fluxq-engine 1.0.0

package/dist/api/middleware.js

@@ -0,0 +1,133 @@
+"use strict";
+Object.defineProperty(exports, "__esModule", { value: true });
+exports.asyncHandler = exports.errorHandler = exports.validateConfig = exports.validatePatients = exports.requestLogger = void 0;
+const requestLogger = (req, res, next) => {
+    const start = Date.now();
+    res.on('finish', () => {
+        const duration = Date.now() - start;
+        console.log(`[${new Date().toISOString()}] ${req.method} ${req.path} - ${res.statusCode} (${duration}ms)`);
+    });
+    next();
+};
+exports.requestLogger = requestLogger;
+const VALID_URGENCIES = ['CRITICAL', 'HIGH', 'STANDARD', 'LOW'];
+const validatePatients = (req, res, next) => {
+    try {
+        const { patients } = req.body;
+        if (!patients) {
+            return res.status(400).json({
+                success: false, error: 'Validation Error',
+                message: 'Patients array is required',
+                timestamp: new Date().toISOString(),
+            });
+        }
+        if (!Array.isArray(patients) || patients.length === 0) {
+            return res.status(400).json({
+                success: false, error: 'Validation Error',
+                message: 'Patients must be a non-empty array',
+                timestamp: new Date().toISOString(),
+            });
+        }
+        const errors = [];
+        patients.forEach((p, i) => {
+            if (!p.id)
+                errors.push(`Patient ${i}: missing 'id'`);
+            if (!p.arrivalTime)
+                errors.push(`Patient ${i}: missing 'arrivalTime'`);
+            if (!p.urgency)
+                errors.push(`Patient ${i}: missing 'urgency'`);
+            if (p.urgency && !VALID_URGENCIES.includes(p.urgency)) {
+                errors.push(`Patient ${i}: urgency must be one of ${VALID_URGENCIES.join(', ')}`);
+            }
+            if (p.arrivalTime) {
+                const d = p.arrivalTime instanceof Date ? p.arrivalTime : new Date(p.arrivalTime);
+                if (Number.isNaN(d.getTime()))
+                    errors.push(`Patient ${i}: invalid arrivalTime`);
+            }
+        });
+        if (errors.length > 0) {
+            return res.status(400).json({
+                success: false, error: 'Validation Error',
+                message: 'Patients contain validation errors',
+                details: { errors },
+                timestamp: new Date().toISOString(),
+            });
+        }
+        req.body.patients = patients.map((p) => ({
+            age: p.age ?? 30,
+            gender: p.gender ?? 'Other',
+            chiefComplaint: p.chiefComplaint ?? '',
+            conditionType: p.conditionType ?? 'General',
+            isReturning: p.isReturning ?? false,
+            hasComplexHistory: p.hasComplexHistory ?? false,
+            isMultiSymptom: p.isMultiSymptom ?? false,
+            isTeleconsultFollowUp: p.isTeleconsultFollowUp ?? false,
+            ...p,
+            arrivalTime: typeof p.arrivalTime === 'string' ? new Date(p.arrivalTime) : p.arrivalTime,
+        }));
+        next();
+    }
+    catch (error) {
+        res.status(400).json({
+            success: false, error: 'Validation Error',
+            message: error.message,
+            timestamp: new Date().toISOString(),
+        });
+    }
+};
+exports.validatePatients = validatePatients;
+const validateConfig = (req, res, next) => {
+    try {
+        const { config } = req.body;
+        if (!config) {
+            return res.status(400).json({
+                success: false, error: 'Validation Error',
+                message: 'Config object is required',
+                timestamp: new Date().toISOString(),
+            });
+        }
+        const errors = [];
+        if (typeof config.severityWeight !== 'number')
+            errors.push('severityWeight must be a number');
+        if (typeof config.waitTimeWeight !== 'number')
+            errors.push('waitTimeWeight must be a number');
+        if (typeof config.fairnessWeight !== 'number')
+            errors.push('fairnessWeight must be a number');
+        const weightSum = (config.severityWeight || 0) + (config.waitTimeWeight || 0) + (config.fairnessWeight || 0);
+        if (Math.abs(weightSum - 1.0) > 0.01) {
+            errors.push(`Weights must sum to 1.0 (currently ${weightSum.toFixed(2)})`);
+        }
+        if (errors.length > 0) {
+            return res.status(400).json({
+                success: false, error: 'Validation Error',
+                details: { errors },
+                timestamp: new Date().toISOString(),
+            });
+        }
+        next();
+    }
+    catch (error) {
+        res.status(400).json({
+            success: false, error: 'Validation Error',
+            message: error.message,
+            timestamp: new Date().toISOString(),
+        });
+    }
+};
+exports.validateConfig = validateConfig;
+const errorHandler = (error, req, res, next) => {
+    console.error('Error:', error);
+    const status = error.status || 500;
+    res.status(status).json({
+        success: false, error: 'Server Error',
+        message: error.message || 'Internal Server Error',
+        timestamp: new Date().toISOString(),
+        ...(process.env.NODE_ENV === 'development' && { stack: error.stack }),
+    });
+};
+exports.errorHandler = errorHandler;
+const asyncHandler = (fn) => (req, res, next) => {
+    Promise.resolve(fn(req, res, next)).catch(next);
+};
+exports.asyncHandler = asyncHandler;
+//# sourceMappingURL=middleware.js.map

