DevSoftTech Server
5d6acdd480
- add facility QR support and OPD queue bridge fixes - support care-context push warnings for lab, radiology, IPD and remaining HI types - improve ABHA patient matching and diagnosis autocomplete performance - clean up webcam streams on page navigation
587 lines
22 KiB
PHP
587 lines
22 KiB
PHP
<?php
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namespace App\Libraries;
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use CodeIgniter\Database\BaseConnection;
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/**
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* SNOMED CT terminology service.
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* Priority: local DB (snomed_description + snomed_concept tables).
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* Falls back to external csnotk.e-atria.in API only when local tables are absent.
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*/
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class CsnotkTerminologyService
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{
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/** SNOMED type_id for Fully Specified Names (ends with semantic tag in parentheses) */
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private const FSN_TYPE_ID = '900000000000003001';
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private string $baseUrl;
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private int $timeoutSec;
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private bool $apiEnabled;
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private ?BaseConnection $db = null;
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private bool $localAvailable = false;
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private bool $hasFtIndex = false;
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public function __construct()
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{
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$baseUrl = trim((string) env('snomed.csnotk.baseUrl', ''));
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if ($baseUrl === '') {
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$baseUrl = trim((string) env('CSNOTK_BASE_URL', 'https://csnotk.e-atria.in'));
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}
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$this->baseUrl = rtrim($baseUrl, '/');
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$this->timeoutSec = max(1, (int) env('snomed.csnotk.timeoutSec', 5));
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$enabledRaw = strtolower(trim((string) env('snomed.csnotk.enabled', env('CSNOTK_ENABLED', ''))));
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$this->apiEnabled = in_array($enabledRaw, ['1', 'true', 'yes', 'on'], true) || $this->baseUrl !== '';
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try {
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$db = db_connect();
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if ($db->tableExists('snomed_description') && $db->tableExists('snomed_concept')) {
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$this->db = $db;
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$this->localAvailable = true;
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$this->hasFtIndex = $this->checkFtIndex($db);
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}
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} catch (\Throwable $e) {
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// Local DB not available — will fall through to API
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}
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}
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public function isEnabled(): bool
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{
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return $this->localAvailable || ($this->apiEnabled && $this->baseUrl !== '');
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}
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// ─── Public search API ────────────────────────────────────────────────
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/**
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* General diagnosis search (findings + disorders).
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* @return array<int, array{concept_id:string,term:string,source:string}>
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*/
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public function searchDiagnosis(string $query, int $limit = 20): array
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{
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$q = trim($query);
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if ($q === '') {
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return [];
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}
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$limit = max(1, min(50, $limit));
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// Local DB is primary — ~17ms vs ~330ms for external API from server
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$rows = $this->localSearch($q, $limit, ['finding', 'disorder', 'morphologic abnormality', 'disease']);
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if (count($rows) < $limit && mb_strlen($q) >= 3 && $this->apiEnabled && $this->baseUrl !== '') {
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$rows = $this->mergeFallback($rows, $this->apiSearchDiagnosis($q, $limit), $limit);
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}
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return array_map(fn ($r) => [
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'concept_id' => (string) ($r['concept_id'] ?? ''),
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'term' => (string) ($r['term'] ?? ''),
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'source' => (string) ($r['source'] ?? 'local'),
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], array_slice($rows, 0, $limit));
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}
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/**
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* Search for clinical findings / symptoms / disorders (for chief complaints autocomplete).
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* @return array<int, array{concept_id:string,term:string,fsn:string,hierarchy:string,source:string}>
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*/
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public function searchFinding(string $query, int $limit = 20): array
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{
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$q = trim($query);
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if ($q === '') {
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return [];
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}
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$limit = max(1, min(50, $limit));
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// Local DB is primary — ~17ms vs ~330ms for external API from server
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$rows = $this->localSearch($q, $limit, ['finding', 'disorder']);
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if (count($rows) < $limit && mb_strlen($q) >= 3 && $this->apiEnabled && $this->baseUrl !== '') {
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$rows = $this->mergeFallback($rows, $this->apiSearchBySemTag($q, $limit, ['finding', 'disorder']), $limit);
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}
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return array_slice($rows, 0, $limit);
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}
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/**
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* Search for SNOMED CT substance / pharmaceutical product concepts.
