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HTNtree.php
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HTNtree.php
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<?php
namespace Stanford\HTNapi;
// NOTE That for this to work in shibboleth, you must add a define("NOAUTH",true) to the main index.php before redcap connect.
class HTNtree {
private $enabledProjects
, $patients_project
, $tree_templates_project
, $meds_project
, $providers_project
, $module;
public function __construct($module) {
// This is how to access the parent EM class in these other Classes
$this->module = $module;
$enabledProjects = $this->module->showEnabledProjects();
foreach($enabledProjects as $project){
$pid = $project["pid"];
$project_mode = $project["mode"];
switch($project_mode){
case "patients":
$this->patients_project = $pid;
break;
case "tree_templates":
$this->tree_templates_project = $pid;
break;
case "meds":
$this->meds_project = $pid;
break;
case "providers":
$this->providers_project = $pid;
break;
}
}
}
public function getPrescriptionTree($id,$API_TOKEN, $API_URL){
$extra_params = array(
"records" => $id,
"events" => "tree_arm_2"
);
$results = RC::callApi($extra_params, true, $API_URL, $API_TOKEN);
$trees = array();
$prev_id = null;
foreach($results as $result){
$record_id = $result["record_id"];
if($prev_id !== $record_id){
$trees[$record_id] = array();
$trees[$record_id]["name"] = $result["htn_tree_name"];
}else{
$repeat = $result["redcap_repeat_instrument"];
$instance = $result["redcap_repeat_instance"];
if(!empty($repeat) && !empty($instance)){
if(!array_key_exists("meds", $trees[$record_id])){
$trees[$record_id]["meds"] = array();
}
$steps = array();
for($i=1; $i < 11; $i++){
$evaluate = "evaluate_step_" . $i;
$dose = "step_dose_" .$i;
$freq = "freq_step_" .$i;
$steps[$i] = array(
$evaluate => $result[$evaluate],
$dose => $result[$dose],
$freq => $result[$freq]
);
}
$trees[$record_id]["meds"][] = array(
"class" => $result["tree_med_class"],
"name" => $result["tree_med_name"],
"note" => $result["tree_med_note"],
"alt" => $result["tree_med_alt_name"],
"alt_dose" => $result["tree_med_alt_dose"],
"steps" => $steps
);
}
}
$prev_id = $record_id;
}
return $trees;
}
public function getPrescriptionTrees($API_TOKEN, $API_URL){
$extra_params = array(
"fields" => array("record_id","htn_tree_name"),
"events" => "tree_arm_2"
);
$results = RC::callApi($extra_params, true, $API_URL, $API_TOKEN);
$trees = array();
foreach($results as $result){
$trees[$result["record_id"]] = $result["htn_tree_name"];
}
return $trees;
}
public function logPatientTreeChange($logdata,$API_TOKEN, $API_URL){
$edit_id = $logdata["patient_id"] ?? null;
if(is_null($edit_id)){
return array("error" => "invalid record id");
}
$results = $this->getPatient($edit_id,$API_TOKEN,$API_URL);
$log_count = count($results);
$data["redcap_repeat_instance"] = $log_count;
$data["redcap_event_name"] = "patients_arm_1";
$data["redcap_repeat_instrument"] = "tree_log";
$data["record_id"] = $edit_id;
$data["ptree_log_ts"] = date("Y-m-d H:i:s");;
$data["ptree_log_current_step"] = $logdata["step_idx"];
$cur_meds = array();
$eval = 7;
foreach($logdata["current_meds"] as $med){
array_push($cur_meds, $med["name"]. " " . $med["dose"] );
}
$data["ptree_current_meds"] = implode(", ", $cur_meds);
if($logdata["status"] == "Controlled"){
$data["ptree_next_meds"] = $data["ptree_current_meds"];
$data["ptree_log_next_step"] = $data["ptree_log_current_step"];
}else if($logdata["status"] == "side effect"){
// is this a repeat of previous step with side effect med? i think so
