public static NeurologyFormTotals LoadNeurologyFormTotalsFrom(XDocument xmlDocument)
{
var totalsXml = xmlDocument.Root.Element("NeurologyFormTotals");
var neurologyFormTotals = new NeurologyFormTotals
{
LeftPrickContainsNt = bool.Parse(totalsXml.Element("LeftPrickContainsNt").Value),
LeftPrickTotal = GetIntValueFrom(totalsXml.Element("LeftPrickTotal").Value),
LeftPrickTotalHasImpairmentNotDueToSci = DoesTotalHaveImpairmentNotDueToSci(totalsXml.Element("LeftPrickTotal").Value),
LeftTouchContainsNt = bool.Parse(totalsXml.Element("LeftTouchContainsNt").Value),
LeftTouchTotal = GetIntValueFrom(totalsXml.Element("LeftTouchTotal").Value),
LeftTouchTotalHasImpairmentNotDueToSci = DoesTotalHaveImpairmentNotDueToSci(totalsXml.Element("LeftTouchTotal").Value),
LeftLowerMotorContainsNt = bool.Parse(totalsXml.Element("LeftLowerMotorContainsNt").Value),
LeftLowerMotorTotal = GetIntValueFrom(totalsXml.Element("LeftLowerMotorTotal").Value),
LeftLowerMotorTotalHasImpairmentNotDueToSci = DoesTotalHaveImpairmentNotDueToSci(totalsXml.Element("LeftLowerMotorTotal").Value),
LeftUpperMotorContainsNt = bool.Parse(totalsXml.Element("LeftUpperMotorContainsNt").Value),
LeftUpperMotorTotal = GetIntValueFrom(totalsXml.Element("LeftUpperMotorTotal").Value),
LeftUpperMotorTotalHasImpairmentNotDueToSci = DoesTotalHaveImpairmentNotDueToSci(totalsXml.Element("LeftUpperMotorTotal").Value),
LowerMotorTotal = GetIntValueFrom(totalsXml.Element("LowerMotorTotal").Value),
PrickTotal = GetIntValueFrom(totalsXml.Element("PrickTotal").Value),
RightLowerMotorContainsNt = bool.Parse(totalsXml.Element("RightLowerMotorContainsNt").Value),
RightLowerMotorTotal = GetIntValueFrom(totalsXml.Element("RightLowerMotorTotal").Value),
RightLowerMotorTotalHasImpairmentNotDueToSci = DoesTotalHaveImpairmentNotDueToSci(totalsXml.Element("RightLowerMotorTotal").Value),
RightUpperMotorContainsNt = bool.Parse(totalsXml.Element("RightUpperMotorContainsNt").Value),
RightUpperMotorTotal = GetIntValueFrom(totalsXml.Element("RightUpperMotorTotal").Value),
RightUpperMotorTotalHasImpairmentNotDueToSci = DoesTotalHaveImpairmentNotDueToSci(totalsXml.Element("RightUpperMotorTotal").Value),
RightPrickContainsNt = bool.Parse(totalsXml.Element("RightPrickContainsNt").Value),
RightPrickTotal = GetIntValueFrom(totalsXml.Element("RightPrickTotal").Value),
RightPrickTotalHasImpairmentNotDueToSci = DoesTotalHaveImpairmentNotDueToSci(totalsXml.Element("RightPrickTotal").Value),
RightTouchContainsNt = bool.Parse(totalsXml.Element("RightTouchContainsNt").Value),
RightTouchTotal = GetIntValueFrom(totalsXml.Element("RightTouchTotal").Value),
RightTouchTotalHasImpairmentNotDueToSci = DoesTotalHaveImpairmentNotDueToSci(totalsXml.Element("RightTouchTotal").Value),
TouchTotal = GetIntValueFrom(totalsXml.Element("TouchTotal").Value),
UpperMotorTotal = GetIntValueFrom(totalsXml.Element("UpperMotorTotal").Value),
};
var levelsDictionary = GetLevelsDictionary();
foreach (var value in totalsXml.Element("RightSensory").Value.Split(',').Select(v => v.Trim()))
neurologyFormTotals.AddRightSensoryValue(levelsDictionary[value.ToUpper()]);
foreach (var value in totalsXml.Element("LeftSensory").Value.Split(',').Select(v => v.Trim()))
neurologyFormTotals.AddLeftSensoryValue(levelsDictionary[value.ToUpper()]);
foreach (var value in totalsXml.Element("RightMotor").Value.Split(',').Select(v => v.Trim()))
neurologyFormTotals.AddRightMotorValue(levelsDictionary[value.ToUpper()]);
foreach (var value in totalsXml.Element("LeftMotor").Value.Split(',').Select(v => v.Trim()))
neurologyFormTotals.AddLeftMotorValue(levelsDictionary[value.ToUpper()]);
foreach (var value in totalsXml.Element("NeurologicalLevelOfInjury").Value.Split(',').Select(v => v.Trim()))
