app.js

// ACS CDSS Dashboard - reactive Vanilla JS app

// State
let state = {
  isLoggedIn: false,
  currentUser: null,
  patients: [],
  selectedPatient: null,
  searchQuery: "",
  filterDiagnosis: "all",
  filterRisk: "all",
  activeSection: "demographics",
  formMode: "add", // 'add' or 'edit'
  statistics: {
    total: 0,
    highIschemic: 0,
    highBleeding: 0,
    complianceScore: 0
  }
};

// Default template for a new patient form
const defaultPatientForm = {
  patientId: "",
  name: "",
  age: 60,
  gender: "Male",
  weight: 70, // default weight in kg
  diagnosis: 1, // STEMI
  troponin: 0, // Normal
  ecg: 0, // Normal
  ischemicInstability: 0,
  ischemicAngina: 0,
  ischemicHeartFailure: 0,
  ischemicArrhythmia: 0,
  bleedingRenal: 0,
  bleedingAnemia: 0,
  bleedingAF: 0,
  bleedingStroke: 0,
  // new parameters
  spo2: 98,
  sbp: 120,
  hr: 75,
  cpType: 1,
  diabetes: 0,
  ckd: 0,
  priorStroke: 0,
  pepticUlcer: 0,
  nsaid: 0,
  minorBleeding: 0,
  concurrentOac: 0,
  ppiPrescribed: 0,
  // treatments
  reperfusion: 1, // PCI
  p2y12: 1, // Clopidogrel
  statin: 1, // Low/Mod
  ldlc: 85,
  betaBlocker: 1,
  raasInhibitor: 1,
  anticoagulation: 1,
  transfusion: 0,
  thrombocytopenia: 0,
  dementia: 0,
  expectancy: 0,
  arf: 0
};

// Initial form data
let formData = { ...defaultPatientForm };

// Initialize Application
document.addEventListener("DOMContentLoaded", async () => {
  setupEventListeners();
  await loadPatients();
  updateStatistics();
  renderPatientList();
  resetForm();
  renderSelectedPatient();
});

// Load patient database
async function loadPatients() {
  if (typeof initialPatientsData !== "undefined" && Array.isArray(initialPatientsData) && initialPatientsData.length > 0) {
    state.patients = initialPatientsData;
    console.log("Loaded patients from global variable initialPatientsData:", state.patients.length);
  } else {
    try {
      const response = await fetch("patients.json");
      if (response.ok) {
        state.patients = await response.json();
        console.log("Loaded patients from JSON:", state.patients.length);
      } else {
        throw new Error("Failed to load patients.json");
      }
    } catch (error) {
      console.warn("Could not fetch patients.json. Seeding mock data.", error);
      // Hardcoded fallback data in case of direct local file opening without server (CORS)
      state.patients = getFallbackPatients();
    }
  }
  
  if (state.patients.length > 0) {
    // Select first patient by default
    state.selectedPatient = { ...state.patients[0] };
    state.formMode = "edit";
    formData = { ...state.selectedPatient };
  }
}

// ML Random Forest Evaluation Helper
function scaleFeatures(features, scaler) {
  return features.map((x, i) => (x - scaler.mean[i]) / scaler.scale[i]);
}

function evaluateTree(node, scaledX) {
  if (node.leaf) return node.value;
  const val = scaledX[node.feature];
  if (val <= node.threshold) {
    return evaluateTree(node.left, scaledX);
  } else {
    return evaluateTree(node.right, scaledX);
  }
}

function predictRF(patient) {
  if (typeof trainedModelData === "undefined") {
    // fallback clinical rules if model not loaded
    if (patient.ecg === 1) return 1;
    if (patient.troponin === 1) return 2;
    return 3;
  }
  
  const features = trainedModelData.features;
  const pVec = features.map(col => {
    switch (col) {
      case 'Age_Group': return (patient.age >= 75) ? 1 : 0;
      case 'SpO2': return (patient.spo2 !== undefined) ? patient.spo2 : 98;
      case 'SBP': return (patient.sbp !== undefined) ? patient.sbp : 120;
      case 'HR': return (patient.hr !== undefined) ? patient.hr : 75;
      case 'Troponin': return (patient.troponin !== undefined) ? patient.troponin : 0;
      case 'ECG': return (patient.ecg !== undefined) ? patient.ecg : 0;
      case 'ischemicInstability': return (patient.ischemicInstability !== undefined) ? patient.ischemicInstability : 0;
      case 'ischemicAngina': return (patient.ischemicAngina !== undefined) ? patient.ischemicAngina : 0;
      case 'ischemicHeartFailure': return (patient.ischemicHeartFailure !== undefined) ? patient.ischemicHeartFailure : 0;
      case 'ischemicArrhythmia': return (patient.ischemicArrhythmia !== undefined) ? patient.ischemicArrhythmia : 0;
      case 'bleedingRenal': return (patient.bleedingRenal !== undefined) ? patient.bleedingRenal : 0;
      case 'bleedingAnemia': return (patient.bleedingAnemia !== undefined) ? patient.bleedingAnemia : 0;
      case 'bleedingAF': return (patient.bleedingAF !== undefined) ? patient.bleedingAF : 0;
      case 'bleedingStroke': return (patient.bleedingStroke !== undefined) ? patient.bleedingStroke : 0;
      case 'pepticUlcer': return (patient.pepticUlcer !== undefined) ? patient.pepticUlcer : 0;
      case 'nsaid': return (patient.nsaid !== undefined) ? patient.nsaid : 0;
      case 'minorBleeding': return (patient.minorBleeding !== undefined) ? patient.minorBleeding : 0;
      default: return 0;
    }
  });
  
  const scaledX = scaleFeatures(pVec, trainedModelData.scaler);
  const sums = new Array(trainedModelData.classes.length).fill(0);
  
  trainedModelData.trees.forEach(tree => {
    const leafVal = evaluateTree(tree, scaledX);
    leafVal.forEach((val, i) => {
      sums[i] += val;
    });
  });
  
  let maxIdx = 0;
  let maxVal = sums[0];
  sums.forEach((val, i) => {
    if (val > maxVal) {
      maxVal = val;
      maxIdx = i;
    }
  });
  
  return trainedModelData.classes[maxIdx];
}

// Calculate Risk Levels
function calculateIschemicRisk(p) {
  return p.troponin === 1 || 
         p.ischemicInstability === 1 || 
         p.ischemicAngina === 1 || 
         p.ischemicHeartFailure === 1 || 
         p.ischemicArrhythmia === 1;
}

// Calculate Bleeding Risk (ARC-HBR)
function calculateBleedingRisk(p) {
  return p.age >= 75 || 
         p.bleedingRenal === 1 || 
         p.bleedingAnemia === 1 || 
         p.bleedingAF === 1 || 
         p.bleedingStroke === 1;
}

// Table 7 Dosing Considerations
function generateAntiplateletDosing(p) {
  const diagnosis = parseInt(p.diagnosis) || 3;
  const reperfusion = parseInt(p.reperfusion) || 4;
  const age = parseInt(p.age) || 60;
  const weight = parseFloat(p.weight) || 70;
  const p2y12 = parseInt(p.p2y12) || 0;

  // 1. Aspirin Logic (for all ACS patients)
  const aspirin = {
    name: "Aspirin",
    loadingDose: "162–325 mg orally (chewed)",
    maintenanceDose: "75–100 mg orally once daily",
    adjustments: "None",
    warnings: ""
  };

  // 2. Selected P2Y12 Inhibitor Logic
  let p2y12Name = "None Selected";
  let p2y12LD = "N/A";
  let p2y12MD = "N/A";
  let p2y12Adj = "None";
  let p2y12Warn = "";

  const isSTEMI = diagnosis === 1;
  const isFibrinolysis = reperfusion === 2;
  const isPCI = reperfusion === 1;

  if (p2y12 === 1) { // Clopidogrel
    p2y12Name = "Clopidogrel";
    if (isSTEMI && isFibrinolysis) {
      if (age < 75) {
        p2y12LD = "300 mg orally";
        p2y12MD = "75 mg orally daily";
      } else {
        p2y12LD = "No loading dose (initial dose 75 mg orally)";
        p2y12MD = "75 mg orally daily";
        p2y12Adj = "Loading dose is omitted because the patient is older than 75 years.";
      }
    } else {
      // NSTEMI or STEMI without fibrinolysis, or Unstable Angina
      p2y12LD = "300–600 mg orally";
      p2y12MD = "75 mg orally daily";
    }
  } else if (p2y12 === 2) { // Ticagrelor
    p2y12Name = "Ticagrelor";
    // Applicable for NSTEMI, STEMI without fibrinolysis, or UA
    p2y12LD = "180 mg orally";
    p2y12MD = "90 mg orally twice daily";
    if (isSTEMI && isFibrinolysis) {
      p2y12Warn = "WARNING: Ticagrelor is not preferred post-fibrinolysis according to clinical guidelines.";
    }
  } else if (p2y12 === 3) { // Prasugrel
    p2y12Name = "Prasugrel";
    // Applicable only for PCI patients, and no fibrinolysis
    p2y12LD = "60 mg orally";
    if (isFibrinolysis) {
      p2y12MD = "N/A";
      p2y12Warn = "WARNING: Prasugrel is contraindicated with Fibrinolytic therapy.";
    } else if (!isPCI) {
      p2y12MD = "10 mg orally daily (Not recommended for non-PCI)";
      p2y12Warn = "WARNING: Prasugrel should only be used in patients undergoing PCI.";
    } else {
      // PCI and no fibrinolysis
      if (weight >= 60 && age < 75) {
        p2y12MD = "10 mg orally daily";
      } else {
        p2y12MD = "5 mg orally daily";
        p2y12Adj = `Maintenance dose is reduced to 5 mg daily due to ${age >= 75 ? 'age ≥ 75' : ''}${age >= 75 && weight < 60 ? ' or ' : ''}${weight < 60 ? 'body weight < 60 kg' : ''}.`;
        p2y12Warn = `CAUTION: Maintenance dose is reduced to 5 mg daily because of ${age >= 75 ? 'age ≥ 75' : ''}${age >= 75 && weight < 60 ? ' or ' : ''}${weight < 60 ? 'body weight < 60 kg' : ''}.`;
      }
    }
  }

  return {
    aspirin,
    p2y12: {
      name: p2y12Name,
      loadingDose: p2y12LD,
      maintenanceDose: p2y12MD,
      adjustments: p2y12Adj,
      warnings: p2y12Warn
    }
  };
}

