""" COMPREHENSIVE MEDICAL ANALYSIS PROMPT ENGINEERING FRAMEWORK Creates meaningful clinical insights across ALL medical categories This file provides enhanced prompt templates and structured output schemas for: - Cardiology/ECG Analysis - Radiology (X-ray, CT, MRI, Ultrasound) - Laboratory Medicine - Pathology (Biopsies, Cytology) - Clinical Documentation - General Medical Analysis Each prompt includes: 1. Domain-specific clinical context 2. Structured diagnostic framework 3. Professional medical terminology 4. Evidence-based recommendations 5. Clinical correlation requirements """ import json from typing import Dict, Any, List from datetime import datetime class ComprehensiveMedicalPromptEngine: """ Enhanced medical prompt engineering for meaningful clinical insights across all medical categories """ def __init__(self): self.medical_domains = self._initialize_medical_domains() self.output_schemas = self._initialize_output_schemas() def _initialize_medical_domains(self) -> Dict[str, Dict[str, Any]]: """Initialize comprehensive medical analysis domains with enhanced prompts""" return { # ===== CARDIOLOGY/ECG ANALYSIS ===== "cardiology_ecg": { "clinical_context": """You are a board-certified cardiologist specializing in electrocardiography and cardiac electrophysiology. Provide comprehensive ECG analysis with clinical expertise.""", "prompt_template": """CLINICAL SCENARIO: Comprehensive Electrocardiogram Analysis Patient Context: {patient_info} ECG Data: {ecg_data} Provide detailed cardiac electrophysiology assessment including: 1. **RHYTHM ANALYSIS & CARDIAC RATE** - Primary rhythm identification with confidence assessment - Heart rate analysis with normal/abnormal range determination - Sinus rhythm characteristics and any arrhythmic patterns 2. **CONDUCTION SYSTEM ASSESSMENT** - P wave morphology, duration, and timing analysis - PR interval interpretation (normal, prolonged, shortened) - QRS complex analysis (duration, morphology, axis determination) - QT/QTc interval measurement with clinical significance 3. **MYOCARDIAL ISCHEMIA/INFARCTION DETECTION** - ST-segment elevation/depression analysis with lead distribution - T wave abnormalities and their clinical significance - Q wave presence indicating prior infarction territory - Pathological Q waves vs physiological variants 4. **CLINICAL CORRELATION & RECOMMENDATIONS** - Risk stratification based on ECG findings - Correlation with clinical presentation and cardiac biomarkers - Evidence-based management recommendations - Follow-up testing requirements (stress test, echo, catheterization) Provide professional cardiac electrophysiology interpretation.""", "domain_expertise": "Cardiology, Electrophysiology, Clinical Medicine", "critical_elements": ["rhythm", "intervals", "ischemia", "axis", "recommendations"] }, # ===== RADIOLOGY ANALYSIS ===== "radiology_xray": { "clinical_context": """You are a board-certified radiologist specializing in diagnostic imaging interpretation. Provide comprehensive radiological analysis with clinical expertise.""", "prompt_template": """CLINICAL SCENARIO: Comprehensive Radiological Analysis Imaging Study: {imaging_study} Patient Context: {patient_context} Radiological Data: {image_data} Provide detailed radiological interpretation including: 1. **TECHNICAL ASSESSMENT** - Imaging modality and acquisition parameters - Image quality and technical adequacy - Anatomical coverage and positioning 2. **ANATOMICAL & PATHOLOGICAL FINDINGS** - Systematic review of anatomical structures - Primary pathological findings with specific descriptions - Differential diagnosis considerations based on imaging patterns - Critical findings requiring urgent attention 3. **CLINICAL SIGNIFICANCE & INTERPRETATION** - Correlation with clinical presentation and symptoms - Severity assessment and prognostic implications - Disease progression or treatment response indicators - Comparison with prior imaging when available 4. **MANAGEMENT RECOMMENDATIONS** - Additional imaging studies if indicated - Clinical correlation requirements - Treatment implications and monitoring needs - Follow-up imaging recommendations Provide expert radiological consultation with clinical correlation.""", "domain_expertise": "Radiology, Diagnostic Imaging, Clinical Medicine", "critical_elements": ["findings", "differential", "severity", "recommendations"] }, "radiology_ct": { "clinical_context": """You are a board-certified radiologist specializing in CT imaging and cross-sectional anatomy. Provide comprehensive CT analysis with clinical expertise.""", "prompt_template": """CLINICAL SCENARIO: Comprehensive CT Scan Analysis CT Study: {ct_study} Clinical