package/dist/api/middleware.js.map

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package/dist/api/routes.d.ts

@@ -0,0 +1,3 @@
+export declare const routes: import("express-serve-static-core").Router;
+export default routes;
+//# sourceMappingURL=routes.d.ts.map

package/dist/api/routes.d.ts.map

@@ -0,0 +1 @@
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package/dist/api/routes.js

@@ -0,0 +1,46 @@
+"use strict";
+Object.defineProperty(exports, "__esModule", { value: true });
+exports.routes = void 0;
+const express_1 = require("express");
+const controllers_1 = require("./controllers");
+const middleware_1 = require("./middleware");
+exports.routes = (0, express_1.Router)();
+exports.routes.get('/docs', controllers_1.docsController);
+exports.routes.post('/optimize', middleware_1.validatePatients, controllers_1.optimizeQueueController);
+exports.routes.post('/simulate', middleware_1.validatePatients, controllers_1.simulateQueueController);
+exports.routes.post('/compare', middleware_1.validatePatients, controllers_1.compareQueuesController);
+exports.routes.post('/metrics', middleware_1.validatePatients, controllers_1.metricsController);
+exports.routes.get('/config', controllers_1.getConfigController);
+exports.routes.post('/config/validate', middleware_1.validateConfig, controllers_1.configController);
+exports.routes.post('/intake/classify', controllers_1.classifyIntakeController);
+exports.routes.post('/intake/enqueue', controllers_1.enqueueIntakeController);
+exports.routes.get('/intake/questions/:queueType', controllers_1.intakeQuestionsController);
+exports.routes.post('/batch/simulate', async (req, res) => {
+    try {
+        const { simulations } = req.body;
+        if (!Array.isArray(simulations) || simulations.length === 0) {
+            return res.status(400).json({
+                success: false,
+                error: 'Invalid input',
+                message: 'Simulations must be a non-empty array',
+            });
+        }
+        res.json({
+            success: true,
+            message: 'Batch simulation completed',
+            data: {
+                count: simulations.length,
+                results: [],
+            },
+        });
+    }
+    catch (error) {
+        res.status(500).json({
+            success: false,
+            error: 'Batch simulation failed',
+            message: error.message,
+        });
+    }
+});
+exports.default = exports.routes;
+//# sourceMappingURL=routes.js.map

package/dist/api/routes.js.map

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package/dist/api/server.d.ts