// Run 2025 ACC/AHA Rules Engine
function evaluateClinicalRules(p) {
  const isHighIschemic = calculateIschemicRisk(p);
  const isHighBleeding = calculateBleedingRisk(p);
  
  const deviations = [];
  const alerts = [];
  const regimen = [];
  
  // Get Table 7 Antiplatelet Dosing Recommendations
  const dosing = generateAntiplateletDosing(p);
  
  const aspirinRec = `<strong>Drug Recommendation: Aspirin</strong><br>• Loading Dose: ${dosing.aspirin.loadingDose}<br>• Maintenance Dose: ${dosing.aspirin.maintenanceDose}`;
  const p2y12Rec = `<strong>Selected P2Y12 Inhibitor: ${dosing.p2y12.name}</strong><br>• Loading Dose: ${dosing.p2y12.loadingDose}<br>• Maintenance Dose: ${dosing.p2y12.maintenanceDose}${dosing.p2y12.adjustments !== "None" ? `<br>• Reason for adjustment: ${dosing.p2y12.adjustments}` : ''}`;
  
  if (dosing.p2y12.warnings) {
    alerts.push(dosing.p2y12.warnings);
  }

  // 1. Oxygenation Check
  if (p.spo2 !== undefined && p.spo2 < 90) {
    alerts.push("HYPOXEMIA ALERT: Patient SpO2 < 90%. Administer supplementary oxygen immediately.");
  }
  
  // 2. Reperfusion Strategy vs Antiplatelet Mapping Rules
  if (p.diagnosis === 1) { // STEMI
    if (p.reperfusion === 2) { // Fibrinolytics
      // Table 14 contraindications
      if (p.sbp > 180) {
        alerts.push("CRITICAL: Absolute contraindication for Fibrinolysis (Severe uncontrolled SBP > 180 mmHg).");
        deviations.push("CONTRAINDICATION FAULT: Fibrinolysis selected despite SBP > 180 mmHg.");
      }
      if (p.bleedingStroke === 1 || p.priorStroke === 1) {
        alerts.push("CRITICAL: Absolute contraindication for Fibrinolysis (History of Stroke/TIA).");
        deviations.push("CONTRAINDICATION FAULT: Fibrinolysis selected in patient with prior Stroke/TIA.");
      }
      if (p.bleedingAF === 1 || p.concurrentOac === 1) {
        alerts.push("WARNING: Relative contraindication for Fibrinolysis (Oral Anticoagulant therapy).");
      }
      if (p.pepticUlcer === 1) {
        alerts.push("WARNING: Relative contraindication for Fibrinolysis (Active peptic ulcer).");
      }
      if (p.dementia === 1) {
        alerts.push("WARNING: Relative contraindication for Fibrinolysis (Dementia).");
      }

      regimen.push(aspirinRec);
      regimen.push(p2y12Rec);
      
      if (p.p2y12 === 2 || p.p2y12 === 3) {
        deviations.push("CRITICAL MISMATCH: Potent antiplatelets (Prasugrel/Ticagrelor) run concurrently with Fibrinolytics.");
        alerts.push("HEMORRHAGE RISK HIGH: Discontinue Prasugrel/Ticagrelor immediately to mitigate intracranial bleeding risk.");
      }
    } else if (p.reperfusion === 1) { // Primary PCI
      regimen.push(aspirinRec);
      regimen.push(p2y12Rec);
      if (p.p2y12 === 1 && !isHighBleeding) {
        deviations.push("SUBOPTIMAL PROTECTION: Clopidogrel used in standard risk PPCI path.");
        alerts.push("EFFICACY WARNING: Upgrade to Ticagrelor or Prasugrel for superior protection against stent thrombosis.");
      } else if (p.p2y12 === 0) {
        deviations.push("CRITICAL OMISSION: A P2Y12 inhibitor is required for all STEMI patients undergoing Primary PCI.");
      }
    }
  } else if (p.diagnosis === 2 || p.diagnosis === 3) { // NSTE-ACS
    // Table 15 relative contraindications
    const hasInvasiveContra = isHighBleeding || p.thrombocytopenia === 1 || p.bleedingRenal === 1 || p.arf === 1 || p.expectancy === 1 || p.dementia === 1;
    
    if (hasInvasiveContra) {
      alerts.push("RELATIVE CONTRAINDICATION: Routine invasive procedure has contraindications (due to HBR, thrombocytopenia, CKD/ARF, limited expectancy, or dementia). Route to Conservative Medical Management instead.");
      if (p.reperfusion === 1) {
        deviations.push("CONTRAINDICATION FAULT: Routine invasive procedure selected despite relative contraindications.");
      }
    }

    if (p.reperfusion === 4) { // Conservative Medical Management
      regimen.push(aspirinRec);
      regimen.push(p2y12Rec);
      if (p.p2y12 === 1 && !isHighBleeding) {
        deviations.push("NON-PREFERENTIAL REGIMEN: Clopidogrel selected for standard risk medical management.");
      }
    } else if (p.reperfusion === 1) { // Invasive Strategy
      regimen.push(aspirinRec);
      regimen.push(p2y12Rec);
      if (p.p2y12 === 1 && !isHighBleeding) {
        deviations.push("SUBOPTIMAL EFFICACY: Clopidogrel is less effective than Ticagrelor/Prasugrel. Switch to a high-potency agent unless contraindicated or high bleeding risk exists.");
      }
    }
  }
  
  // 3. NSTE-ACS Invasive Strategy Timing
  if (p.diagnosis === 2 || p.diagnosis === 3) {
    if (isHighIschemic) {
      alerts.push("CRITICAL: Immediate Invasive Strategy Required (Angiography within 2 hours) due to presence of High Ischemic Risk Indicators (cardiogenic shock, refractory angina, heart failure, or sustained VT/VF).");
    } else {
      regimen.push("Guideline Compliant: Early Invasive Strategy (Angiography within 24 hours) is indicated for standard-risk NSTE-ACS.");
    }
  }

  // 4. Baseline Pharmacotherapy Checks (Anticoagulation, Beta-Blockers, RAAS)
  if (p.anticoagulation === 0) {
    deviations.push("OMISSION FAULT: Parenteral anticoagulation not administered.");
    regimen.push("Initiate Parenteral Anticoagulation (UFH, Enoxaparin, Bivalirudin, or Fondaparinux).");
  }
  if (p.betaBlocker === 0) {
    deviations.push("OMISSION FAULT: Baseline Beta-Blocker therapy not initiated.");
    regimen.push("Initiate Oral Beta-Blocker therapy (e.g., Metoprolol succinate or Carvedilol) within 24 hours.");
  }
  if (p.raasInhibitor === 0) {
    deviations.push("OMISSION FAULT: Baseline RAAS Inhibitor (ACEI/ARB) not initiated.");
    regimen.push("Initiate ACE Inhibitor (e.g., Ramipril) or ARB (e.g., Valsartan) within 24 hours.");
  }

  // 5. RBC Transfusion Protocol
  if (p.bleedingAnemia === 1 && p.minorBleeding === 0) {
    if (p.transfusion === 0) {
      deviations.push("OMISSION FAULT: RBC transfusion not administered despite severe anemia without active bleeding.");
      regimen.push("Administer RBC Transfusion to maintain hemoglobin target of 10 g/dL (Class 2b).");
    } else {
      regimen.push("Guideline Compliant: RBC Transfusion administered to maintain Hb target (10 g/dL).");
    }
  }
  
  // 6. HBR Overrides
  if (isHighBleeding) {
    if (p.p2y12 === 3) { // Prasugrel in HBR
      deviations.push("CONTRAINDICATION OVERRIDE: Prasugrel allocated within high bleeding risk profile.");
      alerts.push("STOP SIGN: Immediately discontinue Prasugrel. Substitute with Clopidogrel 75mg daily.");
    }
    
    // Rules A, B, C
    if (p.concurrentOac === 1 || p.bleedingAF === 1) { // Rule C
      regimen.push("Convert to Dual Therapy (OAC + Clopidogrel 75mg) after 1-4 weeks; completely drop Aspirin.");
    } else if (p.minorBleeding === 1) { // Rule B
      regimen.push("P2Y12 Down-Titration: Transition from Ticagrelor/Prasugrel to Clopidogrel 75mg daily due to bleeding/Hb drop.");
    } else { // Rule A
      regimen.push("Short-Course DAPT: Transition to Ticagrelor Monotherapy after 1-3 months, completely dropping Aspirin.");
    }
  }
  