neurologyFormTotals.AddNeurologicalLevelOfInjury(levelsDictionary[value.ToUpper()]);
foreach (var value in totalsXml.Element("RightSensoryZpp").Value.Split(',').Select(v => v.Trim()))
if (!string.IsNullOrEmpty(value))
neurologyFormTotals.AddRightSensoryZppValue(levelsDictionary[value.ToUpper()]);
foreach (var value in totalsXml.Element("LeftSensoryZpp").Value.Split(',').Select(v => v.Trim()))
if (!string.IsNullOrEmpty(value))
neurologyFormTotals.AddLeftSensoryZppValue(levelsDictionary[value.ToUpper()]);
foreach (var value in totalsXml.Element("RightMotorZpp").Value.Split(',').Select(v => v.Trim()))
if (!string.IsNullOrEmpty(value))
neurologyFormTotals.AddRightMotorZppValue(levelsDictionary[value.ToUpper()]);
foreach (var value in totalsXml.Element("LeftMotorZpp").Value.Split(',').Select(v => v.Trim()))
if (!string.IsNullOrEmpty(value))
neurologyFormTotals.AddLeftMotorZppValue(levelsDictionary[value.ToUpper()]);
foreach (var value in totalsXml.Element("AsiaImpairmentScale").Value.Split(',').Select(v => v.Trim()))
neurologyFormTotals.AddAsiaImpairmentScaleValue(value.ToUpper());
return neurologyFormTotals;
}
/// <summary>
/// Recursive method which iterates through the values in a nuerology form while it updates the totals generating the results produced by the algorithm.
/// </summary>
/// <param name="neurologyForm">Form being evaluated.</param>
/// <param name="totals">Brand new totals object where the results are to be stored.</param>
/// <param name="level">Current neurology level being evaluated</param>
/// <param name="nextNonKeyMuscleShouldBeRightMotor">Flag used to evaluate the Kathy Collins condition on the right motor results.</param>
/// <param name="nextNonKeyMuscleShouldBeLeftMotor">Flag used to evaluate the Kathy Collins condition on the left motor results.</param>
private static void UpdateTotalsWithLevelAt(NeurologyForm neurologyForm, NeurologyFormTotals totals, NeurologyFormLevel level, bool nextNonKeyMuscleShouldBeRightMotor, bool nextNonKeyMuscleShouldBeLeftMotor)
{
totals.RightTouchTotal += level.RightTouchValue;
totals.LeftTouchTotal += level.LeftTouchValue;
totals.RightPrickTotal += level.RightPrickValue;
totals.LeftPrickTotal += level.LeftPrickValue;
if (level.IsKeyMuscle)
{
if (level.IsLowerMuscle)
{
if (level.RightMotorImpairmentNotDueToSci && !totals.RightLowerMotorTotalHasImpairmentNotDueToSci)
totals.RightLowerMotorTotalHasImpairmentNotDueToSci = true;
if (level.LeftMotorImpairmentNotDueToSci && !totals.LeftLowerMotorTotalHasImpairmentNotDueToSci)
totals.LeftLowerMotorTotalHasImpairmentNotDueToSci = true;
if (NtRegex.IsMatch(level.RightMotorName) && !level.RightMotorImpairmentNotDueToSci)
totals.RightLowerMotorContainsNt = true;
if (NtRegex.IsMatch(level.LeftMotorName) && !level.LeftMotorImpairmentNotDueToSci)
totals.LeftLowerMotorContainsNt = true;
}
else
{
if (level.RightMotorImpairmentNotDueToSci && !totals.RightUpperMotorTotalHasImpairmentNotDueToSci)
totals.RightUpperMotorTotalHasImpairmentNotDueToSci = true;
if (level.LeftMotorImpairmentNotDueToSci && !totals.LeftUpperMotorTotalHasImpairmentNotDueToSci)
totals.LeftUpperMotorTotalHasImpairmentNotDueToSci = true;
if (NtRegex.IsMatch(level.RightMotorName) && !level.RightMotorImpairmentNotDueToSci)
totals.RightUpperMotorContainsNt = true;
if (NtRegex.IsMatch(level.LeftMotorName) && !level.LeftMotorImpairmentNotDueToSci)
totals.LeftUpperMotorContainsNt = true;
}
}
else
{
if (nextNonKeyMuscleShouldBeRightMotor)
{
nextNonKeyMuscleShouldBeRightMotor = false;
totals.AddRightMotorValue(level.Previous);
if (!totals.RightSensoryHasOnlySoftValues)
totals.RightMotorHasOnlySoftValues = false;
}
if (nextNonKeyMuscleShouldBeLeftMotor)
{
nextNonKeyMuscleShouldBeLeftMotor = false;
totals.AddLeftMotorValue(level.Previous);
