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Clinical Trial Triage β Environment (Server-Side)
===================================================
Implements the OpenEnv Environment base with reset(), step(), state().
Full episode management, reward shaping, and multi-task support.
"""
from __future__ import annotations
import json
import threading
import uuid
from datetime import datetime, timezone
from typing import Any, Dict, Optional
from models import (
AdverseEventObservation,
AdverseEventTriageAction,
ProtocolDeviationAction,
ProtocolDeviationObservation,
SafetyNarrativeAction,
SafetyNarrativeObservation,
StepResult,
TaskID,
TriageAction,
TriageObservation,
TriageReward,
TriageState,
)
from tasks.case_bank import AE_CASES, DEVIATION_CASES, NARRATIVE_CASES # noqa: E402
from tasks.graders import ( # noqa: E402
grade_ae_triage,
grade_protocol_deviation,
grade_safety_narrative,
)
# Task β max steps configuration
TASK_MAX_STEPS: Dict[str, int] = {
TaskID.ADVERSE_EVENT_TRIAGE: 3, # 3 AE cases per episode
TaskID.PROTOCOL_DEVIATION_AUDIT: 3, # 3 site audits per episode
TaskID.SAFETY_NARRATIVE_GENERATION: 1, # 1 complex narrative per episode
}
TASK_CASES: Dict[str, list] = {
TaskID.ADVERSE_EVENT_TRIAGE: AE_CASES,
TaskID.PROTOCOL_DEVIATION_AUDIT: DEVIATION_CASES,
TaskID.SAFETY_NARRATIVE_GENERATION: NARRATIVE_CASES,
}
_SCORE_EPS = 1e-3
_sessions: Dict[str, "ClinicalTrialEnvironment"] = {}
_sessions_lock = threading.Lock()
def get_or_create_session(session_id: str = "default") -> "ClinicalTrialEnvironment":
with _sessions_lock:
if session_id not in _sessions:
_sessions[session_id] = ClinicalTrialEnvironment()
return _sessions[session_id]
def clear_session(session_id: str = "default") -> None:
with _sessions_lock:
_sessions.pop(session_id, None)
class ClinicalTrialEnvironment:
"""
Main environment class implementing OpenEnv-compatible APIs.
Episode lifecycle:
reset(task_id) β initial observation
step(action) β observation, reward, done, info
state() β episode metadata
"""
def __init__(self) -> None:
self._state: Optional[TriageState] = None
self._case_index: int = 0
self._current_task: Optional[TaskID] = None
self._cumulative_reward: float = 0.0
self._actions_log: list = []
self._last_action_signature: Optional[str] = None
# βββββββββββββββββββββββββββββββββββββ
# PUBLIC OPENENV API
# βββββββββββββββββββββββββββββββββββββ
def reset(self, task_id: str = TaskID.ADVERSE_EVENT_TRIAGE) -> TriageObservation:
"""Initialize a new episode for the given task."""
task = TaskID(task_id)
self._current_task = task
self._case_index = 0
self._cumulative_reward = 0.0
self._actions_log = []
self._last_action_signature = None
self._state = TriageState(
episode_id=str(uuid.uuid4()),
task_id=task,
step_count=0,
max_steps=TASK_MAX_STEPS[task],
done=False,
cumulative_reward=0.0,
actions_taken=[],
current_case_id=self._get_current_case_id(),
started_at=datetime.now(timezone.utc).isoformat(),
)
return self._build_observation()
def step(self, action: TriageAction) -> StepResult:
"""Execute one action and return (observation, reward, done, info)."""
if self._state is None or self._state.done:
raise RuntimeError("Call reset() before step(), or episode is already done.")
if TaskID(action.task_id) != self._current_task:
raise ValueError(
f"Action task_id '{action.task_id}' does not match "
f"current episode task '{self._current_task}'."
)
current_observation = self._build_observation()
# Grade this step
reward_detail = self._grade(action)
step_reward = reward_detail.total
# Reward shaping: small partial reward for being in the right direction
# This gives signal across the trajectory, not just at episode end
shaped_reward = self._shape_reward(step_reward, reward_detail, action, current_observation)
# Update state
self._cumulative_reward += shaped_reward
self._case_index += 1
self._state.step_count += 1
self._state.cumulative_reward = self._cumulative_reward
self._state.actions_taken.append(
{"step": self._state.step_count, "action": action.model_dump(), "reward": shaped_reward}
)
done = self._state.step_count >= self._state.max_steps
self._state.done = done
if done:
self._state.completed_at = datetime.now(timezone.utc).isoformat()
self._state.current_case_id = None
else:
self._state.current_case_id = self._get_current_case_id()
obs = self._build_observation()
return StepResult(
observation=obs,
reward=shaped_reward,
reward_detail=reward_detail,
done=done,
info={
"episode_id": self._state.episode_id,
"step": self._state.step_count,
"cumulative_reward": self._cumulative_reward,
"done": done,
},
)
def state(self) -> TriageState:
"""Return current episode state metadata."""
if self._state is None:
raise RuntimeError("No active episode. Call reset() first.")
return self._state
# βββββββββββββββββββββββββββββββββββββ
# INTERNAL HELPERS
# βββββββββββββββββββββββββββββββββββββ
def _get_current_case_id(self) -> Optional[str]:
cases = TASK_CASES.get(self._current_task, [])
if self._case_index < len(cases):
case = cases[self._case_index]
return case.get("case_id") or case.get("site_id")
return None
def _build_observation(self) -> TriageObservation:
"""Build the typed observation for the current state."""
if self._state is None:
raise RuntimeError("No active state.")