  // 7. GI Safety Net
  const hasGiTrigger = isHighBleeding || p.pepticUlcer === 1 || p.age >= 75 || p.nsaid === 1;
  if (hasGiTrigger) {
    if (p.ppiPrescribed !== 1) {
      alerts.push("GASTRIC GAP: Co-prescribe a protective PPI (e.g., Pantoprazole) to manage GI bleeding margins.");
    }
    
    if (p.p2y12 === 1 && p.ppiPrescribed === 1) {
      alerts.push("PPI Metabolic Optimization: If Clopidogrel is prescribed, Pantoprazole is preferred over Omeprazole (prevents CYP2C19 inhibition).");
    }
  }
  
  // 8. Lipid Secondary Prevention
  if (p.statin !== 2) {
    deviations.push("OMISSION FAULT: Patient not initiated on baseline High-Intensity Statin therapy.");
    regimen.push("Initiate High-Intensity Atorvastatin 40-80mg or Rosuvastatin 20-40mg.");
  }
  
  if (p.ldlc >= 70) {
    deviations.push("LIPID GOAL MISSED: Follow-up LDL tracking >= 70 mg/dL.");
    regimen.push("Add Non-Statin Therapy: Append Ezetimibe 10mg daily immediately (Class 1).");
  } else if (p.ldlc >= 55 && p.ldlc < 70) {
    regimen.push("Therapeutic Optimization: Evaluate addition of Ezetimibe to reach target < 55 mg/dL (Class 2a).");
  }
  
  // Compute Acute Classification
  let acuteClassification = "";
  if (p.diagnosis === 1) {
    acuteClassification = isHighIschemic ? "High-Risk STEMI" : "Standard-Risk STEMI";
  } else if (p.diagnosis === 2) {
    acuteClassification = isHighIschemic ? "High-Risk NSTEMI" : "Intermediate-Risk NSTEMI";
  } else if (p.diagnosis === 3) {
    acuteClassification = isHighIschemic ? "High-Risk UA" : "Standard-Risk UA";
  } else {
    acuteClassification = "Stable IHD / Unknown";
  }
  
  // Analyze risk variables for Block I: 12-factor calculation (Age, SBP, Troponins, ECG changes).
  const analyzedVariables = [];
  analyzedVariables.push(`Age: ${p.age} years (${p.age >= 75 ? "Age >= 75" : "Age < 75"})`);
  analyzedVariables.push(`Systolic Blood Pressure (SBP): ${p.sbp} mmHg`);
  analyzedVariables.push(`Heart Rate: ${p.hr} bpm`);
  analyzedVariables.push(`Cardiac Troponin: ${p.troponin === 1 ? "Positive/Elevated" : "Negative/Normal"}`);
  analyzedVariables.push(`ECG Findings: ${getEcgLabel(p.ecg)}`);
  
  return {
    block1: {
      title: "Block I: Patient Intake Risk Summary",
      classification: acuteClassification,
      variables: analyzedVariables,
      isHighIschemic,
      isHighBleeding
    },
    block2: {
      title: "Block II: Medical Safety & Compliance Audit",
      compliance: deviations.length === 0 ? "PASS" : "FAIL",
      deviations: deviations
    },
    block3: {
      title: "Block III: Predicted Pharmacist Action Intervention",
      directives: regimen,
      adjustments: alerts
    }
  };
}

// Update App Statistics
function updateStatistics() {
  const total = state.patients.length;
  let highIschemic = 0;
  let highBleeding = 0;
  let compliantCases = 0;

  state.patients.forEach(p => {
    if (calculateIschemicRisk(p)) highIschemic++;
    if (calculateBleedingRisk(p)) highBleeding++;
    
    // Compute compliance based on rules engine
    const audit = evaluateClinicalRules(p);
    if (audit.block2.compliance === "PASS") {
      compliantCases++;
    }
  });

  state.statistics = {
    total,
    highIschemic,
    highBleeding,
    complianceScore: total > 0 ? Math.round((compliantCases / total) * 100) : 0
  };

  // Render Stats
  document.getElementById("stat-total-patients").textContent = state.statistics.total;
  document.getElementById("stat-high-ischemic").textContent = state.statistics.highIschemic;
  document.getElementById("stat-high-bleeding").textContent = state.statistics.highBleeding;
  document.getElementById("stat-compliance-score").textContent = state.statistics.complianceScore + "%";
}

// Render Patient List (Sidebar Directory)
function renderPatientList() {
  const container = document.getElementById("patient-list-container");
  container.innerHTML = "";

  const filtered = state.patients.filter(p => {
    // Search query match
    const term = state.searchQuery.toLowerCase();
    const matchesSearch = p.patientId.toLowerCase().includes(term) || 
                          p.name.toLowerCase().includes(term) ||
                          getDiagnosisLabel(p.diagnosis).toLowerCase().includes(term);

    // Diagnosis filter
    let matchesDiag = true;
    if (state.filterDiagnosis !== "all") {
      matchesDiag = p.diagnosis === parseInt(state.filterDiagnosis);
    }

    // Risk filter
    let matchesRisk = true;
    if (state.filterRisk !== "all") {
      const isHighIsch = calculateIschemicRisk(p);
      const isHighBleed = calculateBleedingRisk(p);
      if (state.filterRisk === "high-ischemic") matchesRisk = isHighIsch;
      else if (state.filterRisk === "high-bleeding") matchesRisk = isHighBleed;
      else if (state.filterRisk === "double-high") matchesRisk = isHighIsch && isHighBleed;
      else if (state.filterRisk === "standard") matchesRisk = !isHighIsch && !isHighBleed;
    }

    return matchesSearch && matchesDiag && matchesRisk;
  });

  if (filtered.length === 0) {
    container.innerHTML = `
      <div class="text-center py-8 text-slate-400">
        <p class="text-sm">No matching patients found</p>
      </div>
    `;
    return;
  }

  filtered.forEach(p => {
    const isSelected = state.selectedPatient && state.selectedPatient.patientId === p.patientId;
    const isHighIschemic = calculateIschemicRisk(p);
    const isHighBleeding = calculateBleedingRisk(p);

    const card = document.createElement("div");
    card.className = `p-4 mb-3 rounded-xl border cursor-pointer transition-all duration-200 ${
      isSelected 
        ? "bg-slate-800/80 border-indigo-500 shadow-md shadow-indigo-500/10" 
        : "bg-slate-900/50 border-slate-800 hover:border-slate-700 hover:bg-slate-900/80"
    }`;

    card.addEventListener("click", () => {
      selectPatient(p);
    });

    let riskBadges = "";
    if (isHighIschemic) {
      riskBadges += `<span class="px-2 py-0.5 text-2xs font-semibold rounded bg-rose-500/10 text-rose-400 border border-rose-500/20 mr-1">Ischemic Risk</span>`;
    }
    if (isHighBleeding) {
      riskBadges += `<span class="px-2 py-0.5 text-2xs font-semibold rounded bg-amber-500/10 text-amber-400 border border-amber-500/20">HBR</span>`;
    }
    if (!isHighIschemic && !isHighBleeding) {
      riskBadges += `<span class="px-2 py-0.5 text-2xs font-semibold rounded bg-emerald-500/10 text-emerald-400 border border-emerald-500/20">Standard Risk</span>`;
    }

    const diagLabel = getDiagnosisLabel(p.diagnosis);
    let diagBadgeColor = "text-indigo-400 bg-indigo-500/10 border-indigo-500/20";
    if (p.diagnosis === 1) diagBadgeColor = "text-rose-400 bg-rose-500/10 border-rose-500/20";
    else if (p.diagnosis === 2) diagBadgeColor = "text-amber-400 bg-amber-500/10 border-amber-500/20";

    card.innerHTML = `
      <div class="flex justify-between items-start mb-2">
        <div>
          <h4 class="font-semibold text-slate-100 text-sm">${p.name}</h4>
          <span class="text-slate-400 text-xs font-mono">${p.patientId}</span>
        </div>
        <span class="px-2 py-0.5 text-2xs font-semibold rounded border ${diagBadgeColor}">${diagLabel}</span>
      </div>
      <div class="flex justify-between items-center mt-3">
        <span class="text-xs text-slate-400">Age: <strong class="text-slate-200">${p.age}</strong> | ${p.gender}</span>
        <div class="flex items-center">
          ${riskBadges}
        </div>
      </div>
    `;

    container.appendChild(card);
  });
}

// Select Patient for Editing/Viewing
function selectPatient(p) {
  state.selectedPatient = { ...p };
  state.formMode = "edit";
  formData = { ...p };
  
  // Fill the form values
  fillFormInputs(formData);
  
  // Update UI panels
  renderPatientList();
  renderSelectedPatient();
  
  // Flash visual selection highlight on audit panel
  const auditPanel = document.getElementById("clinical-audit-panel");
  auditPanel.classList.remove("opacity-50");
  auditPanel.classList.add("animate-pulse-brief");
  setTimeout(() => auditPanel.classList.remove("animate-pulse-brief"), 500);
}

