@the-cascade-protocol/cli 0.3.5 → 0.4.0

package/dist/lib/fhir-converter/index.d.ts.map

@@ -1 +1 @@
-{"version":3,"file":"index.d.ts","sourceRoot":"","sources":["../../../src/lib/fhir-converter/index.ts"],"names":[],"mappings":"AAAA;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;GAsCG;AAMH,OAAO,EACL,KAAK,WAAW,EAChB,KAAK,YAAY,EACjB,KAAK,gBAAgB,EACrB,KAAK,qBAAqB,EAI3B,MAAM,YAAY,CAAC;AASpB,YAAY,EAAE,WAAW,EAAE,YAAY,EAAE,gBAAgB,EAAE,qBAAqB,EAAE,CAAC;AAGnF,OAAO,EAAE,0BAA0B,EAAE,oBAAoB,EAAE,MAAM,sBAAsB,CAAC;AACxF,OAAO,EAAE,oBAAoB,EAAE,MAAM,sBAAsB,CAAC;AAM5D;;;;;;GAMG;AACH,wBAAsB,OAAO,CAC3B,KAAK,EAAE,MAAM,EACb,IAAI,EAAE,WAAW,EACjB,EAAE,EAAE,YAAY,EAChB,mBAAmB,GAAE,QAAQ,GAAG,QAAmB,EACnD,YAAY,CAAC,EAAE,MAAM,EACrB,kBAAkB,UAAQ,GACzB,OAAO,CAAC,qBAAqB,CAAC,CAoKhC;AAMD;;GAEG;AACH,wBAAgB,YAAY,CAAC,KAAK,EAAE,MAAM,GAAG,WAAW,GAAG,IAAI,CA6B9D"}
+{"version":3,"file":"index.d.ts","sourceRoot":"","sources":["../../../src/lib/fhir-converter/index.ts"],"names":[],"mappings":"AAAA;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;GAsCG;AAMH,OAAO,EACL,KAAK,WAAW,EAChB,KAAK,YAAY,EACjB,KAAK,gBAAgB,EACrB,KAAK,qBAAqB,EAI3B,MAAM,YAAY,CAAC;AASpB,YAAY,EAAE,WAAW,EAAE,YAAY,EAAE,gBAAgB,EAAE,qBAAqB,EAAE,CAAC;AAGnF,OAAO,EAAE,0BAA0B,EAAE,oBAAoB,EAAE,MAAM,sBAAsB,CAAC;AACxF,OAAO,EAAE,oBAAoB,EAAE,MAAM,sBAAsB,CAAC;AAM5D;;;;;;GAMG;AACH,wBAAsB,OAAO,CAC3B,KAAK,EAAE,MAAM,EACb,IAAI,EAAE,WAAW,EACjB,EAAE,EAAE,YAAY,EAChB,mBAAmB,GAAE,QAAQ,GAAG,QAAmB,EACnD,YAAY,CAAC,EAAE,MAAM,EACrB,kBAAkB,UAAQ,GACzB,OAAO,CAAC,qBAAqB,CAAC,CAgLhC;AAMD;;GAEG;AACH,wBAAgB,YAAY,CAAC,KAAK,EAAE,MAAM,GAAG,WAAW,GAAG,IAAI,CA6B9D"}

package/dist/lib/fhir-converter/index.js

@@ -196,10 +196,21 @@ export async function convert(input, from, to, outputSerialization = 'turtle', s
         };
     }
     else if (from === 'c-cda') {
-        return {
-            success: false, output: '', format: to, resourceCount: 0, skippedCount: 0,
-            warnings: [], errors: ['C-CDA conversion is not yet supported'], results: [],
-        };
+        // Native C-CDA converter — preserves CVX, LOINC, SNOMED, RxNorm, ICD-10 codes
+        const { convertCcda } = await import('../ccda-converter/index.js');
+        // Detect if input looks like an IHE XDM zip (binary PK header)
+        let inputData;
+        const firstTwo = input.charCodeAt(0) === 0x50 && input.charCodeAt(1) === 0x4b;
+        if (firstTwo) {
+            inputData = Buffer.from(input, 'binary');
+        }
+        else {
+            inputData = input;
+        }
+        return await convertCcda(inputData, {
+            sourceSystem,
+            importedAt: new Date().toISOString(),
+        });
     }
     else {
         return {

package/dist/lib/fhir-converter/index.js.map

@@ -1 +1 @@
