# CLAUDE.md This file provides guidance to Claude Code (claude.ai/code) when working with code in this repository. ## Project Overview NHS High-Cost Drug Patient Pathway Analysis Tool - a web-based application that analyzes secondary care patient treatment pathways. It processes clinical activity data to visualize hierarchical treatment patterns (Trust → Directory/Specialty → Drug → Patient pathway) as interactive Plotly icicle charts. **Key Features:** - Multi-source data loading: CSV/Parquet files, SQLite database, Snowflake data warehouse - GP diagnosis integration for indication validation via SNOMED clusters - Interactive browser-based UI using Reflex framework - Real-time analysis with progress feedback ## Running the Application ```bash # Install dependencies pip install -r requirements.txt # OR with uv uv sync # Run the Reflex web application reflex run ``` The application requires Python 3.10+ and runs on http://localhost:3000 by default. ## Architecture ### Package Structure ``` . ├── core/ # Core configuration and models │ ├── config.py # PathConfig dataclass for file paths │ ├── models.py # AnalysisFilters dataclass │ └── logging_config.py # Structured logging setup │ ├── data_processing/ # Data layer │ ├── database.py # SQLite connection management │ ├── schema.py # Database schema definitions │ ├── loader.py # DataLoader abstraction (CSV/SQLite) │ ├── patient_data.py # Patient data migration and loading │ ├── reference_data.py # Reference data migration │ ├── snowflake_connector.py # Snowflake integration │ ├── cache.py # Query result caching │ ├── data_source.py # Data source fallback chain │ └── diagnosis_lookup.py # GP diagnosis validation │ ├── analysis/ # Analysis pipeline │ ├── pathway_analyzer.py # prepare_data, calculate_statistics, build_hierarchy │ └── statistics.py # Statistical calculation functions │ ├── visualization/ # Chart generation │ └── plotly_generator.py # create_icicle_figure, save_figure_html │ ├── pathways_app/ # Reflex web application │ ├── pathways_app.py # State class and page components │ └── components/ # Layout and navigation components │ ├── tools/ # Legacy modules │ ├── dashboard_gui.py # Original analysis engine (being refactored) │ └── data.py # Data transformations (UPID, drug names, directory) │ ├── config/ # Configuration files │ └── snowflake.toml # Snowflake connection settings │ ├── data/ # Reference data and database │ ├── pathways.db # SQLite database │ └── *.csv # Reference data files │ └── tests/ # Test suite ├── conftest.py # Pytest fixtures └── test_*.py # Test modules ``` ### Core Module (`core/`) - **PathConfig** - Dataclass encapsulating all file paths, with `validate()` method - **AnalysisFilters** - Dataclass for filter state (dates, drugs, trusts, directories) - **logging_config** - Structured logging with file and console output ### Data Processing Module (`data_processing/`) **Database Management:** - `DatabaseManager` - SQLite connection pooling and transaction management - Tables: `ref_drug_names`, `ref_organizations`, `ref_directories`, `ref_drug_directory_map`, `ref_drug_indication_clusters`, `fact_interventions`, `mv_patient_treatment_summary`, `processed_files` **Data Loaders:** - `FileDataLoader` - Loads from CSV/Parquet files - `SQLiteDataLoader` - Queries fact_interventions table - Factory function `get_loader()` selects appropriate loader **Snowflake Integration:** - SSO authentication via `externalbrowser` authenticator - `fetch_activity_data(start_date, end_date, provider_codes)` method - Query caching with TTL-based invalidation - Fallback chain: cache → Snowflake → local files **GP Diagnosis Validation:** - Uses pre-built SNOMED clusters from `ClinicalCodingClusterSnomedCodes` - `patient_has_indication(patient_pseudonym, cluster_ids)` checks GP records - `validate_indication(patient_pseudonym, drug_name)` returns full validation result - Adds `Indication_Source` column: "GP_SNOMED" | "HCD_SNOMED" | "NONE" ### Analysis Module (`analysis/`) Refactored from the original 267-line `generate_graph()` function: - **prepare_data()** - Filter DataFrame by date range, trusts, drugs, directories - **calculate_statistics()** - Compute frequency, cost, duration statistics - **build_hierarchy()** - Create Trust → Directory → Drug → Pathway structure - **prepare_chart_data()** - Format data for Plotly icicle chart ### Visualization Module (`visualization/`) - **create_icicle_figure()** - Generate Plotly icicle chart figure - **save_figure_html()** - Save interactive HTML file - **open_figure_in_browser()** - Open chart in default browser ### Reflex Application (`pathways_app/`) The `State` class manages all application state: - Filter variables: dates, drugs, trusts, directories - Reference data: available options loaded from CSV/SQLite - Analysis state: running flag, status messages, chart data - Data source state: file path, source type, row counts ### Legacy Modules (`tools/`) Still used during transition: - **tools/data.py** - Data transformation functions: - `patient_id()` - Creates UPID = Provider Code (first 3 chars) + PersonKey - `drug_names()` - Standardizes via drugnames.csv lookup - `department_identification()` - 