The followings are the available columns in table 'secondary_diagnosis':
protected function afterSave()
{
foreach (SecondaryDiagnosis::model()->findAll('patient_id=? and disorder_id=?', array($this->patient_id, $this->disorder_id)) as $sd) {
if ($this->eye_id == $sd->eye_id || $this->eye_id == 3 && in_array($sd->eye_id, array(1, 2))) {
$sd->delete();
} elseif (in_array($this->eye_id, array(1, 2)) && $sd->eye_id == 3) {
$sd->eye_id = $this->eye_id == 1 ? 2 : 1;
$sd->save();
}
}
}
public function actionValidateAddDiagnosis()
{
$errors = array();
if (!($patient = Patient::model()->findByPk(@$_POST['patient_id']))) {
throw new Exception("Patient not found: " . @$_POST['patient_id']);
}
if (isset($_POST['DiagnosisSelection']['ophthalmic_disorder_id'])) {
$disorder_id = $_POST['DiagnosisSelection']['ophthalmic_disorder_id'];
} elseif (isset($_POST['DiagnosisSelection']['systemic_disorder_id'])) {
$disorder_id = $_POST['DiagnosisSelection']['systemic_disorder_id'];
}
$sd = new SecondaryDiagnosis();
$sd->patient_id = $patient->id;
$sd->date = $this->processFuzzyDate();
$sd->disorder_id = @$disorder_id;
$sd->eye_id = @$_POST['diagnosis_eye'];
$errors = array();
if (!$sd->validate()) {
foreach ($sd->getErrors() as $field => $_errors) {
$errors[$field] = $_errors[0];
}
}
// Check the diagnosis isn't currently set at the episode level for this patient
foreach ($patient->episodes as $episode) {
if ($episode->disorder_id == $sd->disorder_id && ($episode->eye_id == $sd->eye_id || $episode->eye_id == 3 || $sd->eye_id == 3)) {
$errors['disorder_id'] = "The disorder is already set at the episode level for this patient";
}
}
// Check that the date isn't in the future
if (@$_POST['fuzzy_year'] == date('Y')) {
if (@$_POST['fuzzy_month'] > date('n')) {
$errors['date'] = "The date cannot be in the future.";
} elseif (@$_POST['fuzzy_month'] == date('n')) {
if (@$_POST['fuzzy_day'] > date('j')) {
$errors['date'] = "The date cannot be in the future.";
}
}
}
// Check that the date is valid
$v = new OEFuzzyDateValidator();
$v->validateAttribute($sd, 'date');
echo json_encode($errors);
}
/**
* Update the diagnoses for this element using a hash structure of
* [{
* 'disorder_id' => integer,
* 'eye_id' => \Eye::LEFT|\Eye::RIGHT|\Eye::BOTH,
* 'principal' => boolean
* }, ... ]
*
* @param $update_disorders
* @throws Exception
*/
public function updateDiagnoses($update_disorders)
{
$current_diagnoses = OphCiExamination_Diagnosis::model()->findAll('element_diagnoses_id=?', array($this->id));
$curr_by_disorder_id = array();
$secondary_disorder_ids = array();
foreach ($current_diagnoses as $cd) {
$curr_by_disorder_id[$cd->disorder_id] = $cd;
}
foreach ($update_disorders as $u_disorder) {
if (!($curr = @$curr_by_disorder_id[$u_disorder['disorder_id']])) {
$curr = new OphCiExamination_Diagnosis();
$curr->element_diagnoses_id = $this->id;
$curr->disorder_id = $u_disorder['disorder_id'];
} else {
unset($curr_by_disorder_id[$u_disorder['disorder_id']]);
}
if ($curr->eye_id != $u_disorder['eye_id'] || $curr->principal != $u_disorder['principal']) {
// need to update & save
$curr->eye_id = $u_disorder['eye_id'];
$curr->principal = $u_disorder['principal'];
if (!$curr->save()) {
throw new \Exception("save failed" . print_r($curr->getErrors(), true));
}
}
if ($u_disorder['principal']) {
$this->event->episode->setPrincipalDiagnosis($u_disorder['disorder_id'], $u_disorder['eye_id']);
} else {
//add a secondary diagnosis
// Note that this may be creating duplicate diagnoses, but that is okay as the dates on them will differ
$this->event->episode->patient->addDiagnosis($u_disorder['disorder_id'], $u_disorder['eye_id'], substr($this->event->created_date, 0, 10));
// and track
$secondary_disorder_ids[] = $u_disorder['disorder_id'];
}
}
// remove any current diagnoses no longer needed
foreach ($curr_by_disorder_id as $curr) {
if (!$curr->delete()) {
throw new \Exception('Unable to remove old disorder');
}
}
// ensure secondary diagnoses are consistent
// FIXME: ongoing discussion as to whether we should be removing diagnosis from the patient here
// particularly if this is a save of an older examination record.
