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Overview

Med Agenda’s diagnosis system links medical diagnoses to consultations, integrates with CID (International Classification of Diseases) codes, and maintains comprehensive patient medical histories. Each diagnosis is connected to a specific consultation and includes standardized disease classification.

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Diagnosis Data Model

The diagnosis entity stores medical findings and classifications:
Diagnosis.java:8-38
@Entity
@Table(name = "diagnosis")
public class Diagnosis {

    @Id
    @GeneratedValue(strategy = GenerationType.UUID)
    private UUID id;

    @Column(nullable = false)
    private String descricao;

    @Column(nullable = false)
    private LocalDate data;

    @ManyToOne
    @JoinColumn(name = "consulta_id", nullable = false)
    private Consultation consulta;

    @JoinColumn(name = "cid_id", nullable = false)
    private String cid;

    public Diagnosis(UUID id, String descricao, LocalDate data, 
                     Consultation consulta, String cid) {
        this.id = id;
        this.descricao = descricao;
        this.data = data;
        this.consulta = consulta;
        this.cid = cid;
    }
}
Key Fields:
  • id: Unique UUID identifier
  • descricao: Detailed description of the diagnosis
  • data: Date the diagnosis was made
  • consulta: Reference to the associated consultation
  • cid: CID code for disease classification

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CID Integration

Med Agenda uses the International Classification of Diseases (CID) standard:
Cid.java:8-31
@Entity
@Table(name = "cid")
public class Cid {

    @Id
    @Column(name = "code", length = 5, nullable = false, unique = true)
    private String code; // Examples: A00, A15.3

    @CreationTimestamp
    @Column(name = "created_at", updatable = false)
    private Instant createdAt;

    public Cid() {}

    public Cid(String code) {
        this.code = code;
    }

    public String getCode() { return code; }
    public void setCode(String code) { this.code = code; }

    public Instant getCreatedAt() { return createdAt; }
    public void setCreatedAt(Instant createdAt) { this.createdAt = createdAt; }
}
CID Code Format:
  • Maximum 5 characters
  • Examples: A00 (Cholera), A15.3 (Tuberculosis of lungs), E11 (Type 2 diabetes)
  • Follows international medical classification standards
  • Automatically timestamped on creation

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Creating a Diagnosis

Diagnoses are created and linked to existing consultations:
DiagnosisService.java:22-32
public Optional<Diagnosis> createDiagnosis(Diagnosis diagnosis) {
    UUID consultaId = diagnosis.getConsulta().getConsultationId();
    Optional<Consultation> consulta = consultationRepository.findByConsultationId(consultaId);

    if (consulta.isPresent()) {
        diagnosis.setConsulta(consulta.get());
        return Optional.of(diagnosisRepository.save(diagnosis));
    }

    return Optional.empty();
}

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API Endpoint

DiagnosisController.java:19-28
@PostMapping
public ResponseEntity<?> createDiagnosis(@RequestBody Diagnosis diagnosis) {
    Optional<Diagnosis> created = diagnosisService.createDiagnosis(diagnosis);

    if (created.isPresent()) {
        return ResponseEntity.ok(created.get());
    } else {
        return ResponseEntity.badRequest().body("Consulta inválida.");
    }
}
Endpoint: POST /diagnosis Request Body: 
{
  "descricao": "Patient presents with type 2 diabetes mellitus. Recommended lifestyle changes and metformin treatment.",
  "data": "2024-03-15",
  "consulta": {
    "consultationId": "550e8400-e29b-41d4-a716-446655440000"
  },
  "cid": "E11"
}
Response: 
{
  "id": "f47ac10b-58cc-4372-a567-0e02b2c3d479",
  "descricao": "Patient presents with type 2 diabetes mellitus. Recommended lifestyle changes and metformin treatment.",
  "data": "2024-03-15",
  "consulta": {
    "consultationId": "550e8400-e29b-41d4-a716-446655440000",
    "dateTime": "2024-03-15T10:00:00",
    "patient": { ... },
    "doctor": { ... }
  },
  "cid": "E11"
}