$data["ptree_next_meds"] = $data["ptree_current_meds"];
$data["ptree_log_next_step"] = $data["ptree_log_current_step"];
}else{
// not controlled
$data["ptree_log_next_step"] = $logdata["next_idx"];
$next_meds = array();
foreach($logdata["next_meds"] as $med){
array_push($next_meds, $med["name"]. " " . $med["dose"] );
$eval = $med["eval"] ?? $eval;
}
$data["ptree_next_meds"] = implode(", ", $next_meds);
}
$status = "BP : " . $logdata["status"] ."\r\n\r\n";
$status .= "Current meds : ". $data["ptree_current_meds"] ."\r\n" ;
$status .= "Recommended next step meds : ". $data["ptree_next_meds"] ."\r\n\r\n" ;
$status .= "Re-evaluate in $eval days.";
$data["ptree_log_comment"] = $status;
$result = RC::writeToApi($data, array("overwriteBehavior" => "overwite"), $API_URL, $API_TOKEN);
return array("result" => $result , "data" => $data);
}
public function savePrescriptionTree($ajax,$API_TOKEN, $API_URL){
$response = array();
$data = array();
$treearr = $ajax;
$edit_id = $treearr["record_id"] ?? null;
$tree_name = $treearr["name"];
$next_id = $edit_id ?? RC_Util::getNextId("record_id",$API_TOKEN, $API_URL);
$data["record_id"] = $next_id;
$data["redcap_event_name"] = "tree_arm_2";
$data["htn_tree_name"] = $tree_name;
$result = RC::writeToApi($data, array("overwriteBehavior" => "overwite"), $API_URL, $API_TOKEN);
if(array_key_exists("count", $result)){
$response["record_id"] = $next_id;
$response["name"] = $tree_name;
}else{
array_push($response, $result);
}
// Save Sub Trees
$ladders = $treearr["treatment_plan"];
foreach($ladders as $ladder){
$instance_id = $instance_id ?? 1;
$data = array();
$data["redcap_event_name"] = "tree_arm_2";
$data["record_id"] = $next_id;
$data["redcap_repeat_instance"] = $instance_id;
$data["redcap_repeat_instrument"] = "meds";
$data["tree_med_class"] = $ladder["tree_med_class"];
$data["tree_med_name"] = $ladder["tree_med_name"];
$data["tree_med_note"] = $ladder["tree_med_note"];
$data["tree_med_alt_name"] = $ladder["tree_med_alt_name"];
$data["tree_med_alt_dose"] = $ladder["tree_med_alt_dose"];
$steps = $ladder["steps"];
foreach($steps as $idx => $step){
$idx++;
$evaluation = $step["evaluation"];
$dose = $step["dose"];
$freq = $step["freq"];
if($dose !== "false" && $freq !== "false" && $evaluation !== "false"){
$data["evaluate_step_" . $idx] = $evaluation;
$data["step_dose_" . $idx] = $dose;
$data["freq_step_" . $idx] = $freq;
}
}
// NEED TO SAVE MULTIPLE SUB things
$result = RC::writeToApi($data, array("overwriteBehavior" => "overwite"), $API_URL, $API_TOKEN);
if(!array_key_exists("count", $result)){
array_push($response, $result);
}
$instance_id++;
}
return $response;
}
public function getDefaultTrees($provider_id=0){
$filter = "[provider_id] = $provider_id";
$fields = array();
$params = array(
'project_id' => $this->tree_templates_project,
'return_format' => 'json',
'fields' => $fields,
'filterLogic' => $filter
);
$q = \REDCap::getData($params);
$trees = json_decode($q, true);
$labeled_trees = array();
foreach($trees as $tree){
$def_tree = $this->getTemplateDrugs($tree);
if(!empty($def_tree)){
$tree_id = $tree["record_id"];
$labeled_trees[$tree_id] = array("label" => $tree["template_name"], "tree_meta" => $tree, "doses" => $def_tree);
}
}
return $labeled_trees;
}
public function saveTemplate($provider_id, $post){
$is_edit = !empty($post["record_id"]) ? true : false;
if($is_edit && $post["record_id"] < 5){
//Dont Edit Default Templates
return array("errors" => "Default Prescription Tree Templates aren't editable." );
}
$next_id = !empty($post["record_id"]) ? $post["record_id"] : $this->module->getNextAvailableRecordId($this->module->enabledProjects['tree_templates']['pid']);
