def test_bmi_with_zero_values():
    session = make_session()

    weight_code = "X76C7"
    height_code = "XM01E"

    patient = Patient(DateOfBirth="1950-01-01")
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=weight_code, NumericValue=0, ConsultationDate="2001-06-01")
    )
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=height_code, NumericValue=0, ConsultationDate="2001-06-01")
    )
    session.add(patient)
    session.commit()

    study = StudyDefinition(
        population=patients.all(),
        BMI=patients.most_recent_bmi(
            on_or_after="1995-01-01", on_or_before="2005-01-01",
        ),
        BMI_date_measured=patients.date_of("BMI", date_format="YYYY-MM-DD"),
    )
    results = study.to_dicts()
    assert [x["BMI"] for x in results] == ["0.0"]
    assert [x["BMI_date_measured"] for x in results] == ["2001-06-01"]
def test_patients_registered_with_one_practice_between():
    session = make_session()

    patient_registered_in_2001 = Patient()
    patient_registered_in_2002 = Patient()
    patient_unregistered_in_2002 = Patient()
    patient_registered_in_2001.RegistrationHistory = [
        RegistrationHistory(StartDate="2001-01-01", EndDate="9999-01-01")
    ]
    patient_registered_in_2002.RegistrationHistory = [
        RegistrationHistory(StartDate="2002-01-01", EndDate="9999-01-01")
    ]
    patient_unregistered_in_2002.RegistrationHistory = [
        RegistrationHistory(StartDate="2001-01-01", EndDate="2002-01-01")
    ]

    session.add(patient_registered_in_2001)
    session.add(patient_registered_in_2002)
    session.add(patient_unregistered_in_2002)
    session.commit()

    study = StudyDefinition(
        population=patients.registered_with_one_practice_between(
            "2001-12-01", "2003-01-01"
        )
    )
    results = study.to_dicts()
    assert [x["patient_id"] for x in results] == [
        str(patient_registered_in_2001.Patient_ID)
    ]
def setup_function(function):
    session = make_session()
    session.query(CodedEventSnomed).delete()
    session.query(Organisation).delete()
    session.query(Patient).delete()
    session.query(RegistrationHistory).delete()
    session.commit()
def test_clinical_event_with_category():
    session = make_session()
    session.add_all(
        [
            Patient(),
            Patient(
                CodedEvents=[
                    CodedEvent(CTV3Code="foo1", ConsultationDate="2018-01-01"),
                    CodedEvent(CTV3Code="foo2", ConsultationDate="2020-01-01"),
                ]
            ),
            Patient(
                CodedEvents=[CodedEvent(CTV3Code="foo3", ConsultationDate="2019-01-01")]
            ),
        ]
    )
    session.commit()
    codes = codelist([("foo1", "A"), ("foo2", "B"), ("foo3", "C")], "ctv3")
    study = StudyDefinition(
        population=patients.all(),
        code_category=patients.with_these_clinical_events(
            codes,
            returning="category",
            find_last_match_in_period=True,
            include_date_of_match=True,
        ),
    )
    results = study.to_dicts()
    assert [x["code_category"] for x in results] == ["", "B", "C"]
    assert [x["code_category_date"] for x in results] == ["", "2020", "2019"]
def test_patients_with_death_recorded_in_cpns():
    session = make_session()
    session.add_all(
        [
            # Not dead
            Patient(),
            # Died after date cutoff
            Patient(CPNS=[CPNS(DateOfDeath="2021-01-01")]),
            # Patient should be included
            Patient(CPNS=[CPNS(DateOfDeath="2020-02-01")]),
            # Patient has multple entries but with the same date of death so
            # should be handled correctly
            Patient(
                CPNS=[CPNS(DateOfDeath="2020-03-01"), CPNS(DateOfDeath="2020-03-01")]
            ),
        ]
    )
    session.commit()
    study = StudyDefinition(
        population=patients.all(),
        cpns_death=patients.with_death_recorded_in_cpns(on_or_before="2020-06-01"),
        cpns_death_date=patients.with_death_recorded_in_cpns(
            on_or_before="2020-06-01",
            returning="date_of_death",
            date_format="YYYY-MM-DD",
        ),
    )
    results = study.to_dicts()
    assert [i["cpns_death"] for i in results] == ["0", "0", "1", "1"]
    assert [i["cpns_death_date"] for i in results] == [
        "",
        "",
        "2020-02-01",
        "2020-03-01",
    ]
def test_patients_died_from_any_cause():
    session = make_session()
    session.add_all(
        [
            # Not dead
            Patient(),
            # Died after date cutoff
            Patient(ONSDeath=[ONSDeaths(dod="2021-01-01")]),
            # Died
            Patient(ONSDeath=[ONSDeaths(dod="2020-02-01")]),
        ]
    )
    session.commit()
    study = StudyDefinition(
        population=patients.all(),
        died=patients.died_from_any_cause(on_or_before="2020-06-01"),
        date_died=patients.died_from_any_cause(
            on_or_before="2020-06-01",
            returning="date_of_death",
            include_month=True,
            include_day=True,
        ),
    )
    results = study.to_dicts()
    assert [i["died"] for i in results] == ["0", "0", "1"]
    assert [i["date_died"] for i in results] == ["", "", "2020-02-01"]
def test_explicit_bmi_fallback():
    session = make_session()

