@precisa-saude/fhir 0.33.0 → 0.34.0

package/README.md

@@ -107,6 +107,8 @@ const range = getReferenceRange('TSH', {
 // → { max: 2.5, min: 0.1, ... } (alvo ATA 2017 para 1º trimestre)
 ```
 
+Cada faixa diz que tipo de afirmação ela é (`kind`: intervalo de referência do ensaio, limiar de decisão de diretriz ou distribuição populacional) e, por limite, se ele é corte clínico ou só desenho (`minKind`/`maxKind`). Para sinalizar um valor contra a faixa do catálogo, use `flagAgainstCatalogRange`, que ignora os limites de desenho; o `direction` diz para que lado o marcador melhora e não decide flag. Detalhes em [docs/biomarcadores.md](../../docs/biomarcadores.md#tipo-da-faixa).
+
 O metadado opcional `fastingRequired` em `BiomarkerReferenceRange` indica se a amostra exige jejum estrito (ex.: `Glucose`, `Insulin`, `HOMA_IR`) ou se o jejum é preferido mas não obrigatório (ex.: `Triglycerides`, que aceita dosagem não-jejum por SBC 2017/2025).
 
 ## Aviso médico

package/dist/{chunk-ZCIZUBMR.cjs → chunk-376KM7IL.cjs}

@@ -107,20 +107,27 @@ function mapFHIRObservationToInternal(observation, index) {
   }
   let referenceMin;
   let referenceMax;
+  let referenceKind;
   if (_optionalChain([observation, 'access', _18 => _18.referenceRange, 'optionalAccess', _19 => _19[0]])) {
     referenceMin = _optionalChain([observation, 'access', _20 => _20.referenceRange, 'access', _21 => _21[0], 'access', _22 => _22.low, 'optionalAccess', _23 => _23.value]);
     referenceMax = _optionalChain([observation, 'access', _24 => _24.referenceRange, 'access', _25 => _25[0], 'access', _26 => _26.high, 'optionalAccess', _27 => _27.value]);
+    const meaning = _optionalChain([observation, 'access', _28 => _28.referenceRange, 'access', _29 => _29[0], 'access', _30 => _30.type, 'optionalAccess', _31 => _31.coding, 'optionalAccess', _32 => _32.find, 'call', _33 => _33(
+      (c) => c.system === "http://terminology.hl7.org/CodeSystem/referencerange-meaning"
+    ), 'optionalAccess', _34 => _34.code]);
+    if (meaning === "normal") referenceKind = "reference-interval";
+    else if (meaning === "recommended") referenceKind = "decision-threshold";
   }
   const imported = {
     biomarkerCode: internalCode,
-    biomarkerName: _optionalChain([definition, 'optionalAccess', _28 => _28.names, 'access', _29 => _29.pt, 'access', _30 => _30[0]]) || _optionalChain([definition, 'optionalAccess', _31 => _31.names, 'access', _32 => _32.en, 'access', _33 => _33[0]]) || observation.code.text || internalCode,
+    biomarkerName: _optionalChain([definition, 'optionalAccess', _35 => _35.names, 'access', _36 => _36.pt, 'access', _37 => _37[0]]) || _optionalChain([definition, 'optionalAccess', _38 => _38.names, 'access', _39 => _39.en, 'access', _40 => _40[0]]) || observation.code.text || internalCode,
     collectionDate,
     flag: extractFlag(observation),
     isQualitative,
     loincCode,
+    ...referenceKind && { referenceKind },
     referenceMax,
     referenceMin,
-    unit: unit || _optionalChain([definition, 'optionalAccess', _34 => _34.unit]) || "",
+    unit: unit || _optionalChain([definition, 'optionalAccess', _41 => _41.unit]) || "",
     value
   };
   return { observation: imported };
@@ -162,4 +169,4 @@ function processImportBundle(data) {
 
 
 exports.MAX_OBSERVATIONS = MAX_OBSERVATIONS; exports.MAX_FILE_SIZE = MAX_FILE_SIZE; exports.extractObservationsFromBundle = extractObservationsFromBundle; exports.mapFHIRObservationToInternal = mapFHIRObservationToInternal; exports.processImportBundle = processImportBundle;
-//# sourceMappingURL=chunk-ZCIZUBMR.cjs.map
+//# sourceMappingURL=chunk-376KM7IL.cjs.map

package/dist/chunk-376KM7IL.cjs.map

@@ -0,0 +1 @@