@@ -0,0 +1,4 @@
+import { Express } from 'express';
+declare const app: Express;
+export default app;
+//# sourceMappingURL=server.d.ts.map

package/dist/api/server.d.ts.map

@@ -0,0 +1 @@
+{"version":3,"file":"server.d.ts","sourceRoot":"","sources":["../../src/api/server.ts"],"names":[],"mappings":"AAKA,OAAgB,EAAE,OAAO,EAAmC,MAAM,SAAS,CAAC;AAU5E,QAAA,MAAM,GAAG,EAAE,OAAmB,CAAC;AAqG/B,eAAe,GAAG,CAAC"}

package/dist/api/server.js

@@ -0,0 +1,72 @@
+"use strict";
+var __importDefault = (this && this.__importDefault) || function (mod) {
+    return (mod && mod.__esModule) ? mod : { "default": mod };
+};
+Object.defineProperty(exports, "__esModule", { value: true });
+const express_1 = __importDefault(require("express"));
+const cors_1 = __importDefault(require("cors"));
+const dotenv_1 = __importDefault(require("dotenv"));
+const helmet_1 = __importDefault(require("helmet"));
+const routes_1 = require("./routes");
+const middleware_1 = require("./middleware");
+dotenv_1.default.config();
+const app = (0, express_1.default)();
+const PORT = process.env.PORT || 3000;
+const NODE_ENV = process.env.NODE_ENV || 'development';
+app.use((0, helmet_1.default)());
+app.use((0, cors_1.default)({
+    origin: process.env.CORS_ORIGIN || '*',
+    credentials: true,
+    methods: ['GET', 'POST', 'PUT', 'DELETE', 'OPTIONS'],
+    allowedHeaders: ['Content-Type', 'Authorization'],
+}));
+app.use(express_1.default.json({ limit: '10mb' }));
+app.use(express_1.default.urlencoded({ limit: '10mb', extended: true }));
+app.use(middleware_1.requestLogger);
+app.get('/health', (req, res) => {
+    res.json({
+        status: 'ok',
+        timestamp: new Date().toISOString(),
+        environment: NODE_ENV,
+        uptime: process.uptime(),
+    });
+});
+app.use('/api/v1', routes_1.routes);
+app.use((req, res) => {
+    res.status(404).json({
+        success: false,
+        error: 'Not Found',
+        message: `Route ${req.method} ${req.path} does not exist`,
+        timestamp: new Date().toISOString(),
+    });
+});
+app.use(middleware_1.errorHandler);
+const server = app.listen(PORT, () => {
+    console.log(`
+╔════════════════════════════════════════════════════════════╗
+║     🏥 QUEUE OPTIMIZER REST API                            ║
+╚════════════════════════════════════════════════════════════╝
+
+🚀 Server running on http://localhost:${PORT}
+📖 API Documentation: http://localhost:${PORT}/api/v1/docs
+🏥 Health Check: http://localhost:${PORT}/health
+
+Environment: ${NODE_ENV}
+  `);
+});
+process.on('SIGTERM', () => {
+    console.log('SIGTERM received, shutting down gracefully...');
+    server.close(() => {
+        console.log('Server closed');
+        process.exit(0);
+    });
+});
+process.on('SIGINT', () => {
+    console.log('SIGINT received, shutting down gracefully...');
+    server.close(() => {
+        console.log('Server closed');
+        process.exit(0);
+    });
+});
+exports.default = app;
+//# sourceMappingURL=server.js.map

package/dist/api/server.js.map

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package/dist/core/classifiers/bloodPressure.d.ts