    weight_code = "X76C7"
    bmi_code = "22K.."

    patient = Patient(DateOfBirth="1950-01-01")
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=weight_code, NumericValue=50, ConsultationDate="2001-06-01")
    )
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=bmi_code, NumericValue=99, ConsultationDate="2001-10-01")
    )
    session.add(patient)
    session.commit()

    study = StudyDefinition(
        population=patients.all(),
        BMI=patients.most_recent_bmi(
            on_or_after="1995-01-01",
            on_or_before="2005-01-01",
            include_measurement_date=True,
            include_month=True,
            include_day=True,
        ),
    )
    results = study.to_dicts()
    assert [x["BMI"] for x in results] == ["99.0"]
    assert [x["BMI_date_measured"] for x in results] == ["2001-10-01"]
def test_bmi_rounded():
    session = make_session()

    weight_code = "X76C7"
    height_code = "XM01E"

    patient = Patient(DateOfBirth="1950-01-01")
    patient.CodedEvents.append(
        CodedEvent(
            CTV3Code=weight_code, NumericValue=10.12345, ConsultationDate="2001-06-01"
        )
    )
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=height_code, NumericValue=10, ConsultationDate="2000-02-01")
    )
    session.add(patient)
    session.commit()

    study = StudyDefinition(
        population=patients.all(),
        BMI=patients.most_recent_bmi(
            "2005-01-01",
            include_measurement_date=True,
            include_month=True,
            include_day=True,
        ),
    )
    results = study.to_dicts()
    assert [x["BMI"] for x in results] == ["0.1"]
    assert [x["BMI_date_measured"] for x in results] == ["2001-06-01"]
def test_no_bmi_when_measurement_after_reference_date():
    session = make_session()

    bmi_code = "22K.."

    patient = Patient(DateOfBirth="1900-01-01")
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=bmi_code, NumericValue=99, ConsultationDate="2001-01-01")
    )
    session.add(patient)
    session.commit()

    study = StudyDefinition(
        population=patients.all(),
        BMI=patients.most_recent_bmi(
            on_or_after="1990-01-01",
            on_or_before="2000-01-01",
            include_measurement_date=True,
            include_month=True,
            include_day=True,
        ),
    )
    results = study.to_dicts()
    assert [x["BMI"] for x in results] == ["0.0"]
    assert [x["BMI_date_measured"] for x in results] == [""]
def test_patient_characteristics_for_covid_status():
    session = make_session()
    old_patient_with_covid = Patient(
        DateOfBirth="1900-01-01",
        CovidStatus=CovidStatus(Result="COVID19", AdmittedToITU=True),
        Sex="M",
    )
    young_patient_1_with_covid = Patient(
        DateOfBirth="2000-01-01",
        CovidStatus=CovidStatus(Result="COVID19", Died=True),
        Sex="F",
    )
    young_patient_2_without_covid = Patient(DateOfBirth="2001-01-01", Sex="F")
    session.add(old_patient_with_covid)
    session.add(young_patient_1_with_covid)
    session.add(young_patient_2_without_covid)
    session.commit()

