364 lines
13 KiB
Python
364 lines
13 KiB
Python
"""
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OT Scoring Service
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Handles scoring calculations for OT consultations with dynamic configuration support.
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"""
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from django.db.models import Q
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from .models import OTConsult, OTScoringConfig
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class OTScoringService:
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"""
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Service class for calculating OT consultation scores.
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Supports dynamic scoring configuration.
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"""
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def __init__(self, consult: OTConsult):
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"""
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Initialize scoring service for a consultation.
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Args:
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consult: OTConsult instance to score
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"""
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self.consult = consult
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self.config = self._get_active_config()
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def _get_active_config(self) -> OTScoringConfig:
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"""Get active scoring configuration for the tenant."""
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config = OTScoringConfig.objects.filter(
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tenant=self.consult.tenant,
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is_active=True
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).first()
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if not config:
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# Create default configuration if none exists
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config = OTScoringConfig.objects.create(
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tenant=self.consult.tenant,
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name="Default OT Scoring Configuration",
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is_active=True
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)
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return config
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def calculate_self_help_score(self) -> int:
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"""
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Calculate self-help skills score.
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Returns:
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Score based on yes/no responses (yes=2, no=0)
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"""
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score = 0
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for skill in self.consult.self_help_skills.all():
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if skill.response == 'yes':
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score += 2
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return min(score, self.config.self_help_max)
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def calculate_behavior_score(self) -> int:
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"""
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Calculate behavior score from infant and current behaviors.
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Returns:
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Score based on responses (yes=2, sometimes=1, no=0)
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"""
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score = 0
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# Infant behaviors
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for behavior in self.consult.infant_behaviors.all():
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if behavior.response == 'yes':
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score += 2
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elif behavior.response == 'sometimes':
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score += 1
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# Current behaviors
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for behavior in self.consult.current_behaviors.all():
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if behavior.response == 'yes':
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score += 2
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elif behavior.response == 'sometimes':
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score += 1
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return min(score, self.config.behavior_max)
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def calculate_developmental_score(self) -> int:
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"""
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Calculate developmental milestones score.
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Only counts required milestones.
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Returns:
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Score based on required milestones achieved (2 points each)
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"""
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score = 0
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required_milestones = self.consult.milestones.filter(is_required=True)
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for milestone in required_milestones:
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if milestone.age_achieved and milestone.age_achieved.strip():
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score += 2
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return min(score, self.config.developmental_max)
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def calculate_eating_score(self) -> int:
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"""
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Calculate eating/feeding score.
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Returns:
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Score based on yes/no responses (yes=2, no=0)
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"""
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score = 0
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if self.consult.eats_healthy_variety:
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score += 2
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if self.consult.eats_variety_textures:
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score += 2
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if self.consult.participates_family_meals:
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score += 2
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return min(score, self.config.eating_max)
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def calculate_total_score(self) -> dict:
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"""
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Calculate all scores and interpretation.
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Returns:
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Dictionary with all scores and interpretation
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"""
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self_help = self.calculate_self_help_score()
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behavior = self.calculate_behavior_score()
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developmental = self.calculate_developmental_score()
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eating = self.calculate_eating_score()
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total = self_help + behavior + developmental + eating
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# Determine interpretation based on thresholds
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if total <= self.config.immediate_attention_threshold:
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interpretation = self.config.immediate_attention_label
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recommendation = self.config.immediate_attention_recommendation
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elif total <= self.config.moderate_difficulty_threshold:
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interpretation = self.config.moderate_difficulty_label
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recommendation = self.config.moderate_difficulty_recommendation
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else:
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interpretation = self.config.age_appropriate_label
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recommendation = self.config.age_appropriate_recommendation
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# Check for critical flags
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critical_flags = self._get_critical_flags()
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if critical_flags:
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recommendation += "\n\n⚠ Additional concerns flagged: " + "; ".join(critical_flags)
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recommendation += ". These should be reviewed in the full evaluation."
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return {
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'self_help': self_help,
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'behavior': behavior,
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'developmental': developmental,
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'eating': eating,
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'total': total,
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'interpretation': interpretation,
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'recommendation': recommendation,
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'critical_flags': critical_flags,
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'max_scores': {
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'self_help': self.config.self_help_max,
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'behavior': self.config.behavior_max,
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'developmental': self.config.developmental_max,
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'eating': self.config.eating_max,
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'total': self.config.total_max_score,
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}
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}
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def _get_critical_flags(self) -> list:
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"""
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Identify critical concerns that need attention.
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Returns:
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List of critical concern descriptions
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"""
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flags = []
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# Check for developmental regression
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if self.consult.motor_skill_regression:
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flags.append("Developmental regression reported")
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# Check for irregular sleep patterns in infancy
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infant_sleep = self.consult.infant_behaviors.filter(
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behavior='sleepIrregular',
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response='yes'
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).first()
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if infant_sleep:
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flags.append("Irregular sleep patterns (infancy)")
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# Check for feeding difficulties
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if self.consult.eats_variety_textures is False:
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flags.append("Feeding difficulty with textures")
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# Check for aggressive behavior
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current_fights = self.consult.current_behaviors.filter(
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behavior='fights',
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response='yes'
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).first()
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if current_fights:
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flags.append("Frequent aggressive behavior (fights)")
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# Check for frequent tantrums
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current_tantrums = self.consult.current_behaviors.filter(
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behavior='tantrums',
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response='yes'
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).first()
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if current_tantrums:
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flags.append("Frequent temper tantrums")
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# Check for high restlessness
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current_restless = self.consult.current_behaviors.filter(
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behavior='restless',
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response='yes'
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).first()
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if current_restless:
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flags.append("High restlessness and inattention")
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# Check for resistance to change
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current_resistant = self.consult.current_behaviors.filter(
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behavior='resistant',
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response='yes'
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).first()
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if current_resistant:
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flags.append("Strong resistance to change or routines")
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return flags
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def save_scores(self) -> OTConsult:
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"""
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Calculate and save all scores to the consultation.