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* Used for medicine SNOMED CT coding on the opd_medicince page.
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*
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* Semantic tags searched: substance, product, medicinal product
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* Local DB first (snomed_description), falls back to CSNOtk API.
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*
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* @return array<int, array{concept_id:string,term:string,fsn:string,hierarchy:string,source:string}>
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*/
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public function searchSubstance(string $query, int $limit = 15): array
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{
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$q = trim($query);
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if ($q === '') {
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return [];
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}
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$limit = max(1, min(50, $limit));
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$substanceTags = ['substance', 'product', 'medicinal product', 'clinical drug'];
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$rows = $this->localSearch($q, $limit, $substanceTags);
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if (count($rows) < $limit && mb_strlen($q) >= 3 && $this->apiEnabled && $this->baseUrl !== '') {
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// CSNOtk: search substance tag first, then product tag as fallback
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$apiRows = $this->apiSearchBySemTag($q, $limit, ['substance', 'product']);
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$rows = $this->mergeFallback($rows, $apiRows, $limit);
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}
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// If still empty try broader local search and filter post-hoc for drug-related terms
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if (empty($rows) && $this->localAvailable) {
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$broader = $this->localSearch($q, $limit, []);
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$rows = array_filter($broader, static function (array $r) use ($substanceTags): bool {
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$h = mb_strtolower((string) ($r['hierarchy'] ?? ''));
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foreach ($substanceTags as $tag) {
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if ($h === $tag || str_contains($h, $tag)) {
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return true;
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}
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}
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return false;
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});
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$rows = array_values($rows);
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}
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return array_slice($rows, 0, $limit);
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}
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/**
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* Search for procedures / observable entities (for investigation advice autocomplete).
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* @return array<int, array{concept_id:string,term:string,fsn:string,hierarchy:string,source:string}>
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*/
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public function searchProcedure(string $query, int $limit = 20): array
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{
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$q = trim($query);
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if ($q === '') {
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return [];
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}
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$limit = max(1, min(50, $limit));
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// Local DB is primary — ~17ms vs ~330ms for external API from server
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$rows = $this->localSearch($q, $limit, ['procedure', 'observable entity', 'regime/therapy']);
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if (count($rows) < $limit && mb_strlen($q) >= 3 && $this->apiEnabled && $this->baseUrl !== '') {
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$rows = $this->mergeFallback($rows, $this->apiSearchBySemTag($q, $limit, ['procedure', 'observable entity']), $limit);
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}
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return array_slice($rows, 0, $limit);
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}
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// ─── Local DB search ──────────────────────────────────────────────────
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/**
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* Search local snomed_description.
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* Uses FULLTEXT MATCH if index exists, falls back to prefix then substring LIKE.
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*
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* @param string[] $semanticTags e.g. ['finding','disorder'] — matched against FSN suffix
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* @return array<int, array{concept_id:string,term:string,fsn:string,hierarchy:string,source:string}>
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*/
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private function localSearch(string $q, int $limit, array $semanticTags = []): array
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{
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if (! $this->localAvailable || $this->db === null) {
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return [];
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}
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$fetchLimit = max($limit * 5, 100);
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// 1. Try FULLTEXT
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$dbRows = $this->hasFtIndex ? $this->localFtSearch($q, $fetchLimit) : [];
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// 2. Try prefix on term_normalized (indexed)
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if (empty($dbRows)) {
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$dbRows = $this->localPrefixSearch($q, $fetchLimit);
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}
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// 3. Try substring (slower — full scan but catches mid-word)
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if (empty($dbRows)) {
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$dbRows = $this->localSubstringSearch($q, $fetchLimit);
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}
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return $this->filterAndFormat($dbRows, $semanticTags, $limit);
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}
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/**
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* FULLTEXT MATCH ... AGAINST (Boolean Mode) search.