    study = StudyDefinition(
        population=patients.with_positive_covid_test(),
        age=patients.age_as_of("2020-01-01"),
        sex=patients.sex(),
        died=patients.have_died_of_covid(),
    )
    results = study.to_dicts()

    assert [x["sex"] for x in results] == ["M", "F"]
    assert [x["died"] for x in results] == ["0", "1"]
    assert [x["age"] for x in results] == ["120", "20"]
def test_to_sql_passes():
    session = make_session()
    patient = Patient(DateOfBirth="1950-01-01")
    patient.CodedEvents.append(
        CodedEvent(CTV3Code="XYZ", NumericValue=50, ConsultationDate="2002-06-01")
    )
    session.add(patient)
    session.commit()

    study = StudyDefinition(
        population=patients.with_these_clinical_events(codelist(["XYZ"], "ctv3"))
    )
    sql = "SET NOCOUNT ON; "  # don't output count after table output
    sql += study.to_sql()
    db_dict = study.get_db_dict()
    cmd = [
        "sqlcmd",
        "-S",
        db_dict["hostname"] + "," + str(db_dict["port"]),
        "-d",
        db_dict["database"],
        "-U",
        db_dict["username"],
        "-P",
        db_dict["password"],
        "-Q",
        sql,
        "-W",  # strip whitespace
    ]
    result = subprocess.run(
        cmd, capture_output=True, check=True, encoding="utf8"
    ).stdout
    patient_id = result.splitlines()[-1]
    assert patient_id == str(patient.Patient_ID)
def test_bmi_when_only_some_measurements_of_child():
    session = make_session()

    bmi_code = "22K.."
    weight_code = "X76C7"
    height_code = "XM01E"

    patient = Patient(DateOfBirth="1990-01-01")
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=bmi_code, NumericValue=99, ConsultationDate="1995-01-01")
    )
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=weight_code, NumericValue=50, ConsultationDate="2010-01-01")
    )
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=height_code, NumericValue=10, ConsultationDate="2010-01-01")
    )
    session.add(patient)
    session.commit()

    study = StudyDefinition(
        population=patients.all(),
        BMI=patients.most_recent_bmi(
            on_or_after="2005-01-01",
            on_or_before="2015-01-01",
            include_measurement_date=True,
            include_month=True,
            include_day=True,
        ),
    )
    results = study.to_dicts()
    assert [x["BMI"] for x in results] == ["0.5"]
    assert [x["BMI_date_measured"] for x in results] == ["2010-01-01"]
Exemple #13
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def test_vaccination_events_sql():
    session = make_session()
    session.add_all(
        [
            # This patient is too old and should be ignored
            Patient(
                DateOfBirth="2002-05-04",
                Vaccinations=[
                    Vaccination(
                        VaccinationName="Infanrix Hexa", VaccinationDate="2002-06-01",
                    )
                ],
            ),
            # This patient is too young and should be ignored
            Patient(
                DateOfBirth="2019-10-04",
                Vaccinations=[
                    Vaccination(
                        VaccinationName="Infanrix Hexa", VaccinationDate="2019-11-04",
                    )
                ],
            ),
            Patient(
                DateOfBirth="2018-10-28",
                Vaccinations=[
                    Vaccination(
                        VaccinationName="Infanrix Hexa", VaccinationDate="2018-11-01",
                    )
                ],
                MedicationIssues=[
                    MedicationIssue(
                        MedicationDictionary=MedicationDictionary(
                            DMD_ID="123", MultilexDrug_ID="123"
                        ),
                        ConsultationDate="2019-01-01",
                    ),
                ],
                CodedEvents=[CodedEvent(CTV3Code="abc", ConsultationDate="2019-06-01")],
            ),
        ]
    )
    session.commit()
    sql = vaccination_events_sql(
        date_of_birth_range=("2012-01-01", "2019-06-01"),
        tpp_vaccination_codelist=codelist(
            [("Infanrix Hexa", "dtap_hex")], system="tpp_vaccines",
        ),
        ctv3_codelist=codelist([("abc", "menb")], system="ctv3"),
        snomed_codelist=codelist([("123", "rotavirus")], system="snomed"),
    )
    results = sql_to_dicts(sql)
    result_tuples = [(x["date_given"], x["vaccine_name"]) for x in results]
    # Results are ordered by patient ID but within each patient's results the
    # order is arbitrary. To make testing easier we sort them here.
    result_tuples = sorted(result_tuples)
    assert result_tuples == [
        ("2018-11-01", "dtap_hex"),
        ("2019-01-01", "rotavirus"),
        ("2019-06-01", "menb"),
    ]
def test_patient_registered_as_of():
    session = make_session()