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+{"version":3,"file":"index.js","sourceRoot":"","sources":["../../../src/lib/fhir-converter/index.ts"],"names":[],"mappings":"AAAA;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;GAsCG;AAIH,OAAO,EAAE,WAAW,EAAE,MAAM,IAAI,CAAC;AAEjC,OAAO,EAKL,EAAE,EACF,aAAa,EACb,aAAa,GACd,MAAM,YAAY,CAAC;AAEpB,MAAM,EAAE,SAAS,EAAE,OAAO,EAAE,IAAI,EAAE,QAAQ,EAAE,GAAG,WAAW,CAAC;AAE3D,OAAO,EAAE,0BAA0B,EAAE,MAAM,sBAAsB,CAAC;AAClE,OAAO,EAAE,oBAAoB,EAAE,MAAM,sBAAsB,CAAC;AAC5D,OAAO,EAAE,cAAc,EAAE,MAAM,6BAA6B,CAAC;AAK7D,8CAA8C;AAC9C,OAAO,EAAE,0BAA0B,EAAE,oBAAoB,EAAE,MAAM,sBAAsB,CAAC;AACxF,OAAO,EAAE,oBAAoB,EAAE,MAAM,sBAAsB,CAAC;AAE5D,8EAA8E;AAC9E,yCAAyC;AACzC,8EAA8E;AAE9E;;;;;;GAMG;AACH,MAAM,CAAC,KAAK,UAAU,OAAO,CAC3B,KAAa,EACb,IAAiB,EACjB,EAAgB,EAChB,sBAA2C,QAAQ,EACnD,YAAqB,EACrB,kBAAkB,GAAG,KAAK;IAE1B,MAAM,QAAQ,GAAa,EAAE,CAAC;IAC9B,MAAM,MAAM,GAAa,EAAE,CAAC;IAC5B,MAAM,OAAO,GAAuB,EAAE,CAAC;IACvC,IAAI,YAAY,GAAG,CAAC,CAAC;IAErB,IAAI,IAAI,KAAK,MAAM,IAAI,CAAC,EAAE,KAAK,SAAS,IAAI,EAAE,KAAK,QAAQ,IAAI,EAAE,KAAK,QAAQ,CAAC,EAAE,CAAC;QAChF,kBAAkB;QAClB,IAAI,MAAW,CAAC;QAChB,IAAI,CAAC;YACH,MAAM,GAAG,IAAI,CAAC,KAAK,CAAC,KAAK,CAAC,CAAC;QAC7B,CAAC;QAAC,MAAM,CAAC;YACP,OAAO;gBACL,OAAO,EAAE,KAAK,EAAE,MAAM,EAAE,EAAE,EAAE,MAAM,EAAE,EAAE,EAAE,aAAa,EAAE,CAAC,EAAE,YAAY,EAAE,CAAC;gBACzE,QAAQ,EAAE,EAAE,EAAE,MAAM,EAAE,CAAC,oBAAoB,CAAC,EAAE,OAAO,EAAE,EAAE;aAC1D,CAAC;QACJ,CAAC;QAED,mDAAmD;QACnD,MAAM,aAAa,GAAU,EAAE,CAAC;QAChC,IAAI,MAAM,CAAC,YAAY,KAAK,QAAQ,IAAI,KAAK,CAAC,OAAO,CAAC,MAAM,CAAC,KAAK,CAAC,EAAE,CAAC;YACpE,KAAK,MAAM,KAAK,IAAI,MAAM,CAAC,KAAK,EAAE,CAAC;gBACjC,IAAI,KAAK,CAAC,QAAQ;oBAAE,aAAa,CAAC,IAAI,CAAC,KAAK,CAAC,QAAQ,CAAC,CAAC;YACzD,CAAC;QACH,CAAC;aAAM,IAAI,MAAM,CAAC,YAAY,EAAE,CAAC;YAC/B,aAAa,CAAC,IAAI,CAAC,MAAM,CAAC,CAAC;QAC7B,CAAC;aAAM,CAAC;YACN,OAAO;gBACL,OAAO,EAAE,KAAK,EAAE,MAAM,EAAE,EAAE,EAAE,MAAM,EAAE,EAAE,EAAE,aAAa,EAAE,CAAC,EAAE,YAAY,EAAE,CAAC;gBACzE,QAAQ,EAAE,EAAE,EAAE,MAAM,EAAE,CAAC,uDAAuD,CAAC,EAAE,OAAO,EAAE,EAAE;aAC7F,CAAC;QACJ,CAAC;QAED,MAAM,QAAQ,GAAW,EAAE,CAAC;QAC5B,KAAK,MAAM,GAAG,IAAI,aAAa,EAAE,CAAC;YAChC,IAAI,cAAc,CAAC,GAAG,CAAC,GAAG,CAAC,YAAY,CAAC,EAAE,CAAC;gBACzC,YAAY,EAAE,CAAC;gBACf,SAAS;YACX,CAAC;YACD,MAAM,MAAM,GAAG,0BAA0B,CAAC,GAAG,EAAE,kBAAkB,CAAC,CAAC;YACnE,IAAI,MAAM,EAAE,CAAC;gBACX,QAAQ,CAAC,IAAI,CAAC,GAAG,MAAM,CAAC,MAAM,CAAC,CAAC;gBAChC,OAAO,CAAC,IAAI,CAAC;oBACX,MAAM,EAAE,EAAE,EAAE,sCAAsC;oBAClD,MAAM,EAAE,MAAM,CAAC,MAAM;oBACrB,QAAQ,EAAE,MAAM,CAAC,QAAQ;oBACzB,YAAY,EAAE,MAAM,CAAC,YAAY;oBACjC,WAAW,EAAE,MAAM,CAAC,WAAW;iBAChC,CAAC,CAAC;gBACH,QAAQ,CAAC,IAAI,CAAC,GAAG,MAAM,CAAC,QAAQ,CAAC,CAAC;YACpC,CAAC;QACH,CAAC;QAED,IAAI,QAAQ,CAAC,MAAM,KAAK,CAAC,EAAE,CAAC;YAC1B,OAAO;gBACL,OAAO,EAAE,KAAK,EAAE,MAAM,EAAE,EAAE,EAAE,MAAM,EAAE,EAAE,EAAE,aAAa,EAAE,CAAC,EAAE,YAAY;gBACtE,QAAQ,EAAE,MAAM,EAAE,CAAC,qCAAqC,CAAC,EAAE,OAAO,EAAE,EAAE;aACvE,CAAC;QACJ,CAAC;QAED,8EAA8E;QAC9E,uFAAuF;QACvF,2FAA2F;QAC3F,MAAM,gBAAgB,GAAG,IAAI,GAAG,CAAC;YAC/B,EAAE,CAAC,QAAQ,GAAG,kBAAkB;YAChC,EAAE,CAAC,QAAQ,GAAG,eAAe;YAC7B,EAAE,CAAC,QAAQ,GAAG,kBAAkB;YAChC,EAAE,CAAC,QAAQ,GAAG,cAAc;SAC7B,CAAC,CAAC;QACH,MAAM,mBAAmB,