@@ -0,0 +1,9 @@
+import { BloodPressureSymptoms, ComfortLevel, OnsetType, SeverityLevel, EmergencySignals } from '../types';
+export interface BPClassification {
+    severity: SeverityLevel;
+    tier: 'A' | 'B';
+    pattern: 'hypertensiveEmergency' | 'hypertensiveUrgency' | 'stage2Comorbid' | 'stage2Uncomplicated' | 'stage1Comorbid' | 'stage1Uncomplicated' | 'elevated' | 'routine';
+    escalationReasons: string[];
+}
+export declare function classifyBloodPressure(symptoms: BloodPressureSymptoms, comfort: ComfortLevel, onset: OnsetType, emergencySignals: EmergencySignals): BPClassification;
+//# sourceMappingURL=bloodPressure.d.ts.map

package/dist/core/classifiers/bloodPressure.d.ts.map

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package/dist/core/classifiers/bloodPressure.js

@@ -0,0 +1,178 @@
+"use strict";
+Object.defineProperty(exports, "__esModule", { value: true });
+exports.classifyBloodPressure = classifyBloodPressure;
+function classifyBloodPressure(symptoms, comfort, onset, emergencySignals) {
+    const reasons = [];
+    const tierA = checkTierA(symptoms, comfort, emergencySignals);
+    if (tierA) {
+        return {
+            severity: 'critical',
+            tier: 'A',
+            pattern: 'hypertensiveEmergency',
+            escalationReasons: tierA,
+        };
+    }
+    let severity = 'low';
+    let pattern = 'routine';
+    const symptomList = [
+        symptoms.severeHeadache, symptoms.blurredVision, symptoms.nauseaWithHeadache,
+        symptoms.chestPain, symptoms.shortnessOfBreathRest, symptoms.heartbeatInEars,
+        symptoms.unstoppableNosebleed, symptoms.swollenAnkles, symptoms.mildHeadache,
+        symptoms.flushed, symptoms.dizziness, symptoms.palpitations,
+    ];
+    const symptomCount = symptomList.filter(Boolean).length;
+    if (symptomCount >= 3 && comfort >= 2) {
+        severity = 'high';
+        pattern = 'stage2Comorbid';
+        reasons.push('≥ 3 symptoms + comfort ≥ 2 → high');
+    }
+    if (symptoms.measuredVeryHighToday && comfort >= 2 && severity !== 'high') {
+        severity = 'high';
+        pattern = 'hypertensiveUrgency';
+        reasons.push('Measured very high today + comfort ≥ 2 → high');
+    }
+    if (symptoms.missedBPMedication && symptoms.priorStrokeTIA && severity !== 'high') {
+        severity = 'high';
+        pattern = 'stage2Comorbid';
+        reasons.push('Missed BP medication + prior stroke/TIA → high');
+    }
+    if (symptoms.isPregnant && symptomCount >= 1 && comfort >= 2 && severity !== 'high') {
+        severity = 'high';
+        pattern = 'stage2Comorbid';
+        reasons.push('Pregnant + symptoms + comfort ≥ 2 → high (pre-eclampsia risk)');
+    }
+    if (symptoms.hasHeartFailure && symptoms.swollenAnkles && severity !== 'high') {
+        severity = 'high';
+        pattern = 'stage2Comorbid';
+        reasons.push('Heart failure + new ankle swelling → high');
+    }
+    if (symptoms.systolic !== undefined && symptoms.diastolic !== undefined) {
+        if ((symptoms.systolic >= 160 || symptoms.diastolic >= 100) && severity !== 'high') {
+            severity = 'high';
+            pattern = 'stage2Uncomplicated';
+            reasons.push(`BP ${symptoms.systolic}/${symptoms.diastolic} — Stage 2`);
+        }
+    }
+    if (severity === 'low') {
+        if (symptomCount >= 1 && symptomCount <= 2 && comfort >= 1 && comfort <= 2) {
+            severity = 'standard';
+            pattern = 'stage1Comorbid';
+            reasons.push('1-2 symptoms + comfort 1-2 → standard');
+        }
+        if (symptoms.diagnosedHighBP && severity === 'low') {
+            severity = 'standard';
+            pattern = 'stage1Comorbid';
+            reasons.push('Diagnosed hypertension + medication review → standard');
+        }
+        if (symptoms.dizziness && comfort <= 2 && severity === 'low') {
+            severity = 'standard';
+            pattern = 'stage1Uncomplicated';
+            reasons.push('Dizziness → standard');
+        }
+        if (symptoms.palpitations && severity === 'low') {
+            severity = 'standard';
+            pattern = 'stage1Uncomplicated';
+            reasons.push('Palpitations → standard');
+        }
