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089d665 | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 | """Multimodal clinical extraction — single image → structured entities.
Lives in the Python backend (rather than the Next.js serverless function)
because:
1. We can re-use `gemeo.extractor._kg_normalize_phenotypes` to map
free-text labels to HP:xxxxxxx IDs via the raras-app KG
phenotype_search fulltext (PT-BR coverage). The Vercel function
can't reach Neo4j directly without extra latency.
2. AI logic stays centralized — same auth/audit/redaction pipeline.
3. Render gives fixed-cost compute; Vercel function execution costs
scale per-call with vision payloads (~600KB each).
Provider chain — same model as the Next.js path (Groq Llama 4 Scout)
plus an optional Gemini fallback if the GEMINI_API_KEY is healthy.
Both share the same response shape so the front-end is agnostic to
which provider answered.
Public API:
await extract_image(image_bytes, mime, source_url=None) -> dict
"""
from __future__ import annotations
import json
import logging
import os
from base64 import b64encode
from typing import Any
import httpx
logger = logging.getLogger("gemeo.multimodal_extract")
SYSTEM_PROMPT = """Você é um extrator clínico para um sistema de doenças raras.
Recebe uma imagem (screenshot de prontuário eletrônico, PDF, laudo, planilha)
e extrai entidades estruturadas em JSON.
Regras:
- Idioma fonte é provavelmente PT-BR — preserve termos clínicos no
original em "label" e adicione tradução EN só se óbvia.
- Mapeie fenótipos a HPO IDs (HP:xxxxxxx) quando confiante. Se não
conseguir mapear com >70% de confiança, omita o "id".
- Mapeie diagnósticos a ICD-10-BR e/ou ORPHA quando confiante.
- "confidence" 0..1 conforme certeza da extração (visibilidade do
texto, ambiguidade clínica, qualidade da imagem).
- "evidence" copia a frase fonte que sustenta o achado — máximo 80 chars.
- Se a imagem não contém dado clínico, retorne arrays vazios e
free_text descrevendo o que viu.
- NÃO INVENTE dados. Se um campo não está visível, omita-o.
Retorne APENAS um objeto JSON com este schema (campos vazios viram
array/objeto vazio, jamais null):
{
"hpo": [{"id": "HP:xxxxxxx", "label": "...", "confidence": 0..1, "evidence": "..."}],
"medications": [{"name": "...", "dose": "...", "route": "...", "confidence": 0..1}],
"diagnoses": [{"name": "...", "icd10": "...", "orpha": "...", "confidence": 0..1}],
"labs": [{"name": "...", "value": "...", "unit": "...", "date": "...", "confidence": 0..1}],
"patient": {"age": "...", "sex": "...", "weight": "..."},
"free_text": "...",
"language": "pt-BR"
}"""
GROQ_URL = "https://api.groq.com/openai/v1/chat/completions"
GROQ_MODEL_DEFAULT = "meta-llama/llama-4-scout-17b-16e-instruct"
GEMINI_URL_TPL = (
"https://generativelanguage.googleapis.com/v1beta/models/{model}:generateContent?key={key}"
)
GEMINI_MODEL_DEFAULT = "gemini-2.5-flash"
def _normalize_entities(raw: dict[str, Any]) -> dict[str, Any]:
"""Cope with the model emitting Portuguese keys when the schema
hint loses fidelity. Map alternates back to canonical keys + ensure
arrays exist so the front-end never crashes on a missing key."""
def pick_list(*keys: str) -> list:
for k in keys:
v = raw.get(k)
if isinstance(v, list):
return v
return []
return {
"hpo": pick_list("hpo", "achados", "phenotypes", "fenotipos"),
"medications": pick_list("medications", "medicamentos", "meds", "drugs"),
"diagnoses": pick_list("diagnoses", "diagnosticos", "hipoteses", "differentials"),
"labs": pick_list("labs", "exames", "laboratory", "tests"),
"patient": raw.get("patient") or raw.get("paciente") or {},
"free_text": (
raw.get("free_text")
if isinstance(raw.get("free_text"), str)
else (raw.get("observacao") if isinstance(raw.get("observacao"), str) else "")
),
"language": raw.get("language") if isinstance(raw.get("language"), str) else "pt-BR",
}
def _parse_json_safely(text: str) -> dict[str, Any]:
cleaned = text.strip()
# Strip optional markdown code fences.
if cleaned.startswith("```"):
cleaned = cleaned.split("```", 2)[1] if "```" in cleaned[3:] else cleaned[3:]
if cleaned.startswith("json"):
cleaned = cleaned[4:]
cleaned = cleaned.strip().rstrip("`").strip()
return json.loads(cleaned)
async def _call_groq(image_b64: str, mime: str, user_prompt: str) -> dict[str, Any]:
"""Groq Llama 4 Scout vision — primary provider. ~600ms p50."""
