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"""
Base classes and utilities for the validation framework.
Provides:
- ValidationCase: a single test case with input + ground truth
- ValidationResult: scored result for a single case
- ValidationSummary: aggregate metrics for a dataset
- run_cds_pipeline(): runs a case through the orchestrator directly
- fuzzy_match(): soft string matching for diagnosis comparison
"""
from __future__ import annotations
import asyncio
import json
import re
import time
from dataclasses import dataclass, field
from datetime import datetime, timezone
from pathlib import Path
from typing import Any, Dict, List, Optional
# ββ CDS pipeline imports ββ
import sys
# Ensure the backend app is importable
BACKEND_DIR = Path(__file__).resolve().parent.parent
if str(BACKEND_DIR) not in sys.path:
sys.path.insert(0, str(BACKEND_DIR))
from app.agent.orchestrator import Orchestrator
from app.models.schemas import (
CaseSubmission,
CDSReport,
ClinicalReasoningResult,
AgentState,
AgentStepStatus,
)
# ββββββββββββββββββββββββββββββββββββββββββββββ
# Data classes
# ββββββββββββββββββββββββββββββββββββββββββββββ
@dataclass
class ValidationCase:
"""A single validation test case."""
case_id: str
source_dataset: str # "medqa", "mtsamples", "pmc"
input_text: str # Clinical text fed to the pipeline
ground_truth: Dict[str, Any] # Dataset-specific ground truth
metadata: Dict[str, Any] = field(default_factory=dict)
@dataclass
class ValidationResult:
"""Result of running one case through the pipeline + scoring."""
case_id: str
source_dataset: str
success: bool # Pipeline completed without crash
scores: Dict[str, float] # Metric name β score (0.0β1.0)
pipeline_time_ms: int = 0
step_results: Dict[str, str] = field(default_factory=dict) # step_id β status
report_summary: Optional[str] = None
error: Optional[str] = None
details: Dict[str, Any] = field(default_factory=dict) # Extra scoring info
@dataclass
class ValidationSummary:
"""Aggregate metrics for a dataset validation run."""
dataset: str
total_cases: int
successful_cases: int
failed_cases: int
metrics: Dict[str, float] # Metric name β average score
per_case: List[ValidationResult]
run_duration_sec: float
timestamp: str = ""
def __post_init__(self):
if not self.timestamp:
self.timestamp = datetime.now(timezone.utc).isoformat()
# ββββββββββββββββββββββββββββββββββββββββββββββ
# Pipeline runner
# ββββββββββββββββββββββββββββββββββββββββββββββ
async def run_cds_pipeline(
patient_text: str,
include_drug_check: bool = True,
include_guidelines: bool = True,
timeout_sec: int = 180,
) -> tuple[Optional[AgentState], Optional[CDSReport], Optional[str]]:
"""
Run a single case through the CDS pipeline directly (no HTTP server needed).
Returns:
(state, report, error) β error is None on success
"""
case = CaseSubmission(
patient_text=patient_text,
include_drug_check=include_drug_check,
include_guidelines=include_guidelines,
)
orchestrator = Orchestrator()
try:
async for _step_update in orchestrator.run(case):
pass # consume all step updates
report = orchestrator.get_result()
# If no report was produced, collect errors from failed steps
if report is None and orchestrator.state:
failed_steps = [
s for s in orchestrator.state.steps
if s.status == AgentStepStatus.FAILED
]
if failed_steps:
error_msgs = [f"{s.step_id}: {s.error}" for s in failed_steps]
return orchestrator.state, None, "; ".join(error_msgs)
return orchestrator.state, None, "Pipeline completed but produced no report"
return orchestrator.state, report, None
except asyncio.TimeoutError:
return orchestrator.state, None, f"Pipeline timed out after {timeout_sec}s"
except Exception as e:
return orchestrator.state, None, str(e)
# ββββββββββββββββββββββββββββββββββββββββββββββ
# Fuzzy string matching for diagnosis comparison
# ββββββββββββββββββββββββββββββββββββββββββββββ
def normalize_text(text: str) -> str:
"""Lowercase, strip punctuation, normalize whitespace."""