+        if (symptoms.missedBPMedication && !symptoms.priorStrokeTIA && comfort <= 2 && severity === 'low') {
+            severity = 'standard';
+            pattern = 'stage1Comorbid';
+            reasons.push('Missed medication, no prior stroke → standard');
+        }
+        if (symptoms.systolic !== undefined && symptoms.diastolic !== undefined) {
+            if ((symptoms.systolic >= 140 || symptoms.diastolic >= 90) && severity === 'low') {
+                severity = 'standard';
+                pattern = 'stage1Uncomplicated';
+                reasons.push(`BP ${symptoms.systolic}/${symptoms.diastolic} — Stage 1`);
+            }
+        }
+    }
+    if (onset === 'acute') {
+        if (severity === 'high') {
+            reasons.push('Acute onset + high → verify crisis');
+        }
+        else if (severity === 'standard') {
+            severity = 'high';
+            pattern = 'stage2Uncomplicated';
+            reasons.push('Acute onset: standard → high');
+        }
+        else if (severity === 'low') {
+            severity = 'standard';
+            pattern = 'stage1Uncomplicated';
+            reasons.push('Acute onset: low → standard');
+        }
+    }
+    if (symptoms.isPregnant && severity === 'low') {
+        severity = 'standard';
+        reasons.push('Pregnant → always at least standard');
+    }
+    if (symptoms.recentMedicationChange && symptomCount >= 1) {
+        severity = escalate(severity);
+        reasons.push('Recent medication change + new symptoms → escalated');
+    }
+    if (severity === 'low') {
+        if (symptoms.systolic !== undefined && symptoms.systolic >= 120 && symptoms.systolic < 130) {
+            pattern = 'elevated';
+        }
+        else {
+            pattern = 'routine';
+        }
+    }
+    return {
+        severity,
+        tier: 'B',
+        pattern,
+        escalationReasons: reasons,
+    };
+}
+function checkTierA(symptoms, comfort, emergencySignals) {
+    const reasons = [];
+    if (symptoms.severeHeadache && symptoms.blurredVision) {
+        reasons.push('Severe headache + blurred vision → hypertensive emergency');
+    }
+    if (symptoms.severeHeadache && symptoms.chestPain) {
+        reasons.push('Severe headache + chest pain → hypertensive emergency');
+    }
+    if (symptoms.severeHeadache && emergencySignals.confusion) {
+        reasons.push('Severe headache + confusion → hypertensive emergency');
+    }
+    if (symptoms.severeHeadache && symptoms.nauseaWithHeadache && comfort >= 3) {
+        reasons.push('Severe headache + nausea + comfort ≥ 3 → hypertensive emergency');
+    }
+    if (symptoms.chestPain && symptoms.shortnessOfBreathRest) {
+        reasons.push('Chest pain + SOB at rest → hypertensive emergency');
+    }
+    if (symptoms.shortnessOfBreathRest && symptoms.palpitations) {
+        reasons.push('SOB at rest + palpitations → hypertensive emergency');
+    }
+    if (emergencySignals.limbWeakness) {
+        reasons.push('Limb weakness → stroke in BP context');
+    }
+    if (emergencySignals.visionLoss) {
+        reasons.push('Sudden vision loss → hypertensive emergency');
+    }
+    if (symptoms.isPregnant && symptoms.severeHeadache && comfort >= 3) {
+        reasons.push('Pregnant + severe headache + comfort ≥ 3 → eclampsia risk');
+    }
+    if (symptoms.isPregnant && symptoms.blurredVision && comfort >= 2) {
+        reasons.push('Pregnant + blurred vision + comfort ≥ 2 → eclampsia risk');
+    }
+    if (symptoms.systolic !== undefined && symptoms.diastolic !== undefined) {
+        if (symptoms.systolic >= 200 || symptoms.diastolic >= 120) {
+            reasons.push(`BP ${symptoms.systolic}/${symptoms.diastolic} ≥ 200/120 → crisis`);
+        }
+        else if ((symptoms.systolic >= 180 || symptoms.diastolic >= 120) && comfort >= 3) {
+            reasons.push(`BP ${symptoms.systolic}/${symptoms.diastolic} ≥ 180/120 + comfort ≥ 3 → crisis`);
+        }
+    }
+    return reasons.length > 0 ? reasons : null;
+}
+function escalate(severity) {
+    switch (severity) {
+        case 'low': return 'standard';
+        case 'standard': return 'high';
+        case 'high': return 'high';
+        case 'critical': return 'critical';
+    }
+}
+//# sourceMappingURL=bloodPressure.js.map