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Retrieving Diagnosis by Consultation

Get the diagnosis associated with a specific consultation:
DiagnosisService.java:34-36
public Optional<Diagnosis> findByConsultationId(UUID consultationId) {
    return diagnosisRepository.findByConsulta_ConsultationId(consultationId);
}

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API Endpoint

DiagnosisController.java:30-35
@GetMapping("/consultation/{id}")
public ResponseEntity<?> getDiagnosisByConsultationId(@PathVariable UUID id) {
    return diagnosisService.findByConsultationId(id)
            .map(ResponseEntity::ok)
            .orElseGet(() -> ResponseEntity.noContent().build());
}
Endpoint: GET /diagnosis/consultation/{consultationId}

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Patient Medical History

Patient medical history is tracked through:
  1. Medical History Field: Free-text field on the patient entity
Patient.java:31-32
@Column(name = "medical_history")
private String medicalHistory;
  1. Consultation History: All past consultations with linked diagnoses
Patient.java:34-36
@OneToMany(mappedBy = "patient", cascade = CascadeType.ALL, fetch = FetchType.LAZY)
@JsonIgnore
private List<Consultation> historicoConsultas;
  1. Diagnosis Records: All diagnoses linked through consultations

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Complete Medical History Flow

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Diagnosis-Consultation Relationship

Each diagnosis is directly tied to one consultation: 
@ManyToOne
@JoinColumn(name = "consulta_id", nullable = false)
private Consultation consulta;
This ensures:
  • Every diagnosis has context (date, doctor, patient)
  • Medical findings are traceable to specific visits
  • Historical records maintain referential integrity
  • Cascading deletes preserve data consistency

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Cascade Deletion

When a consultation is canceled, associated diagnoses are automatically deleted:
ConsultationService.java:86-92
public boolean cancelConsultation(UUID consultationId) {
    if (consultationRepository.existsById(consultationId)) {
        Optional<Diagnosis> diagnosis = diagnosisRepository
            .findByConsulta_ConsultationId(consultationId);
        if (diagnosis.isPresent()) {
            diagnosisRepository.delete(diagnosis.get());
        }
        // ... continue with consultation deletion
    }
}

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CID Code Examples

Common CID codes used in Med Agenda:
CID CodeDescription
A00Cholera
A15.3Tuberculosis of lungs
E10Type 1 diabetes mellitus
E11Type 2 diabetes mellitus
I10Essential (primary) hypertension
J00Acute nasopharyngitis (common cold)
J45Asthma
M54Dorsalgia (back pain)

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Building Patient Medical Timeline

To construct a complete medical timeline for a patient:
  1. Query patient by CPF
  2. Get all consultations for that patient
  3. For each consultation, retrieve the diagnosis
  4. Combine with patient’s medical history field
// Get patient
Optional<Patient> patient = patientRepository.findByCpf(cpf);

// Get consultation history
List<Consultation> consultations = consultationRepository.findByPatient_Cpf(cpf);

// For each consultation, get diagnosis
for (Consultation consultation : consultations) {
    Optional<Diagnosis> diagnosis = diagnosisRepository
        .findByConsulta_ConsultationId(consultation.getConsultationId());
    // Process diagnosis...
}

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Data Structure Overview

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Best Practices

  1. Always validate consultation exists before creating a diagnosis
  2. Use standardized CID codes for disease classification
  3. Include detailed descriptions to provide context beyond the CID code
  4. Date the diagnosis to track when conditions were identified
  5. Maintain referential integrity when deleting consultations
  6. Combine structured diagnoses with free-text medical history for comprehensive records
  7. Use UUID for diagnosis IDs to ensure global uniqueness

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Integration Points

  • Consultation System: Every diagnosis links to a consultation
  • Patient Records: Diagnoses contribute to patient medical history
  • CID Database: Standardized disease classification
  • Reporting: Diagnoses enable medical analytics and reporting

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