api_key = os.getenv("GROQ_API_KEY")
if not api_key:
raise RuntimeError("GROQ_API_KEY not set")
model = os.getenv("GROQ_EXTRACT_MODEL", GROQ_MODEL_DEFAULT)
data_url = f"data:{mime};base64,{image_b64}"
payload = {
"model": model,
"messages": [
{"role": "system", "content": SYSTEM_PROMPT},
{
"role": "user",
"content": [
{"type": "text", "text": user_prompt},
{"type": "image_url", "image_url": {"url": data_url}},
],
},
],
"response_format": {"type": "json_object"},
"temperature": 0.1,
"max_tokens": 4096,
}
async with httpx.AsyncClient(timeout=60.0) as client:
r = await client.post(
GROQ_URL,
headers={
"Authorization": f"Bearer {api_key}",
"Content-Type": "application/json",
},
json=payload,
)
r.raise_for_status()
j = r.json()
text = j.get("choices", [{}])[0].get("message", {}).get("content", "")
entities = _normalize_entities(_parse_json_safely(text))
usage = j.get("usage") or {}
return {
"entities": entities,
"model": f"groq:{model}",
"tokens": {
"input": usage.get("prompt_tokens"),
"output": usage.get("completion_tokens"),
},
}
async def _call_gemini(image_b64: str, mime: str, user_prompt: str) -> dict[str, Any]:
"""Gemini 2.5 Flash vision — fallback. Uses responseSchema for
strict JSON. Native PT-BR; handles tabular reports a touch better
than Llama 4 Scout but ~3× slower."""
api_key = os.getenv("GEMINI_API_KEY")
if not api_key:
raise RuntimeError("GEMINI_API_KEY not set")
model = os.getenv("GEMINI_EXTRACT_MODEL", GEMINI_MODEL_DEFAULT)
url = GEMINI_URL_TPL.format(model=model, key=api_key)
payload = {
"systemInstruction": {"parts": [{"text": SYSTEM_PROMPT}]},
"contents": [
{
"role": "user",
"parts": [
{"text": user_prompt},
{"inlineData": {"mimeType": mime, "data": image_b64}},
],
}
],
"generationConfig": {
"responseMimeType": "application/json",
"temperature": 0.1,
"maxOutputTokens": 4096,
},
}
async with httpx.AsyncClient(timeout=60.0) as client:
r = await client.post(url, json=payload)
r.raise_for_status()
j = r.json()
text = j.get("candidates", [{}])[0].get("content", {}).get("parts", [{}])[0].get("text", "")
entities = _normalize_entities(_parse_json_safely(text))
usage = j.get("usageMetadata") or {}
return {
"entities": entities,
"model": f"gemini:{model}",
"tokens": {
"input": usage.get("promptTokenCount"),
"output": usage.get("candidatesTokenCount"),
},
}
async def extract_image(
image_bytes: bytes,
mime: str = "image/png",
source_url: str | None = None,
) -> dict[str, Any]:
"""Run a screenshot / clinical image through a multimodal model and
return canonical structured entities.
Provider order: Groq Llama 4 Scout → Gemini Flash. Returns
`{entities, model, tokens, fallback?, elapsed_ms}` so the caller can
log which provider answered.
"""
import time
started = time.time()
image_b64 = b64encode(image_bytes).decode("ascii")
user_prompt = (
f"Captura de tela vinda de: {source_url}. Extraia as entidades clínicas."
if source_url
else "Extraia as entidades clínicas desta imagem."
)
errors: list[str] = []
for fn, label in [(_call_groq, "groq"), (_call_gemini, "gemini")]:
try:
result = await fn(image_b64, mime, user_prompt)
result["elapsed_ms"] = int((time.time() - started) * 1000)
if label != "groq":
result["fallback"] = True
return result
except Exception as e:
msg = str(e)[:240]
logger.warning("[multimodal_extract] %s failed: %s", label, msg)
errors.append(f"{label}: {msg}")
raise RuntimeError(f"all providers failed — {' | '.join(errors)}")
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