text = text.lower().strip()
text = re.sub(r'[^\w\s]', ' ', text)
text = re.sub(r'\s+', ' ', text)
return text.strip()
# Medical stopwords that don't carry diagnostic meaning
_MEDICAL_STOPWORDS = frozenset({
"the", "a", "an", "of", "in", "to", "and", "or", "is", "are", "was",
"were", "be", "been", "with", "for", "on", "at", "by", "from", "this",
"that", "these", "those", "it", "its", "has", "have", "had", "do",
"does", "did", "will", "would", "could", "should", "may", "might",
"most", "likely", "following", "which", "what", "patient", "patients",
})
def _content_tokens(text: str) -> set:
"""Extract meaningful content tokens, removing medical stopwords."""
tokens = set(normalize_text(text).split())
return tokens - _MEDICAL_STOPWORDS
def fuzzy_match(candidate: str, target: str, threshold: float = 0.6) -> bool:
"""
Check if candidate text is a fuzzy match for target.
Strategy (checked in order, first match wins):
1. Normalized substring containment (either direction)
2. All content tokens of target appear in candidate (recall=1.0)
3. Token overlap ratio >= threshold (using content tokens, recall-based)
Args:
candidate: Text from the pipeline output (may be long)
target: Ground truth text (usually short)
threshold: Minimum token overlap ratio (0.0-1.0)
"""
c_norm = normalize_text(candidate)
t_norm = normalize_text(target)
if not t_norm:
return False
# 1. Substring containment (either direction)
if t_norm in c_norm or c_norm in t_norm:
return True
# 2. All content tokens of target present in candidate
t_content = _content_tokens(target)
c_content = _content_tokens(candidate)
if t_content and t_content.issubset(c_content):
return True
# 3. Token overlap ratio (recall-based: what fraction of target is present?)
if not t_content or not c_content:
return False
overlap = len(t_content & c_content)
recall = overlap / len(t_content)
return recall >= threshold
def diagnosis_in_differential(
target_diagnosis: str,
report: CDSReport,
top_n: Optional[int] = None,
) -> tuple[bool, int, str]:
"""
Check if target_diagnosis appears in the report's differential.
Returns:
(found, rank, match_location) β rank is 0-indexed position, or -1 if not found.
match_location is one of: "differential", "next_steps", "recommendations",
"fulltext", or "not_found".
"""
diagnoses = report.differential_diagnosis
if top_n:
diagnoses = diagnoses[:top_n]
for i, dx in enumerate(diagnoses):
if fuzzy_match(dx.diagnosis, target_diagnosis):
return True, i, "differential"
# Check suggested_next_steps (for management-type answers)
for i, action in enumerate(report.suggested_next_steps):
if fuzzy_match(action.action, target_diagnosis):
return True, len(diagnoses) + i, "next_steps"
# Check guideline recommendations (for treatment-type answers)
for i, rec in enumerate(report.guideline_recommendations):
if fuzzy_match(rec, target_diagnosis):
return True, len(diagnoses) + len(report.suggested_next_steps) + i, "recommendations"
# Broad fulltext check (patient_summary, recommendations, next steps combined)
full_text = " ".join([
report.patient_summary or "",
" ".join(report.guideline_recommendations),
" ".join(a.action for a in report.suggested_next_steps),
" ".join(dx.reasoning for dx in report.differential_diagnosis),
])
if fuzzy_match(full_text, target_diagnosis, threshold=0.3):
return True, len(diagnoses), "fulltext"
return False, -1, "not_found"
# ββββββββββββββββββββββββββββββββββββββββββββββ
# Type-aware scoring (P4)
# ββββββββββββββββββββββββββββββββββββββββββββββ
def score_case(
target_answer: str,
report: CDSReport,
question_type: str = "diagnostic",
reasoning_result: Optional[ClinicalReasoningResult] = None,
) -> dict:
"""
Score a case based on its question type.
Returns a dict of metric_name -> score (0.0 or 1.0), plus
'match_location' (str) and 'match_rank' (int) detail fields.