if (!totals.LeftSensoryHasOnlySoftValues)
totals.LeftMotorHasOnlySoftValues = false;
}
}
if (level.RightTouchImpairmentNotDueToSci && !totals.RightTouchTotalHasImpairmentNotDueToSci)
totals.RightTouchTotalHasImpairmentNotDueToSci = true;
if (level.LeftTouchImpairmentNotDueToSci && !totals.LeftTouchTotalHasImpairmentNotDueToSci)
totals.LeftTouchTotalHasImpairmentNotDueToSci = true;
if (level.RightPrickImpairmentNotDueToSci && !totals.RightPrickTotalHasImpairmentNotDueToSci)
totals.RightPrickTotalHasImpairmentNotDueToSci = true;
if (level.LeftPrickImpairmentNotDueToSci && !totals.LeftPrickTotalHasImpairmentNotDueToSci)
totals.LeftPrickTotalHasImpairmentNotDueToSci = true;
// Check if a column contains any NT value so we can properly format the total presented to the user
if (NtRegex.IsMatch(level.RightTouchName) && !level.RightTouchImpairmentNotDueToSci && !totals.RightTouchContainsNt)
totals.RightTouchContainsNt = true;
if (NtRegex.IsMatch(level.LeftTouchName) && !level.LeftTouchImpairmentNotDueToSci && !totals.LeftTouchContainsNt)
totals.LeftTouchContainsNt = true;
if (NtRegex.IsMatch(level.RightPrickName) && !level.RightPrickImpairmentNotDueToSci && !totals.RightPrickContainsNt)
totals.RightPrickContainsNt = true;
if (NtRegex.IsMatch(level.LeftPrickName) && !level.LeftPrickImpairmentNotDueToSci && !totals.LeftPrickContainsNt)
totals.LeftPrickContainsNt = true;
if (totals.RightSensoryHasOnlySoftValues &&
((level.RightTouchValue != 2 && !level.RightTouchImpairmentNotDueToSci) ||
(level.RightPrickValue != 2 && !level.RightPrickImpairmentNotDueToSci)))
{
totals.AddRightSensoryValue(level.Previous);
if ("S4_5".Equals(level.Name)
&& (level.RightTouchValue == 2 || NtRegex.IsMatch(level.RightTouchName))
&& (level.RightPrickValue == 2 || NtRegex.IsMatch(level.RightPrickName)))
{
totals.AddRightSensoryValue(level);
if (totals.NeurologicalLevelOfInjuryHasOnlySoftValues)
totals.AddNeurologicalLevelOfInjury(level);
}
if (totals.NeurologicalLevelOfInjuryHasOnlySoftValues)
totals.AddNeurologicalLevelOfInjury(level.Previous);
if ((level.RightTouchValue != 2 && !NtRegex.IsMatch(level.RightTouchName))
|| (level.RightPrickValue != 2 && !NtRegex.IsMatch(level.RightPrickName)))
{
totals.RightSensoryHasOnlySoftValues = false;
totals.NeurologicalLevelOfInjuryHasOnlySoftValues = false;
}
if (level.IsKeyMuscle)
{
nextNonKeyMuscleShouldBeRightMotor = true;
totals.HasRightCollins = true;
}
}
if (totals.LeftSensoryHasOnlySoftValues &&
((level.LeftTouchValue != 2 && !level.LeftTouchImpairmentNotDueToSci) ||
(level.LeftPrickValue != 2 && !level.LeftPrickImpairmentNotDueToSci)))
{
totals.AddLeftSensoryValue(level.Previous);
if ("S4_5".Equals(level.Name)
&& (level.LeftTouchValue == 2 || NtRegex.IsMatch(level.LeftTouchName))
&& (level.LeftPrickValue == 2 || NtRegex.IsMatch(level.LeftPrickName)))
{
totals.AddLeftSensoryValue(level);
if (totals.NeurologicalLevelOfInjuryHasOnlySoftValues)
totals.AddNeurologicalLevelOfInjury(level);
}
if (totals.NeurologicalLevelOfInjuryHasOnlySoftValues)
totals.AddNeurologicalLevelOfInjury(level.Previous);
if ((level.LeftTouchValue != 2 && !NtRegex.IsMatch(level.LeftTouchName))
|| (level.LeftPrickValue != 2 && !NtRegex.IsMatch(level.LeftPrickName)))
{
totals.LeftSensoryHasOnlySoftValues = false;
totals.NeurologicalLevelOfInjuryHasOnlySoftValues = false;
}
if (level.IsKeyMuscle)
{
nextNonKeyMuscleShouldBeLeftMotor = true;
totals.HasLeftCollins = true;
}
}
if (totals.RightMotorHasOnlySoftValues && level.RightMotorValue != 5 && !level.RightMotorImpairmentNotDueToSci)
{
if (level.IsKeyMuscle && (level.RightMotorValue >= 3 || NtRegex.IsMatch(level.RightMotorName)))
{
totals.AddRightMotorValue(level);
// Check if left won't make the NLI have to be the previous level.