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Returns:
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Updated OTConsult instance
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"""
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scores = self.calculate_total_score()
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self.consult.self_help_score = scores['self_help']
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self.consult.behavior_score = scores['behavior']
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self.consult.developmental_score = scores['developmental']
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self.consult.eating_score = scores['eating']
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self.consult.total_score = scores['total']
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self.consult.score_interpretation = scores['interpretation']
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# Update recommendation if not already set
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if not self.consult.recommendation_notes:
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self.consult.recommendation_notes = scores['recommendation']
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self.consult.save()
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return self.consult
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def get_score_summary(self) -> dict:
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"""
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Get a formatted summary of scores for display.
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Returns:
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Dictionary with formatted score information
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"""
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scores = self.calculate_total_score()
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return {
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'scores': scores,
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'percentages': {
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'self_help': round((scores['self_help'] / scores['max_scores']['self_help']) * 100, 1) if scores['max_scores']['self_help'] > 0 else 0,
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'behavior': round((scores['behavior'] / scores['max_scores']['behavior']) * 100, 1) if scores['max_scores']['behavior'] > 0 else 0,
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'developmental': round((scores['developmental'] / scores['max_scores']['developmental']) * 100, 1) if scores['max_scores']['developmental'] > 0 else 0,
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'eating': round((scores['eating'] / scores['max_scores']['eating']) * 100, 1) if scores['max_scores']['eating'] > 0 else 0,
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'total': round((scores['total'] / scores['max_scores']['total']) * 100, 1) if scores['max_scores']['total'] > 0 else 0,
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},
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'chart_data': {
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'labels': ['Self-Help', 'Behavior', 'Developmental', 'Eating'],
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'scores': [scores['self_help'], scores['behavior'], scores['developmental'], scores['eating']],
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'max_scores': [
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scores['max_scores']['self_help'],
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scores['max_scores']['behavior'],
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scores['max_scores']['developmental'],
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scores['max_scores']['eating']
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]
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}
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}
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def initialize_consultation_data(consult: OTConsult):
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"""
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Initialize all required related data for a new consultation.
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Creates empty records for milestones, self-help skills, and behaviors.
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Args:
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consult: OTConsult instance to initialize
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"""
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from .models import OTMilestone, OTSelfHelpSkill, OTInfantBehavior, OTCurrentBehavior
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# Initialize milestones
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milestone_data = [
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('headControl', False),
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('reachObject', False),
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('rollOver', False),
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('fingerFeed', False),
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('sitting', True), # Required
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('pullStand', False),
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('crawling', True), # Required
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('drawCircle', False),
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('spoon', False),
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('cutScissors', False),
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('walking', True), # Required
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('drinkCup', False),
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('jump', False),
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('hop', False),
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('hopOneFoot', False),
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('bike', False),
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]
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for milestone, is_required in milestone_data:
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OTMilestone.objects.get_or_create(
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consult=consult,
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milestone=milestone,
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defaults={'is_required': is_required}
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)
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# Initialize self-help skills
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self_help_data = [
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('8-9', 'Grasps small items with thumb and index finger'),
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('8-9', 'Finger feeds self'),
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('12-18', 'Holds a spoon'),
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('12-18', 'Removes socks'),
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('12-18', 'Notifies parent that diapers are soiled'),
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('12-18', 'Cooperates with dressing'),
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('18-24', 'Holds and drinks from a cup with minimal spilling'),
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('18-24', 'Able to load spoon and bring to mouth with moderate spilling'),
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('2-3', 'Unzips zippers and unbuttons large buttons'),
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('2-3', 'Requires assistance to manage pullover clothing'),
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('2-3', 'Able to take off pants, coat, socks and shoes without fasteners'),
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('2-3', 'Able to feed self with little to no spilling'),
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('3-4', 'Independently dresses self, may need help with fasteners'),
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('3-4', 'Independent with toilet control and notification'),
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('5-6', 'Independent with all dressing, including shoe tying'),
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]
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for age_range, skill_name in self_help_data:
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OTSelfHelpSkill.objects.get_or_create(
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consult=consult,
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age_range=age_range,
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skill_name=skill_name
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)
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# Initialize infant behaviors
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infant_behaviors = [
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'cried', 'good', 'alert', 'quiet', 'passive', 'active',
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'likedHeld', 'resistedHeld', 'floppy', 'tense', 'sleepGood', 'sleepIrregular'
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]
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for behavior in infant_behaviors:
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OTInfantBehavior.objects.get_or_create(
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consult=consult,
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behavior=behavior
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)
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# Initialize current behaviors
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current_behaviors = [
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'quiet', 'active', 'tires', 'talks', 'impulsive', 'restless',
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'stubborn', 'resistant', 'fights', 'tantrums', 'clumsy', 'frustrated'
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]
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for behavior in current_behaviors:
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OTCurrentBehavior.objects.get_or_create(
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consult=consult,
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behavior=behavior
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)
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