public void Classification_GivenParams_ReturnsCorrectAscvdRiskClassification(GenderIdentity genderIdentity,
int systolic, double hdl, double totalCholesterol, double ldl,
bool diabetic, bool antiHypertensive, bool smoker, bool ascvdPresent, AscvdRiskClassification expected)
{
_patient.Gender = Gender.Build(genderIdentity);
if (diabetic)
{
_patient.Comorbidities.Add(ChronicDisease.Diabetes);
}
if (antiHypertensive)
{
_patient.Comorbidities.Add(ChronicDisease.HypertensionTreated);
}
if (smoker)
{
_patient.Comorbidities.Add(ChronicDisease.TobaccoSmoker);
}
if (ascvdPresent)
{
_patient.Comorbidities.Add(ChronicDisease.DiagnosedCardiovascularDisease);
}
var ascvdClassification = new AscvdClassification(AscvdParameters.Build(_patient,
BloodPressure.Build(systolic, 75), Quantitative.Serum.CholesterolTotal(totalCholesterol),
Quantitative.Serum.LowDensityLipoprotein(ldl), Quantitative.Serum.HighDensityLipoprotein(hdl)));
Assert.Equal(expected, ascvdClassification.Classification.TenYearRiskClassification);
}
public AscvdParametersTests()
{
_patient = PatientBuilder.Initialize().BuildWithoutModelValidation();
_bloodPressure = BloodPressure.Build(0, 0);
_totalCholesterol = Quantitative.Serum.CholesterolTotal(0);
_ldlCholesterol = Quantitative.Serum.LowDensityLipoprotein(0);
_hdlCholesterol = Quantitative.Serum.HighDensityLipoprotein(0);
}
public void ToString_ContainsAllElementsOfInterpretationText(string element, int systolic = 0,
int diastolic = 70, bool organDamage = false)
{
var fakeInterp = new FakeBloodPressureInterpretation(
BloodPressure.Build(systolic, diastolic, organDamage));
Assert.Contains(element.ToLower(), fakeInterp.ToString().ToLower());
}
public void ToString_ReturnsNonEmptyString()
{
var riskFactors = new AscvdClassification(AscvdParameters.Build(
PatientBuilder.Initialize().SetGender(GenderIdentity.Male).BuildWithoutModelValidation(),
BloodPressure.Build(0, 0), Quantitative.Serum.CholesterolTotal(0),
Quantitative.Serum.LowDensityLipoprotein(0), Quantitative.Serum.HighDensityLipoprotein(0)));
Assert.NotEmpty(riskFactors.ToString());
}
public void Classification_GivenParameters_ReturnsProperStageClassification(int systolic, int diastolic,
BloodPressureStage expectedStage, bool organDamagePresent = false)
{
var bloodPressure = BloodPressure.Build(systolic, diastolic, organDamagePresent);
var bpClassification = new BloodPressureClassification(bloodPressure).Classification;
Assert.Equal(expectedStage, bpClassification.Stage);
}
public PooledCohortsEquationTests()
{
var dateOfBirth = DateTime.Now.AddYears(-55);
_patient = PatientBuilder.Initialize()
.SetDateOfBirth(dateOfBirth.Year, dateOfBirth.Month, dateOfBirth.Day)
.BuildWithoutModelValidation();
_parametersBuilder = PooledCohortEquationParametersBuilder.Initialize()
.SetBloodPressure(BloodPressure.Build(120, 75))
.SetHdlCholesterol(50)
.SetTotalCholesterol(213);
}
public AscvdParametersBuilderTests()
{
var bloodPressure = BloodPressure.Build(0, 0);
var hdlCholesterol = Quantitative.Serum.HighDensityLipoprotein(0);
var ldlCholesterol = Quantitative.Serum.LowDensityLipoprotein(0);
var totalCholesterol = Quantitative.Serum.CholesterolTotal(0);