"""
qt = question_type.lower()
if qt == "diagnostic":
return _score_diagnostic(target_answer, report)
elif qt == "treatment":
return _score_treatment(target_answer, report)
elif qt == "mechanism":
return _score_mechanism(target_answer, report, reasoning_result)
elif qt == "lab_finding":
return _score_lab_finding(target_answer, report, reasoning_result)
else:
return _score_generic(target_answer, report, reasoning_result)
def _score_diagnostic(target: str, report: CDSReport) -> dict:
"""Score a diagnostic question -- primary field is differential_diagnosis."""
found_top1, r1, l1 = diagnosis_in_differential(target, report, top_n=1)
found_top3, r3, l3 = diagnosis_in_differential(target, report, top_n=3)
found_any, ra, la = diagnosis_in_differential(target, report)
return {
"top1_accuracy": 1.0 if found_top1 else 0.0,
"top3_accuracy": 1.0 if found_top3 else 0.0,
"mentioned_accuracy": 1.0 if found_any else 0.0,
"differential_accuracy": 1.0 if (found_any and la == "differential") else 0.0,
"match_location": la,
"match_rank": ra,
}
def _score_treatment(target: str, report: CDSReport) -> dict:
"""Score a treatment question -- primary fields are next_steps + recommendations."""
# Check suggested_next_steps first (most specific for treatment)
for i, action in enumerate(report.suggested_next_steps):
if fuzzy_match(action.action, target):
return {
"top1_accuracy": 1.0 if i == 0 else 0.0,
"top3_accuracy": 1.0 if i < 3 else 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "next_steps",
"match_rank": i,
}
# Check guideline_recommendations
for i, rec in enumerate(report.guideline_recommendations):
if fuzzy_match(rec, target):
return {
"top1_accuracy": 0.0,
"top3_accuracy": 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "recommendations",
"match_rank": i,
}
# Check differential reasoning text (treatment may appear in reasoning)
for dx in report.differential_diagnosis:
if fuzzy_match(dx.reasoning, target, threshold=0.3):
return {
"top1_accuracy": 0.0,
"top3_accuracy": 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "reasoning_text",
"match_rank": -1,
}
# Fulltext fallback
full_text = _build_fulltext(report)
if fuzzy_match(full_text, target, threshold=0.3):
return {
"top1_accuracy": 0.0,
"top3_accuracy": 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "fulltext",
"match_rank": -1,
}
return _not_found()
def _score_mechanism(
target: str,
report: CDSReport,
reasoning_result: Optional[ClinicalReasoningResult] = None,
) -> dict:
"""Score a mechanism question -- primary field is reasoning_chain."""
# Check reasoning chain from clinical reasoning step
if reasoning_result and reasoning_result.reasoning_chain:
if fuzzy_match(reasoning_result.reasoning_chain, target, threshold=0.3):
return {
"top1_accuracy": 0.0,
"top3_accuracy": 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "reasoning_chain",
"match_rank": -1,
}
# Check differential reasoning text
for dx in report.differential_diagnosis:
if fuzzy_match(dx.reasoning, target, threshold=0.3):
return {
"top1_accuracy": 0.0,
"top3_accuracy": 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "differential_reasoning",
"match_rank": -1,
}
# Fulltext fallback
full_text = _build_fulltext(report)
if fuzzy_match(full_text, target, threshold=0.3):
return {
"top1_accuracy": 0.0,
"top3_accuracy": 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "fulltext",
"match_rank": -1,
}
return _not_found()
def _score_lab_finding(
target: str,
report: CDSReport,
reasoning_result: Optional[ClinicalReasoningResult] = None,
) -> dict:
"""Score a lab/finding question -- primary field is recommended_workup."""
# Check recommended workup from clinical reasoning step
if reasoning_result:
for i, action in enumerate(reasoning_result.recommended_workup):
if fuzzy_match(action.action, target, threshold=0.4):
return {
"top1_accuracy": 1.0 if i == 0 else 0.0,
"top3_accuracy": 1.0 if i < 3 else 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "recommended_workup",
"match_rank": i,
}
# Check next steps in final report
for i, action in enumerate(report.suggested_next_steps):
if fuzzy_match(action.action, target, threshold=0.4):
return {
"top1_accuracy": 0.0,
"top3_accuracy": 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "next_steps",
"match_rank": i,
}
# Fulltext fallback
full_text = _build_fulltext(report)
if fuzzy_match(full_text, target, threshold=0.3):
return {
"top1_accuracy": 0.0,
"top3_accuracy": 0.0,
"mentioned_accuracy": 1.0,
"differential_accuracy": 0.0,
"match_location": "fulltext",
"match_rank": -1,
}
return _not_found()
def _score_generic(
target: str,
report: CDSReport,
reasoning_result: Optional[ClinicalReasoningResult] = None,
) -> dict:
"""Score any question type -- searches all fields broadly."""