GAAG,IAAI,IAAI,EAAE,CAAC,WAAW,EAAE,CAAC;QACrD,MAAM,mBAAmB,GAAG,IAAI,GAAG,EAAU,CAAC;QAC9C,MAAM,cAAc,GAAG,IAAI,GAAG,EAAU,CAAC;QACzC,KAAK,MAAM,CAAC,IAAI,QAAQ,EAAE,CAAC;YACzB,IAAI,CAAC,CAAC,SAAS,CAAC,KAAK,KAAK,EAAE,CAAC,GAAG,GAAG,MAAM,EAAE,CAAC;gBAC1C,cAAc,CAAC,GAAG,CAAC,CAAC,CAAC,OAAO,CAAC,KAAK,CAAC,CAAC;gBACpC,IAAI,gBAAgB,CAAC,GAAG,CAAC,CAAC,CAAC,MAAM,CAAC,KAAK,CAAC,EAAE,CAAC;oBACzC,mBAAmB,CAAC,GAAG,CAAC,CAAC,CAAC,OAAO,CAAC,KAAK,CAAC,CAAC;gBAC3C,CAAC;YACH,CAAC;QACH,CAAC;QACD,IAAI,YAAY,EAAE,CAAC;YACjB,KAAK,MAAM,UAAU,IAAI,cAAc,EAAE,CAAC;gBACxC,QAAQ,CAAC,IAAI,CACX,QAAQ,CACN,SAAS,CAAC,UAAU,CAAC,EACrB,SAAS,CAAC,EAAE,CAAC,OAAO,GAAG,cAAc,CAAC,EACtC,OAAO,CAAC,YAAY,CAAC,CACtB,CACF,CAAC;YACJ,CAAC;QACH,CAAC;QACD,KAAK,MAAM,UAAU,IAAI,mBAAmB,EAAE,CAAC;YAC7C,QAAQ,CAAC,IAAI,CACX,QAAQ,CAAC,SAAS,CAAC,UAAU,CAAC,EAAE,SAAS,CAAC,EAAE,CAAC,QAAQ,GAAG,YAAY,CAAC,EACnE,OAAO,CAAC,mBAAmB,EAAE,SAAS,CAAC,EAAE,CAAC,GAAG,GAAG,UAAU,CAAC,CAAC,CAAC,CAChE,CAAC;YACF,IAAI,YAAY,EAAE,CAAC;gBACjB,QAAQ,CAAC,IAAI,CACX,QAAQ,CAAC,SAAS,CAAC,UAAU,CAAC,EAAE,SAAS,CAAC,EAAE,CAAC,QAAQ,GAAG,WAAW,CAAC,EAAE,OAAO,CAAC,YAAY,CAAC,CAAC,CAC7F,CAAC;YACJ,CAAC;QACH,CAAC;QAED,0BAA0B;QAC1B,IAAI,MAAc,CAAC;QACnB,IAAI,mBAAmB,KAAK,QAAQ,IAAI,EAAE,KAAK,QAAQ,EAAE,CAAC;YACxD,MAAM,MAAM,GAAG,aAAa,CAAC,QAAQ,EAAE,OAAO,CAAC,CAAC,CAAC,EAAE,WAAW,IAAI,EAAE,CAAC,CAAC;YACtE,MAAM,GAAG,IAAI,CAAC,SAAS,CAAC,MAAM,EAAE,IAAI,EAAE,CAAC,CAAC,CAAC;QAC3C,CAAC;aAAM,CAAC;YACN,MAAM,GAAG,MAAM,aAAa,CAAC,QAAQ,CAAC,CAAC;QACzC,CAAC;QAED,OAAO;YACL,OAAO,EAAE,IAAI;YACb,MAAM;YACN,MAAM,EAAE,EAAE,KAAK,SAAS,CAAC,CAAC,CAAC,CAAC,mBAAmB,KAAK,QAAQ,CAAC,CAAC,CAAC,QAAQ,CAAC,CAAC,CAAC,QAAQ,CAAC,CAAC,CAAC,CAAC,EAAE;YACxF,aAAa,EAAE,OAAO,CAAC,MAAM;YAC7B,YAAY;YACZ,QAAQ;YACR,MAAM;YACN,OAAO;SACR,CAAC;IACJ,CAAC;SAAM,IAAI,IAAI,KAAK,SAAS,IAAI,EAAE,KAAK,MAAM,EAAE,CAAC;QAC/C,kBAAkB;QAClB,MAAM,EAAE,SAAS,EAAE,QAAQ,EAAE,YAAY,EAAE,GAAG,MAAM,oBAAoB,CAAC,KAAK,CAAC,CAAC;QAChF,QAAQ,CAAC,IAAI,CAAC,GAAG,YAAY,CAAC,CAAC;QAE/B,IAAI,SAAS,CAAC,MAAM,KAAK,CAAC,EAAE,CAAC;YAC3B,OAAO;gBACL,OAAO,EAAE,KAAK,EAAE,MAAM,EAAE,EAAE,EAAE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package/dist/lib/fhir-converter/types.d.ts

@@ -82,6 +82,30 @@ export declare function tripleDate(subject: string, predicate: string, dateStr:
  * - If no resource.id: falls back to a random UUID (last resort)
  */
 export declare function mintSubjectUri(resource: any): string;
+/**
+ * Generate a deterministic urn:uuid: URI from clinical content fields.
+ * Used when no stable FHIR resource ID is available.
+ *
+ * Identity string construction:
+ *   "{resourceType}::{sortedKeyValuePairs}"
+ *   where sortedKeyValuePairs =
+ *     entries of contentFields where value is non-null and non-empty after .trim()
+ *     sorted ascending by key (localeCompare)
+ *     mapped as "key=value"
+ *     joined with "|"
+ *
+ * URI selection:
+ *   If identity string has content: return "urn:uuid:" + deterministicUuid(identity)