// Fill Form Inputs with Selected Patient Data
function fillFormInputs(data) {
  document.getElementById("input-patient-id").value = data.patientId;
  document.getElementById("input-patient-id").readOnly = true; // Can't change ID in edit mode
  document.getElementById("input-name").value = data.name;
  document.getElementById("input-age").value = data.age;
  document.getElementById("input-gender").value = data.gender;
  document.getElementById("input-weight").value = data.weight !== undefined ? data.weight : 70;
  document.getElementById("input-diagnosis").value = data.diagnosis;
  document.getElementById("input-troponin").value = data.troponin;
  document.getElementById("input-ecg").value = data.ecg;
  
  // Continuous variables
  document.getElementById("input-sbp").value = data.sbp !== undefined ? data.sbp : 120;
  document.getElementById("input-hr").value = data.hr !== undefined ? data.hr : 75;
  document.getElementById("input-spo2").value = data.spo2 !== undefined ? data.spo2 : 98;
  document.getElementById("input-cptype").value = data.cpType !== undefined ? data.cpType : 1;
  
  // Checkboxes
  document.getElementById("cb-instability").checked = data.ischemicInstability === 1;
  document.getElementById("cb-angina").checked = data.ischemicAngina === 1;
  document.getElementById("cb-hf").checked = data.ischemicHeartFailure === 1;
  document.getElementById("cb-arrhythmia").checked = data.ischemicArrhythmia === 1;
  
  document.getElementById("cb-renal").checked = data.bleedingRenal === 1 || data.ckd === 1;
  document.getElementById("cb-anemia").checked = data.bleedingAnemia === 1;
  document.getElementById("cb-af").checked = data.bleedingAF === 1 || data.concurrentOac === 1;
  document.getElementById("cb-stroke").checked = data.bleedingStroke === 1 || data.priorStroke === 1;
  
  document.getElementById("cb-diabetes").checked = data.diabetes === 1;
  document.getElementById("cb-peptic-ulcer").checked = data.pepticUlcer === 1;
  document.getElementById("cb-nsaid").checked = data.nsaid === 1;
  document.getElementById("cb-minor-bleeding").checked = data.minorBleeding === 1;

  // New checkboxes
  document.getElementById("cb-thrombocytopenia").checked = data.thrombocytopenia === 1;
  document.getElementById("cb-dementia").checked = data.dementia === 1;
  document.getElementById("cb-expectancy").checked = data.expectancy === 1;
  document.getElementById("cb-arf").checked = data.arf === 1;

  // Treatment & Discharge Metrics
  document.getElementById("input-reperfusion").value = data.reperfusion;
  document.getElementById("input-p2y12").value = data.p2y12;
  document.getElementById("input-statin").value = data.statin;
  document.getElementById("input-ldlc").value = data.ldlc;
  
  document.getElementById("input-ppi").value = data.ppiPrescribed !== undefined ? data.ppiPrescribed : 0;
  document.getElementById("input-oac").value = data.concurrentOac !== undefined ? data.concurrentOac : 0;

  // New select elements
  document.getElementById("input-beta-blocker").value = data.betaBlocker !== undefined ? data.betaBlocker : 1;
  document.getElementById("input-raas-inhibitor").value = data.raasInhibitor !== undefined ? data.raasInhibitor : 1;
  document.getElementById("input-anticoagulation").value = data.anticoagulation !== undefined ? data.anticoagulation : 1;
  document.getElementById("input-transfusion").value = data.transfusion !== undefined ? data.transfusion : 0;

  // Set form mode header
  document.getElementById("form-action-title").textContent = "Modify Patient Profile";
  document.getElementById("btn-submit-form").innerHTML = `
    <svg class="w-4 h-4 mr-2" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M8 7H5a2 2 0 00-2 2v9a2 2 0 002 2h14a2 2 0 002-2V9a2 2 0 00-2-2h-3m-1 4l-3 3m0 0l-3-3m3 3V4"/></svg>
    Save Changes
  `;
  document.getElementById("btn-cancel-edit").classList.remove("hidden");
}

// Reset Ingestion Form
function resetForm() {
  state.formMode = "add";
  formData = { ...defaultPatientForm };
  
  document.getElementById("input-patient-id").value = "";
  document.getElementById("input-patient-id").readOnly = false;
  document.getElementById("input-name").value = "";
  document.getElementById("input-age").value = 60;
  document.getElementById("input-gender").value = "Male";
  document.getElementById("input-weight").value = 70;
  document.getElementById("input-diagnosis").value = 1;
  document.getElementById("input-troponin").value = 0;
  document.getElementById("input-ecg").value = 0;
  
  document.getElementById("input-sbp").value = 120;
  document.getElementById("input-hr").value = 75;
  document.getElementById("input-spo2").value = 98;
  document.getElementById("input-cptype").value = 1;
  
  document.getElementById("cb-instability").checked = false;
  document.getElementById("cb-angina").checked = false;
  document.getElementById("cb-hf").checked = false;
  document.getElementById("cb-arrhythmia").checked = false;
  
  document.getElementById("cb-renal").checked = false;
  document.getElementById("cb-anemia").checked = false;
  document.getElementById("cb-af").checked = false;
  document.getElementById("cb-stroke").checked = false;
  
  document.getElementById("cb-diabetes").checked = false;
  document.getElementById("cb-peptic-ulcer").checked = false;
  document.getElementById("cb-nsaid").checked = false;
  document.getElementById("cb-minor-bleeding").checked = false;

  // New checkboxes reset
  document.getElementById("cb-thrombocytopenia").checked = false;
  document.getElementById("cb-dementia").checked = false;
  document.getElementById("cb-expectancy").checked = false;
  document.getElementById("cb-arf").checked = false;
  
  document.getElementById("input-reperfusion").value = 1;
  document.getElementById("input-p2y12").value = 1;
  document.getElementById("input-statin").value = 1;
  document.getElementById("input-ldlc").value = 85;
  
  document.getElementById("input-ppi").value = 0;
  document.getElementById("input-oac").value = 0;

  // New select elements reset
  document.getElementById("input-beta-blocker").value = 1;
  document.getElementById("input-raas-inhibitor").value = 1;
  document.getElementById("input-anticoagulation").value = 1;
  document.getElementById("input-transfusion").value = 0;

  document.getElementById("form-action-title").textContent = "Add New Patient Record";
  document.getElementById("btn-submit-form").innerHTML = `
    <svg class="w-4 h-4 mr-2" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M12 4v16m8-8H4"/></svg>
    Ingest Patient
  `;
  document.getElementById("btn-cancel-edit").classList.add("hidden");
}

// Render Selected Patient Details & Rules Engine Panel
function renderSelectedPatient() {
  const detailsContainer = document.getElementById("patient-details-panel");
  const auditContainer = document.getElementById("clinical-audit-panel");

  if (!state.selectedPatient) {
    detailsContainer.innerHTML = `
      <div class="text-center py-20 text-slate-500">
        <svg class="w-16 h-16 mx-auto mb-4 text-slate-600" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="1.5" d="M9 12h6m-6 4h6m2 5H7a2 2 0 01-2-2V5a2 2 0 012-2h5.586a1 1 0 01.707.293l5.414 5.414a1 1 0 01.293.707V19a2 2 0 01-2 2z"/></svg>
        <p class="text-base font-semibold">No Patient Selected</p>
        <p class="text-xs mt-1 text-slate-500">Select a patient from the directory or ingest a new one to evaluate guidelines.</p>
      </div>
    `;
    auditContainer.innerHTML = `
      <div class="text-center py-20 text-slate-500">
        <p class="text-sm">Audit results will display here once a patient is loaded.</p>
      </div>
    `;
    return;
  }

  const p = state.selectedPatient;
  const audit = evaluateClinicalRules(p);
  const b1 = audit.block1;
  const b2 = audit.block2;
  const b3 = audit.block3;
  const dosing = generateAntiplateletDosing(p);

  // 1. Compile risk flags
  let ischemicFlags = [];
  if (p.troponin === 1) ischemicFlags.push("Positive Troponin Assay");
  if (p.ischemicInstability === 1) ischemicFlags.push("Hemodynamic Instability / Cardiogenic Shock");
  if (p.ischemicAngina === 1) ischemicFlags.push("Severe/Recurrent Refractory Angina");
  if (p.ischemicHeartFailure === 1) ischemicFlags.push("Acute Heart Failure or New/Worsening MR");
  if (p.ischemicArrhythmia === 1) ischemicFlags.push("Sustained Ventricular Arrhythmias (VT/VF)");

  let bleedingFlags = [];
  if (p.age >= 75) bleedingFlags.push("Advanced Age (Age >= 75)");
  if (p.bleedingRenal === 1 || p.ckd === 1) bleedingFlags.push("Severe Renal Impairment / CKD");
  if (p.bleedingAnemia === 1) bleedingFlags.push("Baseline Severe Anemia (Hb < 11)");
  if (p.bleedingAF === 1 || p.concurrentOac === 1) bleedingFlags.push("Atrial Fibrillation / Concurrent OAC");
  if (p.bleedingStroke === 1 || p.priorStroke === 1) bleedingFlags.push("Prior Stroke / TIA");
  if (p.thrombocytopenia === 1) bleedingFlags.push("Severe Thrombocytopenia");
  if (p.dementia === 1) bleedingFlags.push("Advanced Dementia");
  if (p.expectancy === 1) bleedingFlags.push("Limited Life Expectancy");
  if (p.arf === 1) bleedingFlags.push("Acute Renal Failure");

  const ischemicBadge = b1.isHighIschemic 
    ? `<span class="inline-flex items-center px-3 py-1 rounded-full text-xs font-semibold bg-rose-500/10 text-rose-400 border border-rose-500/20">HIGH ISCHEMIC RISK</span>`
    : `<span class="inline-flex items-center px-3 py-1 rounded-full text-xs font-semibold bg-emerald-500/10 text-emerald-400 border border-emerald-500/20">STANDARD ISCHEMIC RISK</span>`;

  const bleedingBadge = b1.isHighBleeding 
    ? `<span class="inline-flex items-center px-3 py-1 rounded-full text-xs font-semibold bg-amber-500/10 text-amber-400 border border-amber-500/20">HIGH BLEEDING RISK (HBR)</span>`
    : `<span class="inline-flex items-center px-3 py-1 rounded-full text-xs font-semibold bg-emerald-500/10 text-emerald-400 border border-emerald-500/20">STANDARD BLEEDING RISK</span>`;

  detailsContainer.innerHTML = `
    <!-- Block I Heading -->
    <div class="mb-4">
      <span class="text-2xs font-semibold uppercase tracking-wider text-indigo-400 font-mono">Block I</span>
      <h4 class="text-base font-bold text-slate-100 font-display">Patient Intake Risk Summary</h4>
    </div>