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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  let referenceKind: ImportedObservation['referenceKind'];\n  if (observation.referenceRange?.[0]) {\n    referenceMin = observation.referenceRange[0].low?.value;\n    referenceMax = observation.referenceRange[0].high?.value;\n    const meaning = observation.referenceRange[0].type?.coding?.find(\n      (c) => c.system === 'http://terminology.hl7.org/CodeSystem/referencerange-meaning',\n    )?.code;\n    if (meaning === 'normal') referenceKind = 'reference-interval';\n    else if (meaning === 'recommended') referenceKind = 'decision-threshold';\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    ...(referenceKind && { referenceKind }),\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"]}

package/dist/{chunk-KS2YZBAS.js → chunk-K3VZ3F5Z.js}

@@ -2,6 +2,9 @@ import {
   BIOMARKER_CODE_SYSTEM,
   LOINC_SYSTEM
 } from "./chunk-A6HR4XDK.js";
+import {
+  referenceRangeMeaning
+} from "./chunk-P4G534AQ.js";
 import {
   getDefaultUnit,
   resolveUcum
@@ -59,7 +62,10 @@ var buildReferenceRanges = (observation, quantity) => {
   if (observation.referenceRanges && observation.referenceRanges.length > 0) {
     return observation.referenceRanges.flatMap((r) => toRanges(r.low, r.high, r.appliesTo));
   }
-  return toRanges(observation.referenceMin, observation.referenceMax);
+  const meaning = observation.referenceKind && referenceRangeMeaning(observation.referenceKind);
+  return toRanges(observation.referenceMin, observation.referenceMax).map(
+    (range) => meaning ? { ...range, type: { coding: [meaning] } } : range
+  );
 };
 function labObservationToFHIR(observation, patientId, laboratoryName) {
   const loincCode = codeToLoinc(observation.biomarkerCode);
@@ -265,4 +271,4 @@ export {
   userProfileToFHIR,
   labResultToFHIRBundle
 };
-//# sourceMappingURL=chunk-KS2YZBAS.js.map
+//# sourceMappingURL=chunk-K3VZ3F5Z.js.map

package/dist/chunk-K3VZ3F5Z.js.map

@@ -0,0 +1 @@
+{"version":3,"sources":["../src/bundle-urls.ts","../src/converter.ts"],"sourcesContent":["/**\n * Endereço das entradas de um Bundle.\n *\n * O `fullUrl` identifica a entrada, e é contra ele que o validador resolve as\n * referências entre os recursos. Um Bundle com `subject.reference` valendo\n * `Patient/abc` só resolve se alguma entrada tiver `fullUrl` terminando em\n * `/Patient/abc`: a referência relativa é lida contra a base do `fullUrl` da\n * entrada, que é como os exemplos da própria HL7 montam Bundle de coleção.\n *\n * Antes o `fullUrl` era `urn:uuid:observation-<laudo>-<código>`, que erra duas\n * vezes. `urn:uuid:` exige a sintaxe de UUID e aquilo não era um UUID, e num\n * Bundle de entradas `urn:uuid:` a referência precisa repetir a URN inteira,\n * então nenhuma das relativas resolvia. Um laudo de 22 marcadores saía com 24\n * erros de URN e 22 referências perdidas.\n */\n/**\n * Recurso que já tem id, e por isso pode ser endereçado numa entrada.\n *\n * No FHIR o `id` é opcional, porque um recurso pode viajar sem identidade\n * própria. Numa entrada de Bundle ele não pode: sem id não há `fullUrl`, e sem\n * `fullUrl` nenhuma referência chega ao recurso. Os conversores daqui sempre\n * atribuem um, e o tipo passa a dizer isso em vez de deixar `undefined` chegar\n * até a montagem da URL.\n */\nexport type Addressable<T> = T & { id: string };\n\n/**\n * Base dos `fullUrl`.\n *\n * Não precisa responder a uma requisição: no FHIR o `fullUrl` é identidade, não\n * endereço de download. Fica sob um domínio nosso para não colidir com a\n * identidade de recurso de outra instituição, que é o risco real de usar\n * `example.org` em dado que sai da máquina.\n */\nexport const BUNDLE_BASE_URL = 'https://precisa-saude.com.br/fhir';\n\n/**\n * Monta o `fullUrl` a partir do próprio recurso.\n *\n * Recebe o recurso em vez do tipo e do id soltos de propósito. O defeito que\n * isto substitui nasceu de montar os dois lados em separado: o `fullUrl` dizia\n * `observation-demo-Hgb` enquanto o recurso tinha id `demo-Hgb`, e ninguém\n * percebeu porque nada obrigava os dois a concordarem.\n *\n * O parâmetro pede o mínimo que a URL consome, e não a união de recursos que\n * este pacote converte. Um Bundle pode carregar qualquer recurso do R4, e quem\n * acrescenta uma entrada de um tipo que não está nessa união (um `Specimen`,\n * por exemplo) precisa do mesmo endereço, senão monta o dele e as duas formas\n * divergem outra vez.