Hm 138 pregnancy USPSTF Recommendation

lib/src/open_health_manager/patient_data.dart

@@ -17,6 +17,7 @@
 // useful as a Flutter model.
 
 import 'package:flutter/foundation.dart';
+import 'package:rosie/src/open_health_manager/pregnancy_status.dart';
 import 'account.dart';
 import 'open_health_manager.dart';
 import 'blood_pressure.dart';
@@ -127,6 +128,10 @@ class PatientData extends ChangeNotifier {
       CachedData<List<SmokingStatusObservation>>(() async {
     return await healthManager.querySmokingStatus();
   });
+  late final pregnancyStatus =
+      CachedData<List<PregnancyStatusObservation>>(() async {
+    return await healthManager.queryPregnancyStatus();
+  });
   late final account = CachedData<Account>(() async {
     return await healthManager.getAccount();
   });
@@ -135,6 +140,7 @@ class PatientData extends ChangeNotifier {
     patientDemographics.reload();
     bloodPressure.reload();
     smokingStatus.reload();
+    pregnancyStatus.reload();
     // Reloading the account data may be excessive
     account.reload();
   }

lib/src/open_health_manager/pregnancy_status.dart

@@ -0,0 +1,109 @@
+// Copyright 2022 The MITRE Corporation
+//
+// Licensed under the Apache License, Version 2.0 (the "License");
+// you may not use this file except in compliance with the License.
+// You may obtain a copy of the License at
+//
+//     http://www.apache.org/licenses/LICENSE-2.0
+//
+// Unless required by applicable law or agreed to in writing, software
+// distributed under the License is distributed on an "AS IS" BASIS,
+// WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+// See the License for the specific language governing permissions and
+// limitations under the License.
+
+import 'dart:developer';
+import 'package:fhir/r4.dart'
+    show
+        Code,
+        CodeableConcept,
+        Coding,
+        FhirDateTime,
+        FhirUri,
+        Observation,
+        ObservationStatus,
+        Reference;
+import 'open_health_manager.dart';
+import 'util.dart';
+
+/// A condition of a Pregnancy Status.
+class PregnancyStatusObservation {
+  final bool pregnancyStatus;
+
+  const PregnancyStatusObservation(this.pregnancyStatus);
+
+  /// Attempts to parse a Pregnancy Status condition from a given FHIR condition.
+  ///
+  /// The coding in the condition itself is **ignored**. This will assume it's a valid coding, and will look for the
+  /// pregnancy status value
+  factory PregnancyStatusObservation.fromObservation(Observation observation) {
+    final observationCodes = observation.valueCodeableConcept?.coding;
+    if (observationCodes == null || observationCodes.isEmpty) {
+      throw const InvalidResourceException(
+          "No observationCodes in pregnancy status observation.");
+    }
+    bool pregnancyStatus = false;
+
+    var dateTime = observation.effectiveDateTime?.valueDateTime;
+
+    final now = DateTime.now();
+
+    if (dateTime != null) {
+      for (final observationCode in observationCodes) {
+        final theCode = observationCode.code?.value;
+
+        if (theCode == "77386006") {
+          // Pregnant Status Code
+          if (now.isAfter(dateTime)) {
+            pregnancyStatus = true;
+          } else {
+            pregnancyStatus = false;
+          }
+        } else if (theCode == "60001007") {
+          // Not Pregnant Status Code
+          if (now.isBefore(dateTime)) {
+            pregnancyStatus = true;
+          } else {
+            pregnancyStatus = false;
+          }
+        }
+      }
+    }
+    return PregnancyStatusObservation(pregnancyStatus);
+  }
+}
+
+extension PregnancyStatusQuerying on OpenHealthManager {
+  /// Loads a list of Pregnancy observations.
+  ///
+  /// Any exceptions during loading are thrown, and any exceptions during parsing are logged to the FINE (500) log level
+  /// but otherwise eaten and simply left out of the result.
+  Future<List<PregnancyStatusObservation>> queryPregnancyStatus() async {
+    // returns most recent Observations first
+    final bundle = await queryResource(
+        "Observation", {"code": "http://loinc.org|82810-3", "_sort": "-date"});
+    final results = <PregnancyStatusObservation>[];
+    var entries = bundle.entry;
+    if (entries == null) {
+      return results;
+    }
+
+    // Get latest entry - first Observation
+    var finalEntry = entries.first;
+
+    final resource = finalEntry.resource;
+    if (resource != null && resource is Observation) {
+      try {
+        var pregnancyStatusObservation =
+            PregnancyStatusObservation.fromObservation(resource);
+        // add to result list
+        results.insert(0, pregnancyStatusObservation);
+      } on InvalidResourceException catch (error) {
+        log('Unable to parse Observation for a Pregnancy Status',
+            level: 500, error: error);
+      }
+    }
+
+    return results;
+  }
+}

lib/src/service/preventative_services_task_force.dart

@@ -130,9 +130,14 @@ class PreventativeServicesTaskForce with ChangeNotifier {
     String? gender = (demographics != null && demographics.gender != null)
         ? demographics.gender
         : null;
+    final pregnancyStatusList = await patientData?.pregnancyStatus.get();
+    final pregnancyStatusValue =
+        (pregnancyStatusList != null && pregnancyStatusList.isNotEmpty)
+            ? pregnancyStatusList[0].pregnancyStatus
+            : null;
 
-    return await getRecommendedServices(
-        age, gender, null, smokingStatusValue?.toTaskForceAPIParam(), null);
+    return await getRecommendedServices(age, gender, pregnancyStatusValue,
+        smokingStatusValue?.toTaskForceAPIParam(), null);
   }
 
   Future<Map<String, dynamic>> getRecommendedServices(int? age, String? sex,