var patient = PatientBuilder.Initialize().BuildWithoutModelValidation();
_builder = AscvdParametersBuilder.Initialize()
.SetBloodPressure(bloodPressure)
.SetHdlCholesterol(hdlCholesterol)
.SetLdlCholesterol(ldlCholesterol)
.SetPatient(patient)
.SetTotalCholesterol(totalCholesterol);
}
public void Classfication_GivenParams_ReturnsCorrectListOfRiskFactors()
{
_patient.Comorbidities.AddRange(new List <ChronicDisease>
{
ChronicDisease.Diabetes,
ChronicDisease.TobaccoSmoker
});
var ascvd = new AscvdClassification(AscvdParameters.Build(_patient, BloodPressure.Build(130, 75),
Quantitative.Serum.CholesterolTotal(213), Quantitative.Serum.LowDensityLipoprotein(195),
Quantitative.Serum.HighDensityLipoprotein(50)));
var riskFactors = ascvd.Classification.RiskFactors;
Assert.Contains(AscvdModifiableRiskFactors.BloodPressureElevated, riskFactors);
Assert.Contains(AscvdModifiableRiskFactors.TotalCholesterolElevated, riskFactors);
Assert.Contains(AscvdModifiableRiskFactors.Diabetes, riskFactors);
Assert.Contains(AscvdModifiableRiskFactors.Smoker, riskFactors);
}
public void IdealPercentAscvdRisk10Year_Given2013AccAhaSampleParams_ReturnsCorrectRiskPercentage(Race race,
GenderIdentity genderIdentity, double expected)
{
_patient.Gender = Gender.Build(genderIdentity);
_patient.Race = race;
_parametersBuilder
.SetPatient(_patient)
.SetBloodPressure(BloodPressure.Build(default(int), default(int)))
.SetTotalCholesterol(default(int))
.SetHdlCholesterol(default(int));
var idealAscvd = new PooledCohortsEquation(_parametersBuilder.Build()).IdealAscvd10YearRiskPercentage;
const double tolerance = 0.31; // Tolerance necessary because expected values are estimates.
Assert.InRange(idealAscvd, expected - tolerance, expected + tolerance);
}
public TreadmillExerciseStressTestBuilder SetMaximumBloodPressure(int systolic, int diastolic)
{
_maximumBloodPressure = BloodPressure.Build(systolic, diastolic);
return(this);
}
public VitalSignsBuilder SetBloodPressure(int systolic, int diastolic, bool endOrganDamage)
{
_bloodPressure = BloodPressure.Build(systolic, diastolic, endOrganDamage);
return(this);
}
public void GivenProperBloodPressure_ReturnsNonEmptyString()
{
var bpInterp = new BloodPressureInterpretation(BloodPressure.Build(175, 95));
Assert.NotEmpty(bpInterp.ToString());
}
public void GivenProperBloodPressure_ReturnsCorrectType()
{
var bpInterp = new BloodPressureInterpretation(BloodPressure.Build(175, 95));
Assert.IsType <BloodPressureInterpretation>(bpInterp);
}
public static void Main(string[] args)
{
var patient = PatientBuilder
.Initialize()
.SetDateOfBirth(1952, 3, 31)
.SetGender(GenderIdentity.NonBinaryXy)
.SetMedicalRecordNumber("1234")
.SetName("Joe", "Bob")
.SetRace(Race.BlackOrAfricanAmerican)
.Build();
Console.WriteLine($"Meet our patient: {patient}{NewLine}");
var vitals = VitalSignsBuilder.Initialize()
.SetBloodPressure(168, 99, false)
.SetOxygenSaturation(96)
.SetPulseRate(105)
.SetTemperature(101.2)
.Build();
Console.WriteLine($"{patient.Name.First}'s vitals: {vitals}{NewLine}");
var bp = BloodPressure.Build(100, 66);
Console.WriteLine($"If {patient.Name.First} used to have good blood pressure, it was {bp}.{NewLine}");
var bodyComposition = BodyCompositionBuilder
.Initialize()