foreach (\SecondaryDiagnosis::model()->findAll('patient_id=?', array($this->event->episode->patient_id)) as $sd) {
if ($sd->disorder->specialty && $sd->disorder->specialty->code == 130) {
if (!in_array($sd->disorder_id, $secondary_disorder_ids)) {
$this->event->episode->patient->removeDiagnosis($sd->id);
}
}
}
}
public function getSdl()
{
$criteria = new CDbCriteria();
$criteria->compare('patient_id', $this->id);
$criteria->order = 'created_date asc';
$diagnoses = array();
foreach (SecondaryDiagnosis::model()->findAll('patient_id=?', array($this->id)) as $i => $sd) {
if ($sd->disorder->specialty && $sd->disorder->specialty->code == 130) {
$diagnoses[] = strtolower(($sd->eye ? $sd->eye->adjective . ' ' : '') . $sd->disorder->term);
}
}
return Helper::formatList($diagnoses);
}
/**
* if a secondary diagnosis disorder id has been set, we need to ensure its created on the patient.
*
* @see parent::beforeSave()
*/
public function beforeSave()
{
$curr_sd = $this->_getSecondaryDiagnosis();
if ($this->secondarydiagnosis_disorder_id && $curr_sd && $curr_sd->disorder_id != $this->secondarydiagnosis_disorder_id) {
// looks like this is an edit and the previous secondary diagnosis should be removed
// so we can set the correct value
$curr_disorder = $curr_sd->disorder;
$curr_sd->delete();
$curr_sd = null;
Yii::app()->user->setFlash('warning.alert', "Disorder '" . $curr_disorder->term . "' has been removed because DR Grading diagnosis was updated.");
}
if (!$curr_sd) {
// need to determine if we are setting a specific disorder on the patient, or a generic diabetes
// diagnosis (which is implied by recording DR)
$patient = $this->event->episode->patient;
$sd = null;
if ($this->secondarydiagnosis_disorder_id) {
// no secondary diagnosis has been set by this element yet but one has been
// assigned (i.e. the element is being created with a diabetes type)
// final check to ensure nothing has changed whilst processing
if (!$patient->hasDisorderTypeByIds(array_merge(\Disorder::$SNOMED_DIABETES_TYPE_I_SET, \Disorder::$SNOMED_DIABETES_TYPE_II_SET))) {
$sd = new \SecondaryDiagnosis();
$sd->patient_id = $patient->id;
$sd->disorder_id = $this->secondarydiagnosis_disorder_id;
} else {
// clear out the secondarydiagnosis_disorder_id
$this->secondarydiagnosis_disorder_id = null;
// reset required flag as patient now has a diabetes type
$this->secondarydiagnosis_disorder_required = false;
}
} elseif (!$patient->hasDisorderTypeByIds(\Disorder::$SNOMED_DIABETES_SET)) {
// Set the patient to have diabetes
$sd = new \SecondaryDiagnosis();
$sd->patient_id = $patient->id;
$sd->disorder_id = \Disorder::SNOMED_DIABETES;
}
if ($sd !== null) {
$sd->save();
\Audit::add('SecondaryDiagnosis', 'add', $sd->id, null, array('patient_id' => $patient->id));
$this->secondarydiagnosis_id = $sd->id;
Yii::app()->user->setFlash('info.info', "Disorder '" . $sd->disorder->term . "' has been added to patient by DR Grading.");
}
}
return parent::beforeSave();
}
/**
* Reset diagnosis data on the event based on the diagnosis set on this element.
*/
protected function afterSave()
{
if (!$this->event->episode->eye && !$this->event->episode->disorder_id) {
$this->event->episode->setPrincipalDiagnosis($this->disorder_id, $this->eye_id);
if ($sd = SecondaryDiagnosis::model()->find('patient_id=? and disorder_id=? and eye_id = ?', array($this->event->episode->patient_id, $this->disorder_id, 3))) {
$this->event->episode->patient->removeDiagnosis($sd->id);
if (in_array($this->eye_id, array(1, 2))) {
$this->event->episode->patient->addDiagnosis($this->disorder_id, $this->eye_id == 1 ? 2 : 1);
}
}
} else {
if (!SecondaryDiagnosis::model()->find('patient_id=? and disorder_id=? and eye_id in (' . $this->eye_id . ',3)', array($this->event->episode->patient_id, $this->disorder_id))) {
if (!Episode::model()->find('patient_id=? and disorder_id=? and eye_id in (' . $this->eye_id . ',3)', array($this->event->episode->patient_id, $this->disorder_id))) {
$this->event->episode->patient->addDiagnosis($this->disorder_id, $this->eye_id);
}
}
}
return parent::afterSave();
}