# Try diagnostic scoring first
result = _score_diagnostic(target, report)
if result.get("mentioned_accuracy", 0.0) > 0.0:
return result
# Try treatment scoring
result = _score_treatment(target, report)
if result.get("mentioned_accuracy", 0.0) > 0.0:
return result
# Try mechanism scoring
if reasoning_result:
result = _score_mechanism(target, report, reasoning_result)
if result.get("mentioned_accuracy", 0.0) > 0.0:
return result
return _not_found()
def _build_fulltext(report: CDSReport) -> str:
"""Concatenate all report fields into a single searchable string."""
parts = [
report.patient_summary or "",
" ".join(report.guideline_recommendations),
" ".join(a.action for a in report.suggested_next_steps),
" ".join(dx.diagnosis + " " + dx.reasoning for dx in report.differential_diagnosis),
" ".join(report.sources_cited),
]
if report.conflicts:
parts.append(" ".join(c.description for c in report.conflicts))
return " ".join(parts)
def _not_found() -> dict:
"""Return a zero-score result dict."""
return {
"top1_accuracy": 0.0,
"top3_accuracy": 0.0,
"mentioned_accuracy": 0.0,
"differential_accuracy": 0.0,
"match_location": "not_found",
"match_rank": -1,
}
# ββββββββββββββββββββββββββββββββββββββββββββββ
# I/O utilities
# ββββββββββββββββββββββββββββββββββββββββββββββ
DATA_DIR = Path(__file__).resolve().parent / "data"
RESULTS_DIR = Path(__file__).resolve().parent / "results"
def ensure_data_dir():
"""Create the data directory if it doesn't exist."""
DATA_DIR.mkdir(parents=True, exist_ok=True)
def _result_to_dict(r: ValidationResult) -> dict:
"""Convert a ValidationResult to a serialisable dict."""
return {
"case_id": r.case_id,
"source_dataset": r.source_dataset,
"success": r.success,
"scores": r.scores,
"pipeline_time_ms": r.pipeline_time_ms,
"step_results": r.step_results,
"report_summary": r.report_summary,
"error": r.error,
"details": r.details,
}
# ββββββββββββββββββββββββββββββββββββββββββββββ
# Incremental checkpoint (JSONL)
# ββββββββββββββββββββββββββββββββββββββββββββββ
def checkpoint_path(dataset: str) -> Path:
"""Return the path to the checkpoint JSONL for *dataset*."""
RESULTS_DIR.mkdir(parents=True, exist_ok=True)
return RESULTS_DIR / f"{dataset}_checkpoint.jsonl"
def save_incremental(result: ValidationResult, dataset: str) -> None:
"""Append a single case result to the checkpoint JSONL file."""
path = checkpoint_path(dataset)
with open(path, "a", encoding="utf-8") as f:
f.write(json.dumps(_result_to_dict(result), default=str) + "\n")
def load_checkpoint(dataset: str) -> List[ValidationResult]:
"""
Load previously-completed results from the checkpoint file.
Returns a list of ValidationResult objects (may be empty).
"""
path = checkpoint_path(dataset)
if not path.exists():
return []
results: List[ValidationResult] = []
for line in path.read_text(encoding="utf-8").strip().split("\n"):
if not line.strip():
continue
d = json.loads(line)
results.append(ValidationResult(
case_id=d["case_id"],
source_dataset=d.get("source_dataset", dataset),
success=d["success"],
scores=d["scores"],
pipeline_time_ms=d.get("pipeline_time_ms", 0),
step_results=d.get("step_results", {}),
report_summary=d.get("report_summary"),
error=d.get("error"),
details=d.get("details", {}),
))
return results
def clear_checkpoint(dataset: str) -> None:
"""Delete checkpoint file for a fresh run."""
path = checkpoint_path(dataset)
if path.exists():
path.unlink()
# ββββββββββββββββββββββββββββββββββββββββββββββ
# Final results save
# ββββββββββββββββββββββββββββββββββββββββββββββ
def save_results(summary: ValidationSummary, filename: Optional[str] = None):
"""Save validation results to JSON."""
