# Progress Log - Indication-Based Pathway Charts ## Project Context This project adds indication-based icicle charts alongside the existing directory-based charts. Patient diagnoses are matched from GP records using SNOMED cluster codes queried directly from Snowflake. **Key Change from Previous Approach**: Instead of maintaining a local CSV/SQLite mapping of SNOMED codes, we now query the `ClinicalCodingClusterSnomedCodes` clusters directly in Snowflake during the data refresh. This simplifies the architecture and ensures we always use the latest cluster definitions. ## Key Files Reference **Existing (reuse these):** - `data_processing/schema.py` - SQLite schema (chart_type column already added) - `data_processing/diagnosis_lookup.py` - Extend with new Snowflake query - `data_processing/pathway_pipeline.py` - Pathway processing (indication functions exist) - `cli/refresh_pathways.py` - CLI refresh command (chart_type arg exists) - `pathways_app/pathways_app.py` - Reflex app (add chart type toggle) - `tools/data.py` - Data transformations including department_identification() **New/Key:** - `snomed_indication_mapping_query.sql` - Master SNOMED cluster query to embed in Snowflake calls ## Known Patterns ### SNOMED Cluster Query Approach The `snomed_indication_mapping_query.sql` contains the Search_Term → Cluster_ID mappings: - ~148 conditions mapped to clinical coding clusters - Joins with `DATA_HUB.PHM."ClinicalCodingClusterSnomedCodes"` to get SNOMED codes - Includes explicit manual mappings for conditions not in clusters - Returns: Search_Term, SNOMEDCode, SNOMEDDescription ### GP Record Matching To find a patient's indication: 1. Use the cluster query as a CTE 2. Join with `PrimaryCareClinicalCoding` on SNOMEDCode 3. Filter by PatientPseudonym (use PseudoNHSNoLinked from HCD data) 4. Use most recent match by EventDateTime 5. Return Search_Term for matched patients ### Patient Identifier Mapping - HCD data has `PseudoNHSNoLinked` column - this matches `PatientPseudonym` in GP records - DO NOT use `PersonKey` (LocalPatientID) - this is provider-specific and won't match GP records - UPID = Provider Code (3 chars) + PersonKey ### Chart Type Architecture - `chart_type` column in pathway_nodes: "directory" or "indication" - 12 total pathway datasets: 6 date filters x 2 chart types - Indication chart: mixed labels (Search_Term for matched, Directorate for unmatched) ### Date Filter Combinations | ID | Initiated | Last Seen | Default | |----|-----------|-----------|---------| | `all_6mo` | All years | Last 6 months | Yes | | `all_12mo` | All years | Last 12 months | No | | `1yr_6mo` | Last 1 year | Last 6 months | No | | `1yr_12mo` | Last 1 year | Last 12 months | No | | `2yr_6mo` | Last 2 years | Last 6 months | No | | `2yr_12mo` | Last 2 years | Last 12 months | No | ### Previous Work (Reusable) These components from the previous approach are still valid: - `chart_type` column and schema migration (Task 2.1 - complete) - `generate_icicle_chart_indication()` function (Task 2.2 - complete) - `process_indication_pathway_for_date_filter()` function (Task 2.2 - complete) - `extract_indication_fields()` function (Task 2.2 - complete) - `--chart-type` CLI argument (Task 2.3 - complete) ### What Needs Replacement The previous `batch_lookup_indication_groups()` function in `diagnosis_lookup.py` used a local SQLite table. This needs to be replaced with a new function that queries Snowflake directly using the cluster query. --- ## Iteration Log ## Iteration 1 — 2026-02-05 ### Task: 1.1 Create Indication Lookup Query ### Why this task: - This is the foundation task — other tasks (1.2 CLI integration, 2.3 refresh command) depend on this function - The progress.txt explicitly noted the old approach needs replacement - Logical flow: data query function must exist before pipeline integration ### Status: COMPLETE ### What was done: - Created `get_patient_indication_groups()` function in `data_processing/diagnosis_lookup.py` - Embedded the full cluster mapping SQL (from snomed_indication_mapping_query.sql) as `CLUSTER_MAPPING_SQL` constant - Function takes list of PseudoNHSNoLinked values and queries Snowflake directly - Uses QUALIFY ROW_NUMBER() OVER (PARTITION BY PatientPseudonym ORDER BY EventDateTime DESC) = 1 to get most recent match - Returns DataFrame with PatientPseudonym, Search_Term, EventDateTime columns - Handles edge cases: empty patient list, Snowflake unavailable/unconfigured - Added batch processing (default 500 patients per batch) for large datasets - Added logging for match statistics (match rate, unique Search_Terms, top 5 indications) - Added both function and CLUSTER_MAPPING_SQL to __all__ exports ### Validation results: - Tier 1 (Code): ✅ `python -m py_compile` passed, import check passed - Tier 2 (Data): ✅ Empty list returns correct empty DataFrame with expected columns - Tier 3 (Functional): N/A (not a UI task) ### Files changed: - `data_processing/diagnosis_lookup.py` — added CLUSTER_MAPPING_SQL constant and get_patient_indication_groups() function - `IMPLEMENTATION_PLAN.md` — marked Task 1.1 items complete ### Committed: 052256c "feat: add get_patient_indication_groups() for Snowflake-direct GP lookup (Task 1.1)" ### Patterns discovered: - Snowflake's QUALIFY clause is cleaner than subquery for row_number filtering - The cluster CTE has 148 Search_Term mappings plus 13 explicit SNOMED codes ### Next iteration should: - Test the function with real patient data to verify it returns expected Search_Terms (Task 1.1 verification) - OR proceed to Task 1.2 (integrate with CLI refresh command) if confident in the function - The key integration point: extract unique PseudoNHSNoLinked values from HCD data, call this function, map results back to UPID for indication_df ### Blocked items: - None