\n */\nexport const entryFullUrl = (resource: Addressable<{ resourceType: string }>): string =>\n  `${BUNDLE_BASE_URL}/${resource.resourceType}/${resource.id}`;\n","/**\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 { type Addressable, entryFullUrl } from './bundle-urls';\nimport { BIOMARKER_CODE_SYSTEM, LOINC_SYSTEM } from './code-systems';\nimport type {\n  FHIRBundle,\n  FHIRDiagnosticReport,\n  FHIRObservation,\n  FHIRPatient,\n  FHIRQuantity,\n  FHIRReferenceRange,\n} from './fhir-types';\nimport { referenceRangeMeaning } from './reference-ranges';\nimport type { Flag, LabObservationData, LabReportData, UserProfileData } from './types';\nimport { getDefaultUnit, resolveUcum } 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 * O `coding` do sexo, que vai **dentro** do CodeableConcept do `appliesTo`.\n *\n * O nome diz `CODING` e não `APPLIES_TO` de propósito: isto não é o valor do\n * campo, é uma entrada da lista de codificações dele. O embrulho acontece no\n * uso, em `{ coding: [SEX_CODING[sex]] }`.\n *\n * É o `AdministrativeGender`, e não o v3-ObservationInterpretation nem um\n * sistema nosso: um consumidor que já lê `Patient.gender` compara os dois sem\n * tabela de tradução no meio.\n */\nconst SEX_CODING = {\n  female: {\n    code: 'female',\n    display: 'Female',\n    system: 'http://hl7.org/fhir/administrative-gender',\n  },\n  male: { code: 'male', display: 'Male', system: 'http://hl7.org/fhir/administrative-gender' },\n} as const;\n\n/**\n * Monta as faixas de referência do `Observation`.\n *\n * Duas mudanças em relação ao que existia, e as duas são sobre não perder o que\n * o laudo imprimiu.\n *\n * **Um limite só já basta.** Antes a faixa só saía com os dois, e um laudo que\n * publica \"inferior a 190 mg/dL\" ou \"superior a 60 mL/min/1,73m²\" perdia o\n * campo inteiro. O R4 trata `low` e `high` como opcionais independentes e\n * documenta o caso de um lado só, e o importador deste mesmo pacote já lia\n * `low?.value` e `high?.value` com acesso opcional: a assimetria era só do\n * escritor. Ver PRE-430.\n *\n * **Mais de uma faixa, anotada.** Laudo com uma coluna de referência por sexo\n * passa a sair com as duas, cada uma com o seu `appliesTo`, em vez de o\n * pipeline escolher uma sem saber de quem é o exame. 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Unidade que o\n  // pacote não sabe traduzir fica só em `unit`, como texto: afirmar\n  // `http://unitsofmeasure.org` sobre `x10^3/mm3` era publicar um código\n  // falso, e quem consome o Bundle confiando no system trataria aquilo como\n  // UCUM de verdade.\n  const ucumUnit = resolveUcum(sourceUnit, observation.biomarkerCode);\n  const quantity = (value: number): FHIRQuantity => ({\n    ...(ucumUnit ? { code: ucumUnit, system: 'http://unitsofmeasure.org' } : {}),\n    ...(sourceUnit ? { unit: sourceUnit } : {}),\n    value,\n  });\n  const isQualitative = observation.isQualitative || typeof observation.value === 'string';\n\n  // Base observation structure\n  const fhirObs: Addressable<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 = quantity(observation.value as number);\n\n    // Reference range only applies to quantitative values\n    const referenceRange = buildReferenceRanges(observation, quantity);\n    if (referenceRange.length > 0) fhirObs.referenceRange = referenceRange;\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): Addressable<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): Addressable<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      ? [\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 ? [{ 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    const resource = labObservationToFHIR(\n      { ...obs, collectionDate: report.collectionDate },\n      patientId,\n      report.laboratoryName,\n    );\n\n    return { fullUrl: entryFullUrl(resource), resource };\n  });\n\n  // Os ids vêm dos recursos já montados, e não de uma segunda montagem da mesma\n  // regra. O `DiagnosticReport.result` aponta para eles, e era aqui que a\n  // referência se separava do recurso.\n  const observationIds = fhirObservations.map((entry) => entry.resource.id);\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      { fullUrl: entryFullUrl(fhirPatient), resource: fhirPatient },\n      { fullUrl: entryFullUrl(diagnosticReport), resource: diagnosticReport },\n      ...fhirObservations,\n    ],\n    resourceType: 'Bundle',\n    type: 'collection',\n  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package/dist/{chunk-X5WVIJGG.js → chunk-NJM45WAH.js}