    <!-- Patient Demographic Table -->
    <table class="w-full text-xs mb-6 border border-slate-800 border-collapse">
      <thead>
        <tr class="bg-slate-900/80">
          <th colspan="4" class="p-2.5 text-left text-slate-100 font-bold border-b border-slate-800">Demographic & Diagnostic Details</th>
        </tr>
      </thead>
      <tbody>
        <tr class="border-b border-slate-800/60">
          <td class="p-2.5 text-slate-400 font-medium w-1/4">Patient ID</td>
          <td class="p-2.5 text-slate-200 font-mono w-1/4">${p.patientId}</td>
          <td class="p-2.5 text-slate-400 font-medium w-1/4">Patient Name</td>
          <td class="p-2.5 text-slate-200 font-semibold w-1/4">${p.name}</td>
        </tr>
        <tr class="border-b border-slate-800/60">
          <td class="p-2.5 text-slate-400 font-medium">Age / Gender</td>
          <td class="p-2.5 text-slate-200">${p.age} years / ${p.gender}</td>
          <td class="p-2.5 text-slate-400 font-medium">Primary Diagnosis</td>
          <td class="p-2.5 text-slate-200">${getDiagnosisLabel(p.diagnosis)}</td>
        </tr>
        <tr class="border-b border-slate-800/60">
          <td class="p-2.5 text-slate-400 font-medium">Hemodynamics</td>
          <td class="p-2.5 text-slate-200">${p.sbp} mmHg SBP / ${p.hr} bpm HR</td>
          <td class="p-2.5 text-slate-400 font-medium">Oxygen Saturation</td>
          <td class="p-2.5 text-slate-200">${p.spo2}% SpO2</td>
        </tr>
        <tr>
          <td class="p-2.5 text-slate-400 font-medium">Calculated Classification</td>
          <td class="p-2.5 text-indigo-300 font-semibold font-display">${b1.classification}</td>
          <td class="p-2.5 text-slate-400 font-medium">Follow-Up LDL-C</td>
          <td class="p-2.5 text-slate-200">${p.ldlc} mg/dL</td>
        </tr>
      </tbody>
    </table>

    <!-- Risk Level Badges and Qualifying Lists -->
    <div class="space-y-4 mb-6">
      <div class="bg-slate-900/60 p-4 rounded-2xl border border-slate-800">
        <div class="flex justify-between items-center mb-3">
          <h4 class="font-semibold text-slate-200 text-xs uppercase tracking-wider">Ischemic Risk</h4>
          ${ischemicBadge}
        </div>
        <div class="text-xs">
          <p class="text-slate-400 mb-2">Qualifying Indicators:</p>
          ${ischemicFlags.length > 0 
            ? `<ul class="list-disc pl-4 space-y-1 text-rose-300">
                ${ischemicFlags.map(f => `<li>${f}</li>`).join('')}
               </ul>` 
            : `<p class="text-emerald-400 font-medium">None (Standard Ischemic Risk)</p>`}
        </div>
      </div>

      <div class="bg-slate-900/60 p-4 rounded-2xl border border-slate-800">
        <div class="flex justify-between items-center mb-3">
          <h4 class="font-semibold text-slate-200 text-xs uppercase tracking-wider">Bleeding Risk (ARC-HBR)</h4>
          ${bleedingBadge}
        </div>
        <div class="text-xs">
          <p class="text-slate-400 mb-2">Qualifying Indicators:</p>
          ${bleedingFlags.length > 0 
            ? `<ul class="list-disc pl-4 space-y-1 text-amber-300">
                ${bleedingFlags.map(f => `<li>${f}</li>`).join('')}
               </ul>` 
            : `<p class="text-emerald-400 font-medium">None (Standard Bleeding Risk)</p>`}
        </div>
      </div>
    </div>

    <!-- Prescribed Secondary Prevention Table -->
    <table class="w-full text-xs border border-slate-800 border-collapse">
      <thead>
        <tr class="bg-slate-900/80">
          <th colspan="4" class="p-2.5 text-left text-slate-100 font-bold border-b border-slate-800">Prescribed Secondary Prevention Pharmacotherapy</th>
        </tr>
      </thead>
      <tbody>
        <tr class="border-b border-slate-800/60">
          <td class="p-2.5 text-slate-400 font-medium w-1/4">Reperfusion Strategy</td>
          <td class="p-2.5 text-slate-200 w-1/4">${getReperfusionLabel(p.reperfusion)}</td>
          <td class="p-2.5 text-slate-400 font-medium w-1/4">P2Y12 Inhibitor</td>
          <td class="p-2.5 text-slate-200 w-1/4">${getP2y12Label(p.p2y12)}</td>
        </tr>
        <tr class="border-b border-slate-800/60">
          <td class="p-2.5 text-slate-400 font-medium">Statin Intensity</td>
          <td class="p-2.5 text-slate-200">${getStatinLabel(p.statin)}</td>
          <td class="p-2.5 text-slate-400 font-medium">PPI Prescribed?</td>
          <td class="p-2.5 text-slate-200">${p.ppiPrescribed === 1 ? "PPI Prescribed" : "No PPI"}</td>
        </tr>
        <tr>
          <td class="p-2.5 text-slate-400 font-medium">Oral Anticoagulant (OAC)?</td>
          <td class="p-2.5 text-slate-200">${p.concurrentOac === 1 ? "Yes (Concurrent OAC)" : "No OAC"}</td>
          <td class="p-2.5 text-slate-400 font-medium">Beta-Blocker / RAAS?</td>
          <td class="p-2.5 text-slate-200">
            ${p.betaBlocker === 1 ? "Beta-Blocker" : "No BB"} / 
            ${p.raasInhibitor === 1 ? "RAAS Inhibitor" : "No RAAS"}
          </td>
        </tr>
      </tbody>
    </table>
  `;

  // 2. Render Block II and Block III (Right Panel)
  let deviationsHtml = "";
  if (b2.deviations.length === 0) {
    deviationsHtml = `
      <div class="p-3.5 rounded-xl border border-emerald-500/20 bg-emerald-500/5 flex items-center gap-3">
        <div class="flex-shrink-0 flex items-center justify-center w-8 h-8 rounded bg-emerald-500/10 text-emerald-400">
          <svg class="w-5 h-5" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2.5" d="M5 13l4 4L19 7"/></svg>
        </div>
        <div>
          <p class="text-xs font-semibold text-emerald-300">All rules compliant. No deviations identified.</p>
        </div>
      </div>
    `;
  } else {
    deviationsHtml = `
      <div class="space-y-2">
        ${b2.deviations.map(dev => `
          <div class="p-3.5 rounded-xl border border-rose-500/30 bg-rose-500/5 flex items-start gap-3">
            <div class="flex-shrink-0 flex items-center justify-center w-8 h-8 rounded bg-rose-500/10 text-rose-400 mt-0.5">
              <svg class="w-5 h-5" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2.5" d="M12 9v2m0 4h.01m-6.938 4h13.856c1.54 0 2.502-1.667 1.732-3L13.732 4c-.77-1.333-2.694-1.333-3.464 0L3.34 16c-.77 1.333.192 3 1.732 3z"/></svg>
            </div>
            <div>
              <p class="text-xs font-bold text-rose-300">Deviation / Guideline Omission</p>
              <p class="text-2xs text-slate-300 mt-0.5 leading-relaxed">${dev}</p>
            </div>
          </div>
        `).join('')}
      </div>
    `;
  }

  let directivesHtml = "";
  if (b3.directives.length === 0) {
    directivesHtml = `<p class="text-2xs text-slate-400 italic">No specific directives needed. Maintain current guideline-adherent regimen.</p>`;
  } else {
    directivesHtml = `
      <ul class="space-y-2">
        ${b3.directives.map(dir => `
          <li class="p-2.5 bg-slate-900/50 rounded-lg border border-slate-800/80 flex items-start gap-2.5 text-xs text-slate-300">
            <svg class="w-4 h-4 text-indigo-400 mt-0.5 flex-shrink-0" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2.5" d="M9 5l7 7-7 7"/></svg>
            <span>${dir}</span>
          </li>
        `).join('')}
      </ul>
    `;
  }