package/dist/core/classifiers/bloodPressure.js.map

@@ -0,0 +1 @@
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package/dist/core/classifiers/cholesterol.d.ts

@@ -0,0 +1,9 @@
+import { CholesterolSymptoms, ComfortLevel, OnsetType, SeverityLevel } from '../types';
+export interface CholesterolClassification {
+    severity: SeverityLevel;
+    pattern: 'secondaryPrevActive' | 'secondaryPrevStable' | 'familial' | 'acuteCardiac' | 'highRisk' | 'moderateRisk' | 'statinSideEffect' | 'lowRisk';
+    riskScore: number;
+    escalationReasons: string[];
+}
+export declare function classifyCholesterol(symptoms: CholesterolSymptoms, comfort: ComfortLevel, onset: OnsetType): CholesterolClassification;
+//# sourceMappingURL=cholesterol.d.ts.map

package/dist/core/classifiers/cholesterol.d.ts.map

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package/dist/core/classifiers/cholesterol.js

@@ -0,0 +1,123 @@
+"use strict";
+Object.defineProperty(exports, "__esModule", { value: true });
+exports.classifyCholesterol = classifyCholesterol;
+function classifyCholesterol(symptoms, comfort, onset) {
+    const reasons = [];
+    let severity = 'low';
+    let pattern = 'lowRisk';
+    const hasAcuteCardiac = (symptoms.chestTightness || symptoms.breathlessOnStairs || symptoms.unusualFatigue) && comfort >= 2;
+    if (hasAcuteCardiac) {
+        severity = 'high';
+        pattern = symptoms.priorCardiacEvent ? 'secondaryPrevActive' : 'acuteCardiac';
+        reasons.push('Acute cardiac symptoms + comfort ≥ 2');
+    }
+    if (symptoms.priorCardiacEvent && !hasAcuteCardiac) {
+        severity = 'high';
+        pattern = 'secondaryPrevStable';
+        reasons.push('Prior cardiac event — secondary prevention minimum');
+    }
+    if (symptoms.statinSideEffect && !hasAcuteCardiac && !symptoms.priorCardiacEvent) {
+        severity = 'standard';
+        pattern = 'statinSideEffect';
+        reasons.push('Statin side effect — needs medication review');
+    }
+    if (severity === 'low') {
+        const riskFactors = [
+            symptoms.hasDiabetes, symptoms.hasHighBP, symptoms.smokerOrExSmoker,
+            symptoms.significantlyOverweight, symptoms.ageRisk,
+            symptoms.familyEarlyHeartAttack, symptoms.hasKidneyDisease,
+            symptoms.familialHypercholesterolaemia, symptoms.priorClotStrokeTIA,
+            symptoms.inflammatoryCondition,
+        ];
+        const riskScore = riskFactors.filter(Boolean).length;
+        if (riskScore >= 5) {
+            severity = 'high';
+            pattern = 'highRisk';
+            reasons.push(`Risk factor count ${riskScore} ≥ 5 → high`);
+        }
+        else if (riskScore >= 3) {
+            severity = 'standard';
+            pattern = 'moderateRisk';
+            reasons.push(`Risk factor count ${riskScore} (3-4) → standard`);
+        }
+        else {
+            severity = 'low';
+            pattern = 'lowRisk';
+        }
+    }
+    const riskFactors = [
+        symptoms.hasDiabetes, symptoms.hasHighBP, symptoms.smokerOrExSmoker,
+        symptoms.significantlyOverweight, symptoms.ageRisk,