Indication: {indication} Patient Context: {patient_context} Provide detailed CT interpretation including: 1. **TECHNICAL ASSESSMENT** - CT protocol and imaging parameters - Contrast enhancement status - Image quality and diagnostic adequacy 2. **SYSTEMATIC ORGAN REVIEW** - Brain/nervous system (if head CT) - Chest (lung parenchyma, mediastinum, pleural spaces) - Abdomen/pelvis (solid organs, bowel, vasculature) - Musculoskeletal structures as applicable 3. **PATHOLOGICAL FINDINGS & INTERPRETATION** - Primary lesion characterization (size, location, enhancement) - Secondary findings and metastatic assessment - Inflammatory, infectious, or neoplastic processes - Vascular abnormalities and perfusion deficits 4. **CLINICAL CORRELATION & RECOMMENDATIONS** - Findings correlation with clinical presentation - Differential diagnosis with probability assessment - Tissue sampling recommendations if indicated - Treatment planning and monitoring protocols Provide expert CT interpretation with clinical management guidance.""", "domain_expertise": "Radiology, Cross-sectional Imaging, Clinical Medicine", "critical_elements": ["systematic_review", "pathology", "differential", "management"] }, # ===== LABORATORY MEDICINE ===== "laboratory_chemistry": { "clinical_context": """You are a board-certified clinical pathologist specializing in laboratory medicine. Provide comprehensive laboratory interpretation with clinical expertise.""", "prompt_template": """CLINICAL SCENARIO: Comprehensive Laboratory Analysis Laboratory Data: {lab_data} Patient Context: {patient_context} Clinical Indication: {indication} Provide detailed laboratory interpretation including: 1. **NORMAL & ABNORMAL VALUE ASSESSMENT** - Reference range comparison with flagging of abnormal values - Critical value identification requiring immediate attention - Trending analysis for serial measurements - Hemolysis, lipemia, or other specimen quality issues 2. **CLINICAL SIGNIFICANCE & CORRELATION** - Clinical interpretation of abnormal findings - Correlation with patient symptoms and medical history - Drug-induced laboratory abnormalities - Organ-specific findings (hepatic, renal, cardiac markers) 3. **DIAGNOSTIC & PROGNOSTIC IMPLICATIONS** - Disease diagnosis support based on laboratory patterns - Prognostic indicators and risk stratification - Treatment monitoring and therapeutic drug levels - Baseline and follow-up testing requirements 4. **RECOMMENDATIONS & CLINICAL ACTION** - Repeat testing requirements or confirmatory studies - Additional laboratory testing for diagnosis/monitoring - Clinical correlation with other diagnostic modalities - Specialist consultation recommendations Provide expert clinical pathology interpretation.""", "domain_expertise": "Laboratory Medicine, Clinical Pathology, Clinical Medicine", "critical_elements": ["reference_ranges", "abnormalities", "significance", "recommendations"] }, # ===== PATHOLOGY ANALYSIS ===== "pathology_biopsy": { "clinical_context": """You are a board-certified pathologist specializing in histopathology and molecular pathology. Provide comprehensive pathological analysis with clinical expertise.""", "prompt_template": """CLINICAL SCENARIO: Comprehensive Pathology Analysis Specimen Type: {specimen_type} Anatomical Site: {site} Clinical Information: {clinical_info} Histopathological Data: {path_data} Provide detailed pathological interpretation including: 1. **MORPHOLOGICAL ASSESSMENT** - Specimen adequacy and diagnostic quality - Histological pattern analysis and architectural features - Cellular morphology, nuclear characteristics, and cytoplasmic features - Staining characteristics and immunohistochemical profile 2. **DIAGNOSTIC INTERPRETATION** - Primary diagnosis with confidence level - Differential diagnosis considerations - Grading and staging information when applicable - Molecular/immunohistochemical markers and their significance 3. **CLINICAL CORRELATION & PROGNOSIS** - Correlation with clinical presentation and imaging findings - Prognostic factors and risk stratification - Treatment response prediction and therapeutic targets - Genetic/molecular alterations with clinical implications 4. **CLINICAL MANAGEMENT RECOMMENDATIONS** - Surgical margin assessment and adequacy - Additional staining or molecular testing recommendations - Treatment planning implications - Follow-up protocols and surveillance recommendations Provide expert pathological consultation with clinical management guidance.""", "domain_expertise": "Pathology, Histopathology, Molecular Pathology, Clinical Medicine", "critical_elements": ["morphology", "diagnosis", "prognosis", "management"] }, # ===== CLINICAL