5-level fallback chain for directory assignment - **tools/dashboard_gui.py** - Original analysis engine (being replaced by `analysis/` module) ### Data Flow ``` Data Sources: CSV/Parquet file upload OR SQLite database query OR Snowflake fetch (with caching) │ ▼ ┌──────────────────────────────────────────┐ │ Data Transformations (tools/data.py) │ │ → patient_id() creates UPID │ │ → drug_names() standardizes names │ │ → department_identification() → Dir │ └──────────────────────────────────────────┘ │ ▼ ┌──────────────────────────────────────────┐ │ Analysis Pipeline (analysis/) │ │ → prepare_data() - filter by criteria │ │ → calculate_statistics() │ │ → build_hierarchy() │ │ → prepare_chart_data() │ └──────────────────────────────────────────┘ │ ▼ ┌──────────────────────────────────────────┐ │ Visualization (visualization/) │ │ → create_icicle_figure() │ │ → Display in rx.plotly() component │ └──────────────────────────────────────────┘ ``` ### Reference Data Files (`data/`) | File | Purpose | |------|---------| | `include.csv` | Drug filter list with default selections (Include=1) | | `defaultTrusts.csv` | NHS Trust list for filter | | `directory_list.csv` | Medical specialties/directories | | `drugnames.csv` | Drug name standardization mapping | | `org_codes.csv` | Provider code to organization name mapping | | `drug_directory_list.csv` | Valid drug-to-directory mappings (pipe-separated) | | `treatment_function_codes.csv` | NHS treatment function code mappings | | `drug_indication_clusters.csv` | Drug to SNOMED cluster mappings | | `ta-recommendations.xlsx` | NICE TA recommendations | | `pathways.db` | SQLite database with all tables | ### Key Patterns **Department Identification Fallback Chain:** The `department_identification()` function has 5 levels of fallback: 1. **SINGLE_VALID_DIR** - Drug has only one valid directory 2. **EXTRACTED** - Extracted from Additional Detail/Description fields 3. **CALCULATED_MOST_FREQ** - Most frequent valid directory for UPID/Drug 4. **UPID_INFERENCE** - Inferred from other records with same UPID 5. **UNDEFINED** - No directory could be determined **Indication Validation Workflow:** 1. Map drug → SNOMED cluster IDs (e.g., ADALIMUMAB → RARTH_COD, PSORIASIS_COD) 2. Get all SNOMED codes for those clusters 3. Check GP records (PrimaryCareClinicalCoding) for matching codes 4. Report match/no-match with source tracking **Data Source Fallback Chain:** 1. Query cache for recent results 2. Attempt Snowflake connection 3. Fall back to SQLite database 4. Fall back to CSV/Parquet files ## Database Schema ### Reference Tables - `ref_drug_names` - Drug name standardization - `ref_organizations` - Provider code to name mapping - `ref_directories` - Valid directory names - `ref_drug_directory_map` - Valid drug-directory pairs - `ref_drug_indication_clusters` - Drug to SNOMED cluster mapping ### Fact Tables - `fact_interventions` - Patient intervention records (UPID, drug, date, cost, directory) ### Materialized Views - `mv_patient_treatment_summary` - Pre-aggregated patient statistics ### File Tracking - `processed_files` - Hash-based tracking for incremental loading ## Input Data Requirements The input data (CSV/Parquet) must contain columns including: - `Provider Code`, `PersonKey` - Used to create UPID - `Drug Name`, `Intervention Date`, `Price Actual` - `OrganisationName` - Various `Additional Detail/Description` columns for directory extraction - `Treatment Function Code` ## Output Interactive Plotly icicle chart showing: - Patient counts and percentages at each hierarchy level - Total and average costs - Treatment duration and dosing frequency information - Color gradient based on patient volume ## Testing ```bash # Run all tests with coverage python -m pytest tests/ -v --cov=core --cov=analysis # Run specific test file python -m pytest tests/test_config.py -v # Run specific test class python -m pytest tests/test_data_transformations.py::TestPatientId -v ``` Test coverage includes: - PathConfig validation (23 tests) - AnalysisFilters validation (26 tests) - Data transformation functions (23 tests) - Directory assignment logic (19 tests) ## Configuration ### Snowflake Connection (`config/snowflake.toml`) ```toml [snowflake] account = "your-account" database = "DATA_HUB" schema = "CDM" warehouse = "your-warehouse" authenticator = "externalbrowser" # Required for NHS SSO ``` ### Logging Logs are written to `logs/` directory with structured format. Configure via `core/logging_config.py`. ## Development ### Adding New Data Sources 1. Create loader class implementing `DataLoader` protocol in `data_processing/loader.py` 2. Add to factory function `get_loader()` 3. Update `DataSourceManager` fallback chain if needed ### Adding New Analysis Features 1. Add statistical functions to `analysis/statistics.py` 2. Integrate into pipeline in `analysis/pathway_analyzer.py` 3. Update visualization in `visualization/plotly_generator.py` ### Adding New Reference Data 1. Add CSV file to `data/` directory 2. Define schema in `data_processing/schema.py` 3. Create migration function in `data_processing/reference_data.py` 4. Add path to `PathConfig` in `core/config.py`