,MAAM,YAAY,WAAW;AAAA,IAC7B;AAAA,IACA;AAAA,IACA;AAAA,IACA;AAAA,IACA,MAAM,QAAQ,YAAY,QAAQ;AAAA,IAClC;AAAA,EACF;AAEA,SAAO,EAAE,aAAa,SAAS;AACjC;AAKO,SAAS,oBAAoB,MAAiC;AAEnE,QAAM,mBAAmB,yBAAyB,IAAI;AACtD,MAAI,iBAAiB,SAAS,GAAG;AAC/B,WAAO;AAAA,MACL,QAAQ;AAAA,MACR,UAAU,CAAC;AAAA,MACX,SAAS,CAAC;AAAA,MACV,gBAAgB;AAAA,IAClB;AAAA,EACF;AAEA,QAAM,SAAS;AAGf,QAAM,EAAE,cAAc,QAAQ,IAAI,8BAA8B,MAAM;AAGtE,QAAM,WAAkC,CAAC;AACzC,QAAM,aAA6B,CAAC,GAAG,OAAO;AAE9C,WAAS,IAAI,GAAG,IAAI,aAAa,QAAQ,KAAK;AAC5C,UAAM,SAAS,6BAA6B,aAAa,CAAC,GAAI,CAAC;AAE/D,QAAI,iBAAiB,QAAQ;AAC3B,eAAS,KAAK,OAAO,WAAW;AAAA,IAClC,OAAO;AACL,iBAAW,KAAK,OAAO,OAAO;AAAA,IAChC;AAAA,EACF;AAEA,SAAO;AAAA,IACL,QAAQ,CAAC;AAAA,IACT;AAAA,IACA,SAAS;AAAA,IACT,gBAAgB,aAAa;AAAA,EAC/B;AACF;","names":[]}

package/dist/chunk-A6HR4XDK.js

@@ -0,0 +1,9 @@
+// src/code-systems.ts
+var LOINC_SYSTEM = "http://loinc.org";
+var BIOMARKER_CODE_SYSTEM = "http://fhir-brasil.dev/biomarker-codes";
+
+export {
+  LOINC_SYSTEM,
+  BIOMARKER_CODE_SYSTEM
+};
+//# sourceMappingURL=chunk-A6HR4XDK.js.map

package/dist/chunk-A6HR4XDK.js.map

@@ -0,0 +1 @@
+{"version":3,"sources":["../src/code-systems.ts"],"sourcesContent":["/**\n * Identificadores de sistema de código usados nos recursos FHIR.\n *\n * Ficam num módulo próprio porque exportação e importação precisam concordar\n * literalmente: o importador procura o coding pelo `system`, e uma string\n * divergente de um lado faz o biomarcador desaparecer sem erro.\n */\n\n/** LOINC, o vocabulário oficial de exames laboratoriais. */\nexport const LOINC_SYSTEM = 'http://loinc.org';\n\n/**\n * Códigos internos do fhir-brasil.\n *\n * Cobre o que não tem LOINC publicado: composição corporal por DEXA,\n * densidade óssea e escore de cálcio, entre outros. É o que permite o ciclo\n * exportar/importar preservar esses biomarcadores.\n */\nexport const BIOMARKER_CODE_SYSTEM = 'http://fhir-brasil.dev/biomarker-codes';\n"],"mappings":";AASO,IAAM,eAAe;AASrB,IAAM,wBAAwB;","names":[]}