    patient_registered_in_2001 = Patient()
    patient_registered_in_2002 = Patient()
    patient_unregistered_in_2002 = Patient()
    patient_registered_in_2001.RegistrationHistory = [
        RegistrationHistory(StartDate="2001-01-01", EndDate="9999-01-01")
    ]
    patient_registered_in_2002.RegistrationHistory = [
        RegistrationHistory(StartDate="2002-01-01", EndDate="9999-01-01")
    ]
    patient_unregistered_in_2002.RegistrationHistory = [
        RegistrationHistory(StartDate="2001-01-01", EndDate="2002-01-01")
    ]

    session.add(patient_registered_in_2001)
    session.add(patient_registered_in_2002)
    session.add(patient_unregistered_in_2002)
    session.commit()

    # No date criteria
    study = StudyDefinition(population=patients.registered_as_of("2002-03-02"))
    results = study.to_dicts()
    assert [x["patient_id"] for x in results] == [
        str(patient_registered_in_2001.Patient_ID),
        str(patient_registered_in_2002.Patient_ID),
    ]
def test_patients_categorised_as():
    session = make_session()
    session.add_all(
        [
            Patient(
                Sex="M",
                CodedEvents=[
                    CodedEvent(CTV3Code="foo1", ConsultationDate="2000-01-01")
                ],
            ),
            Patient(
                Sex="F",
                CodedEvents=[
                    CodedEvent(CTV3Code="foo2", ConsultationDate="2000-01-01"),
                    CodedEvent(CTV3Code="bar1", ConsultationDate="2000-01-01"),
                ],
            ),
            Patient(
                Sex="M",
                CodedEvents=[
                    CodedEvent(CTV3Code="foo2", ConsultationDate="2000-01-01")
                ],
            ),
            Patient(
                Sex="F",
                CodedEvents=[
                    CodedEvent(CTV3Code="foo3", ConsultationDate="2000-01-01")
                ],
            ),
        ]
    )
    session.commit()
    foo_codes = codelist([("foo1", "A"), ("foo2", "B"), ("foo3", "C")], "ctv3")
    bar_codes = codelist(["bar1"], "ctv3")
    study = StudyDefinition(
        population=patients.all(),
        category=patients.categorised_as(
            {
                "W": "foo_category = 'B' AND female_with_bar",
                "X": "sex = 'F' AND (foo_category = 'B' OR foo_category = 'C')",
                "Y": "sex = 'M' AND foo_category = 'A'",
                "Z": "DEFAULT",
            },
            sex=patients.sex(),
            foo_category=patients.with_these_clinical_events(
                foo_codes, returning="category", find_last_match_in_period=True
            ),
            female_with_bar=patients.satisfying(
                "has_bar AND sex = 'F'",
                has_bar=patients.with_these_clinical_events(bar_codes),
            ),
        ),
    )
    results = study.to_dicts()
    assert [x["category"] for x in results] == ["Y", "W", "Z", "X"]
    # Assert that internal columns do not appear
    assert "foo_category" not in results[0].keys()
    assert "female_with_bar" not in results[0].keys()
    assert "has_bar" not in results[0].keys()
def test_number_of_episodes():
    session = make_session()
    session.add_all(
        [
            Patient(
                CodedEvents=[
                    CodedEvent(CTV3Code="foo1", ConsultationDate="2010-01-01"),
                    # Throw in some irrelevant events
                    CodedEvent(CTV3Code="mto1", ConsultationDate="2010-01-02"),
                    CodedEvent(CTV3Code="mto2", ConsultationDate="2010-01-03"),
                    # These two should be merged in to the previous event
                    # because there's not more than 14 days between them
                    CodedEvent(CTV3Code="foo2", ConsultationDate="2010-01-14"),
                    CodedEvent(CTV3Code="foo3", ConsultationDate="2010-01-20"),
                    # This is just outside the limit so should count as another event
                    CodedEvent(CTV3Code="foo1", ConsultationDate="2010-02-04"),
                    # This shouldn't count because there's an "ignore" event on
                    # the same day (though at a different time)
                    CodedEvent(CTV3Code="foo1", ConsultationDate="2012-01-01T10:45:00"),
                    CodedEvent(CTV3Code="bar2", ConsultationDate="2012-01-01T16:10:00"),
                    # This should be another episode
                    CodedEvent(CTV3Code="foo1", ConsultationDate="2015-03-05"),
                    # This "ignore" event should have no effect because it occurs
                    # on a different day
                    CodedEvent(CTV3Code="bar1", ConsultationDate="2015-03-06"),
                    # This is after the time limit and so shouldn't count
                    CodedEvent(CTV3Code="foo1", ConsultationDate="2020-02-05"),
                ]
            ),
            # This patient doesn't have any relevant events
            Patient(
                CodedEvents=[
                    CodedEvent(CTV3Code="mto1", ConsultationDate="2010-01-01"),
                    CodedEvent(CTV3Code="mto2", ConsultationDate="2010-01-14"),
                    CodedEvent(CTV3Code="mto3", ConsultationDate="2010-01-20"),
                    CodedEvent(CTV3Code="mto1", ConsultationDate="2010-02-04"),
                    CodedEvent(CTV3Code="mto1", ConsultationDate="2012-01-01T10:45:00"),
                    CodedEvent(CTV3Code="mtr2", ConsultationDate="2012-01-01T16:10:00"),
                    CodedEvent(CTV3Code="mto1", ConsultationDate="2015-03-05"),
                    CodedEvent(CTV3Code="mto1", ConsultationDate="2020-02-05"),
                ]
            ),
        ]
    )
    session.commit()
    foo_codes = codelist(["foo1", "foo2", "foo3"], "ctv3")
    bar_codes = codelist(["bar1", "bar2"], "ctv3")
    study = StudyDefinition(
        population=patients.all(),
        episode_count=patients.with_these_clinical_events(
            foo_codes,
            on_or_before="2020-01-01",
            ignore_days_where_these_codes_occur=bar_codes,
            returning="number_of_episodes",
            episode_defined_as="series of events each <= 14 days apart",
        ),
    )
    results = study.to_dicts()
    assert [i["episode_count"] for i in results] == ["3", "0"]
def test_patient_random_sample():
    session = make_session()
    sample_size = 1000
    for _ in range(sample_size):
        patient = Patient()
        session.add(patient)
    session.commit()