$data = array(
"record_id" => $next_id,
"provider_id" => $provider_id,
"template_name" => $post["template_name"],
"acei_class" => $post["acei_class"],
"arb_class" => $post["arb_class"],
"diuretic_class" => $post["diuretic_class"],
"ccb_class" => $post["ccb_class"],
"bb_class" => $post["bb_class"],
"spirno_class" => $post["spirno_class"],
"epler_class" => $post["epler_class"]
);
$r = \REDCap::saveData($this->tree_templates_project, 'json', json_encode(array($data)) );
//NOW SAVE THE MEDS IN MED PROJECT
$map_med_class = array(
1 => "ACEI",
2 => "ARB",
3 => "DIURETIC",
4 => "SPIRNO",
5 => "EPLER",
6 => "CCB",
7 => "BB",
);
$map_med_class_r = array_flip($map_med_class);
$med_instance = array();
if($is_edit){
//GET MEDS BY tree_id (record_id) from above
$params = array(
'project_id' => $this->meds_project,
'return_format' => 'json',
'fields' => array("record_id","med_name", "med_unit", "med_class"),
'filterLogic' => "[tree_id] = $next_id"
);
$q = \REDCap::getData($params);
$meds = json_decode($q, true);
$this->module->emDebug("EDIT meds for tree_id $next_id");
foreach($meds as $med){
$med_name = $med["med_name"];
$med_unit = $med["med_unit"];
$med_id = $med["record_id"];
$med_class = $med["med_class"];
$post_med = strtolower($map_med_class[$med_class])."_class";
$post_doses = strtolower($map_med_class[$med_class])."_doses";
$new_doses = $post[$post_doses];
$post_unit = array_shift($new_doses);
if($post[$post_med] != $med_name){
//DRUG WAS CHANGED SO UPDATE IT NOW
$temp = array(
"record_id" => $med_id
,"med_name" => $post[$post_med]
,"med_unit" => $post_unit
);
array_push($med_instance, $temp);
}
$params = array(
'project_id' => $this->meds_project,
'return_format' => 'json',
'records' => $med_id,
'fields' => array("dose_value", "record_id")
);
$q = \REDCap::getData($params);
$doses = json_decode($q, true);
array_shift($doses);
foreach($new_doses as $i => $new_dose){
$edit_instance_id = isset($doses[$i]) ? $doses[$i]["redcap_repeat_instance"] : $edit_instance_id;
$old_dose = isset($doses[$i]) ? $doses[$i]["dose_value"] : null;
if($old_dose != $new_dose){
$temp = array(
"record_id" => $med_id,
"redcap_repeat_instance" => $edit_instance_id,
"redcap_repeat_instrument" => "doses",
"dose_value" => $new_dose
);
array_push($med_instance,$temp);
}
$edit_instance_id++;
}
}
$this->module->emDebug("Final Updates for tree_id $next_id", $med_instance);
}else{
$next_med_id = $this->module->getNextAvailableRecordId($this->meds_project);
foreach($post as $key => $doses){
if(strpos($key,"_doses") > -1){
$temp = explode("_",$key);
$med_class = $map_med_class_r[strtoupper($temp[0])];
$unit = array_shift($doses);
$meddata = array(
"record_id" => $next_med_id
,"tree_id" => $next_id
,"med_class" => $med_class
,"med_name" => $post[$temp[0]."_class"]
,"med_unit" => $unit
);
$r = \REDCap::saveData($this->meds_project, 'json', json_encode(array($meddata)) );
$field = "dose_value";
$params = array(
'project_id' => $this->meds_project,
'return_format' => 'json',
'records' => $next_med_id,
'fields' => $field,
'filterLogic' => "[$field] != ''"
);
$q = \REDCap::getData($params);
$records = json_decode($q, true);
$last_instance_id = count($records);
$last_instance_id++;
foreach($doses as $dose){
$temp = array(
"record_id" => $next_med_id,
"redcap_repeat_instance" => $last_instance_id,
"redcap_repeat_instrument" => "doses",
"dose_value" => $dose
);
array_push($med_instance,$temp);
$last_instance_id++;
}
$next_med_id++;
}
}
}
$r = \REDCap::saveData($this->meds_project, 'json', json_encode($med_instance) );
return $r;