@@ -107,9 +107,15 @@ function mapFHIRObservationToInternal(observation, index) {
   }
   let referenceMin;
   let referenceMax;
+  let referenceKind;
   if (observation.referenceRange?.[0]) {
     referenceMin = observation.referenceRange[0].low?.value;
     referenceMax = observation.referenceRange[0].high?.value;
+    const meaning = observation.referenceRange[0].type?.coding?.find(
+      (c) => c.system === "http://terminology.hl7.org/CodeSystem/referencerange-meaning"
+    )?.code;
+    if (meaning === "normal") referenceKind = "reference-interval";
+    else if (meaning === "recommended") referenceKind = "decision-threshold";
   }
   const imported = {
     biomarkerCode: internalCode,
@@ -118,6 +124,7 @@ function mapFHIRObservationToInternal(observation, index) {
     flag: extractFlag(observation),
     isQualitative,
     loincCode,
+    ...referenceKind && { referenceKind },
     referenceMax,
     referenceMin,
     unit: unit || definition?.unit || "",
@@ -162,4 +169,4 @@ export {
   mapFHIRObservationToInternal,
   processImportBundle
 };
-//# sourceMappingURL=chunk-X5WVIJGG.js.map
+//# sourceMappingURL=chunk-NJM45WAH.js.map

package/dist/chunk-NJM45WAH.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  /** Lido do `referenceRange.type`, quando o Bundle o traz. */\n  referenceKind?: 'decision-threshold' | 'reference-interval';\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 ?? 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package/dist/{chunk-FGZXQWSR.cjs → chunk-NKDUVSDK.cjs}

@@ -4,6 +4,9 @@
 var _chunkOR67NJDZcjs = require('./chunk-OR67NJDZ.cjs');
 
 
+var _chunkVKLWTTUOcjs = require('./chunk-VKLWTTUO.cjs');
+
+
 
 var _chunk5RC7C7HJcjs = require('./chunk-5RC7C7HJ.cjs');
 
@@ -59,7 +62,10 @@ var buildReferenceRanges = (observation, quantity) => {
   if (observation.referenceRanges && observation.referenceRanges.length > 0) {
     return observation.referenceRanges.flatMap((r) => toRanges(r.low, r.high, r.appliesTo));
   }
-  return toRanges(observation.referenceMin, observation.referenceMax);
+  const meaning = observation.referenceKind && _chunkVKLWTTUOcjs.referenceRangeMeaning.call(void 0, observation.referenceKind);
+  return toRanges(observation.referenceMin, observation.referenceMax).map(
+    (range) => meaning ? { ...range, type: { coding: [meaning] } } : range
+  );
 };
 function labObservationToFHIR(observation, patientId, laboratoryName) {
   const loincCode = _chunkT75NZM56cjs.codeToLoinc.call(void 0, observation.biomarkerCode);
@@ -265,4 +271,4 @@ function labResultToFHIRBundle(report, observations, userProfile) {
 
 
 exports.BUNDLE_BASE_URL = BUNDLE_BASE_URL; exports.entryFullUrl = entryFullUrl; exports.labObservationToFHIR = labObservationToFHIR; exports.labReportToFHIR = labReportToFHIR; exports.userProfileToFHIR = userProfileToFHIR; exports.labResultToFHIRBundle = labResultToFHIRBundle;
-//# sourceMappingURL=chunk-FGZXQWSR.cjs.map
+//# sourceMappingURL=chunk-NKDUVSDK.cjs.map

package/dist/chunk-NKDUVSDK.cjs.map