.SetHeight(70.9)
.SetHips(40)
.SetWaist(34)
.SetWeight(193)
.Build();
Console.WriteLine($"Simple body composition measures: {bodyComposition}{NewLine}");
var bodyCompositionExpanded = BodyCompositionExpandedBuilder
.Initialize()
.SetBodyFatPercentage(16.5)
.SetHeight(bodyComposition.Height.Inches)
.SetHips(bodyComposition.Hips.Inches)
.SetVisceralFat(70)
.SetWaist(bodyComposition.Waist.Inches)
.SetWeight(bodyComposition.Weight.Pounds)
.Build();
Console.WriteLine($"Expanded body composition measures: {bodyCompositionExpanded}{NewLine}");
var quantitativeLabChoesterol = Quantitative.Serum.CholesterolTotal(300);
Console.WriteLine($"Quantitative Lab: {quantitativeLabChoesterol}.{NewLine}");
var quantitativeLabHdlC = Quantitative.Serum.HighDensityLipoprotein(35);
Console.WriteLine($"Quantitative Lab: {quantitativeLabHdlC}.{NewLine}");
var quantitativeLabLdlC = Quantitative.Serum.LowDensityLipoprotein(173);
Console.WriteLine($"Quantitative Lab: {quantitativeLabLdlC}.{NewLine}");
var qualitativeLab = Qualitative.HepatitisCAntibody(QualitativeLabResult.Negative);
Console.WriteLine($"Qualitative Lab: {qualitativeLab.Type}, Result: {qualitativeLab.Result}{NewLine}");
var cardioRegimen = CardiovascularRegimen.Build(3, 98.5, ExerciseIntensity.Moderate);
Console.WriteLine($"Cardio regimen: {cardioRegimen}{NewLine}");
var stretchRegimen = StretchingRegimen.Build(1, 10, ExerciseIntensity.Low);
Console.WriteLine($"Stretching regimen: {stretchRegimen}{NewLine}");
var resistanceRegimen = ResistanceRegimenBuilder
.Initialize()
.SetAverageSessionDuration(120)
.SetIntensity(ExerciseIntensity.Moderate)
.SetSecondsRestDurationPerSet(90)
.SetSessionsPerWeek(6)
.ConfirmUpperBodyTrained()
.ConfirmPullingMovementsPerformed()
.ConfirmPushingMovementsPerformed()
.ConfirmRepetitionsToNearFailure()
.Build();
Console.WriteLine($"Resistance regimen: {resistanceRegimen}{NewLine}");
var audiogramDataLeft = AudiogramDatasetBuilder
.Initialize()
.Set125HertzDataPoint(10)
.Set250HertzDataPoint(20)
.Set500HertzDataPoint(30)
.Set1000HertzDataPoint(10)
.Set2000HertzDataPoint(25)
.Set3000HertzDataPoint(45)
.Set4000HertzDataPoint(40)
.Set6000HertzDataPoint(50)
.Set8000HertzDataPoint(70)
.Build();
var audiogramDataRight = AudiogramDatasetBuilder
.Initialize()
.Set125HertzDataPoint(10)
.Set250HertzDataPoint(20)
.Set500HertzDataPoint(30)
.Set1000HertzDataPoint(10)
.Set2000HertzDataPoint(25)
.Set3000HertzDataPoint(45)
.Set4000HertzDataPoint(40)
.Set6000HertzDataPoint(50)
.Set8000HertzDataPoint(90)
.Build();
var audiogram = Audiogram.Build(audiogramDataLeft, audiogramDataRight);
Console.WriteLine($"Audiogram{NewLine}{audiogram}{NewLine}");
var carotidLeft = CarotidUltrasoundResultBuilder
.Initialize()
.SetIntimaMediaThickeness(0.693)
.Build();
var carotidRight = CarotidUltrasoundResultBuilder
.Initialize()
.SetIntimaMediaThickeness(0.732)
.SetImtGrade(CarotidIntimaMediaThicknessGrade.Mild)
.SetPercentStenosisGrade(CarotidPercentStenosisGrade.Nominal)
.SetPlaqueCharacter(CarotidPlaqueCharacter.EarlyBuildup)
.Build();
var carotidUs = CarotidUltrasound.Build(carotidLeft, carotidRight);
Console.WriteLine($"Carotid US{NewLine}{carotidUs}{NewLine}");
var centralBp = CentralBloodPressureBuilder