DOCUMENTATION ===== "clinical_notes": { "clinical_context": """You are an experienced clinical physician reviewing medical documentation. Provide comprehensive clinical assessment with medical expertise.""", "prompt_template": """CLINICAL SCENARIO: Clinical Documentation Review Medical Document: {document_data} Document Type: {doc_type} Patient Context: {patient_context} Provide comprehensive clinical analysis including: 1. **DOCUMENT STRUCTURE & CONTENT ASSESSMENT** - Chief complaint and presenting problem analysis - History of present illness extraction and analysis - Past medical, surgical, and social history review - Physical examination findings and documentation quality 2. **CLINICAL ASSESSMENT & DIAGNOSTIC REASONING** - Primary assessment and clinical impression extraction - Differential diagnosis considerations and reasoning - Problem prioritization and clinical decision-making - Evidence-based diagnostic approach assessment 3. **TREATMENT PLAN & MANAGEMENT** - Therapeutic interventions and medication orders - Diagnostic testing recommendations and rationale - Follow-up care and monitoring protocols - Patient education and discharge planning 4. **CLINICAL QUALITY ASSURANCE** - Documentation completeness and accuracy - Clinical reasoning adequacy and decision-making quality - Standard of care compliance and best practice adherence - Areas for improvement and education recommendations Provide professional clinical assessment and quality review.""", "domain_expertise": "Clinical Medicine, Internal Medicine, Medical Documentation", "critical_elements": ["assessment", "reasoning", "management", "quality"] }, # ===== EMERGENCY MEDICINE ===== "emergency_medicine": { "clinical_context": """You are an emergency medicine physician specializing in acute care assessment. Provide comprehensive emergency medicine evaluation with clinical expertise.""", "prompt_template": """CLINICAL SCENARIO: Emergency Medicine Assessment Emergency Presentation: {emergency_data} Patient Context: {patient_context} Clinical Scenario: {scenario} Provide comprehensive emergency medicine evaluation including: 1. **ACUTE PRESENTATION ASSESSMENT** - Chief complaint and triage priority assessment - Vital signs analysis and stability determination - Acute symptom progression and severity - Risk stratification and immediate threats 2. **EMERGENCY CLINICAL FINDINGS** - Critical diagnostic findings requiring immediate attention - Organ system dysfunction assessment - Pain assessment and management needs - Environmental and trauma considerations 3. **EMERGENCY MANAGEMENT PROTOCOL** - Immediate life-saving interventions required - Diagnostic testing priorities (CT, labs, ECG) - Specialist consultation requirements - Admission vs discharge decisions 4. **DISPOSITION & FOLLOW-UP** - Admission criteria and level of care determination - Outpatient follow-up requirements - Patient education and discharge instructions - Emergency re-evaluation triggers Provide expert emergency medicine consultation with acute care protocols.""", "domain_expertise": "Emergency Medicine, Acute Care, Critical Care", "critical_elements": ["triage", "critical_findings", "management", "disposition"] } } def _initialize_output_schemas(self) -> Dict[str, Dict[str, Any]]: """Initialize structured output schemas for each medical domain""" return { "cardiology_ecg": { "required_fields": [ "rhythm_analysis", "heart_rate", "conduction_intervals", "ischemia_findings", "clinical_significance", "recommendations" ], "output_structure": { "rhythm_analysis": "Primary rhythm identification and characteristics", "heart_rate": "Rate analysis with clinical interpretation", "conduction_intervals": "PR, QRS, QT intervals with significance", "ischemia_findings": "ST-T changes, Q waves, infarct location", "clinical_significance": "Risk assessment and correlation", "recommendations": "Evidence-based management and follow-up" } }, "radiology_xray": { "required_fields": [ "technical_assessment", "anatomical_findings", "pathological_lesions", "differential_diagnosis", "clinical_correlation", "recommendations" ], "output_structure": { "technical_assessment": "Image quality, positioning, adequacy", "anatomical_findings": "Systematic review of structures", "pathological_lesions": "Primary findings with descriptions", "differential_diagnosis": "List of possibilities with rationale", "clinical_correlation": "Symptom correlation and significance", "recommendations": "Additional imaging, treatment, follow-up" } }, "laboratory_chemistry": { "required_fields": [ "normal_values", "abnormal_values", "critical_values", "clinical_significance", "trending_analysis", "recommendations" ], "output_structure": { "normal_values": "Results