  let adjustmentsHtml = "";
  if (b3.adjustments.length === 0) {
    adjustmentsHtml = `<p class="text-2xs text-emerald-400 font-medium">Patient stable. No proactive safety adjustments triggered.</p>`;
  } else {
    adjustmentsHtml = `
      <ul class="space-y-2">
        ${b3.adjustments.map(adj => {
          let colorClass = "border-slate-800 bg-slate-900/40 text-slate-300";
          let iconClass = "text-indigo-400";
          if (adj.includes("HYPOXEMIA") || adj.includes("STOP SIGN") || adj.includes("HEMORRHAGE") || adj.includes("CRITICAL")) {
            colorClass = "border-rose-500/20 bg-rose-500/5 text-rose-300";
            iconClass = "text-rose-400";
          } else if (adj.includes("GASTRIC GAP") || adj.includes("WARNING")) {
            colorClass = "border-amber-500/20 bg-amber-500/5 text-amber-300";
            iconClass = "text-amber-400";
          }
          return `
            <li class="p-2.5 rounded-lg border ${colorClass} flex items-start gap-2.5 text-xs">
              <svg class="w-4 h-4 ${iconClass} mt-0.5 flex-shrink-0" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2.5" d="M13 16h-1v-4h-1m1-4h.01M21 12a9 9 0 11-18 0 9 9 0 0118 0z"/></svg>
              <span>${adj}</span>
            </li>
          `;
        }).join('')}
      </ul>
    `;
  }

  const complianceBadge = b2.compliance === "PASS"
    ? `<span class="px-3 py-1 text-xs font-extrabold rounded-full bg-emerald-500/20 text-emerald-400 border border-emerald-500/30 flex items-center gap-1.5 font-mono">
         <svg class="w-3.5 h-3.5" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="3" d="M5 13l4 4L19 7"/></svg>
         PASS
       </span>`
    : `<span class="px-3 py-1 text-xs font-extrabold rounded-full bg-rose-500/20 text-rose-400 border border-rose-500/30 flex items-center gap-1.5 font-mono">
         <svg class="w-3.5 h-3.5" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="3" d="M6 18L18 6M6 6l12 12"/></svg>
         FAIL
       </span>`;

  auditContainer.innerHTML = `
    <!-- Top Action Bar -->
    <div class="flex justify-between items-center mb-6">
      <div>
        <span class="text-2xs font-semibold uppercase tracking-wider text-slate-400 font-mono">Medication Safety</span>
        <h4 class="text-base font-bold text-slate-100 font-display">Clinical Audit Report</h4>
      </div>
      <button onclick="window.print()" class="px-3 py-1.5 text-xs rounded-xl border border-slate-700 bg-slate-800 text-slate-300 hover:bg-slate-700 transition flex items-center font-medium">
        <svg class="w-3.5 h-3.5 mr-1.5" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M17 17h2a2 2 0 002-2v-4a2 2 0 00-2-2H5a2 2 0 00-2 2v4a2 2 0 002 2h2m2 4h6a2 2 0 002-2v-4a2 2 0 00-2-2H9a2 2 0 00-2 2v4a2 2 0 002 2zm8-12V5a2 2 0 00-2-2H9a2 2 0 00-2 2v4h10z"/></svg>
        Print Audit
      </button>
    </div>

    <!-- Block II: Medical Safety & Compliance Audit -->
    <div class="bg-slate-900/60 p-5 rounded-2xl border border-slate-800 mb-6">
      <div class="flex justify-between items-center mb-4">
        <div>
          <span class="text-3xs font-semibold uppercase tracking-wider text-indigo-400 font-mono">Block II</span>
          <h5 class="text-xs font-bold uppercase tracking-wider text-slate-200 mt-0.5">Medical Safety & Compliance Audit</h5>
        </div>
        ${complianceBadge}
      </div>
      ${deviationsHtml}
    </div>

    <!-- Table 7: Dosing Considerations for Oral Antiplatelet Therapy -->
    <div class="bg-slate-900/60 p-5 rounded-2xl border border-slate-800 mb-6 ant-dosing-card">
      <div class="mb-4">
        <span class="text-3xs font-semibold uppercase tracking-wider text-indigo-400 font-mono">Table 7 Dosing</span>
        <h5 class="text-xs font-bold uppercase tracking-wider text-slate-200 mt-0.5">Oral Antiplatelet Dosing Recommendations</h5>
      </div>
      
      <div class="overflow-x-auto">
        <table class="w-full text-2xs border border-slate-800 border-collapse">
          <thead>
            <tr class="bg-slate-900/80 text-slate-300 font-mono text-3xs uppercase tracking-wider">
              <th class="p-2 text-left font-bold border border-slate-800 w-1/5">Drug Name</th>
              <th class="p-2 text-left font-bold border border-slate-800 w-1/4">Loading Dose</th>
              <th class="p-2 text-left font-bold border border-slate-800 w-1/4">Maintenance Dose</th>
              <th class="p-2 text-left font-bold border border-slate-800 w-2/5">Dose Adjustments & Warnings</th>
            </tr>
          </thead>
          <tbody>
            <tr class="border-b border-slate-800/60">
              <td class="p-2 font-bold text-slate-200 border border-slate-800">Aspirin</td>
              <td class="p-2 text-slate-300 border border-slate-800">${dosing.aspirin.loadingDose}</td>
              <td class="p-2 text-slate-300 border border-slate-800">${dosing.aspirin.maintenanceDose}</td>
              <td class="p-2 text-slate-400 italic border border-slate-800">None</td>
            </tr>
            <tr class="border-b border-slate-800/60">
              <td class="p-2 font-bold text-slate-200 border border-slate-800">${dosing.p2y12.name}</td>
              <td class="p-2 text-slate-300 border border-slate-800">${dosing.p2y12.loadingDose}</td>
              <td class="p-2 text-slate-300 border border-slate-800">${dosing.p2y12.maintenanceDose}</td>
              <td class="p-2 text-slate-300 border border-slate-800 font-medium">
                ${dosing.p2y12.adjustments !== "None" ? `<span class="text-amber-300">${dosing.p2y12.adjustments}</span>` : '<span class="text-slate-400 italic">None</span>'}
                ${dosing.p2y12.warnings ? `<div class="text-rose-400 mt-1 font-semibold">${dosing.p2y12.warnings}</div>` : ''}
              </td>
            </tr>
          </tbody>
        </table>
      </div>
    </div>

    <!-- Block III: Predicted Pharmacist Action Intervention -->
    <div class="bg-slate-900/60 p-5 rounded-2xl border border-slate-800">
      <div class="mb-4">
        <span class="text-3xs font-semibold uppercase tracking-wider text-indigo-400 font-mono">Block III</span>
        <h5 class="text-xs font-bold uppercase tracking-wider text-slate-200 mt-0.5">Predicted Pharmacist Action Intervention</h5>
      </div>
      
      <div class="space-y-4">
        <div>
          <h6 class="text-2xs font-semibold text-slate-400 mb-2 uppercase tracking-wide">Guideline Therapy Directives</h6>
          ${directivesHtml}
        </div>
        
        <div>
          <h6 class="text-2xs font-semibold text-slate-400 mb-2 uppercase tracking-wide">Proactive Safety Adjustments</h6>
          ${adjustmentsHtml}
        </div>
      </div>
    </div>

    <!-- Disclaimer -->
    <div class="mt-6 pt-4 border-t border-slate-800/80 text-[10px] text-slate-500 text-center leading-relaxed">
      Guideline definitions derived from the 2025 ACC/AHA/ACEP/NAEMSP/SCAI Clinical Guidelines for ACS. CDSS alerts are intended for clinical audit purposes. Final therapeutic decisions rest with the prescribing practitioner.
    </div>
  `;
}

// Select Patient Helper Methods
function getDiagnosisLabel(code) {
  switch (parseInt(code)) {
    case 1: return "STEMI";
    case 2: return "NSTEMI";
    case 3: return "Unstable Angina (UA)";
    default: return "Unknown";
  }
}

function getEcgLabel(code) {
  switch (parseInt(code)) {
    case 0: return "Normal";
    case 1: return "ST-Elevation";
    case 2: return "Dynamic ST-Depression/T-Wave Inversion";
    default: return "Normal";
  }
}

function getReperfusionLabel(code) {
  switch (parseInt(code)) {
    case 1: return "Primary PCI";
    case 2: return "Fibrinolytic Therapy";
    case 3: return "CABG";
    case 4: return "Medical Management";
    default: return "None";
  }
}

function getP2y12Label(code) {
  switch (parseInt(code)) {
    case 0: return "None";
    case 1: return "Clopidogrel (Plavix)";
    case 2: return "Ticagrelor (Brilinta)";
    case 3: return "Prasugrel (Effient)";
    default: return "None";
  }
}

function getStatinLabel(code) {
  switch (parseInt(code)) {
    case 0: return "None";
    case 1: return "Low/Moderate Intensity";
    case 2: return "High-Intensity Statin";
    default: return "None";
  }
}

// Setup Event Listeners
function setupEventListeners() {
  // Login Form
  const loginForm = document.getElementById("login-form");
  if (loginForm) {
    loginForm.addEventListener("submit", (e) => {
      e.preventDefault();
      const usernameInput = document.getElementById("login-username").value.trim();
      const passwordInput = document.getElementById("login-password").value.trim();
      