.Initialize()
.SetAugmentedIndex(25)
.SetAugmentedPressure(4)
.SetCentralSystolicPressure(113)
.SetPulsePressure(16)
.SetPulseWaveVelocity(7.9)
.SetReferenceAge(43)
.Build();
Console.WriteLine($"Central BP: {centralBp}{NewLine}");
var functionalMovementScreen = FunctionalMovementScreenBuilder
.Initialize()
.SetActiveStraightLegRaise(2, 3)
.SetDeepSquat(3)
.SetHurdleStep(2, 2)
.SetInlineLunge(3, 3)
.SetRotaryStability(2, 2, true)
.SetShoulderMobility(2, false, 2, false)
.SetTrunkStabilityPuhsup(2, false)
.Build();
Console.WriteLine($"Functional Movement Screen{NewLine}{functionalMovementScreen}{NewLine}");
var gripStrength = GripStrength.Build(123, 135);
Console.WriteLine($"Grip strength {gripStrength}{NewLine}");
var ishiharaSix = IshiharaSixPlateScreenBuilder
.Initialize()
.SetPlate1(IshiharaAnswerResult.NormalVision)
.SetPlate2(IshiharaAnswerResult.ColorVisionDefict)
.SetPlate3(IshiharaAnswerResult.NormalVision)
.SetPlate4(IshiharaAnswerResult.NormalVision)
.SetPlate5(IshiharaAnswerResult.NormalVision)
.SetPlate6(IshiharaAnswerResult.ColorVisionDefict)
.Build();
Console.WriteLine("Ishihara Six Plate Screener");
Console.WriteLine($"{ishiharaSix}{NewLine}");
var ocularPressure = OccularPressure.Build(15, 13);
Console.WriteLine($"Ocular pressure: {ocularPressure}{NewLine}");
var peripheralVision = PeripheralVision.Build(85, 85);
Console.WriteLine($"Peripheral vision: {peripheralVision}{NewLine}");
var pushups = Pushups.Build(35);
Console.WriteLine($"Pushups: {pushups}{NewLine}");
var sitAndReach = SitAndReach.Build(13);
Console.WriteLine($"Sit & Reach: {sitAndReach}{NewLine}");
var situps = Situps.Build(55);
Console.WriteLine($"Situps: {situps}{NewLine}");
var spirometry = SpirometryBuilder
.Initialize()
.SetForcedVitalCapacity(6.3)
.SetForcedExpiratoryVolume1Second(5.5)
.SetForcedExpiratoryFlow25To75(6.3)
.SetForcedExpiratoryTime(7.5)
.SetPeakExpiratoryFlow(9.3)
.Build();
Console.WriteLine($"Spirometry: {spirometry}{NewLine}");
var treadmillStressTest = TreadmillExerciseStressTestBuilder
.Initialize()
.SetMaximumBloodPressure(205, 95)
.SetMaximumHeartRate(183)
.SetProtocol()
.SetResult(TmstResult.Normal)
.SetSupineBloodPressure(133, 82)
.SetSupineHeartRate(66)
.SetTime(11, 33)
.Build();
Console.WriteLine($"Treadmill: {treadmillStressTest}{NewLine}");
var visualAcuity = VisualAcuity.Build(20, 20, 20);
Console.WriteLine($"Visual acuity: {visualAcuity}{NewLine}");
var predictedMaxHrStd = PredictMaximumHeartRate.Standard(patient.Age);
Console.WriteLine($"Joes predicted max HR (standard formula): {predictedMaxHrStd} bpm{NewLine}");
var predictedMaxHrRevisited = PredictMaximumHeartRate.Revisited(patient.Age);
Console.WriteLine($"Joes predicted max HR (revisted formula): {predictedMaxHrRevisited} bpm{NewLine}");
var vo2Max = CalculateVo2Max.FromTreadmillStressTest(treadmillStressTest, patient);
Console.WriteLine($"Joes VO2Max as calculated from his treadmill stress test: {vo2Max}{NewLine}");
var metsTreadmill = CalculateMetabolicEquivalents.FromTreadmillStressTest(treadmillStressTest, patient);
Console.WriteLine($"Joes METS as calculated from his treadmill stress test: {metsTreadmill}{NewLine}");