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Um Bundle com `subject.reference` valendo\n * `Patient/abc` só resolve se alguma entrada tiver `fullUrl` terminando em\n * `/Patient/abc`: a referência relativa é lida contra a base do `fullUrl` da\n * entrada, que é como os exemplos da própria HL7 montam Bundle de coleção.\n *\n * Antes o `fullUrl` era `urn:uuid:observation-<laudo>-<código>`, que erra duas\n * vezes. `urn:uuid:` exige a sintaxe de UUID e aquilo não era um UUID, e num\n * Bundle de entradas `urn:uuid:` a referência precisa repetir a URN inteira,\n * então nenhuma das relativas resolvia. Um laudo de 22 marcadores saía com 24\n * erros de URN e 22 referências perdidas.\n */\n/**\n * Recurso que já tem id, e por isso pode ser endereçado numa entrada.\n *\n * No FHIR o `id` é opcional, porque um recurso pode viajar sem identidade\n * própria. Numa entrada de Bundle ele não pode: sem id não há `fullUrl`, e sem\n * `fullUrl` nenhuma referência chega ao recurso. Os conversores daqui sempre\n * atribuem um, e o tipo passa a dizer isso em vez de deixar `undefined` chegar\n * até a montagem da URL.\n */\nexport type Addressable<T> = T & { id: string };\n\n/**\n * Base dos `fullUrl`.\n *\n * Não precisa responder a uma requisição: no FHIR o `fullUrl` é identidade, não\n * endereço de download. Fica sob um domínio nosso para não colidir com a\n * identidade de recurso de outra instituição, que é o risco real de usar\n * `example.org` em dado que sai da máquina.\n */\nexport const BUNDLE_BASE_URL = 'https://precisa-saude.com.br/fhir';\n\n/**\n * Monta o `fullUrl` a partir do próprio recurso.\n *\n * Recebe o recurso em vez do tipo e do id soltos de propósito. O defeito que\n * isto substitui nasceu de montar os dois lados em separado: o `fullUrl` dizia\n * `observation-demo-Hgb` enquanto o recurso tinha id `demo-Hgb`, e ninguém\n * percebeu porque nada obrigava os dois a concordarem.\n *\n * O parâmetro pede o mínimo que a URL consome, e não a união de recursos que\n * este pacote converte. Um Bundle pode carregar qualquer recurso do R4, e quem\n * acrescenta uma entrada de um tipo que não está nessa união (um `Specimen`,\n * por exemplo) precisa do mesmo endereço, senão monta o dele e as duas formas\n * divergem outra vez.\n */\nexport const entryFullUrl = (resource: Addressable<{ resourceType: string }>): string =>\n  `${BUNDLE_BASE_URL}/${resource.resourceType}/${resource.id}`;\n","/**\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 { type Addressable, entryFullUrl } from './bundle-urls';\nimport { BIOMARKER_CODE_SYSTEM, LOINC_SYSTEM } from './code-systems';\nimport type {\n  FHIRBundle,\n  FHIRDiagnosticReport,\n  FHIRObservation,\n  FHIRPatient,\n  FHIRQuantity,\n  FHIRReferenceRange,\n} from './fhir-types';\nimport { referenceRangeMeaning } from './reference-ranges';\nimport type { Flag, LabObservationData, LabReportData, UserProfileData } from './types';\nimport { getDefaultUnit, resolveUcum } 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 * O `coding` do sexo, que vai **dentro** do CodeableConcept do `appliesTo`.\n *\n * O nome diz `CODING` e não `APPLIES_TO` de propósito: isto não é o valor do\n * campo, é uma entrada da lista de codificações dele. O embrulho acontece no\n * uso, em `{ coding: [SEX_CODING[sex]] }`.\n *\n * É o `AdministrativeGender`, e não o v3-ObservationInterpretation nem um\n * sistema nosso: um consumidor que já lê `Patient.gender` compara os dois sem\n * tabela de tradução no meio.\n */\nconst SEX_CODING = {\n  female: {\n    code: 'female',\n    display: 'Female',\n    system: 'http://hl7.org/fhir/administrative-gender',\n  },\n  male: { code: 'male', display: 'Male', system: 'http://hl7.org/fhir/administrative-gender' },\n} as const;\n\n/**\n * Monta as faixas de referência do `Observation`.\n *\n * Duas mudanças em relação ao que existia, e as duas são sobre não perder o que\n * o laudo imprimiu.\n *\n * **Um limite só já basta.** Antes a faixa só saía com os dois, e um laudo que\n * publica \"inferior a 190 mg/dL\" ou \"superior a 60 mL/min/1,73m²\" perdia o\n * campo inteiro. O R4 trata `low` e `high` como opcionais independentes e\n * documenta o caso de um lado só, e o importador deste mesmo pacote já lia\n * `low?.value` e `high?.value` com acesso opcional: a assimetria era só do\n * escritor. Ver PRE-430.\n *\n * **Mais de uma faixa, anotada.** Laudo com uma coluna de referência por sexo\n * passa a sair com as duas, cada uma com o seu `appliesTo`, em vez de o\n * pipeline escolher uma sem saber de quem é o exame. Ver PRE-424 e PRE-425.