      // Allow any login for demo purposes, but validate it's not blank
      if (usernameInput && passwordInput) {
        state.isLoggedIn = true;
        state.currentUser = usernameInput;
        document.getElementById("user-name-display").textContent = usernameInput;
        document.getElementById("login-overlay").classList.add("hidden");
        document.getElementById("app-main-layout").classList.remove("blur-md", "pointer-events-none");
        
        // Show success notification
        showNotification("Access Granted", `Clinician portal unlocked for ${usernameInput}`, "success");
      } else {
        showNotification("Access Denied", "Please enter valid credentials", "error");
      }
    });
  }

  // Logout Button
  const logoutBtn = document.getElementById("btn-logout");
  if (logoutBtn) {
    logoutBtn.addEventListener("click", () => {
      state.isLoggedIn = false;
      state.currentUser = null;
      document.getElementById("login-overlay").classList.remove("hidden");
      document.getElementById("app-main-layout").classList.add("blur-md", "pointer-events-none");
      document.getElementById("login-username").value = "";
      document.getElementById("login-password").value = "";
      showNotification("Logged Out", "Session ended successfully", "info");
    });
  }

  // Search input
  const searchInput = document.getElementById("search-patients");
  if (searchInput) {
    searchInput.addEventListener("input", (e) => {
      state.searchQuery = e.target.value;
      renderPatientList();
    });
  }

  // Diagnosis filter
  const filterDiag = document.getElementById("filter-diagnosis");
  if (filterDiag) {
    filterDiag.addEventListener("change", (e) => {
      state.filterDiagnosis = e.target.value;
      renderPatientList();
    });
  }

  // Risk filter
  const filterRisk = document.getElementById("filter-risk");
  if (filterRisk) {
    filterRisk.addEventListener("change", (e) => {
      state.filterRisk = e.target.value;
      renderPatientList();
    });
  }

  // Ingestion Form Submit
  const patientForm = document.getElementById("patient-ingestion-form");
  if (patientForm) {
    patientForm.addEventListener("submit", (e) => {
      e.preventDefault();
      
      const pId = document.getElementById("input-patient-id").value.trim();
      const pName = document.getElementById("input-name").value.trim() || `Patient ${pId}`;
      const pAge = parseInt(document.getElementById("input-age").value) || 60;
      const pGender = document.getElementById("input-gender").value;
      const pWeight = parseFloat(document.getElementById("input-weight").value) || 70;
      const pDiag = parseInt(document.getElementById("input-diagnosis").value);
      const pTrop = parseInt(document.getElementById("input-troponin").value);
      const pEcg = parseInt(document.getElementById("input-ecg").value);
      
      // Continuous variables
      const pSbp = parseInt(document.getElementById("input-sbp").value) || 120;
      const pHr = parseInt(document.getElementById("input-hr").value) || 75;
      const pSpo2 = parseInt(document.getElementById("input-spo2").value) || 98;
      const pCpType = parseInt(document.getElementById("input-cptype").value) || 1;

      // Ischemic risks
      const pInstability = document.getElementById("cb-instability").checked ? 1 : 0;
      const pAngina = document.getElementById("cb-angina").checked ? 1 : 0;
      const pHf = document.getElementById("cb-hf").checked ? 1 : 0;
      const pArrhythmia = document.getElementById("cb-arrhythmia").checked ? 1 : 0;
      
      // Bleeding risks
      const pRenal = document.getElementById("cb-renal").checked ? 1 : 0;
      const pAnemia = document.getElementById("cb-anemia").checked ? 1 : 0;
      const pAf = document.getElementById("cb-af").checked ? 1 : 0;
      const pStroke = document.getElementById("cb-stroke").checked ? 1 : 0;
      
      // New checkboxes
      const pThrombocytopenia = document.getElementById("cb-thrombocytopenia").checked ? 1 : 0;
      const pDementia = document.getElementById("cb-dementia").checked ? 1 : 0;
      const pExpectancy = document.getElementById("cb-expectancy").checked ? 1 : 0;
      const pArf = document.getElementById("cb-arf").checked ? 1 : 0;

      // Comorbidities and Safety events
      const pDiabetes = document.getElementById("cb-diabetes").checked ? 1 : 0;
      const pCkd = pRenal;
      const pPriorStroke = pStroke;
      const pPepticUlcer = document.getElementById("cb-peptic-ulcer").checked ? 1 : 0;
      const pNsaid = document.getElementById("cb-nsaid").checked ? 1 : 0;
      const pMinorBleeding = document.getElementById("cb-minor-bleeding").checked ? 1 : 0;
      const pConcurrentOac = pAf;

      // Treatment & Discharge Metrics
      const pReperfusion = parseInt(document.getElementById("input-reperfusion").value);
      const pP2y12 = parseInt(document.getElementById("input-p2y12").value);
      const pStatin = parseInt(document.getElementById("input-statin").value);
      const pLdlc = parseFloat(document.getElementById("input-ldlc").value) || 80;
      
      const pPpi = parseInt(document.getElementById("input-ppi").value) || 0;
      const pOac = parseInt(document.getElementById("input-oac").value) || 0;

      // New select metrics
      const pBetaBlocker = parseInt(document.getElementById("input-beta-blocker").value) || 0;
      const pRaasInhibitor = parseInt(document.getElementById("input-raas-inhibitor").value) || 0;
      const pAnticoagulation = parseInt(document.getElementById("input-anticoagulation").value) || 0;
      const pTransfusion = parseInt(document.getElementById("input-transfusion").value) || 0;

      const pData = {
        patientId: pId,
        name: pName,
        age: pAge,
        gender: pGender,
        weight: pWeight,
        diagnosis: pDiag,
        troponin: pTrop,
        ecg: pEcg,
        ischemicInstability: pInstability,
        ischemicAngina: pAngina,
        ischemicHeartFailure: pHf,
        ischemicArrhythmia: pArrhythmia,
        bleedingRenal: pRenal,
        bleedingAnemia: pAnemia,
        bleedingAF: pAf,
        bleedingStroke: pStroke,
        spo2: pSpo2,
        sbp: pSbp,
        hr: pHr,
        cpType: pCpType,
        diabetes: pDiabetes,
        ckd: pCkd,
        priorStroke: pPriorStroke,
        pepticUlcer: pPepticUlcer,
        nsaid: pNsaid,
        minorBleeding: pMinorBleeding,
        concurrentOac: pConcurrentOac,
        ppiPrescribed: pPpi,
        reperfusion: pReperfusion,
        p2y12: pP2y12,
        statin: pStatin,
        ldlc: pLdlc,
        betaBlocker: pBetaBlocker,
        raasInhibitor: pRaasInhibitor,
        anticoagulation: pAnticoagulation,
        transfusion: pTransfusion,
        thrombocytopenia: pThrombocytopenia,
        dementia: pDementia,
        expectancy: pExpectancy,
        arf: pArf,
        complications: state.formMode === "edit" ? state.selectedPatient.complications : "Newly Added Profile"
      };

      if (!pId) {
        showNotification("Validation Error", "Patient ID/Hospital Number is required", "error");
        return;
      }

      if (state.formMode === "add") {
        const exists = state.patients.some(x => x.patientId.toLowerCase() === pId.toLowerCase());
        if (exists) {
          showNotification("Duplicate Record", `A patient with Hospital Number ${pId} already exists.`, "error");
          return;
        }
        
        state.patients.unshift(pData);
        showNotification("Success", `Patient ${pName} ingested successfully`, "success");
      } else {
        const index = state.patients.findIndex(x => x.patientId === pId);
        if (index !== -1) {
          state.patients[index] = pData;
          showNotification("Success", `Changes saved for ${pName}`, "success");
        }
      }

      state.selectedPatient = pData;
      updateStatistics();
      renderPatientList();
      renderSelectedPatient();
      fillFormInputs(pData);
    });
  }

  // Auto-prediction dynamic classification trigger hookup
  function runLivePrediction() {
    if (state.formMode !== "add") return; // do not overwrite manual patient records
    const tempP = {
      age: parseInt(document.getElementById("input-age").value) || 60,
      spo2: parseInt(document.getElementById("input-spo2").value) || 98,
      sbp: parseInt(document.getElementById("input-sbp").value) || 120,
      hr: parseInt(document.getElementById("input-hr").value) || 75,
      troponin: parseInt(document.getElementById("input-troponin").value) || 0,
      ecg: parseInt(document.getElementById("input-ecg").value) || 0,
      ischemicInstability: document.getElementById("cb-instability").checked ? 1 : 0,
      ischemicAngina: document.getElementById("cb-angina").checked ? 1 : 0,
      ischemicHeartFailure: document.getElementById("cb-hf").checked ? 1 : 0,
      ischemicArrhythmia: document.getElementById("cb-arrhythmia").checked ? 1 : 0,
      bleedingRenal: document.getElementById("cb-renal").checked ? 1 : 0,
      bleedingAnemia: document.getElementById("cb-anemia").checked ? 1 : 0,
      bleedingAF: document.getElementById("cb-af").checked ? 1 : 0,
      bleedingStroke: document.getElementById("cb-stroke").checked ? 1 : 0,
      pepticUlcer: document.getElementById("cb-peptic-ulcer").checked ? 1 : 0,
      nsaid: document.getElementById("cb-nsaid").checked ? 1 : 0,
      minorBleeding: document.getElementById("cb-minor-bleeding").checked ? 1 : 0
    };
    
    const predDiag = predictRF(tempP);
    document.getElementById("input-diagnosis").value = predDiag;
  }

  const ecgInput = document.getElementById("input-ecg");
  const tropInput = document.getElementById("input-troponin");
  const ageInput = document.getElementById("input-age");
  if (ecgInput) ecgInput.addEventListener("change", runLivePrediction);
  if (tropInput) tropInput.addEventListener("change", runLivePrediction);
  if (ageInput) ageInput.addEventListener("change", runLivePrediction);