    study = StudyDefinition(population=patients.random_sample(percent=20))
    results = study.to_dicts()
    # The method is approximate!
    assert len(results) < (sample_size / 2)
def test_patients_with_death_recorded_in_cpns_raises_error_on_bad_data():
    session = make_session()
    session.add_all(
        # Create a patient with duplicate CPNS entries recording an
        # inconsistent date of death
        [Patient(CPNS=[CPNS(DateOfDeath="2020-03-01"), CPNS(DateOfDeath="2020-02-01")])]
    )
    session.commit()
    study = StudyDefinition(
        population=patients.all(), cpns_death=patients.with_death_recorded_in_cpns()
    )
    with pytest.raises(Exception):
        study.to_dicts()
def test_minimal_study_to_csv():
    session = make_session()
    patient_1 = Patient(DateOfBirth="1900-01-01", Sex="M")
    patient_2 = Patient(DateOfBirth="1900-01-01", Sex="F")
    session.add_all([patient_1, patient_2])
    session.commit()
    study = StudyDefinition(population=patients.all(), sex=patients.sex())
    with tempfile.NamedTemporaryFile(mode="w+") as f:
        study.to_csv(f.name)
        results = list(csv.DictReader(f))
        assert results == [
            {"patient_id": str(patient_1.Patient_ID), "sex": "M"},
            {"patient_id": str(patient_2.Patient_ID), "sex": "F"},
        ]
def setup_function(function):
    """Ensure test database is empty
    """
    session = make_session()
    session.query(CovidStatus).delete()
    session.query(CodedEvent).delete()
    session.query(ICNARC).delete()
    session.query(ONSDeaths).delete()
    session.query(CPNS).delete()
    session.query(MedicationIssue).delete()
    session.query(MedicationDictionary).delete()
    session.query(RegistrationHistory).delete()
    session.query(Organisation).delete()
    session.query(PatientAddress).delete()
    session.query(Patient).delete()
    session.commit()
def test_patients_with_ages_and_practices_sql():
    session = make_session()
    session.add_all([
        # This patient is too old and should be ignored
        Patient(DateOfBirth="2002-05-04"),
        # This patient is too young and should be ignored
        Patient(DateOfBirth="2019-10-04"),
        Patient(
            DateOfBirth="2018-10-28",
            RegistrationHistory=[
                RegistrationHistory(
                    StartDate="2015-01-01",
                    EndDate="2021-10-01",
                    Organisation=Organisation(Organisation_ID=456),
                ),
            ],
        ),
        Patient(
            DateOfBirth="2014-09-14",
            RegistrationHistory=[
                RegistrationHistory(
                    StartDate="2010-01-01",
                    EndDate="2015-10-01",
                    Organisation=Organisation(Organisation_ID=123),
                ),
                # Deliberately overlapping registration histories
                RegistrationHistory(
                    StartDate="2015-04-01",
                    EndDate="9999-12-31",
                    Organisation=Organisation(Organisation_ID=345),
                ),
            ],
        ),
    ])
    session.commit()
    sql = patients_with_ages_and_practices_sql(
        date_of_birth_range=("2012-01-01", "2019-06-01"),
        age_thresholds=[12, 24, 60],
    )
    results = sql_to_dicts(sql)
    # Note this is rounded to start of month
    assert [x["date_of_birth"]
            for x in results] == ["2018-10-01", "2014-09-01"]
    assert [x["practice_id_at_month_12"] for x in results] == ["456", "345"]
    assert [x["practice_id_at_month_24"] for x in results] == ["456", "345"]
    assert [x["practice_id_at_month_60"] for x in results] == ["0", "345"]
def test_sqlcmd_and_odbc_outputs_match():
    session = make_session()
    patient = Patient(DateOfBirth="1950-01-01")
    patient.CodedEvents.append(
        CodedEvent(CTV3Code="XYZ", NumericValue=50, ConsultationDate="2002-06-01")
    )
    session.add(patient)
    session.commit()