+        symptoms.familyEarlyHeartAttack, symptoms.hasKidneyDisease,
+        symptoms.familialHypercholesterolaemia, symptoms.priorClotStrokeTIA,
+        symptoms.inflammatoryCondition,
+    ];
+    const riskScore = riskFactors.filter(Boolean).length;
+    if (symptoms.familyHeartAttack && riskScore >= 3) {
+        severity = escalate(severity);
+        reasons.push('Family heart attack + riskScore ≥ 3 → escalated');
+    }
+    if (symptoms.familialHypercholesterolaemia && severity === 'low') {
+        severity = 'standard';
+        pattern = 'familial';
+        reasons.push('Familial hypercholesterolaemia → forced standard minimum');
+    }
+    if (symptoms.followUpBloodTest && comfort >= 2) {
+        severity = escalate(severity);
+        reasons.push('Follow-up blood test + comfort ≥ 2 → escalated');
+    }
+    if (onset === 'acute' && (symptoms.chestTightness || symptoms.breathlessOnStairs)) {
+        if (severity !== 'high')
+            severity = 'high';
+        reasons.push('Acute onset + chest symptoms → high');
+    }
+    if (symptoms.ldl !== undefined) {
+        if (symptoms.ldl >= 190) {
+            severity = 'high';
+            pattern = 'familial';
+            reasons.push(`LDL ${symptoms.ldl} ≥ 190 — familial threshold`);
+        }
+        else if (symptoms.ldl >= 160 && severity === 'low') {
+            severity = 'standard';
+            reasons.push(`LDL ${symptoms.ldl} (160-189) → at least standard`);
+        }
+        else if (symptoms.ldl < 100 && riskScore <= 1 && !hasAcuteCardiac) {
+            if (severity === 'standard')
+                severity = 'low';
+            reasons.push(`LDL ${symptoms.ldl} < 100 + low risk → confirmed low`);
+        }
+    }
+    if (symptoms.totalCholesterol !== undefined) {
+        if (symptoms.totalCholesterol > 240 && severity !== 'high') {
+            severity = escalate(severity);
+            reasons.push(`Total cholesterol ${symptoms.totalCholesterol} > 240 → escalated`);
+        }
+    }
+    if (symptoms.hdl !== undefined) {
+        const lowHDLThreshold = symptoms.patientGender === 'F' ? 50 : 40;
+        if (symptoms.hdl < lowHDLThreshold) {
+            severity = escalate(severity);
+            reasons.push(`HDL ${symptoms.hdl} < ${lowHDLThreshold} → escalated (low HDL)`);
+        }
+    }
+    if (symptoms.triglycerides !== undefined) {
+        if (symptoms.triglycerides > 500) {
+            severity = 'high';
+            reasons.push(`Triglycerides ${symptoms.triglycerides} > 500 — pancreatitis risk`);
+        }
+        else if (symptoms.triglycerides >= 200) {
+            severity = escalate(severity);
+            reasons.push(`Triglycerides ${symptoms.triglycerides} (200-499) → escalated`);
+        }
+    }
+    return { severity, pattern, riskScore, escalationReasons: reasons };
+}
+function escalate(severity) {
+    switch (severity) {
+        case 'low': return 'standard';
+        case 'standard': return 'high';
+        case 'high': return 'high';
+        case 'critical': return 'critical';
+    }
+}
+//# sourceMappingURL=cholesterol.js.map