// $this->module->emDebug("save_template tree, med, doses", $data, $meddata, $med_instance);
}
public function getDrugList(){
return array(
"ACEI" => array("label" => "ACE Inhibitor" , "drugs" => array(
array( "name" => "Lisinopril" , "unit" => "mg" , "common_dosage" => array(10,20,30,40) , "note" => "" )
,array( "name" => "Benazaril" , "unit" => "mg" , "common_dosage" => array(5,10,20,40) , "note" => "" )
,array( "name" => "Fosinopril" , "unit" => "mg" , "common_dosage" => array(10,20,40) , "note" => "" )
,array( "name" => "Quinapril" , "unit" => "mg" , "common_dosage" => array(5,10,20,40) , "note" => "" )
,array( "name" => "Ramipril" , "unit" => "mg" , "common_dosage" => array(1.25,2.5,5,10) , "note" => "" )
,array( "name" => "Trandolapril" , "unit" => "mg" , "common_dosage" => array(1,2,4) , "note" => "" )
)
)
,"ARB" => array("label" => "Angiotensin receptor blocker", "drugs" => array(
array( "name" => "Losartan" , "unit" => "mg" , "common_dosage" => array(50,100) , "note" => "" )
,array( "name" => "Candesartan" , "unit" => "mg" , "common_dosage" => array(8,16,32) , "note" => "may prevent migraine headaches" )
,array( "name" => "Valsartan" , "unit" => "mg" , "common_dosage" => array(40,80,160,320) , "note" => "" )
,array( "name" => "Olmesartan" , "unit" => "mg" , "common_dosage" => array(20,40) , "note" => "" )
,array( "name" => "Telmisartan" , "unit" => "mg" , "common_dosage" => array(20,40,80) , "note" => "" )
)
)
,"DIURETIC" => array("label" => "", "drugs" => array(
array( "name" => "HCTZ" , "unit" => "mg" , "common_dosage" => array(12.5,25,50) , "note" => "most effective when combined with ACEI" )
,array( "name" => "Chlorthalidone" , "unit" => "mg" , "common_dosage" => array(12.5,25) , "note" => "most effective when combined with ACEI" )
,array( "name" => "Indapamide" , "unit" => "mg" , "common_dosage" => array(1.25,2.5) , "note" => "most effective when combined with ACEI" )
,array( "name" => "Triamterene" , "unit" => "mg" , "common_dosage" => array(25,50) , "note" => "most effective when combined with ACEI" )
,array( "name" => "K+ sparing-spironolactone" , "unit" => "mg" , "common_dosage" => array(25,50) , "note" => "most effective when combined with ACEI" )
,array( "name" => "Amiloride" , "unit" => "mg" , "common_dosage" => array(5,10) , "note" => "most effective when combined with ACEI" )
,array( "name" => "Furosemide" , "unit" => "mg" , "common_dosage" => array(20,40,80) , "note" => "most effective when combined with ACEI", "frequency" => 2 )
,array( "name" => "Torsemide" , "unit" => "mg" , "common_dosage" => array(10,20,40) , "note" => "most effective when combined with ACEI" )
)
)
,"ARA" => array("label" => "Aldosterone receptor antagonists" , "drugs" => array(
array( "name" => "SPIRONOLACTONE" , "unit" => "mg" , "common_dosage" => array(12.5,25) , "note" => "" )
)
)
,"MRA" => array("label"=> "Mineralocorticoid receptor antagonists" , "drugs" => array(
array( "name" => "EPLERENONE" , "unit" => "Daily" , "common_dosage" => array("1x","2x") , "note" => "" )
)
)
,"CCB" => array("label"=> "Calcium Channel Blockers" , "drugs" => array(
array( "name" => "Amlodipine" , "unit" => "mg" , "common_dosage" => array(2.5,5,10) , "note" => "" )
,array( "name" => "Nifedipine ER" , "unit" => "mg" , "common_dosage" => array(30,60,90) , "note" => "" )
,array( "name" => "Diltiazem ER" , "unit" => "mg" , "common_dosage" => array(180,240,300,360) , "note" => "" )
,array( "name" => "Verapamil" , "unit" => "mg" , "common_dosage" => array(80,120) , "note" => "" , "frequency" => 3)
,array( "name" => "Verapamil ER" , "unit" => "mg" , "common_dosage" => array(240,480) , "note" => "" )