package/dist/{chunk-6TQ24JCA.js → chunk-LNYG5HBE.js}

@@ -1,6 +1,10 @@
+import {
+  BIOMARKER_CODE_SYSTEM,
+  LOINC_SYSTEM
+} from "./chunk-A6HR4XDK.js";
 import {
   codeToLoinc
-} from "./chunk-3KIJIRCI.js";
+} from "./chunk-ZT5XBA5S.js";
 import {
   getDefaultUnit,
   unitToUCUM
@@ -30,7 +34,7 @@ function interpretationDisplay(flag) {
   }
 }
 function labObservationToFHIR(observation, patientId, laboratoryName) {
-  const loincCode = codeToLoinc(observation.biomarkerCode) || "99999-9";
+  const loincCode = codeToLoinc(observation.biomarkerCode);
   const sourceUnit = observation.unit || getDefaultUnit(observation.biomarkerCode) || observation.unit;
   const ucumUnit = unitToUCUM(sourceUnit);
   const isQualitative = observation.isQualitative || typeof observation.value === "string";
@@ -47,16 +51,23 @@ function labObservationToFHIR(observation, patientId, laboratoryName) {
       }
     ],
     code: {
+      // Sem LOINC, o coding LOINC simplesmente não sai. Antes ia `99999-9`,
+      // que não é código LOINC nenhum: publicava sob `http://loinc.org` uma
+      // afirmação falsa, e quem consumisse o bundle confiando no system
+      // trataria aquilo como código de verdade. Composição corporal, densidade
+      // óssea e escore de cálcio não têm LOINC, e o certo é a lacuna explícita.
       coding: [
-        {
-          code: loincCode,
-          display: observation.biomarkerName,
-          system: "http://loinc.org"
-        },
+        ...loincCode ? [
+          {
+            code: loincCode,
+            display: observation.biomarkerName,
+            system: LOINC_SYSTEM
+          }
+        ] : [],
         {
           code: observation.biomarkerCode,
           display: observation.biomarkerName,
-          system: "http://fhir-brasil.dev/biomarker-codes"
+          system: BIOMARKER_CODE_SYSTEM
         }
       ],
       text: observation.biomarkerName
@@ -248,4 +259,4 @@ export {
   userProfileToFHIR,
   labResultToFHIRBundle
 };
-//# sourceMappingURL=chunk-6TQ24JCA.js.map
+//# sourceMappingURL=chunk-LNYG5HBE.js.map

package/dist/chunk-LNYG5HBE.js.map

@@ -0,0 +1 @@
+{"version":3,"sources":["../src/converter.ts"],"sourcesContent":["/**\n * FHIR Converter\n *\n * Converts lab results to FHIR R4 DiagnosticReport and Observation resources.\n * See: https://hl7.org/fhir/diagnosticreport.html\n */\n\nimport { codeToLoinc } from './biomarkers';\nimport { BIOMARKER_CODE_SYSTEM, LOINC_SYSTEM } from './code-systems';\nimport type { FHIRBundle, FHIRDiagnosticReport, FHIRObservation, FHIRPatient } from './fhir-types';\nimport type { Flag, LabObservationData, LabReportData, UserProfileData } from './types';\nimport { getDefaultUnit, unitToUCUM } from './units';\n\n// Re-export all types and functions\nexport * from './fhir-types';\n\n/**\n * Convert Flag to FHIR interpretation code\n */\nfunction interpretationCode(flag: Flag): string {\n  switch (flag) {\n    case 'H':\n      return 'H'; // High\n    case 'L':\n      return 'L'; // Low\n    default:\n      return 'N'; // Normal\n  }\n}\n\n/**\n * Convert Flag to FHIR interpretation display\n */\nfunction interpretationDisplay(flag: Flag): string {\n  switch (flag) {\n    case 'H':\n      return 'High';\n    case 'L':\n      return 'Low';\n    default:\n      return 'Normal';\n  }\n}\n\n/**\n * Convert generic lab observation to FHIR Observation\n */\nexport function labObservationToFHIR(\n  observation: LabObservationData,\n  patientId: string,\n  laboratoryName?: string,\n): FHIRObservation {\n  const loincCode = codeToLoinc(observation.biomarkerCode);\n  // Use default unit if source unit is empty\n  const sourceUnit =\n    observation.unit || getDefaultUnit(observation.biomarkerCode) || observation.unit;\n  const ucumUnit = unitToUCUM(sourceUnit);\n  const isQualitative = observation.isQualitative || typeof observation.value === 'string';\n\n  // Base observation structure\n  const fhirObs: FHIRObservation = {\n    category: [\n      {\n        coding: [\n          {\n            code: 'laboratory',\n            display: 'Laboratory',\n            system: 'http://terminology.hl7.org/CodeSystem/observation-category',\n          },\n        ],\n      },\n    ],\n    code: {\n      // Sem LOINC, o coding LOINC simplesmente não sai. Antes ia `99999-9`,\n      // que não é código LOINC nenhum: publicava sob `http://loinc.org` uma\n      // afirmação falsa, e quem consumisse o bundle confiando no system\n      // trataria aquilo como código de verdade. Composição corporal, densidade\n      // óssea e escore de cálcio não têm LOINC, e o certo é a lacuna explícita.\n      coding: [\n        ...(loincCode\n          ? [\n              {\n                code: loincCode,\n                display: observation.biomarkerName,\n                system: LOINC_SYSTEM,\n              },\n            ]\n          : []),\n        {\n          code: observation.biomarkerCode,\n          display: observation.biomarkerName,\n          system: BIOMARKER_CODE_SYSTEM,\n        },\n      ],\n      text: observation.biomarkerName,\n    },\n    effectiveDateTime: observation.collectionDate,\n    id: `${observation.reportId}-${observation.biomarkerCode}`,\n    interpretation: [\n      {\n        coding: [\n          {\n            code: interpretationCode(observation.flag),\n            display: interpretationDisplay(observation.flag),\n            system: 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation',\n          },\n        ],\n      },\n    ],\n    performer: laboratoryName ? [{ 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 ? 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[\n          {\n            city: profile.address.city,\n            country: profile.address.country || 'BR',\n            line: [\n              profile.address.street && profile.address.number\n                ? `${profile.address.street}, ${profile.address.number}`\n                : profile.address.street,\n              profile.address.complement,\n            ].filter(Boolean) as string[],\n            postalCode: profile.address.postalCode,\n            state: profile.address.state,\n          },\n        ]\n      : undefined,\n    birthDate: profile.birthDate,\n    gender: profile.gender,\n    id: profile.userId,\n    name: [\n      {\n        family,\n        given: given.length > 0 ? given : undefined,\n        text: profile.name,\n      },\n    ],\n    resourceType: 'Patient',\n    telecom:\n      [\n        ...(profile.email ? [{ system: 'email' as const, value: profile.email }] : []),\n        ...(profile.phone ? [{ 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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package/dist/chunk-OR67NJDZ.cjs