+ *   Else if fallbackId:             return "urn:uuid:" + deterministicUuid("{resourceType}:{fallbackId}")
+ *   Else:                           return "urn:uuid:" + randomUUID()  (non-deterministic fallback)
+ *
+ * Example:
+ *   contentHashedUri("Patient", { dob:"1985-03-15", sex:"male", family:"Smith", given:"John" })
+ *   -> identity: "Patient::dob=1985-03-15|family=Smith|given=John|sex=male"
+ *   -> urn:uuid:{deterministicUuid("Patient::dob=1985-03-15|family=Smith|given=John|sex=male")}
+ *   -> urn:uuid:aba8c9f5-fdc6-5187-a363-0d5a7cb72438
+ */
+export declare function contentHashedUri(resourceType: string, contentFields: Record<string, string | undefined>, fallbackId?: string): string;
 /** Common triples every Cascade resource gets */
 export declare function commonTriples(subject: string): Quad[];
 export declare function quadsToTurtle(quads: Quad[]): Promise<string>;

package/dist/lib/fhir-converter/types.d.ts.map

@@ -1 +1 @@
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package/dist/lib/fhir-converter/types.js

@@ -190,9 +190,24 @@ export function tripleDate(subject, predicate, dateStr) {
 // Subject URI minting (deterministic from resource.id)
 // ---------------------------------------------------------------------------
 const UUID_V4_REGEX = /^[0-9a-f]{8}-[0-9a-f]{4}-4[0-9a-f]{3}-[89ab][0-9a-f]{3}-[0-9a-f]{12}$/i;
+/**
+ * Cascade Protocol Deterministic UUID (CDP-UUID)
+ *
+ * Algorithm:
+ *   Input:   UTF-8 string
+ *   Hash:    SHA-1(input) -> 40-char lowercase hex digest `h`
+ *   Layout:  {h[0:8]}-{h[8:12]}-5{h[13:16]}-{v}{h[18:20]}-{h[20:32]}
+ *            where v = (parseInt(h[16:18], 16) & 0x3f | 0x80).toString(16).padStart(2,'0')
+ *            (Sets UUID version nibble to 5, variant bits to 10xx -- same layout as RFC 4122 v5
+ *             but hashing the raw input string directly, not a namespace+name pair)
+ *
+ * Cross-SDK verification:
+ *   SHA-1("hello") == "aaf4c61ddcc5e8a2dabede0f3b482cd9aea9434d"
+ *   deterministicUuid("hello") == "aaf4c61d-dcc5-58a2-9abe-de0f3b482cd9"
+ *   (verify this value before using in any SDK implementation)
+ */
 function deterministicUuid(input) {
     const hash = createHash('sha1').update(input).digest('hex');
-    // Format as a deterministic UUID-shaped string (SHA-1 based, not strict v5)
     const v = ((parseInt(hash.slice(16, 18), 16) & 0x3f) | 0x80).toString(16).padStart(2, '0');
     return `${hash.slice(0, 8)}-${hash.slice(8, 12)}-5${hash.slice(13, 16)}-${v}${hash.slice(18, 20)}-${hash.slice(20, 32)}`;
 }
@@ -211,6 +226,44 @@ export function mintSubjectUri(resource) {
     const resourceType = resource?.resourceType ?? 'Unknown';
     return `urn:uuid:${deterministicUuid(`${resourceType}:${id}`)}`;
 }
+/**
+ * Generate a deterministic urn:uuid: URI from clinical content fields.
+ * Used when no stable FHIR resource ID is available.
+ *