)
)
,"BB" => array("label"=> "Beta-Blockers" , "drugs" => array(
array( "name" => "Bisoprolol" , "unit" => "mg" , "common_dosage" => array(5,10) , "note" => "" )
,array( "name" => "Metroprolol succinate" , "unit" => "mg" , "common_dosage" => array(1,2,3) , "note" => "" )
,array( "name" => "Tartrate" , "unit" => "mg" , "common_dosage" => array(50,100) , "note" => "" , "frequency" => 2)
,array( "name" => "Propranolol" , "unit" => "mg" , "common_dosage" => array(40,80,120) , "note" => "" , "frequency" => 2)
,array( "name" => "Carvedilol" , "unit" => "mg" , "common_dosage" => array(6.25,12.5,25) , "note" => "" , "frequency" => 2)
,array( "name" => "Labetalol" , "unit" => "mg" , "common_dosage" => array(100,200,300) , "note" => "" , "frequency" => 2)
,array( "name" => "Nebivolol" , "unit" => "mg" , "common_dosage" => array(5,10) , "note" => "" )
)
)
);
}
public function getTemplateDrugs($tree){
//matches radio values from redcap
$map_med_class = array(
1 => "ACEI",
2 => "ARB",
3 => "DIURETIC",
4 => "SPIRNO",
5 => "EPLER",
6 => "CCB",
7 => "BB",
);
$tree_id = $tree["record_id"];
$filter = "[tree_id] = $tree_id";
$fields = array("record_id");
$params = array(
'project_id' => $this->meds_project,
'return_format' => 'json',
'records' => array(),
'fields' => $fields,
'filterLogic' => $filter
);
$q = \REDCap::getData($params);
$meds = json_decode($q, true);
if(!empty($meds)){
$med_ids = array();
foreach($meds as $i => $med){
$med_ids[] = $med["record_id"];
}
$fields = array("record_id", "med_class", "med_unit", "dose_value");
$params = array(
'project_id' => $this->meds_project,
'return_format' => 'json',
'records' => $med_ids,
'fields' => $fields
);
$q = \REDCap::getData($params);
$doses = json_decode($q, true);
$template_drugs = array();
$med_unit = "";
$drug_class = "";
$drug_name = "";
foreach($doses as $el){
if(empty($el["redcap_repeat_instrument"])){
//top level meds instrument
$drug_class = $map_med_class[$el["med_class"]];
$med_unit = $el["med_unit"]; //this will be what it is until the next
$drug_name = $tree[strtolower($drug_class)."_class"];
$template_drugs[$drug_class] = array("raw" => array(), "pretty" => array());
continue;
}
//else repeating dose instrument
$current_drug_dose = $drug_name. " ".$el["dose_value"].$med_unit;
array_push($template_drugs[$drug_class]["raw"], $el["dose_value"]);
array_push($template_drugs[$drug_class]["pretty"], $current_drug_dose);
}
}else {
$template_drugs = array();
}
return $template_drugs;
}
public function treeLogic($provider_id){
//TODO FIX THIS FOR NEW WORKFLOW
$default_trees = $this->getDefaultTrees();
$provider_trees = $this->getDefaultTrees($provider_id);
$default_trees = array_merge($default_trees,$provider_trees);
$provider_logic_trees = array();
foreach($default_trees as $tree){
$tree_id = $tree["tree_meta"]["record_id"];
$template_name = $tree["tree_meta"]["template_name"];
$template_drugs = $tree["doses"];
$logicTree = array();
if(!empty($template_drugs)){
$logicTree = $this->defaultLogicTree1($template_drugs);
}
$tree["logicTree"] = $logicTree;
$provider_logic_trees[$tree_id] = $tree;
}
$this->module->emDebug("This Providers custom Logic trees, including the default ones");
return $provider_logic_trees;
}
public function defaultLogicTree1($template_drugs){
//TODO - STILL NOT SUPER CLeAR, THIS IS WEIRD
$template_drugs["SPIRNO"]["pretty"] = array_merge($template_drugs["SPIRNO"]["pretty"], $template_drugs["EPLER"]["pretty"]);
$drug_classes = array("ACEI" => 3, "ARB" => 2, "DIURETIC" => 3, "SPIRNO" => 4, "CCB" => 3, "BB" => 4);
$ACEI = array();