var metsVo2Max = CalculateMetabolicEquivalents.FromVo2Max(vo2Max);
Console.WriteLine($"Joes METS as calcualted from his VO2Max: {metsVo2Max}{NewLine}");
var cardioIniterp = new CardiovascularRegimenClassification(cardioRegimen);
Console.WriteLine($"Cardio Regimen: {cardioIniterp}{NewLine}");
var resistanceInterp = new ResistanceRegimenClassification(resistanceRegimen);
Console.WriteLine($"Resistance Regimen: {resistanceInterp}{NewLine}");
var stretchingInterp = new StretchingRegimenClassification(stretchRegimen);
Console.WriteLine($"Stretching Regimen: {stretchingInterp}{NewLine}");
var audiogramInterpretation = new AudiogramClassification(audiogram);
Console.WriteLine($"Audiogram Classification: {audiogramInterpretation}{NewLine}");
var bpInterpretation = new BloodPressureClassification(vitals.BloodPressure);
Console.WriteLine($"BP Classification: {bpInterpretation}{NewLine}");
var bodyCompInterp =
new BodyCompositionClassification(
new BodyCompositionClassificationParameters(bodyCompositionExpanded, patient));
Console.WriteLine($"Body comp: {bodyCompInterp}{NewLine}");
var bodyCompExpandedInterp =
new BodyCompositionExpandedClassification(
new BodyCompositionExpandedClassificationParameters(bodyCompositionExpanded, patient));
Console.WriteLine($"Body comp expanded: {bodyCompExpandedInterp}{NewLine}");
var bmiInterp =
new BodyMassIndexClassification(new BodyCompositionClassificationParameters(bodyComposition, patient));
Console.WriteLine($"BMI: {bmiInterp}{NewLine}");
var carotidUsInterp = new CarotidUltrasoundClassification(carotidUs);
Console.WriteLine($"Carotid US: {carotidUsInterp}{NewLine}");
var centralBpInterp =
new CentralBloodPressureClassification(new CentralBloodPressureParameters(centralBp, patient));
Console.WriteLine($"Central BP: {centralBpInterp}{NewLine}");
var fitScoreInterp =
new FitTreadmillScoreClassification(
new TreadmillExerciseStressTestClassificationParameters(treadmillStressTest, patient));
Console.WriteLine($"FIT Score: {fitScoreInterp}{NewLine}");
var fmsInterpretation = new FunctionalMovementScreenClassification(functionalMovementScreen);
Console.WriteLine($"FMS{NewLine}{fmsInterpretation}{NewLine}");
var gripInterp =
new GripStrengthClassification(new GripStrengthClassificationParameters(gripStrength, patient));
Console.WriteLine($"Grip strength: {gripInterp}{NewLine}");
var hipToWaistInterp =
new HipToWaistClassification(
new BodyCompositionClassificationParameters(bodyCompositionExpanded, patient));
Console.WriteLine($"Hip to Waist: {hipToWaistInterp}{NewLine}");
var ishiharaSixInterp = new IshiharaSixPlateClassification(ishiharaSix);
Console.WriteLine($"Ishihara 6 Plate: {ishiharaSixInterp}{NewLine}");
var ocularPressureInterp = new OccularPressureClassification(ocularPressure);
Console.WriteLine($"Ocular Pressure: {ocularPressureInterp}{NewLine}");
var percentBodyFatInterp =
new PercentBodyFatClassification(
new BodyCompositionExpandedClassificationParameters(bodyCompositionExpanded, patient));
Console.WriteLine($"Percent BF: {percentBodyFatInterp}{NewLine}");
var peripheralVisionInterp = new PeripheralVisionClassification(peripheralVision);
Console.WriteLine($"Peripheral Vision: {peripheralVisionInterp}{NewLine}");