cases = TASK_CASES[self._current_task]
step = self._state.step_count
max_steps = self._state.max_steps
if self._state.done or self._case_index >= len(cases):
return TriageObservation(
task_id=self._current_task,
message=f"Episode complete. Cumulative reward: {self._cumulative_reward:.4f}",
)
case = cases[self._case_index]
if self._current_task == TaskID.ADVERSE_EVENT_TRIAGE:
obs = AdverseEventObservation(
case_id=case["case_id"],
narrative=case["narrative"],
patient_age=case["patient_age"],
patient_sex=case["patient_sex"],
study_drug=case["study_drug"],
dose_mg=case["dose_mg"],
days_on_drug=case["days_on_drug"],
relevant_medical_history=case["relevant_medical_history"],
concomitant_medications=case["concomitant_medications"],
lab_values=case["lab_values"],
ae_onset_date=case["ae_onset_date"],
ae_description=case["ae_description"],
outcome=case["outcome"],
step_count=step,
max_steps=max_steps,
)
return TriageObservation(
task_id=self._current_task,
ae_observation=obs,
message=f"Step {step + 1}/{max_steps}: Classify the adverse event.",
)
elif self._current_task == TaskID.PROTOCOL_DEVIATION_AUDIT:
obs = ProtocolDeviationObservation(
site_id=case["site_id"],
site_name=case["site_name"],
visit_type=case["visit_type"],
findings=case["findings"],
prior_deviations=case["prior_deviations"],
active_subjects=case["active_subjects"],
study_phase=case["study_phase"],
last_monitoring_visit=case["last_monitoring_visit"],
step_count=step,
max_steps=max_steps,
)
return TriageObservation(
task_id=self._current_task,
deviation_observation=obs,
message=f"Step {step + 1}/{max_steps}: Audit the site findings.",
)
elif self._current_task == TaskID.SAFETY_NARRATIVE_GENERATION:
obs = SafetyNarrativeObservation(
case_id=case["case_id"],
patient_demographics=case["patient_demographics"],
study_drug=case["study_drug"],
suspect_drugs=case["suspect_drugs"],
concomitant_medications=case["concomitant_medications"],
adverse_event=case["adverse_event"],
lab_values_timeline=case["lab_values_timeline"],
medical_history=case["medical_history"],
action_taken=case["action_taken"],
outcome_at_last_followup=case["outcome_at_last_followup"],
reference_documents=case["reference_documents"],
step_count=step,
max_steps=max_steps,
)
return TriageObservation(
task_id=self._current_task,
narrative_observation=obs,
message=f"Step {step + 1}/{max_steps}: Write the ICSR safety narrative.",
)
return TriageObservation(task_id=self._current_task, message="Unknown task state.")
def _grade(self, action: TriageAction) -> TriageReward:
"""Route grading to the correct task grader."""
cases = TASK_CASES[self._current_task]
if self._case_index >= len(cases):
return TriageReward(total=_SCORE_EPS)
case = cases[self._case_index]
if self._current_task == TaskID.ADVERSE_EVENT_TRIAGE:
if action.ae_triage is None:
return TriageReward(
total=_SCORE_EPS, penalty_applied=True,
penalty_reason="No ae_triage action provided for adverse_event_triage task."
)
return grade_ae_triage(action.ae_triage, case)
elif self._current_task == TaskID.PROTOCOL_DEVIATION_AUDIT:
if action.deviation_audit is None:
return TriageReward(
total=_SCORE_EPS, penalty_applied=True,
penalty_reason="No deviation_audit action provided for protocol_deviation_audit task."
)
return grade_protocol_deviation(action.deviation_audit, case)
elif self._current_task == TaskID.SAFETY_NARRATIVE_GENERATION:
if action.safety_narrative is None:
return TriageReward(
total=_SCORE_EPS, penalty_applied=True,
penalty_reason="No safety_narrative action provided for safety_narrative_generation task."
)
return grade_safety_narrative(action.safety_narrative, case)
return TriageReward(total=_SCORE_EPS)
def _shape_reward(
self,
raw_reward: float,
detail: TriageReward,
action: TriageAction,
current_observation: TriageObservation,
) -> float:
"""
Apply reward shaping to ensure dense signals across the trajectory.
- Small bonus for partial progress (>0.3 total)
- Deduction for penalty-flagged actions
- No bonus for trivially wrong answers
"""
shaped = raw_reward
# Partial progress signal
if 0.3 <= raw_reward < 0.6:
shaped += 0.02 # small encouragement signal
# Penalty deduction
if detail.penalty_applied:
shaped = max(0.0, shaped - 0.05)
# Anti-gaming penalty for obviously inflated severity when narrative implies mild signal.
if (
action.task_id == TaskID.ADVERSE_EVENT_TRIAGE
and action.ae_triage is not None
and current_observation.ae_observation is not None
):
ae_action = action.ae_triage
narrative = current_observation.ae_observation.narrative.lower()
narrative_implies_mild = any(word in narrative for word in ["mild", "minor", "slight", "minimal"])
narrative_has_critical = any(
word in narrative for word in ["life-threatening", "critical", "icu", "intubat", "cardiac arrest"]
)
severity_value = getattr(ae_action.severity_classification, "value", ae_action.severity_classification)
agent_says_life_threatening = str(severity_value) == "life_threatening"
if narrative_implies_mild and not narrative_has_critical and agent_says_life_threatening:
shaped -= 0.15
# Anti-loop penalty for repeating identical consecutive actions.
action_signature = json.dumps(action.model_dump(mode="json"), sort_keys=True)
if self._last_action_signature == action_signature:
shaped -= 0.05
self._last_action_signature = action_signature
return round(min(1.0 - _SCORE_EPS, max(_SCORE_EPS, shaped)), 6) |