$ARB = array();
$DIURETIC = array();
$SPIRNO = array();
$CCB = array();
$BB = array();
foreach($drug_classes as $drug_class => $expected_count){
for($i=0; $i < $expected_count; $i++){
if(isset($template_drugs[$drug_class]["pretty"][$i])){
$current_drug = $template_drugs[$drug_class]["pretty"][$i];
}
array_push($$drug_class, $current_drug);
}
}
$logicTree[] = array(
"step_id" => 0
,"drugs" => array($ACEI[0], $DIURETIC[0])
,"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 1)
,"note" => ""
,"side_effects" => array(
"cough" => 13,
"elevated_cr" => 28,
"hyperkalemia" => 28,
"slow_hr" => null,
"angioedema" => 41,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 1,
"drugs" => array($ACEI[1],$DIURETIC[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 2),
"note" => "",
"side_effects" => array(
"cough" => 14,
"elevated_cr" => 25,
"hyperkalemia" => 25,
"slow_hr" => null,
"angioedema" => 41,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 2,
"drugs" => array($ACEI[1],$DIURETIC[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 3),
"note" => "",
"side_effects" => array(
"cough" => 15,
"elevated_cr" => 25,
"hyperkalemia" => 25,
"slow_hr" => null,
"angioedema" => 41,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 3,
"drugs" => array($ACEI[2],$DIURETIC[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 4),
"note" => "",
"side_effects" => array(
"cough" => 15,
"elevated_cr" => 64,
"hyperkalemia" => 25,
"slow_hr" => null,
"angioedema" => 41,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 4,
"drugs" => array($ACEI[2],$DIURETIC[1], $CCB[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 5),
"note" => "Before adding/increasing Diltiazem or Verapamil, confirm HR > 55bpm",
"side_effects" => array(
"cough" => 16,
"elevated_cr" => null,
"hyperkalemia" => null,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => array("Uncontrolled, K < 4.5" => 69, "Uncontrolled, K > 4.5" => 65),
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 5,
"drugs" => array($ACEI[2],$DIURETIC[1], $CCB[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 6),
"note" => "Before adding/increasing Diltiazem or Verapamil, confirm HR > 55bpm",
"side_effects" => array(
"cough" => 17,
"elevated_cr" => null,
"hyperkalemia" => null,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => array("Uncontrolled, K < 4.5" => 69, "Uncontrolled, K > 4.5" => 65),
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 6,
"drugs" => array($ACEI[2],$DIURETIC[1], $CCB[2] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled, K < 4.5" => 7, "Uncontrolled, K > 4.5" => 9),
"note" => "Before adding/increasing Diltiazem or Verapamil, confirm HR > 55bpm",
"side_effects" => array(
"cough" => 18,
"elevated_cr" => null,
"hyperkalemia" => null,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => array("Uncontrolled, K < 4.5" => 69, "Uncontrolled, K > 4.5" => 65),
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 7,
"drugs" => array($ACEI[2],$DIURETIC[1], $CCB[2], $SPIRNO[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 8),
"note" => "",
"side_effects" => array(
"cough" => 19,
"elevated_cr" => "Stop, Cr elevated or hyperkalemia present",
"hyperkalemia" => "Stop, Cr elevated or hyperkalemia present",
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => 56,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 8,
"drugs" => array($ACEI[2],$DIURETIC[1], $CCB[2], $SPIRNO[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => "End of protocol"),
"note" => "",
"side_effects" => array(
"cough" => 20,
"elevated_cr" => 7,