// Let the logic for left motor handle the SNL instead
if (totals.NeurologicalLevelOfInjuryHasOnlySoftValues
&& (level.LeftMotorValue > 2 || level.LeftMotorImpairmentNotDueToSci || NtRegex.IsMatch(level.LeftMotorName)))
{
totals.AddNeurologicalLevelOfInjury(level);
if (!NtRegex.IsMatch(level.RightMotorName))
totals.NeurologicalLevelOfInjuryHasOnlySoftValues = false;
}
}
if (level.RightMotorValue < 3 || NtRegex.IsMatch(level.RightMotorName))
{
totals.AddRightMotorValue(level.Previous);
if (totals.NeurologicalLevelOfInjuryHasOnlySoftValues)
{
totals.AddNeurologicalLevelOfInjury(level.Previous);
if (!NtRegex.IsMatch(level.RightMotorName))
totals.NeurologicalLevelOfInjuryHasOnlySoftValues = false;
}
}
if (!NtRegex.IsMatch(level.RightMotorName))
totals.RightMotorHasOnlySoftValues = false;
}
if (totals.LeftMotorHasOnlySoftValues && level.LeftMotorValue != 5 && !level.LeftMotorImpairmentNotDueToSci)
{
if (level.IsKeyMuscle && (level.LeftMotorValue >= 3 || NtRegex.IsMatch(level.LeftMotorName)))
{
totals.AddLeftMotorValue(level);
if (totals.NeurologicalLevelOfInjuryHasOnlySoftValues)
totals.AddNeurologicalLevelOfInjury(level);
}
if (level.LeftMotorValue < 3 || NtRegex.IsMatch(level.LeftMotorName))
{
totals.AddLeftMotorValue(level.Previous);
if (totals.NeurologicalLevelOfInjuryHasOnlySoftValues)
totals.AddNeurologicalLevelOfInjury(level.Previous);
}
if (!NtRegex.IsMatch(level.LeftMotorName))
{
totals.LeftMotorHasOnlySoftValues = false;
totals.NeurologicalLevelOfInjuryHasOnlySoftValues = false;
}
}
/* -- RECURSIVE CALL --------------- */
if (level.Next != null)
UpdateTotalsWithLevelAt(neurologyForm, totals, level.Next,
nextNonKeyMuscleShouldBeRightMotor && totals.RightMotorHasOnlySoftValues,
nextNonKeyMuscleShouldBeLeftMotor && totals.LeftMotorHasOnlySoftValues);
#region This happens when there are INTACT values -------------------------------------------
if ("S4_5".Equals(level.Name))
{
if (totals.RightSensoryHasOnlySoftValues && totals.LeftSensoryHasOnlySoftValues
&& totals.RightMotorHasOnlySoftValues && totals.LeftMotorHasOnlySoftValues)
totals.AddNeurologicalLevelOfInjury(level);
if (totals.RightSensoryHasOnlySoftValues)
{
totals.AddRightSensoryValue(level);
totals.RightSensoryHasOnlySoftValues = false;
}
if (totals.LeftSensoryHasOnlySoftValues)
{
totals.AddLeftSensoryValue(level);
totals.LeftSensoryHasOnlySoftValues = false;
}
if (totals.RightMotorHasOnlySoftValues)
{
totals.AddRightMotorValue(level);
totals.RightMotorHasOnlySoftValues = false;
}
if (totals.LeftMotorHasOnlySoftValues)
{
totals.AddLeftMotorValue(level);
totals.LeftMotorHasOnlySoftValues = false;
}
}
#endregion
if (totals.RightSensoryZppHasOnlySoftValues && (!"0".Equals(level.RightTouchName) || !"0".Equals(level.RightPrickName)))
{
if ((level.RightTouchValue > 0 || level.RightTouchImpairmentNotDueToSci)
|| (level.RightPrickValue > 0 || level.RightPrickImpairmentNotDueToSci))
totals.RightSensoryZppHasOnlySoftValues = false;
totals.AddRightSensoryZppValue(level);
}
if (totals.LeftSensoryZppHasOnlySoftValues && (!"0".Equals(level.LeftTouchName) || !"0".Equals(level.LeftPrickName)))