    study = StudyDefinition(
        population=patients.with_these_clinical_events(codelist(["XYZ"], "ctv3"))
    )
    with tempfile.NamedTemporaryFile() as input_csv_odbc, tempfile.NamedTemporaryFile() as input_csv_sqlcmd:
        # windows line endings
        study.to_csv(input_csv_odbc.name, with_sqlcmd=False)
        # unix line endings
        study.to_csv(input_csv_sqlcmd.name, with_sqlcmd=True)
        assert filecmp.cmp(input_csv_odbc.name, input_csv_sqlcmd.name, shallow=False)
def test_patients_satisfying_with_hidden_columns():
    condition_code = "ASTHMA"
    condition_code2 = "COPD"
    session = make_session()
    patient_1 = Patient(DateOfBirth="1940-01-01", Sex="M")
    patient_2 = Patient(DateOfBirth="1940-01-01", Sex="F")
    patient_3 = Patient(DateOfBirth="1990-01-01", Sex="M")
    patient_4 = Patient(DateOfBirth="1940-01-01", Sex="F")
    patient_4.CodedEvents.append(
        CodedEvent(CTV3Code=condition_code, ConsultationDate="2010-01-01")
    )
    patient_5 = Patient(DateOfBirth="1940-01-01", Sex="F")
    patient_5.CodedEvents.append(
        CodedEvent(CTV3Code=condition_code, ConsultationDate="2010-01-01")
    )
    patient_5.CodedEvents.append(
        CodedEvent(CTV3Code=condition_code2, ConsultationDate="2010-01-01")
    )
    session.add_all([patient_1, patient_2, patient_3, patient_4, patient_5])
    session.commit()
    study = StudyDefinition(
        population=patients.all(),
        sex=patients.sex(),
        age=patients.age_as_of("2020-01-01"),
        at_risk=patients.satisfying(
            """
            (age > 70 AND sex = "M")
            OR
            (has_asthma AND NOT copd)
            """,
            has_asthma=patients.with_these_clinical_events(
                codelist([condition_code], "ctv3")
            ),
            copd=patients.with_these_clinical_events(
                codelist([condition_code2], "ctv3")
            ),
        ),
    )
    results = study.to_dicts()
    assert [i["at_risk"] for i in results] == ["1", "0", "0", "1", "0"]
    assert "has_asthma" not in results[0].keys()
def test_patients_with_these_codes_on_death_certificate():
    code = "COVID"
    session = make_session()
    session.add_all(
        [
            # Not dead
            Patient(),
            # Died after date cutoff
            Patient(ONSDeath=[ONSDeaths(dod="2021-01-01", icd10u=code)]),
            # Died of something else
            Patient(ONSDeath=[ONSDeaths(dod="2020-02-01", icd10u="MI")]),
            # Covid underlying cause
            Patient(ONSDeath=[ONSDeaths(dod="2020-02-01", icd10u=code)]),
            # Covid not underlying cause
            Patient(ONSDeath=[ONSDeaths(dod="2020-03-01", ICD10014=code)]),
        ]
    )
    session.commit()
    covid_codelist = codelist([code], system="icd10")
    study = StudyDefinition(
        population=patients.all(),
        died_of_covid=patients.with_these_codes_on_death_certificate(
            covid_codelist, on_or_before="2020-06-01", match_only_underlying_cause=True
        ),
        died_with_covid=patients.with_these_codes_on_death_certificate(
            covid_codelist, on_or_before="2020-06-01", match_only_underlying_cause=False
        ),
        date_died=patients.with_these_codes_on_death_certificate(
            covid_codelist,
            on_or_before="2020-06-01",
            match_only_underlying_cause=False,
            returning="date_of_death",
            include_month=True,
            include_day=True,
        ),
    )
    results = study.to_dicts()
    assert [i["died_of_covid"] for i in results] == ["0", "0", "0", "1", "0"]
    assert [i["died_with_covid"] for i in results] == ["0", "0", "0", "1", "1"]
    assert [i["date_died"] for i in results] == ["", "", "", "2020-02-01", "2020-03-01"]
def test_simple_bmi(include_dates):
    session = make_session()