"hyperkalemia" => 7,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => 56,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 9,
"drugs" => array($ACEI[2],$DIURETIC[1], $CCB[2], $BB[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 10),
"note" => "Before adding/increasing " . $BB[0] . ", confirm HR > 55bpm",
"side_effects" => array(
"cough" => 21,
"elevated_cr" => null,
"hyperkalemia" => "Stop, hyperkalemia present",
"slow_hr" => "Stop, call doctor",
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => "Stop, call doctor"
)
);
$logicTree[] = array(
"step_id" => 10,
"drugs" => array($ACEI[2],$DIURETIC[1], $CCB[2], $BB[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 11),
"note" => "Before adding/increasing " . $BB[1] . ", confirm HR > 55bpm",
"side_effects" => array(
"cough" => 22,
"elevated_cr" => null,
"hyperkalemia" => 9,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => "Stop, call doctor"
)
);
$logicTree[] = array(
"step_id" => 11,
"drugs" => array($ACEI[2],$DIURETIC[1], $CCB[2], $BB[2] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 12),
"note" => "Before adding/increasing " . $BB[2] . ", confirm HR > 55bpm",
"side_effects" => array(
"cough" => 23,
"elevated_cr" => null,
"hyperkalemia" => 10,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => "Stop, call doctor"
)
);
$logicTree[] = array(
"step_id" => 12,
"drugs" => array($ACEI[2], $DIURETIC[1], $CCB[2], $BB[3] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => "End of protocol"),
"note" => "Before adding/increasing " . $BB[3] . ", confirm HR > 55bpm",
"side_effects" => array(
"cough" => 24,
"elevated_cr" => null,
"hyperkalemia" => 11,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => "Stop, call doctor"
)
);
$logicTree[] =array(
"step_id" => 13,
"drugs" => array($ARB[0],$DIURETIC[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 14),
"note" => "",
"side_effects" => array(
"cough" => null,
"elevated_cr" => 28,
"hyperkalemia" => 28,
"slow_hr" => null,
"angioedema" => 41,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 14,
"drugs" => array($ARB[1],$DIURETIC[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 15),
"note" => "",
"side_effects" => array(
"cough" => null,
"elevated_cr" => 31,
"hyperkalemia" => 31,
"slow_hr" => null,
"angioedema" => 41,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 15,
"drugs" => array($ARB[1],$DIURETIC[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 16),
"note" => "",
"side_effects" => array(
"cough" => null,
"elevated_cr" => 31,
"hyperkalemia" => 31,
"slow_hr" => null,
"angioedema" => 41,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 16,
"drugs" => array($ARB[1],$DIURETIC[1], $CCB[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 17),
"note" => "Before adding/increasing Diltiazem or Verapamil, confirm HR > 55bpm",
"side_effects" => array(
"cough" => null,
"elevated_cr" => null,
"hyperkalemia" => null,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => array("Uncontrolled, K < 4.5" => 71, "Uncontrolled, K > 4.5" => 73),
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 17,
"drugs" => array($ARB[1],$DIURETIC[1], $CCB[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 18),
"note" => "Before adding/increasing Diltiazem or Verapamil, confirm HR > 55bpm",
"side_effects" => array(
"cough" => null,
"elevated_cr" => null,
"hyperkalemia" => null,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => array("Uncontrolled, K < 4.5" => 71, "Uncontrolled, K > 4.5" => 73),
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 18,
"drugs" => array($ARB[1],$DIURETIC[1], $CCB[2] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled, K < 4.5" => 19, "Uncontrolled, K > 4.5" => 21),