@@ -0,0 +1,9 @@
+"use strict";Object.defineProperty(exports, "__esModule", {value: true});// src/code-systems.ts
+var LOINC_SYSTEM = "http://loinc.org";
+var BIOMARKER_CODE_SYSTEM = "http://fhir-brasil.dev/biomarker-codes";
+
+
+
+
+exports.LOINC_SYSTEM = LOINC_SYSTEM; exports.BIOMARKER_CODE_SYSTEM = BIOMARKER_CODE_SYSTEM;
+//# sourceMappingURL=chunk-OR67NJDZ.cjs.map

package/dist/chunk-OR67NJDZ.cjs.map

@@ -0,0 +1 @@
+{"version":3,"sources":["/home/runner/work/fhir-brasil/fhir-brasil/packages/core/dist/chunk-OR67NJDZ.cjs","../src/code-systems.ts"],"names":[],"mappings":"AAAA;ACSO,IAAM,aAAA,EAAe,kBAAA;AASrB,IAAM,sBAAA,EAAwB,wCAAA;ADfrC;AACA;AACE;AACA;AACF,2FAAC","file":"/home/runner/work/fhir-brasil/fhir-brasil/packages/core/dist/chunk-OR67NJDZ.cjs","sourcesContent":[null,"/**\n * Identificadores de sistema de código usados nos recursos FHIR.\n *\n * Ficam num módulo próprio porque exportação e importação precisam concordar\n * literalmente: o importador procura o coding pelo `system`, e uma string\n * divergente de um lado faz o biomarcador desaparecer sem erro.\n */\n\n/** LOINC, o vocabulário oficial de exames laboratoriais. */\nexport const LOINC_SYSTEM = 'http://loinc.org';\n\n/**\n * Códigos internos do fhir-brasil.\n *\n * Cobre o que não tem LOINC publicado: composição corporal por DEXA,\n * densidade óssea e escore de cálcio, entre outros. É o que permite o ciclo\n * exportar/importar preservar esses biomarcadores.\n */\nexport const BIOMARKER_CODE_SYSTEM = 'http://fhir-brasil.dev/biomarker-codes';\n"]}