+ * Identity string construction:
+ *   "{resourceType}::{sortedKeyValuePairs}"
+ *   where sortedKeyValuePairs =
+ *     entries of contentFields where value is non-null and non-empty after .trim()
+ *     sorted ascending by key (localeCompare)
+ *     mapped as "key=value"
+ *     joined with "|"
+ *
+ * URI selection:
+ *   If identity string has content: return "urn:uuid:" + deterministicUuid(identity)
+ *   Else if fallbackId:             return "urn:uuid:" + deterministicUuid("{resourceType}:{fallbackId}")
+ *   Else:                           return "urn:uuid:" + randomUUID()  (non-deterministic fallback)
+ *
+ * Example:
+ *   contentHashedUri("Patient", { dob:"1985-03-15", sex:"male", family:"Smith", given:"John" })
+ *   -> identity: "Patient::dob=1985-03-15|family=Smith|given=John|sex=male"
+ *   -> urn:uuid:{deterministicUuid("Patient::dob=1985-03-15|family=Smith|given=John|sex=male")}
+ *   -> urn:uuid:aba8c9f5-fdc6-5187-a363-0d5a7cb72438
+ */
+export function contentHashedUri(resourceType, contentFields, fallbackId) {
+    // Filter out undefined/empty values and sort keys for stability
+    const content = Object.entries(contentFields)
+        .filter(([, v]) => v != null && v.trim().length > 0)
+        .sort(([a], [b]) => a.localeCompare(b))
+        .map(([k, v]) => `${k}=${v}`)
+        .join('|');
+    if (content.length > 0) {
+        return `urn:uuid:${deterministicUuid(`${resourceType}::${content}`)}`;
+    }
+    if (fallbackId) {
+        return `urn:uuid:${deterministicUuid(`${resourceType}:${fallbackId}`)}`;
+    }
+    return `urn:uuid:${randomUUID()}`; // true last resort
+}
 /** Common triples every Cascade resource gets */
 export function commonTriples(subject) {
     return [

package/dist/lib/fhir-converter/types.js.map

@@ -1 +1 @@
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package/dist/lib/reconciler.d.ts.map

@@ -1 +1 @@
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package/dist/lib/reconciler.js

@@ -136,14 +136,76 @@ function matchLabs(a, b, tol) {
     return { match: false, confidence: 0, matchedOn: '' };
 }
 function matchImmunizations(a, b) {
+    // Tier 1: CVX code + exact date (high confidence)
     const cA = getProp(a, NS.health + 'cvxCode');
     const cB = getProp(b, NS.health + 'cvxCode');
     const dA = dateOnly(getProp(a, NS.health + 'administrationDate') ?? getProp(a, NS.health + 'startDate') ?? '');
     const dB = dateOnly(getProp(b, NS.health + 'administrationDate') ?? getProp(b, NS.health + 'startDate') ?? '');
     if (cA && cB && codeFromUri(cA) === codeFromUri(cB) && dA && dA === dB)
         return { match: true, confidence: 1.0, matchedOn: `cvx:${codeFromUri(cA)}+${dA}` };
+    // Tier 2: Vaccine name (normalized) + date -- fallback when CVX absent
+    const nA = (getProp(a, NS.health + 'vaccineName') ?? '').toLowerCase().trim();