    weight_code = "X76C7"
    height_code = "XM01E"

    patient = Patient(DateOfBirth="1950-01-01")
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=weight_code, NumericValue=50, ConsultationDate="2002-06-01")
    )
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=height_code, NumericValue=10, ConsultationDate="2001-06-01")
    )
    session.add(patient)
    session.commit()

    if include_dates == "none":
        bmi_date = None
        bmi_kwargs = {}
    elif include_dates == "year":
        bmi_date = "2002"
        bmi_kwargs = dict(include_measurement_date=True)
    elif include_dates == "month":
        bmi_date = "2002-06"
        bmi_kwargs = dict(include_measurement_date=True, include_month=True)
    elif include_dates == "day":
        bmi_date = "2002-06-01"
        bmi_kwargs = dict(
            include_measurement_date=True, include_month=True, include_day=True
        )
    study = StudyDefinition(
        population=patients.all(),
        BMI=patients.most_recent_bmi(
            on_or_after="1995-01-01", on_or_before="2005-01-01", **bmi_kwargs
        ),
    )
    results = study.to_dicts()
    assert [x["BMI"] for x in results] == ["0.5"]
    assert [x.get("BMI_date_measured") for x in results] == [bmi_date]
def test_no_bmi_when_measurements_of_child():
    session = make_session()

    bmi_code = "22K.."