within reference range", "abnormal_values": "Out of range results with interpretation", "critical_values": "Life-threatening values requiring action", "clinical_significance": "Interpretation of abnormalities", "trending_analysis": "Pattern recognition and changes", "recommendations": "Repeat testing, additional studies" } }, "pathology_biopsy": { "required_fields": [ "morphological_assessment", "diagnostic_interpretation", "grading_staging", "prognosis_factors", "treatment_implications" ], "output_structure": { "morphological_assessment": "Histological pattern and cellular features", "diagnostic_interpretation": "Primary diagnosis and differential", "grading_staging": "Severity assessment and classification", "prognosis_factors": "Risk factors and outcome prediction", "treatment_implications": "Therapeutic targets and monitoring" } }, "clinical_notes": { "required_fields": [ "chief_complaint", "assessment_plan", "clinical_reasoning", "diagnostic_approach", "treatment_recommendations", "documentation_quality" ], "output_structure": { "chief_complaint": "Primary problem and presentation", "assessment_plan": "Clinical impression and assessment", "clinical_reasoning": "Diagnostic logic and decision-making", "diagnostic_approach": "Testing and evaluation strategy", "treatment_recommendations": "Therapeutic interventions", "documentation_quality": "Completeness and accuracy assessment" } } } def generate_enhanced_prompt(self, domain: str, data: Dict[str, Any]) -> str: """Generate enhanced medical prompt for specific domain""" if domain not in self.medical_domains: return self._generate_general_medical_prompt(data) domain_config = self.medical_domains[domain] prompt_template = domain_config["prompt_template"] # Format the prompt with available data formatted_prompt = prompt_template.format(**data) # Add structured output requirements if domain in self.output_schemas: schema = self.output_schemas[domain] formatted_prompt += f""" STRUCTURED OUTPUT REQUIREMENTS: Provide your analysis in the following structured format: """ for field in schema["required_fields"]: formatted_prompt += f"• **{field.replace('_', ' ').title()}**: [Detailed analysis]\n" # Add clinical correlation requirement formatted_prompt += """ CLINICAL CORRELATION REQUIREMENTS: 1. Correlate all findings with patient presentation and medical context 2. Use professional medical terminology and clinical expertise 3. Provide evidence-based recommendations with clinical justification 4. Include risk stratification and management priorities 5. Suggest appropriate follow-up and monitoring protocols Professional medical analysis with clinical correlation required.""" return formatted_prompt def _generate_general_medical_prompt(self, data: Dict[str, Any]) -> str: """Generate general medical prompt for unspecified domains""" return f"""CLINICAL SCENARIO: Comprehensive Medical Document Analysis Medical Information: {data.get('text', 'N/A')} Provide comprehensive medical analysis including: 1. **CLINICAL FINDINGS** - Key medical findings and interpretations - Diagnostic considerations with clinical significance - Correlation with medical standards and guidelines 2. **CLINICAL ASSESSMENT** - Overall clinical impression and interpretation - Risk factors and prognostic indicators - Clinical decision-making guidance 3. **MANAGEMENT RECOMMENDATIONS** - Evidence-based treatment considerations - Follow-up protocols and monitoring requirements - Specialist consultation recommendations 4. **CLINICAL CORRELATION** - Integration with patient presentation and medical history - Quality assessment and clinical standards compliance Provide expert medical consultation with clinical correlation and professional medical interpretation.""" def get_domain_expertise(self, domain: str) -> str: """Get domain-specific medical expertise context""" return self.medical_domains.get(domain, {}).get("domain_expertise", "Clinical Medicine") def get_critical_elements(self, domain: str) -> List[str]: """Get critical analysis elements for domain""" return self.medical_domains.get(domain, {}).get("critical_elements", ["findings", "significance", "recommendations"]) # Global instance for medical analysis medical_prompt_engine = ComprehensiveMedicalPromptEngine() def generate_medical_analysis_prompt(domain: str, data: Dict[str, Any]) -> str: """Generate enhanced medical analysis prompt""" return medical_prompt_engine.generate_enhanced_prompt(domain, data) def get_medical_domain_expertise(domain: str) -> str: """Get medical domain expertise context""" return medical_prompt_engine.get_domain_expertise(domain)