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* @return array<int, array<string, string>>
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*/
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private function localFtSearch(string $q, int $limit): array
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{
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$words = preg_split('/\s+/', mb_strtolower(trim($q))) ?: [$q];
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$ftWords = array_filter($words, fn ($w) => mb_strlen($w) >= 3);
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if (empty($ftWords)) {
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// FT cannot handle words shorter than innodb_ft_min_token_size (default 3)
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return $this->localPrefixSearch($q, $limit);
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}
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$ftQuery = implode(' ', array_map(fn ($w) => '+' . $w . '*', $ftWords));
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try {
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return (array) $this->db->query(
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"SELECT d.concept_id, d.term
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FROM snomed_description d
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INNER JOIN snomed_concept c ON c.concept_id = d.concept_id AND c.active = 1
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WHERE d.active = 1
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AND d.language_code = 'en'
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AND d.type_id = ?
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AND MATCH(d.term) AGAINST(? IN BOOLEAN MODE)
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ORDER BY d.term ASC
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LIMIT ?",
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[self::FSN_TYPE_ID, $ftQuery, $limit]
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)->getResultArray();
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} catch (\Throwable $e) {
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$this->hasFtIndex = false; // Index may not exist yet — disable for this request
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return $this->localPrefixSearch($q, $limit);
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}
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}
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/**
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* Prefix search: term_normalized LIKE 'query%' (uses B-tree index).
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* @return array<int, array<string, string>>
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*/
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private function localPrefixSearch(string $q, int $limit): array
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{
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$norm = mb_strtolower(trim($q));
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try {
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return (array) $this->db->query(
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"SELECT d.concept_id, d.term
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FROM snomed_description d
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INNER JOIN snomed_concept c ON c.concept_id = d.concept_id AND c.active = 1
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WHERE d.active = 1
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AND d.language_code = 'en'
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AND d.type_id = ?
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AND d.term_normalized LIKE ?
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ORDER BY d.term ASC
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LIMIT ?",
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[self::FSN_TYPE_ID, $norm . '%', $limit]
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)->getResultArray();
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} catch (\Throwable $e) {
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return [];
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}
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}
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/**
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* Substring search: term_normalized LIKE '%query%' (full scan — slower).
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* @return array<int, array<string, string>>
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*/
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private function localSubstringSearch(string $q, int $limit): array
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{
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$norm = mb_strtolower(trim($q));
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try {
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return (array) $this->db->query(
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"SELECT d.concept_id, d.term
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FROM snomed_description d
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INNER JOIN snomed_concept c ON c.concept_id = d.concept_id AND c.active = 1
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WHERE d.active = 1
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AND d.language_code = 'en'
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AND d.type_id = ?
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AND d.term_normalized LIKE ?
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ORDER BY d.term ASC
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LIMIT ?",
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[self::FSN_TYPE_ID, '%' . $norm . '%', $limit]
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)->getResultArray();
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} catch (\Throwable $e) {
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return [];
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}
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}
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/**
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* Filter raw DB rows by semantic tag and format for output.
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*
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* @param array<int, array<string, string>> $dbRows
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* @param string[] $semanticTags
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* @return array<int, array{concept_id:string,term:string,fsn:string,hierarchy:string,source:string}>
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*/
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private function filterAndFormat(array $dbRows, array $semanticTags, int $limit): array
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{
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$tagsLower = array_map('mb_strtolower', $semanticTags);
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$out = [];
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$seen = [];
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foreach ($dbRows as $row) {
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if (count($out) >= $limit) {
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break;
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}
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$conceptId = trim((string) ($row['concept_id'] ?? ''));
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$fsn = trim((string) ($row['term'] ?? ''));
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if ($conceptId === '' || $fsn === '') {
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continue;
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}
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if (isset($seen[$conceptId])) {
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continue;
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}
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// Extract semantic tag from FSN suffix: "Fever (finding)" → "finding"
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$hierarchy = '';
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$displayTerm = $fsn;
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if (preg_match('/^(.*)\(([^)]+)\)$/', $fsn, $m)) {
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$hierarchy = trim($m[2]);
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$displayTerm = trim($m[1]);
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}
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// Apply semantic tag filter
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if (! empty($tagsLower)) {