package/dist/{chunk-NXOTXKVB.cjs → chunk-S6LWF5M4.cjs}

@@ -1433,8 +1433,45 @@ var BIOMARKER_DEFINITIONS = [
     codeAliases: ["Urine_Microalbumin"],
     loinc: "14957-5",
     names: {
-      en: ["Microalbumin Urine", "Urine Albumin", "Urine Microalbumin"],
-      pt: ["Albumina Urina", "Microalbumina Urina", "Microalbumina na Urina"]
+      en: [
+        "Microalbumin Urine",
+        "Urine Albumin",
+        "Urine Microalbumin",
+        "Microalbumin",
+        "Microalbuminuria",
+        "Albumin, Urine"
+      ],
+      // Todas as formas abaixo, em pt e en, nomeiam o MESMO analito: albumina
+      // dosada na urina. Não são exames diferentes.
+      //
+      // "Microalbumina" e "microalbuminúria" são herança de nomenclatura: o
+      // prefixo micro nunca se referiu a uma molécula menor, e sim a uma
+      // faixa de excreção. O analito é o mesmo, e por isso as duas formas
+      // pertencem a esta entrada e não a uma separada.
+      //
+      // "Albumina Urinária" vem primeiro de propósito. O gerador do ValueSet
+      // do IG usa o primeiro nome pt como display, então a ordem decide o
+      // rótulo publicado — e essa é a forma que os laboratórios brasileiros
+      // de fato imprimem.
+      //
+      // As formas foram tiradas de dado real, não inventadas: "Albumin,
+      // Urine" e "Albumina Urinária" aparecem como rótulos `UNKNOWN_` na
+      // auditoria de cobertura da plataforma, ou seja, chegaram em laudo e
+      // não casaram com nada.
+      //
+      // Sem elas o pré-scan casava "Albumina Urinária" com `Albumin`, a
+      // albumina sérica. A troca não é cosmética: albumina na urina é
+      // marcador de lesão renal precoce, medida em mg/L, e a sérica é de
+      // função hepática e estado nutricional, medida em g/dL.
+      pt: [
+        "Albumina Urin\xE1ria",
+        "Albumina Urina",
+        "Microalbumina",
+        "Microalbumin\xFAria",
+        "Microalbumina Urina",
+        "Microalbumina na Urina",
+        "Albumina na Urina"
+      ]
     },
     unit: "mg/L"
   },
@@ -3245,4 +3282,4 @@ function getBiomarkersForCategories(categories, options) {
 
 
 exports.BIOMARKER_DEFINITIONS = BIOMARKER_DEFINITIONS; exports.loincToCode = loincToCode; exports.codeToLoinc = codeToLoinc; exports.isValidLoinc = isValidLoinc; exports.isValidCode = isValidCode; exports.normalizeCode = normalizeCode; exports.getSexForCode = getSexForCode; exports.getDefinitionsBySex = getDefinitionsBySex; exports.getDefinitionByCode = getDefinitionByCode; exports.getDefinitionByLoinc = getDefinitionByLoinc; exports.getAllDefinitions = getAllDefinitions; exports.getVisibleDefinitions = getVisibleDefinitions; exports.getAllCodes = getAllCodes; exports.getAllLoincCodes = getAllLoincCodes; exports.generateLLMReference = generateLLMReference; exports.toBiomarkerTests = toBiomarkerTests; exports.getAllSearchPatterns = getAllSearchPatterns; exports.generateFilteredLLMReference = generateFilteredLLMReference; exports.DEXA_INDICATOR_CODES = DEXA_INDICATOR_CODES; exports.DEXA_CATEGORIES = DEXA_CATEGORIES; exports.generateDexaFullReference = generateDexaFullReference; exports.isDexaDocument = isDexaDocument; exports.CAC_INDICATOR_CODES = CAC_INDICATOR_CODES; exports.generateCacFullReference = generateCacFullReference; exports.isCacDocument = isCacDocument; exports.findCodeByName = findCodeByName; exports.validateLoincNameMatch = validateLoincNameMatch; exports.isBiomarkerVisible = isBiomarkerVisible; exports.filterVisibleBiomarkers = filterVisibleBiomarkers; exports.getBiomarkersByCategory = getBiomarkersByCategory; exports.getBiomarkersForCategories = getBiomarkersForCategories;
-//# sourceMappingURL=chunk-NXOTXKVB.cjs.map
+//# sourceMappingURL=chunk-S6LWF5M4.cjs.map