+    const nB = (getProp(b, NS.health + 'vaccineName') ?? '').toLowerCase().trim();
+    if (nA && nB && nA !== 'unknown vaccine' && nA === nB && dA && dA === dB)
+        return { match: true, confidence: 0.80, matchedOn: `name:"${nA}"+${dA}` };
+    // Tier 3: Vaccine name match, no date -- very conservative
+    if (nA && nB && nA !== 'unknown vaccine' && nA === nB)
+        return { match: true, confidence: 0.60, matchedOn: `name-only:"${nA}"` };
     return { match: false, confidence: 0, matchedOn: '' };
 }
+function matchVitalSigns(a, b) {
+    const lcA = getProp(a, NS.health + 'testCode'); // LOINC
+    const lcB = getProp(b, NS.health + 'testCode');
+    const dtA = dateOnly(getProp(a, NS.health + 'effectiveDate') ?? getProp(a, NS.health + 'performedDate') ?? '');
+    const dtB = dateOnly(getProp(b, NS.health + 'effectiveDate') ?? getProp(b, NS.health + 'performedDate') ?? '');
+    if (lcA && lcB && codeFromUri(lcA) === codeFromUri(lcB) && dtA && dtA === dtB) {
+        // Same LOINC, same day -- check value proximity
+        const vA = parseFloat(getProp(a, NS.health + 'value') ?? 'NaN');
+        const vB = parseFloat(getProp(b, NS.health + 'value') ?? 'NaN');
+        if (!isNaN(vA) && !isNaN(vB)) {
+            const diff = Math.abs(vA - vB) / Math.max(Math.abs(vA), 0.001);
+            if (diff <= 0.05)
+                return { match: true, confidence: 0.95, matchedOn: `loinc:${codeFromUri(lcA)}+${dtA}` };
+            if (diff <= 0.15)
+                return { match: true, confidence: 0.75, matchedOn: `loinc-approx:${codeFromUri(lcA)}+${dtA}` };
+        }
+        return { match: true, confidence: 0.85, matchedOn: `loinc:${codeFromUri(lcA)}+${dtA}` };
+    }
+    return { match: false, confidence: 0, matchedOn: '' };
+}
+function matchPatientProfiles(a, b) {
+    const dobA = getProp(a, NS.cascade + 'dateOfBirth');
+    const dobB = getProp(b, NS.cascade + 'dateOfBirth');
+    const sexA = getProp(a, NS.cascade + 'biologicalSex');
+    const sexB = getProp(b, NS.cascade + 'biologicalSex');
+    if (dobA && dobB && dobA === dobB && sexA && sexB && sexA === sexB) {
+        return { match: true, confidence: 0.95, matchedOn: `dob:${dobA}+sex:${sexA}` };
+    }
+    // Try DOB alone (lower confidence)
+    if (dobA && dobB && dobA === dobB) {
+        return { match: true, confidence: 0.75, matchedOn: `dob:${dobA}` };
+    }
+    return { match: false, confidence: 0, matchedOn: '' };
+}
+/**
+ * Returns the confidence threshold to use when comparing two records.
+ *
+ * Records from summarization documents (LOINC 34133-9, e.g. MyChart "Summarization
+ * of Episode Note") contain the patient's full history snapshot.  When the same
+ * patient imports multiple such summaries, every clinical fact appears once per
+ * summary export.  A lower threshold (0.50) catches these cross-summary duplicates
+ * that would otherwise be missed at the standard threshold of 0.65.