  // Cancel edit button
  const cancelEditBtn = document.getElementById("btn-cancel-edit");
  if (cancelEditBtn) {
    cancelEditBtn.addEventListener("click", () => {
      resetForm();
      state.selectedPatient = state.patients.length > 0 ? { ...state.patients[0] } : null;
      if (state.selectedPatient) {
        selectPatient(state.selectedPatient);
      } else {
        renderSelectedPatient();
      }
    });
  }

  // Add new patient trigger
  const triggerAddBtn = document.getElementById("btn-trigger-add");
  if (triggerAddBtn) {
    triggerAddBtn.addEventListener("click", () => {
      resetForm();
      // Visual indicator for form section
      const formEl = document.getElementById("patient-ingestion-form");
      formEl.classList.add("animate-pulse-brief");
      setTimeout(() => formEl.classList.remove("animate-pulse-brief"), 500);
      showNotification("Add Mode", "Fill form to register a new patient", "info");
    });
  }

  // Section collapsible toggles
  const collToggles = document.querySelectorAll(".collapsible-toggle");
  collToggles.forEach(toggle => {
    toggle.addEventListener("click", () => {
      const targetId = toggle.getAttribute("data-target");
      const target = document.getElementById(targetId);
      const icon = toggle.querySelector(".toggle-icon");
      
      if (target.classList.contains("hidden")) {
        target.classList.remove("hidden");
        icon.classList.add("rotate-180");
      } else {
        target.classList.add("hidden");
        icon.classList.remove("rotate-180");
      }
    });
  });
}

// Show Alert Notification
function showNotification(title, text, type = "success") {
  const container = document.getElementById("notification-container");
  if (!container) return;

  const notif = document.createElement("div");
  let bg = "bg-slate-900 border-slate-800 text-slate-100";
  let border = "border-l-4 border-l-indigo-500";
  let iconColor = "text-indigo-400";
  let iconSvg = `<svg class="w-5 h-5" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M13 16h-1v-4h-1m1-4h.01M21 12a9 9 0 11-18 0 9 9 0 0118 0z"/></svg>`;

  if (type === "success") {
    border = "border-l-4 border-l-emerald-500";
    iconColor = "text-emerald-400";
    iconSvg = `<svg class="w-5 h-5" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M9 12l2 2 4-4m6 2a9 9 0 11-18 0 9 9 0 0118 0z"/></svg>`;
  } else if (type === "error") {
    border = "border-l-4 border-l-rose-500";
    iconColor = "text-rose-400";
    iconSvg = `<svg class="w-5 h-5" fill="none" stroke="currentColor" viewBox="0 0 24 24"><path stroke-linecap="round" stroke-linejoin="round" stroke-width="2" d="M12 9v2m0 4h.01m-6.938 4h13.856c1.54 0 2.502-1.667 1.732-3L13.732 4c-.77-1.333-2.694-1.333-3.464 0L3.34 16c-.77 1.333.192 3 1.732 3z"/></svg>`;
  } else if (type === "warning") {
    border = "border-l-4 border-l-amber-500";
    iconColor = "text-amber-400";
  }

  notif.className = `p-4 mb-3 rounded-xl shadow-lg border ${bg} ${border} flex items-start gap-3 transition-all duration-300 transform translate-x-20 opacity-0 max-w-sm w-full`;
  notif.innerHTML = `
    <div class="${iconColor} flex-shrink-0 mt-0.5">${iconSvg}</div>
    <div>
      <h4 class="text-xs font-bold">${title}</h4>
      <p class="text-2xs text-slate-400 mt-0.5 leading-relaxed">${text}</p>
    </div>
  `;

  container.appendChild(notif);
  
  // Trigger entry animation
  setTimeout(() => {
    notif.classList.remove("translate-x-20", "opacity-0");
  }, 10);

  // Auto-remove
  setTimeout(() => {
    notif.classList.add("translate-x-20", "opacity-0");
    setTimeout(() => notif.remove(), 300);
  }, 4000);
}

// Fallback registry data (derived from converted sheet in case fetch fails)
function getFallbackPatients() {
  return [
    {
      "patientId": "2403050038",
      "name": "Robert Miller (1)",
      "age": 59,
      "gender": "Male",
      "diagnosis": 3,
      "troponin": 0,
      "ecg": 0,
      "ischemicInstability": 0,
      "ischemicAngina": 0,
      "ischemicHeartFailure": 1,
      "ischemicArrhythmia": 0,
      "bleedingRenal": 0,
      "bleedingAnemia": 0,
      "bleedingAF": 0,
      "bleedingStroke": 0,
      "spo2": 96,
      "sbp": 120,
      "hr": 75,
      "cpType": 2,
      "diabetes": 1,
      "ckd": 0,
      "priorStroke": 0,
      "pepticUlcer": 0,
      "nsaid": 0,
      "minorBleeding": 0,
      "concurrentOac": 0,
      "ppiPrescribed": 0,
      "reperfusion": 1,
      "p2y12": 2,
      "statin": 2,
      "ldlc": 85,
      "complications": "LV Dysfunction"
    },
    {
      "patientId": "2410290009",
      "name": "William Davis (2)",
      "age": 84,
      "gender": "Male",
      "diagnosis": 3,
      "troponin": 0,
      "ecg": 0,
      "ischemicInstability": 0,
      "ischemicAngina": 0,
      "ischemicHeartFailure": 0,
      "ischemicArrhythmia": 0,
      "bleedingRenal": 0,
      "bleedingAnemia": 0,
      "bleedingAF": 0,
      "bleedingStroke": 0,
      "spo2": 96,
      "sbp": 120,
      "hr": 75,
      "cpType": 2,
      "diabetes": 0,
      "ckd": 0,
      "priorStroke": 0,
      "pepticUlcer": 0,
      "nsaid": 0,
      "minorBleeding": 0,
      "concurrentOac": 0,
      "ppiPrescribed": 0,
      "reperfusion": 1,
      "p2y12": 2,
      "statin": 1,
      "ldlc": 85,
      "complications": "None"
    },
    {
      "patientId": "2412130188",
      "name": "Jennifer Taylor (3)",
      "age": 52,
      "gender": "Female",
      "diagnosis": 3,
      "troponin": 0,
      "ecg": 0,
      "ischemicInstability": 0,
      "ischemicAngina": 0,
      "ischemicHeartFailure": 0,
      "ischemicArrhythmia": 0,
      "bleedingRenal": 0,
      "bleedingAnemia": 0,
      "bleedingAF": 1,
      "bleedingStroke": 0,
      "spo2": 96,
      "sbp": 120,
      "hr": 75,
      "cpType": 2,
      "diabetes": 1,
      "ckd": 0,
      "priorStroke": 0,
      "pepticUlcer": 0,
      "nsaid": 0,
      "minorBleeding": 0,
      "concurrentOac": 1,
      "ppiPrescribed": 0,
      "reperfusion": 1,
      "p2y12": 1,
      "statin": 2,
      "ldlc": 110,
      "complications": "None"
    },
    {
      "patientId": "2406180085",
      "name": "Linda Brown (4)",
      "age": 66,
      "gender": "Female",
      "diagnosis": 3,
      "troponin": 0,
      "ecg": 0,
      "ischemicInstability": 0,
      "ischemicAngina": 0,
      "ischemicHeartFailure": 0,
      "ischemicArrhythmia": 0,
      "bleedingRenal": 0,
      "bleedingAnemia": 0,
      "bleedingAF": 1,
      "bleedingStroke": 0,
      "spo2": 96,
      "sbp": 120,
      "hr": 75,
      "cpType": 2,
      "diabetes": 0,
      "ckd": 0,
      "priorStroke": 0,
      "pepticUlcer": 0,
      "nsaid": 0,
      "minorBleeding": 0,
      "concurrentOac": 1,
      "ppiPrescribed": 0,
      "reperfusion": 3,
      "p2y12": 1,
      "statin": 2,
      "ldlc": 85,
      "complications": "None"
    },
    {
      "patientId": "2403270195",
      "name": "Elizabeth Wilson (5)",
      "age": 77,
      "gender": "Female",
      "diagnosis": 2,
      "troponin": 1,
      "ecg": 2,
      "ischemicInstability": 1,
      "ischemicAngina": 0,
      "ischemicHeartFailure": 0,
      "ischemicArrhythmia": 0,
      "bleedingRenal": 0,
      "bleedingAnemia": 0,
      "bleedingAF": 1,
      "bleedingStroke": 0,
      "spo2": 96,
      "sbp": 85,
      "hr": 115,
      "cpType": 1,
      "diabetes": 0,
      "ckd": 0,
      "priorStroke": 0,
      "pepticUlcer": 0,
      "nsaid": 0,
      "minorBleeding": 0,
      "concurrentOac": 1,
      "ppiPrescribed": 0,
      "reperfusion": 1,
      "p2y12": 1,
      "statin": 1,
      "ldlc": 85,
      "complications": "Cardiogenic shock,PVD"
    }
  ];
}