var pushupsInterp =
new PushupsClassification(new PushupsClassificationParameters(pushups, patient));
Console.WriteLine($"Pushups: {pushupsInterp}{NewLine}");
var qualitativeLabInterp = new QualitativeLabClassification(qualitativeLab);
Console.WriteLine($"Qualitative Lab: {qualitativeLabInterp}{NewLine}");
var quantLabInterpTotalChol =
new QuantitativeLabClassification(
new QuantitativeLabClassificationParameters(quantitativeLabChoesterol, patient));
Console.WriteLine($"Quantitative Lab: {quantLabInterpTotalChol}{NewLine}");
var quantLabInterpHdlC =
new QuantitativeLabClassification(
new QuantitativeLabClassificationParameters(quantitativeLabHdlC, patient));
Console.WriteLine($"Quantitative Lab: {quantLabInterpHdlC}{NewLine}");
var quantLabInterpLdlC =
new QuantitativeLabClassification(
new QuantitativeLabClassificationParameters(quantitativeLabLdlC, patient));
Console.WriteLine($"Quantitative Lab: {quantLabInterpLdlC}{NewLine}");
var sitAndReachInterp =
new SitAndReachClassification(new SitAndReachClassificationParameters(sitAndReach, patient));
Console.WriteLine($"Sit & Reach: {sitAndReachInterp}{NewLine}");
var situpsInterp = new SitupsClassification(new SitupsClassificationParameters(situps, patient));
Console.WriteLine($"Situps: {situpsInterp}{NewLine}");
var spirometryInterp =
new SpirometryClassification(
new SpirometryClassificationParameters(spirometry, patient, bodyComposition));
Console.WriteLine($"Spirometry: {spirometryInterp}{NewLine}");
var visceralFatInterp = new VisceralFatClassification(bodyCompositionExpanded);
Console.WriteLine($"Visceral fat: {visceralFatInterp}{NewLine}");
var visualAcuityInterp = new VisualAcuityClassification(visualAcuity);
Console.WriteLine($"Visual Acuity: {visualAcuityInterp}{NewLine}");
var vo2MaxInterp =
new Vo2MaxClassification(new Vo2MaxClassificationParameters(treadmillStressTest, patient));
Console.WriteLine($"VO2 Max: {vo2MaxInterp}{NewLine}");
var waistToHeightInterp =
new WaistToHeightRatioClassification(
new BodyCompositionClassificationParameters(bodyComposition, patient));
Console.WriteLine($"Waist to Height: {waistToHeightInterp}{NewLine}");
var pooledCohortParams = PooledCohortEquationParametersBuilder.Initialize()
.SetBloodPressure(vitals.BloodPressure)
.SetHdlCholesterol(quantitativeLabHdlC.Result)
.SetTotalCholesterol(quantitativeLabChoesterol.Result)
.SetPatient(patient)
.ConfirmDiabetic()
.ConfirmOnAntiHypertensiveMedication()
.ConfirmSmoker()
.Build();
var pooledCohortsEquation = new PooledCohortsEquation(pooledCohortParams);
Console.WriteLine($"ASCVD 10yr-Risk%: {pooledCohortsEquation.Ascvd10YearRiskPercentage}{NewLine}");
Console.WriteLine($"ASCVD Lifetime Risk%: {pooledCohortsEquation.AscvdLifetimeRiskPercentage}{NewLine}");
var ascvd10YrInterp = new AscvdClassification(AscvdParameters.Build(patient, vitals.BloodPressure,
quantitativeLabChoesterol, quantitativeLabLdlC, quantitativeLabHdlC));
Console.WriteLine($"ASCVD 10-Year Risk Classification{NewLine}{ascvd10YrInterp.Classification}{NewLine}");
}
public PooledCohortEquationParametersBuilder SetBloodPressure(int systolic, int diastolic)
{
_bloodPressure = BloodPressure.Build(systolic, diastolic);
return(this);
}