{
if ((level.LeftTouchValue > 0 || level.LeftTouchImpairmentNotDueToSci)
|| (level.LeftPrickValue > 0 || level.LeftPrickImpairmentNotDueToSci))
totals.LeftSensoryZppHasOnlySoftValues = false;
totals.AddLeftSensoryZppValue(level);
}
if (totals.RightMotorZppHasOnlySoftValues
&& (level.HasOtherRightMotorFunction
|| (!"0".Equals(level.RightMotorName) && (level.IsKeyMuscle || totals.RightMotorContains(level.Name)))))
{
if ((level.RightMotorImpairmentNotDueToSci || level.HasOtherRightMotorFunction || !NtRegex.IsMatch(level.RightMotorName)) &&
(level.IsKeyMuscle
|| level.Ordinal < 4
|| (level.Ordinal > 25 && !totals.RightUpperMotorContainsNt && !totals.RightLowerMotorContainsNt && !totals.HasRightCollins)
|| (level.Ordinal > 8 && level.Ordinal < 21 && !totals.RightUpperMotorContainsNt)))
totals.RightMotorZppHasOnlySoftValues = false;
totals.AddRightMotorZppValue(level);
}
if (totals.LeftMotorZppHasOnlySoftValues
&& (level.HasOtherLeftMotorFunction
|| (!"0".Equals(level.LeftMotorName) && (level.IsKeyMuscle || totals.LeftMotorContains(level.Name)))))
{
if ((level.LeftMotorImpairmentNotDueToSci || level.HasOtherLeftMotorFunction || !NtRegex.IsMatch(level.LeftMotorName)) &&
(level.IsKeyMuscle
|| level.Ordinal < 4
|| (level.Ordinal > 25 && !totals.LeftUpperMotorContainsNt && !totals.LeftLowerMotorContainsNt && !totals.HasLeftCollins)
|| (level.Ordinal > 8 && level.Ordinal < 21 && !totals.LeftUpperMotorContainsNt)))
totals.LeftMotorZppHasOnlySoftValues = false;
totals.AddLeftMotorZppValue(level);
}
// Update most Rostral levels with motor function
if ((level.IsKeyMuscle || level.HasOtherRightMotorFunction)
&& totals.MostRostralRightLevelWithMotorFunction == null
&& (level.RightMotorImpairmentNotDueToSci || level.HasOtherRightMotorFunction || (level.RightMotorValue != 0 && level.IsKeyMuscle)))
totals.MostRostralRightLevelWithMotorFunction = level;
if ((level.IsKeyMuscle || level.HasOtherLeftMotorFunction)
&& totals.MostRostralLeftLevelWithMotorFunction == null
&& (level.LeftMotorImpairmentNotDueToSci || level.HasOtherLeftMotorFunction || (level.LeftMotorValue != 0 && level.IsKeyMuscle)))
totals.MostRostralLeftLevelWithMotorFunction = level;
// Update most Caudal levels with motor function
if ((level.IsKeyMuscle || level.HasOtherRightMotorFunction)
&& totals.MostCaudalRightLevelWithMotorFunction == null
&& (!"0".Equals(level.RightMotorName) || level.HasOtherRightMotorFunction))
totals.MostCaudalRightLevelWithMotorFunction = level;
if ((level.IsKeyMuscle || level.HasOtherLeftMotorFunction)
&& totals.MostCaudalLeftLevelWithMotorFunction == null
&& (!"0".Equals(level.LeftMotorName) || level.HasOtherLeftMotorFunction))
totals.MostCaudalLeftLevelWithMotorFunction = level;
if (!level.IsKeyMuscle)
return;
if (level.IsLowerMuscle)
{
totals.RightLowerMotorTotal += level.RightMotorValue;
totals.LeftLowerMotorTotal += level.LeftMotorValue;
}
else
{
totals.RightUpperMotorTotal += level.RightMotorValue;
totals.LeftUpperMotorTotal += level.LeftMotorValue;
}
}