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FHIR R4, definições de biomarcadores, faixas de referência e conversores para o ecossistema de saúde brasileiro","maintainers":[{"name":"rafael-precisa","email":"admin@precisa-saude.com.br"}],"readme":"# @precisa-saude/fhir\n\nTipos FHIR R4, catálogo de biomarcadores com códigos LOINC, faixas de referência (SBPC/ML, SBC, SBD), conversores e importadores para o contexto clínico brasileiro.\n\nAs contagens do catálogo — quantos biomarcadores, quantos com LOINC, quantas faixas — ficam em [Catálogo em números](../../README.md#catálogo-em-números), geradas a partir deste pacote.\n\n## Instalação\n\n```bash\nnpm install @precisa-saude/fhir\n```\n\n## Uso rápido\n\n### Faixas de referência\n\n```ts\nimport { getReferenceRange } from '@precisa-saude/fhir';\n\nconst range = getReferenceRange('Cholesterol');\n// { min: 0, max: 190, optimalMax: 190, unit: 'mg/dL', ... }\n\nconst rangeForUser = getReferenceRange('HDL', { sex: 'F', age: 35 });\n// Faixa ajustada por sexo e idade\n```\n\n### Converter resultados laboratoriais para FHIR R4\n\n```ts\nimport { labResultToFHIRBundle } from '@precisa-saude/fhir';\n\nconst bundle = labResultToFHIRBundle(report, observations, userProfile);\n// Retorna um FHIR Bundle com DiagnosticReport, Observations e Patient\n```\n\n### Normalizar códigos de biomarcadores\n\n```ts\nimport { normalizeCode, codeToLoinc, loincToCode } from '@precisa-saude/fhir';\n\nnormalizeCode('CholHDL_Ratio'); // 'Cholesterol_HDL_Ratio'\ncodeToLoinc('HDL'); // '2085-9'\nloincToCode('2085-9'); // 'HDL'\n```\n\n### Consultar definições de biomarcadores\n\n```ts\nimport { getDefinitionByCode, getAllDefinitions } from '@precisa-saude/fhir';\n\nconst def = getDefinitionByCode('HDL');\n// { code: 'HDL', loinc: '2085-9', names: { pt: [...], en: [...] }, ... }\n\nconst all = getAllDefinitions(); // todo o catálogo\n```\n\n### URLs das extensões do IG\n\nQuem emite e quem lê uma extensão do IG precisa concordar na URL. As constantes\nsaem do pacote raiz, conferidas por teste contra o FSH do IG:\n\n```ts\nimport { FHIR_BRASIL_EXTENSIONS } from '@precisa-saude/fhir';\n\nconst source = observation.extension?.find(\n  (e) => e.url === FHIR_BRASIL_EXTENSIONS.extractionSource,\n);\n```\n\n## Sub-path imports\n\nPara tree-shaking otimizado, cada módulo pode ser importado individualmente:\n\n```ts\nimport { BIOMARKER_DEFINITIONS } from '@precisa-saude/fhir/biomarkers';\nimport { getReferenceRange } from '@precisa-saude/fhir/reference-ranges';\nimport { labResultToFHIRBundle } from '@precisa-saude/fhir/converter';\nimport { processImportBundle } from '@precisa-saude/fhir/importer';\nimport { getCanonicalUnit, unitToUCUM } from '@precisa-saude/fhir/units';\nimport { validateFHIRObservation } from '@precisa-saude/fhir/validators';\n```\n\n## Módulos\n\n| Sub-path            | Descrição                                                              |\n| ------------------- | ---------------------------------------------------------------------- |\n| `/biomarkers`       | Definições com códigos LOINC, nomes pt/en, sub-categorias              |\n| `/category-groups`  | Agrupamento de 10 categorias clínicas top-level sobre 20 subcategorias |\n| `/reference-ranges` | Faixas de referência por sexo/idade/gestação (SBPC/ML, SBC, SBD, OMS)  |\n| `/converter`        | Converte dados laboratoriais para FHIR R4 Bundle                       |\n| `/importer`         | Importa FHIR Bundle de volta para estruturas internas                  |\n| `/units`            | Mapeamento de unidades, conversão para UCUM                            |\n| `/validators`       | Validação de recursos FHIR (DiagnosticReport, Observation, Bundle)     |\n\n## Escopo das faixas de referência\n\nAs faixas em `/reference-ranges` são **validadas para adultos (≥18 anos)**. Variantes pediátricas não estão incluídas — consumidores que atendem populações pediátricas devem adicionar suas próprias faixas ou buscar fontes específicas (SBP, protocolos neonatais).\n\nVariantes gestacionais estão disponíveis para `TSH`, `Hgb`, `Ferritin`, `Creatinine` e `Glucose`. Para usar, passe `pregnant: true` e, quando conhecido, `pregnancyTrimester` no `ReferenceRangeContext`:\n\n```ts\nconst range = getReferenceRange('TSH', {\n  biologicalSex: 'F',\n  pregnant: true,\n  pregnancyTrimester: 1,\n});\n// → { max: 2.5, min: 0.1, ... } (alvo ATA 2017 para 1º trimestre)\n```\n\nO metadado opcional `fastingRequired` em `BiomarkerReferenceRange` indica se a amostra exige jejum estrito (ex.: `Glucose`, `Insulin`, `HOMA_IR`) ou se o jejum é preferido mas não obrigatório (ex.: `Triglycerides`, que aceita dosagem não-jejum por SBC 2017/2025).\n\n## Aviso médico\n\nEste pacote fornece ferramentas de software para padronização de dados clínicos. **Não substitui orientação médica profissional.** Consulte o [DISCLAIMER.md](../../DISCLAIMER.md) na raiz do repositório para detalhes completos.\n\n## Licença\n\n[Apache-2.0](../../LICENSE)\n\n### Conteúdo LOINC\n\nEste pacote incorpora códigos LOINC, que têm licença própria — permissiva e sem\ncusto, mas com aviso exigido:\n\n> This material contains content from LOINC (http://loinc.org). LOINC is\n> copyright © Regenstrief Institute, Inc. and the Logical Observation\n> Identifiers Names and Codes (LOINC) Committee and is available at no cost\n> under the license at http://loinc.org/license. LOINC® is a registered United\n> States trademark of Regenstrief Institute, Inc.\n","readmeFilename":"README.md"}