    patient = Patient(DateOfBirth="2000-01-01")
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=bmi_code, NumericValue=99, ConsultationDate="2001-01-01")
    )
    session.add(patient)
    session.commit()

    study = StudyDefinition(
        population=patients.all(),
        BMI=patients.most_recent_bmi(
            on_or_after="1995-01-01", on_or_before="2005-01-01",
        ),
        BMI_date_measured=patients.date_of("BMI", date_format="YYYY-MM-DD"),
    )
    results = study.to_dicts()
    assert [x["BMI"] for x in results] == ["0.0"]
    assert [x["BMI_date_measured"] for x in results] == [""]
def test_simple_bmi(include_dates):
    session = make_session()

    weight_code = "X76C7"
    height_code = "XM01E"

    patient = Patient(DateOfBirth="1950-01-01")
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=weight_code, NumericValue=50, ConsultationDate="2002-06-01")
    )
    patient.CodedEvents.append(
        CodedEvent(CTV3Code=height_code, NumericValue=10, ConsultationDate="2001-06-01")
    )
    session.add(patient)
    session.commit()

    if include_dates == "none":
        bmi_date = None
        date_query = None
    elif include_dates == "year":
        bmi_date = "2002"
        date_query = patients.date_of("BMI")
    elif include_dates == "month":
        bmi_date = "2002-06"
        date_query = patients.date_of("BMI", date_format="YYYY-MM")
    elif include_dates == "day":
        bmi_date = "2002-06-01"
        date_query = patients.date_of("BMI", date_format="YYYY-MM-DD")
    study = StudyDefinition(
        population=patients.all(),
        BMI=patients.most_recent_bmi(
            on_or_after="1995-01-01", on_or_before="2005-01-01"
        ),
        **dict(BMI_date_measured=date_query) if date_query else {}
    )
    results = study.to_dicts()
    assert [x["BMI"] for x in results] == ["0.5"]
    assert [x.get("BMI_date_measured") for x in results] == [bmi_date]
def _make_clinical_events_selection(condition_code, patient_dates=None):
    # The default configuration of patients and dates which some tests assume
    if patient_dates is None:
        patient_dates = ["2001-06-01", "2002-06-01", None]
    session = make_session()
    for dates in patient_dates:
        patient = Patient()
        if dates is None:
            dates = []
        elif isinstance(dates, str):
            dates = [dates]
        for date in dates:
            if isinstance(date, tuple):
                date, value = date
            else:
                value = 0.0
            patient.CodedEvents.append(
                CodedEvent(
                    CTV3Code=condition_code, ConsultationDate=date, NumericValue=value
                )
            )
        session.add(patient)
    session.commit()
def test_meds():
    session = make_session()

    asthma_medication = MedicationDictionary(
        FullName="Asthma Drug", DMD_ID="0", MultilexDrug_ID="0"
    )
    patient_with_med = Patient()
    patient_with_med.MedicationIssues = [
        MedicationIssue(MedicationDictionary=asthma_medication)
    ]
    patient_without_med = Patient()
    session.add(patient_with_med)
    session.add(patient_without_med)
    session.commit()

    study = StudyDefinition(
        population=patients.all(),
        asthma_meds=patients.with_these_medications(
            codelist(asthma_medication.DMD_ID, "snomed")
        ),
    )
    results = study.to_dicts()
    assert [x["asthma_meds"] for x in results] == ["1", "0"]
def test_patients_satisfying():
    condition_code = "ASTHMA"
    session = make_session()
    patient_1 = Patient(DateOfBirth="1940-01-01", Sex="M")
    patient_2 = Patient(DateOfBirth="1940-01-01", Sex="F")
    patient_3 = Patient(DateOfBirth="1990-01-01", Sex="M")
    patient_4 = Patient(DateOfBirth="1940-01-01", Sex="F")
    patient_4.CodedEvents.append(
        CodedEvent(CTV3Code=condition_code, ConsultationDate="2010-01-01")
    )
    session.add_all([patient_1, patient_2, patient_3, patient_4])
    session.commit()
    study = StudyDefinition(
        population=patients.all(),
        sex=patients.sex(),
        age=patients.age_as_of("2020-01-01"),
        has_asthma=patients.with_these_clinical_events(
            codelist([condition_code], "ctv3")
        ),
        at_risk=patients.satisfying("(age > 70 AND sex = 'M') OR has_asthma"),
    )
    results = study.to_dicts()
    assert [i["at_risk"] for i in results] == ["1", "0", "0", "1"]