+ *
+ * Additive documents (progress notes, discharge summaries) represent a single
+ * encounter; their records are kept at the standard 0.65 threshold.
+ */
+function getMatchThreshold(a, b) {
+    const aIsSummary = getProp(a, NS.cascade + 'documentType') === 'summarization';
+    const bIsSummary = getProp(b, NS.cascade + 'documentType') === 'summarization';
+    if (aIsSummary || bIsSummary)
+        return 0.50;
+    return 0.65;
+}
 function doRecordsMatch(a, b, tol) {
     if (a.type !== b.type)
         return { match: false, confidence: 0, matchedOn: '' };
@@ -153,6 +215,8 @@ function doRecordsMatch(a, b, tol) {
         case 'health:AllergyRecord': return matchAllergies(a, b);
         case 'health:LabResultRecord': return matchLabs(a, b, tol);
         case 'health:ImmunizationRecord': return matchImmunizations(a, b);
+        case 'clinical:VitalSign': return matchVitalSigns(a, b);
+        case 'cascade:PatientProfile': return matchPatientProfiles(a, b);
         default: return { match: false, confidence: 0, matchedOn: '' };
     }
 }
@@ -311,39 +375,143 @@ export async function runReconciliation(inputs, options) {
     // Match and group
     const groups = [];
     const assigned = new Set();
-    for (let i = 0; i < allRecords.length; i++) {
-        const a = allRecords[i];
-        if (assigned.has(a.uri))
-            continue;
-        if (a.type === 'cascade:PatientProfile' || a.type === 'coverage:InsurancePlan') {
-            groups.push({ matchType: 'pass_through', confidence: 1.0, records: [a], matchedOn: 'profile' });
+    const hasExistingPod = allRecords.some(r => r.sourceSystem === 'existing-pod');
+    if (hasExistingPod) {
+        // ---------------------------------------------------------------------------
+        // Fast path: O(n_new × k) type-indexed matching for --reconcile-existing mode
+        // ---------------------------------------------------------------------------
+        const existingRecords = allRecords.filter(r => r.sourceSystem === 'existing-pod');
+        const newRecords = allRecords.filter(r => r.sourceSystem !== 'existing-pod');
+        // Build a type index over existing records only
+        const existingIndex = new Map();
+        for (const r of existingRecords) {
+            const bucket = existingIndex.get(r.type);
+            if (bucket)
+                bucket.push(r);
+            else
+                existingIndex.set(r.type, [r]);
+        }
+        // Cross-batch pass: match each new record against same-type existing records
+        for (const a of newRecords) {
+            if (assigned.has(a.uri))
+                continue;
+            if (a.type === 'coverage:InsurancePlan') {
+                groups.push({ matchType: 'pass_through', confidence: 1.0, records: [a], matchedOn: 'coverage' });
+                assigned.add(a.uri);
+                continue;
+            }
+            const matched = [a];
+            let matchedOn = '';
+            let bestConf = 1.0;
+            const candidates = existingIndex.get(a.type) ?? [];
+            for (const b of candidates) {
+                if (assigned.has(b.uri) || a.sourceSystem === b.sourceSystem)
+                    continue;
+                const { match, confidence, matchedOn: mo } = doRecordsMatch(a, b, labTol);
+                const threshold = getMatchThreshold(a, b);
+                if (match && confidence >= threshold) {
+                    matched.push(b);
+                    assigned.add(b.uri);
+                    if (!matchedOn) {
+                        matchedOn = mo;
+                        bestConf = confidence;
+                    }
+                }
+            }
             assigned.add(a.uri);
-            continue;
+            if (matched.length === 1) {
+                groups.push({ matchType: 'pass_through', confidence: 1.0, records: matched, matchedOn: '' });
+            }
+            else {
+                const { matchType, conflictField, conflictValues } = classifyGroup(matched, labTol);
+                groups.push({ matchType, confidence: bestConf, records: matched, matchedOn, conflictField, conflictValues });
+            }
         }
-        const matched = [a];
-        let matchedOn = '';
-        let bestConf = 1.0;
-        for (let j = i + 1; j < allRecords.length; j++) {
-            const b = allRecords[j];
-            if (assigned.has(b.uri) || a.sourceSystem === b.sourceSystem)
+        // Within-batch pass: pairwise loop over newRecords only (existing-pod records
+        // from the same sourceSystem never match each other)
+        for (let i = 0; i < newRecords.length; i++) {
+            const a = newRecords[i];
+            if (assigned.has(a.uri))
                 continue;
-            const { match, confidence, matchedOn: mo } = doRecordsMatch(a, b, labTol);
-            if (match && confidence >= 0.65) {
-                matched.push(b);
-                assigned.add(b.uri);
-                if (!matchedOn) {
-                    matchedOn = mo;