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if (! in_array(mb_strtolower($hierarchy), $tagsLower, true)) {
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continue;
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}
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}
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$seen[$conceptId] = true;
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$out[] = [
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'concept_id' => $conceptId,
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'term' => $displayTerm !== '' ? $displayTerm : $fsn,
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'fsn' => $fsn,
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'hierarchy' => $hierarchy,
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'source' => 'local',
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];
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}
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return $out;
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}
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// ─── External API fallbacks ───────────────────────────────────────────
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/**
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* @return array<int, array{concept_id:string,term:string,fsn:string,hierarchy:string,source:string}>
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*/
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private function apiSearchDiagnosis(string $q, int $limit): array
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{
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$rows = [];
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$seen = [];
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$search = $this->requestJson('/api/search/search', [
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'term' => $q,
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'state' => 'active',
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'acceptability' => 'all',
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'groupbyconcept' => 'true',
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'fullconcept' => 'false',
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'returnlimit' => (string) max(10, $limit * 2),
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]);
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foreach ($this->extractItems($search['data']) as $item) {
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if (! is_array($item) || count($rows) >= $limit) {
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break;
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}
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$conceptId = $this->readString($item, ['conceptId', 'concept_id', 'id']);
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$term = $this->readString($item, ['term', 'conceptFsn', 'name']);
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if (! preg_match('/^[0-9]{6,20}$/', $conceptId) || $term === '') {
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continue;
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}
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if (isset($seen[$conceptId])) {
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continue;
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}
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$seen[$conceptId] = true;
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$rows[] = ['concept_id' => $conceptId, 'term' => $term, 'fsn' => $term, 'hierarchy' => '', 'source' => 'csnotk'];
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}
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return $rows;
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}
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/**
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* @param string[] $semTags
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* @return array<int, array{concept_id:string,term:string,fsn:string,hierarchy:string,source:string}>
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*/
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private function apiSearchBySemTag(string $q, int $limit, array $semTags): array
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{
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$rows = [];
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$seen = [];
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foreach ($semTags as $semTag) {
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if (count($rows) >= $limit) {
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break;
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}
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$res = $this->requestJson('/api/search/suggest', [
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'term' => $q,
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'state' => 'active',
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'semantictag' => $semTag,
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'acceptability' => 'preferred',
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'returnlimit' => (string) max(10, $limit * 2),
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]);
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foreach ($this->extractItems($res['data']) as $item) {
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if (count($rows) >= $limit) {
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break;
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}
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$conceptId = '';
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$term = '';
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$fsn = '';
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$hierarchy = $semTag;
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if (is_string($item)) {
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$term = trim($item);
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} elseif (is_array($item)) {
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$conceptId = $this->readString($item, ['conceptId', 'concept_id', 'id']);
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$term = $this->readString($item, ['term', 'name']);
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$fsn = $this->readString($item, ['conceptFsn', 'fsn', 'fullySpecifiedName']);
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$hierarchy = $this->readString($item, ['hierarchy', 'semanticTag', 'semantictag']) ?: $semTag;
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$activeStatus = $item['activeStatus'] ?? $item['active_status'] ?? null;
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if ($activeStatus !== null && (int) $activeStatus !== 1) {
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continue;
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}
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if (strtolower((string) ($item['conceptState'] ?? $item['concept_state'] ?? 'active')) === 'inactive') {
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continue;
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}
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}
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if ($term === '') {
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continue;
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}
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$displayTerm = $fsn !== '' ? $fsn : $term;
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$key = strtoupper($displayTerm) . '|' . $conceptId;
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if (isset($seen[$key])) {
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continue;
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}
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$seen[$key] = true;
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$rows[] = [
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'concept_id' => $conceptId,
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'term' => $displayTerm,
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'fsn' => $fsn,
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'hierarchy' => $hierarchy,
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'source' => 'csnotk',
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];
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}
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}
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return $rows;
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}
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// ─── Shared helpers ───────────────────────────────────────────────────
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/**
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* Merge primary results with fallback rows, deduplicating by concept_id.