RESULTS_DIR.mkdir(parents=True, exist_ok=True)
if filename is None:
ts = datetime.now(timezone.utc).strftime("%Y%m%d_%H%M%S")
filename = f"{summary.dataset}_{ts}.json"
path = RESULTS_DIR / filename
# Convert to serializable dict
data = {
"dataset": summary.dataset,
"total_cases": summary.total_cases,
"successful_cases": summary.successful_cases,
"failed_cases": summary.failed_cases,
"metrics": summary.metrics,
"run_duration_sec": summary.run_duration_sec,
"timestamp": summary.timestamp,
"per_case": [_result_to_dict(r) for r in summary.per_case],
}
path.write_text(json.dumps(data, indent=2, default=str))
return path
def print_summary(summary: ValidationSummary):
"""Pretty-print validation results with stratified breakdown."""
print(f"\n{'='*60}")
print(f" Validation Results: {summary.dataset.upper()}")
print(f"{'='*60}")
print(f" Total cases: {summary.total_cases}")
print(f" Successful: {summary.successful_cases}")
print(f" Failed: {summary.failed_cases}")
print(f" Duration: {summary.run_duration_sec:.1f}s")
# Known question types used for stratification
_KNOWN_TYPES = {
"diagnostic", "treatment", "mechanism", "lab_finding",
"pharmacology", "epidemiology", "ethics", "anatomy", "other",
}
# Overall metrics (exclude per-type breakdowns)
print(f"\n Overall Metrics:")
for metric, value in sorted(summary.metrics.items()):
if metric.startswith("count_"):
continue
if any(metric.endswith(f"_{qt}") for qt in _KNOWN_TYPES):
continue
if metric.endswith("_pipeline_appropriate"):
continue
if "time" in metric and isinstance(value, (int, float)):
print(f" {metric:35s} {value:.0f}ms")
elif isinstance(value, float):
print(f" {metric:35s} {value:.1%}")
else:
print(f" {metric:35s} {value}")
# Stratified breakdown by question type
type_keys = sorted(
k[len("count_"):] for k in summary.metrics
if k.startswith("count_") and k != "count_pipeline_appropriate"
)
if type_keys:
print(f"\n By Question Type:")
print(f" {'Type':15s} {'Count':>6s} {'Top-1':>7s} {'Top-3':>7s} {'Mentioned':>10s} {'MCQ':>7s}")
print(f" {'-'*15} {'-'*6} {'-'*7} {'-'*7} {'-'*10} {'-'*7}")
for qt in type_keys:
count = int(summary.metrics.get(f"count_{qt}", 0))
t1 = summary.metrics.get(f"top1_accuracy_{qt}")
t3 = summary.metrics.get(f"top3_accuracy_{qt}")
ma = summary.metrics.get(f"mentioned_accuracy_{qt}")
mcq = summary.metrics.get(f"mcq_accuracy_{qt}")
t1_s = f"{t1:.0%}" if t1 is not None else "-"
t3_s = f"{t3:.0%}" if t3 is not None else "-"
ma_s = f"{ma:.0%}" if ma is not None else "-"
mcq_s = f"{mcq:.0%}" if mcq is not None else "-"
print(f" {qt:15s} {count:6d} {t1_s:>7s} {t3_s:>7s} {ma_s:>10s} {mcq_s:>7s}")
# Pipeline-appropriate subset
pa_count = summary.metrics.get("count_pipeline_appropriate", 0)
if pa_count > 0:
print(f"\n Pipeline-Appropriate Subset ({int(pa_count)} cases):")
for m in ["top1_accuracy", "top3_accuracy", "mentioned_accuracy"]:
v = summary.metrics.get(f"{m}_pipeline_appropriate")
if v is not None:
print(f" {m:35s} {v:.1%}")
print(f"{'='*60}\n")
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