-                    bestConf = confidence;
+            if (a.type === 'coverage:InsurancePlan') {
+                // Already handled above; skip if already assigned
+                continue;
+            }
+            const matched = [a];
+            let matchedOn = '';
+            let bestConf = 1.0;
+            for (let j = i + 1; j < newRecords.length; j++) {
+                const b = newRecords[j];
+                if (assigned.has(b.uri) || a.sourceSystem === b.sourceSystem)
+                    continue;
+                const { match, confidence, matchedOn: mo } = doRecordsMatch(a, b, labTol);
+                const threshold = getMatchThreshold(a, b);
+                if (match && confidence >= threshold) {
+                    matched.push(b);
+                    assigned.add(b.uri);
+                    if (!matchedOn) {
+                        matchedOn = mo;
+                        bestConf = confidence;
+                    }
                 }
             }
+            assigned.add(a.uri);
+            if (matched.length === 1) {
+                groups.push({ matchType: 'pass_through', confidence: 1.0, records: matched, matchedOn: '' });
+            }
+            else {
+                const { matchType, conflictField, conflictValues } = classifyGroup(matched, labTol);
+                groups.push({ matchType, confidence: bestConf, records: matched, matchedOn, conflictField, conflictValues });
+            }
         }
-        assigned.add(a.uri);
-        if (matched.length === 1) {
-            groups.push({ matchType: 'pass_through', confidence: 1.0, records: matched, matchedOn: '' });
+        // Existing-pod pass-through: records not matched into any group must still
+        // appear as their own pass-through groups so they are written back to the pod
+        for (const r of existingRecords) {
+            if (assigned.has(r.uri))
+                continue;
+            groups.push({ matchType: 'pass_through', confidence: 1.0, records: [r], matchedOn: '' });
+            assigned.add(r.uri);
         }
-        else {
-            const { matchType, conflictField, conflictValues } = classifyGroup(matched, labTol);
-            groups.push({ matchType, confidence: bestConf, records: matched, matchedOn, conflictField, conflictValues });
+    }
+    else {
+        // ---------------------------------------------------------------------------
+        // Original O(n²) algorithm — unchanged when no existing-pod records present
+        // ---------------------------------------------------------------------------
+        for (let i = 0; i < allRecords.length; i++) {
+            const a = allRecords[i];
+            if (assigned.has(a.uri))
+                continue;
+            if (a.type === 'coverage:InsurancePlan') {
+                groups.push({ matchType: 'pass_through', confidence: 1.0, records: [a], matchedOn: 'coverage' });
+                assigned.add(a.uri);
+                continue;
+            }
+            const matched = [a];
+            let matchedOn = '';
+            let bestConf = 1.0;
+            for (let j = i + 1; j < allRecords.length; j++) {
+                const b = allRecords[j];
+                if (assigned.has(b.uri) || a.sourceSystem === b.sourceSystem)
+                    continue;
+                const { match, confidence, matchedOn: mo } = doRecordsMatch(a, b, labTol);
+                const threshold = getMatchThreshold(a, b);
+                if (match && confidence >= threshold) {
+                    matched.push(b);
+                    assigned.add(b.uri);
+                    if (!matchedOn) {
+                        matchedOn = mo;
+                        bestConf = confidence;
+                    }
+                }
+            }
+            assigned.add(a.uri);
+            if (matched.length === 1) {
+                groups.push({ matchType: 'pass_through', confidence: 1.0, records: matched, matchedOn: '' });
+            }
+            else {
+                const { matchType, conflictField, conflictValues } = classifyGroup(matched, labTol);
+                groups.push({ matchType, confidence: bestConf, records: matched, matchedOn, conflictField, conflictValues });
+            }
         }
     }
     // Resolve
@@ -367,6 +535,7 @@ export async function runReconciliation(inputs, options) {
             conflictField: g.conflictField,
             conflictValues: g.conflictValues,
             resolved: res.resolved,
+            documentType: getProp(g.records[0], NS.cascade + 'documentType'),
         };
         switch (g.matchType) {
             case 'exact_duplicate':
@@ -383,7 +552,7 @@ export async function runReconciliation(inputs, options) {
         if (g.matchType !== 'pass_through')
             transformations.push(t);
         if (!res.resolved)
-            unresolvedList.push(t);
+            unresolvedList.push({ ...t, candidateUris: g.records.map(r => r.uri) });
     }
     return {
         turtle,