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*
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* @param array<int, array<string, string>> $primary
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* @param array<int, array<string, string>> $fallback
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* @return array<int, array<string, string>>
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*/
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private function mergeFallback(array $primary, array $fallback, int $limit): array
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{
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$seen = [];
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foreach ($primary as $r) {
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$k = (string) ($r['concept_id'] ?? '');
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if ($k !== '') {
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$seen[$k] = true;
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}
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}
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foreach ($fallback as $r) {
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if (count($primary) >= $limit) {
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break;
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}
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$k = (string) ($r['concept_id'] ?? '');
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if ($k !== '' && isset($seen[$k])) {
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continue;
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}
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if ($k !== '') {
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$seen[$k] = true;
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}
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$primary[] = $r;
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}
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return $primary;
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}
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private function checkFtIndex(BaseConnection $db): bool
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{
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try {
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$rows = $db->query(
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"SHOW INDEX FROM snomed_description WHERE Index_type = 'FULLTEXT' AND Column_name = 'term'"
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)->getResultArray();
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return ! empty($rows);
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} catch (\Throwable $e) {
|
|
return false;
|
|
}
|
|
}
|
|
|
|
/**
|
|
* @param array<string, mixed> $row
|
|
* @param array<int, string> $keys
|
|
*/
|
|
private function readString(array $row, array $keys): string
|
|
{
|
|
foreach ($keys as $key) {
|
|
if (! isset($row[$key])) {
|
|
continue;
|
|
}
|
|
$value = trim((string) $row[$key]);
|
|
if ($value !== '') {
|
|
return $value;
|
|
}
|
|
}
|
|
|
|
return '';
|
|
}
|
|
|
|
/**
|
|
* @param mixed $data
|
|
* @return array<int, mixed>
|
|
*/
|
|
private function extractItems($data): array
|
|
{
|
|
if (! is_array($data)) {
|
|
return [];
|
|
}
|
|
if ($this->isList($data)) {
|
|
return $data;
|
|
}
|
|
foreach (['rows', 'results', 'data', 'items'] as $key) {
|
|
if (isset($data[$key]) && is_array($data[$key])) {
|
|
return $this->isList($data[$key]) ? $data[$key] : [];
|
|
}
|
|
}
|
|
|
|
return [];
|
|
}
|
|
|
|
private function isList(array $arr): bool
|
|
{
|
|
return $arr === [] || array_keys($arr) === range(0, count($arr) - 1);
|
|
}
|
|
|
|
/**
|
|
* @param array<string, string> $query
|
|
* @return array{ok:bool,status:int,body:string,data:mixed}
|
|
*/
|
|
private function requestJson(string $path, array $query): array
|
|
{
|
|
if (! $this->apiEnabled || $this->baseUrl === '') {
|
|
return ['ok' => false, 'status' => 0, 'body' => '', 'data' => null];
|
|
}
|
|
|
|
$url = $this->baseUrl . $path;
|
|
$qs = http_build_query($query);
|
|
if ($qs !== '') {
|
|
$url .= (str_contains($url, '?') ? '&' : '?') . $qs;
|
|
}
|
|
|
|
$ch = curl_init();
|
|
curl_setopt_array($ch, [
|
|
CURLOPT_URL => $url,
|
|
CURLOPT_RETURNTRANSFER => true,
|
|
CURLOPT_CONNECTTIMEOUT => $this->timeoutSec,
|
|
CURLOPT_TIMEOUT => $this->timeoutSec,
|
|
CURLOPT_HTTPHEADER => ['Accept: application/json'],
|
|
]);
|
|
|
|
$body = curl_exec($ch);
|
|
$status = (int) curl_getinfo($ch, CURLINFO_HTTP_CODE);
|
|
$error = curl_error($ch);
|
|
curl_close($ch);
|
|
|
|
if ($body === false || $error !== '') {
|
|
return ['ok' => false, 'status' => $status, 'body' => '', 'data' => null];
|
|
}
|
|
|
|
$decoded = json_decode((string) $body, true);
|
|
|
|
return [
|
|
'ok' => $status >= 200 && $status < 300,
|
|
'status' => $status,
|
|
'body' => (string) $body,
|
|
'data' => $decoded,
|
|
];
|
|
}
|
|
}
|