feature: Simulator Scenarios + Clinical Validation: SOFA/GCS

2026-06-21 04:55:39 +08:00
parent bf46e6554a
commit 3638dd0669
39 changed files with 1619 additions and 213 deletions
@@ -0,0 +1,166 @@
+{
+  "scenario": {
+    "id": "sofa-partial-spo2-fallback-01",
+    "name": "Ward Patient — Partial SOFA with SpO₂/FiO₂ Proxy",
+    "description": "General medicine patient with worsening pneumonia. No ABG — SpO₂/FiO₂ used for respiratory SOFA. Partial scoring when labs missing; carry-forward and staleness flags when data ages.",
+    "durationMinutes": 360,
+    "tags": ["sofa", "partial-scoring", "spo2-fallback", "carry-forward", "ward"]
+  },
+  "patient": {
+    "firstName": "Priya",
+    "lastName": "Sharma",
+    "dateOfBirth": "1970-01-14",
+    "gender": "Female"
+  },
+  "encounter": {
+    "department": "GeneralMedicine",
+    "encounterType": "Inpatient",
+    "attendingPhysician": "Dr. Noah Chen",
+    "roomBed": "GM-8B-2",
+    "admissionReason": "Worsening pneumonia, transferred from ED"
+  },
+  "events": [
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "HEART_RATE", "value": 92, "unit": "bpm", "source": "Device" }
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "RESP_RATE", "value": 20, "unit": "/min", "source": "Device" }
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "SYSTOLIC_BP", "value": 118, "unit": "mmHg", "source": "Device" }
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "DIASTOLIC_BP", "value": 72, "unit": "mmHg", "source": "Device" }
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "SPO2", "value": 93, "unit": "%", "source": "Device" }
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "FIO2_PCT", "value": 28, "unit": "%", "source": "Manual" },
+      "note": "Nasal cannula 2L — S/F ~332, SOFA Resp 0"
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "SUPPLEMENTAL_O2", "value": 1, "unit": "flag", "source": "Manual" }
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "TEMP_C", "value": 38.5, "unit": "°C", "source": "Manual" }
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "GCS_EYE", "value": 4, "unit": "score", "source": "Manual" }
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "GCS_VERBAL", "value": 5, "unit": "score", "source": "Manual" }
+    },
+    {
+      "offsetMinutes": 0,
+      "type": "observation",
+      "data": { "code": "GCS_MOTOR", "value": 6, "unit": "score", "source": "Manual" }
+    },
+    {
+      "offsetMinutes": 30,
+      "type": "observation",
+      "data": { "code": "CREATININE_MG_DL", "value": 1.1, "unit": "mg/dL", "source": "Lab" },
+      "note": "Partial SOFA — no platelets/bilirubin yet"
+    },
+    {
+      "offsetMinutes": 120,
+      "type": "observation",
+      "data": { "code": "PLATELET_K_UL", "value": 165, "unit": "k/µL", "source": "Lab" }
+    },
+    {
+      "offsetMinutes": 120,
+      "type": "observation",
+      "data": { "code": "BILIRUBIN_MG_DL", "value": 0.8, "unit": "mg/dL", "source": "Lab" },
+      "note": "Baseline SOFA now more complete"
+    },
+    {
+      "offsetMinutes": 180,
+      "type": "observation",
+      "data": { "code": "SPO2", "value": 88, "unit": "%", "source": "Device" }
+    },
+    {
+      "offsetMinutes": 180,
+      "type": "observation",
+      "data": { "code": "FIO2_PCT", "value": 40, "unit": "%", "source": "Manual" },
+      "note": "S/F 220 → SOFA Resp ~1; usedSpO2Fallback true"
+    },
+    {
+      "offsetMinutes": 180,
+      "type": "observation",
+      "data": { "code": "RESP_RATE", "value": 26, "unit": "/min", "source": "Device" }
+    },
+    {
+      "offsetMinutes": 240,
+      "type": "observation",
+      "data": { "code": "SPO2", "value": 84, "unit": "%", "source": "Device" }
+    },
+    {
+      "offsetMinutes": 240,
+      "type": "observation",
+      "data": { "code": "FIO2_PCT", "value": 60, "unit": "%", "source": "Manual" },
+      "note": "S/F 140 → SOFA Resp 2"
+    },
+    {
+      "offsetMinutes": 240,
+      "type": "observation",
+      "data": { "code": "CREATININE_MG_DL", "value": 1.9, "unit": "mg/dL", "source": "Lab" }
+    },
+    {
+      "offsetMinutes": 240,
+      "type": "observation",
+      "data": { "code": "PLATELET_K_UL", "value": 110, "unit": "k/µL", "source": "Lab" },
+      "note": "SOFA Coag 1"
+    },
+    {
+      "offsetMinutes": 300,
+      "type": "observation",
+      "data": { "code": "SYSTOLIC_BP", "value": 88, "unit": "mmHg", "source": "Device" }
+    },
+    {
+      "offsetMinutes": 300,
+      "type": "observation",
+      "data": { "code": "DIASTOLIC_BP", "value": 52, "unit": "mmHg", "source": "Device" },
+      "note": "MAP 64 → SOFA CV 1"
+    },
+    {
+      "offsetMinutes": 300,
+      "type": "observation",
+      "data": { "code": "CREATININE_MG_DL", "value": 2.5, "unit": "mg/dL", "source": "Lab" },
+      "note": "SOFA Renal 2; delta may reach ≥ 2"
+    }
+  ],
+  "expectedOutcomes": [
+    {
+      "afterOffsetMinutes": 180,
+      "type": "score",
+      "scoreType": "SOFA",
+      "description": "SOFA computed with usedSpO2Fallback in staleness flags"
+    },
+    {
+      "afterOffsetMinutes": 300,
+      "type": "alert",
+      "alertType": "SOFA_SEPSIS",
+      "description": "Multi-organ decline — delta ≥ 2 from baseline"
+    }
+  ]
+}