"note" => "Before adding/increasing Diltiazem or Verapamil, confirm HR > 55bpm",
"side_effects" => array(
"cough" => null,
"elevated_cr" => null,
"hyperkalemia" => null,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => array("Uncontrolled, K < 4.5" => 71, "Uncontrolled, K > 4.5" => 73),
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 19,
"drugs" => array($ARB[1],$DIURETIC[1], $CCB[2], $SPIRNO[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 20),
"note" => "",
"side_effects" => array(
"cough" => null,
"elevated_cr" => "Stop, Cr elevatedor hyperkalemia present",
"hyperkalemia" => "Stop, Cr elevated or hyperkalemia present",
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => 58,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 20,
"drugs" => array($ARB[1],$DIURETIC[1], $CCB[2], $SPIRNO[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => "End of protocol"),
"note" => "",
"side_effects" => array(
"cough" => null,
"elevated_cr" => 19,
"hyperkalemia" => 19,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => 58,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 21,
"drugs" => array($ARB[1],$DIURETIC[1], $CCB[2], $BB[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 22),
"note" => "Before adding/increasing " . $BB[0] . ", confirm HR > 55bpm",
"side_effects" => array(
"cough" => null,
"elevated_cr" => null,
"hyperkalemia" => "Stop, hyperkalemia present",
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => "Stop, call doctor"
)
);
$logicTree[] = array(
"step_id" => 22,
"drugs" => array($ARB[1],$DIURETIC[1], $CCB[2], $BB[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 23),
"note" => "Before adding/increasing " . $BB[1] . ", confirm HR > 55bpm",
"side_effects" => array(
"cough" => null,
"elevated_cr" => null,
"hyperkalemia" => 21,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => "Stop, call doctor"
)
);
$logicTree[] = array(
"step_id" => 23,
"drugs" => array($ARB[1],$DIURETIC[1], $CCB[2], $BB[2] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 24),
"note" => "Before adding/increasing " . $BB[2] . ", confirm HR > 55bpm",
"side_effects" => array(
"cough" => null,
"elevated_cr" => null,
"hyperkalemia" => 22,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => "Stop, call doctor"
)
);
$logicTree[] = array(
"step_id" => 24,
"drugs" => array($ARB[1],$DIURETIC[1], $CCB[2], $BB[3] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => "End of protocol"),
"note" => "Before adding/increasing " . $BB[3] . ", confirm HR > 55bpm",
"side_effects" => array(
"cough" => null,
"elevated_cr" => null,
"hyperkalemia" => 23,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => "Stop, call doctor"
)
);
$logicTree[] = array(
"step_id" => 25,
"drugs" => array($ACEI[0], $DIURETIC[0], $CCB[0] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 26),
"note" => "Before adding/increasing Diltiazem or Verapamil, confirm HR > 55bpm",
"side_effects" => array(
"cough" => null,
"elevated_cr" => 28,
"hyperkalemia" => 28,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 26,
"drugs" => array($ACEI[0], $DIURETIC[0], $CCB[1] ),
"bp_status" => array("Controlled"=> "Continue current step", "Uncontrolled" => 27),
"note" => "Before adding/increasing Diltiazem or Verapamil, confirm HR > 55bpm",
"side_effects" => array(
"cough" => null,
"elevated_cr" => 29,
"hyperkalemia" => null,
"slow_hr" => null,
"angioedema" => null,
"breast_discomfort" => null,
"rash_other" => "Stop, call doctor",
"asthma" => null
)
);
$logicTree[] = array(
"step_id" => 27,