\n */\nconst buildReferenceRanges = (\n  observation: LabObservationData,\n  quantity: (value: number) => FHIRQuantity,\n): FHIRReferenceRange[] => {\n  // Devolve lista, e não uma faixa: o caso sem limite nenhum vira lista vazia\n  // em vez de `undefined`, e aí os dois caminhos abaixo se compõem com\n  // `flatMap` sem ninguém precisar filtrar nada depois.\n  const toRanges = (low?: number, high?: number, sex?: 'female' | 'male'): FHIRReferenceRange[] => {\n    if (low === undefined && high === undefined) return [];\n\n    return [\n      {\n        ...(sex === undefined ? {} : { appliesTo: [{ coding: [SEX_CODING[sex]] }] }),\n        ...(high === undefined ? {} : { high: quantity(high) }),\n        ...(low === undefined ? {} : { low: quantity(low) }),\n      },\n    ];\n  };\n\n  // A lista anotada tem precedência: quando ela existe, o par simples é o\n  // resumo de uma das colunas e repeti-lo publicaria a mesma faixa duas vezes,\n  // uma delas sem dizer a quem se aplica.\n  //\n  // Lista vazia cai no par simples, igual a ausente, e isso é escolha: as duas\n  // dizem \"não tenho faixa anotada\", e tratá-las diferente faria um `[]` vindo\n  // de um `.filter()` apagar em silêncio a faixa que o chamador também mandou\n  // em `referenceMin` e `referenceMax`.\n  if (observation.referenceRanges && observation.referenceRanges.length > 0) {\n    return observation.referenceRanges.flatMap((r) => toRanges(r.low, r.high, r.appliesTo));\n  }\n\n  const meaning = observation.referenceKind && referenceRangeMeaning(observation.referenceKind);\n  return toRanges(observation.referenceMin, observation.referenceMax).map((range) =>\n    meaning ? { ...range, type: { coding: [meaning] } } : range,\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): Addressable<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  // `system` + `code` só saem quando a unidade resolve em UCUM. Unidade que o\n  // pacote não sabe traduzir fica só em `unit`, como texto: afirmar\n  // `http://unitsofmeasure.org` sobre `x10^3/mm3` era publicar um código\n  // falso, e quem consome o Bundle confiando no system trataria aquilo como\n  // UCUM de verdade.\n  const ucumUnit = resolveUcum(sourceUnit, observation.biomarkerCode);\n  const quantity = (value: number): FHIRQuantity => ({\n    ...(ucumUnit ? { code: ucumUnit, system: 'http://unitsofmeasure.org' } : {}),\n    ...(sourceUnit ? { unit: sourceUnit } : {}),\n    value,\n  });\n  const isQualitative = observation.isQualitative || typeof observation.value === 'string';\n\n  // Base observation structure\n  const fhirObs: Addressable<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 = quantity(observation.value as number);\n\n    // Reference range only applies to quantitative values\n    const referenceRange = buildReferenceRanges(observation, quantity);\n    if (referenceRange.length > 0) fhirObs.referenceRange = referenceRange;\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): Addressable<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): Addressable<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      ? [\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 ? [{ 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    const resource = labObservationToFHIR(\n      { ...obs, collectionDate: report.collectionDate },\n      patientId,\n      report.laboratoryName,\n    );\n\n    return { fullUrl: entryFullUrl(resource), resource };\n  });\n\n  // Os ids vêm dos recursos já montados, e não de uma segunda montagem da mesma\n  // regra. O `DiagnosticReport.result` aponta para eles, e era aqui que a\n  // referência se separava do recurso.\n  const observationIds = fhirObservations.map((entry) => entry.resource.id);\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      { fullUrl: entryFullUrl(fhirPatient), resource: fhirPatient },\n      { fullUrl: entryFullUrl(diagnosticReport), resource: diagnosticReport },\n      ...fhirObservations,\n    ],\n    resourceType: 'Bundle',\n    type: 'collection',\n  };\n}\n"]}