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Add patient action items to clinicedc/edc projects

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edc-action-items

Add patient action items to the Edc

Overview

Action items are reminders to submit a form.

Action items can be configured to drive data collection

  • for forms that do not fit well in a visit schedule;

  • for forms that are required based on some clinical event.

Action items are tracked. Each is allocated a unique action_identifier and maintain status (New, Open, Closed).

Actions can be chained. One action can create another action, group of actions or recreate itself.

Adverse Events, Death, OffSchedule are all good candidates.

Adverse Event reports are required based on some clinical event. Since the event must be reported, leaving the decision to report the user is not sufficient. An action item can be opened based on the clinical event and the status of the action item tracked administratively. The action item is associtaed with the AE report. Once the report is submitted, the action item closes. If additional data is required after an initial AE report is submitted, a follow-up action can automatically be opened.

See module ambition-ae.action_items for examples.

Defining action items

In the root of your App, define an action_items module. The edc-action-item site controller will autodiscover this module and register the action item classes.

Register action item classes in the action_items module like this

site_action_items.register(AeInitialAction)

A simple action item

In it define actions using the Action class.

from edc_action_item import Action, site_action_items
from edc_constants.constants HIGH_PRIORITY
from ambition_ae.action_items import AeFollowupAction, AeTmgAction

class AeInitialAction(Action):

    name = AE_INITIAL_ACTION
    display_name = 'Submit AE Initial Report'
    model = 'ambition_ae.aeinitial'
    show_on_dashboard = True
    instructions = 'Complete the initial report and forward to the TMG'
    priority = HIGH_PRIORITY

The action item is associated with its model

from edc_action_item.model_mixins import ActionModelMixin
from edc_identifier.model_mixins import NonUniqueSubjectIdentifierFieldMixin

class AeInitial(ActionModelMixin, NonUniqueSubjectIdentifierFieldMixin,
                BaseUuidModel):

action_cls = AeInitialAction

... # field classes

Somewhere in your code, instantiate the action item

AeInitialAction(subject_identifier='12345')

This creates an ActionItem model instance for this subject with a status of New (if it does not exist).

Now create the associated model instance

AeInitial.objects.create(subject_identifier='12345', ...)

The ActionItem model instance now has a status of Closed.

Changing the criteria to close an action

By default an action is closed once the associated model instance has been saved. For more refined behavior define close_action_item_on_save on the action item class

class AeInitialAction(Action):

...

def close_action_item_on_save(self):
    self.delete_children_if_new(action_cls=self)
    return self.model_obj.report_status == CLOSED

Singleton action items

To ensure an action item does not create more than one instance per subject, use the singleton attribute.

class EnrollToSubstudyAction(Action):
    name = 'My Action'
    display_name = 'Enroll to sub-study'
    model = 'myapp.enroll'
    show_link_to_changelist = True
    admin_site_name = 'myapp_admin'
    priority = HIGH_PRIORITY
    create_by_user = False
    singleton=True

Action items that create a next action item

For an action item to open another action item(s) once closed, set next_actions.

class AeInitialAction(Action):

    name = AE_INITIAL_ACTION
    display_name = 'Submit AE Initial Report'
    model = 'ambition_ae.aeinitial'
    show_on_dashboard = True
    instructions = 'Complete the initial report and forward to the TMG'
    priority = HIGH_PRIORITY
    next_actions = [AeFollowupAction]

If the criteria for the next action is based on some other information declare get_next_actions on the action item and return the list of action items needed.

class AeInitialAction(Action):

...

def get_next_actions(self):
    next_actions = []
    try:
        self.reference_model_cls().objects.get(
            ae_initial=self.model_obj.ae_initial)
    except MultipleObjectsReturned:
        pass
    else:
        if (self.model_obj.ae_initial.ae_classification
                != self.model_obj.ae_classification):
            next_actions = [self]
    return next_actions

Action items with a notification

An action item can be associated with a notification from edc_notification so that when an action is created a notification (email or sms) is sent to those registered to receive it.

A subclass of ‘’Action``, ActionWithNotification` adds notifications to the action. The notification for the action is automatically registered when the action is registered by site_action_items.

For example:

class AeTmgAction(ActionWithNotification):
    name = AE_TMG_ACTION
    display_name = "TMG AE Report pending"
    notification_display_name = "TMG AE Report"
    parent_action_names = [AE_INITIAL_ACTION],
    reference_model = "ambition_ae.aetmg"
    related_reference_model = "ambition_ae.aeinitial"
    related_reference_fk_attr = "ae_initial"
    show_link_to_changelist = True
    admin_site_name = "ambition_ae_admin"

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