DiagnosticoX

Advanced AI-Powered Medical Diagnosis Platform

DiagnosticoX is a comprehensive, production-grade medical diagnosis platform featuring intelligent multi-layer caching, pre-emptive data crawling, and extensive symptomatology analysis. Built with cutting-edge web technologies and optimized for performance, DiagnosticoX reduces API calls by up to 70% while delivering sub-second response times.

Repository Structure

apps/frontend/ - Vite + React 18 application (primary UI).
apps/backend/ - Express + TypeScript prototype API.
docs/ - documentation index at docs/README.md.
- docs/guides/ - setup, deployment, cache/testing guides.
- docs/architecture/ - system design overview.
- docs/reports/ - progress, research, and implementation reports.
- docs/records/ - changelog and release history.
research/ - ICD/DSM/symptom research references.
user_input_files/ - preserved sample input artefacts for context.

Quickstart (pnpm workspace)

Install deps: pnpm install
Frontend dev: pnpm run dev:frontend (http://localhost:5173)
Backend dev: pnpm run dev:backend (http://localhost:3000)
Lint/checks: pnpm run lint and pnpm run format:check
Tests: pnpm run test
Build (frontend): pnpm run build:prod

Features

Core Clinical Capabilities

1. ICD-10/ICD-11 Integration

WHO ICD-API OAuth 2.0 Integration: Secure authentication with the WHO ICD classification system
Code Lookup & Search: Fast entity search with caching
Post-coordination Support: Advanced code combination capabilities
ICD-10 ↔ ICD-11 Mapping: Seamless translation between versions
30-Day Cache TTL: Optimized for clinical workflow

2. DSM-5-TR Psychiatric Assessments

PHQ-9 Depression Screening: Patient Health Questionnaire with automatic severity scoring
GAD-7 Anxiety Assessment: Generalized Anxiety Disorder screening with clinical interpretation
PC-PTSD-5: Primary Care PTSD screening tool
Suicide Risk Detection: Mandatory clinical follow-up workflows for item 9 responses
FHIR-Compatible Data: Integration with US Behavioral Health Profiles

3. Comprehensive Symptom Database (2000+ Symptoms)

11 Organ Systems: Cardiovascular, Respiratory, Neurological, Gastrointestinal, Musculoskeletal, Dermatological, Endocrine, Genitourinary, Hematological, Psychiatric, Immunological
Symptom Overlap Detection: Multi-system symptom analysis
Correlation Analysis: Statistical co-occurrence patterns
Rare Disease Pattern Recognition: Advanced pattern matching for rare conditions
Urgency Assessment: EMERGENT, URGENT, SEMI-URGENT, NON-URGENT classification
Red Flag Detection: Automatic identification of critical warning signs
SNOMED CT & UMLS Integration: Clinical terminology standards compliance

4. VINDICATE-M Diagnostic Framework

Systematic Differential Diagnosis: Vascular, Infectious, Neoplastic, Degenerative, Intoxication, Congenital, Autoimmune, Traumatic, Endocrine, Mechanical
Bayesian Probability Calculator: Prior probability, likelihood ratios, sensitivity/specificity analysis
Treatment Trial Protocols: Evidence-based diagnostic interventions
Evidence Scoring: Clinical guideline-based probability assessment

5. FHIR R4 Interoperability

FHIR Resource Creation: Patient, Observation, Condition, MedicationRequest, DiagnosticReport, Bundle
Medical Coding Standards: SNOMED CT (clinical terms), LOINC (lab observations), RxNorm (medications), ICD-10 (diagnoses)
JSON Export: Download FHIR resources for external systems
Validation & Error Reporting: Real-time FHIR compliance checking

Advanced Performance Features

6. Intelligent Multi-Layer Caching System

Three-Tier Architecture for Optimal Performance

Memory Cache: Lightning-fast in-memory storage (100 entry limit, LRU eviction)
IndexedDB Persistent Cache: Large-capacity browser storage for offline capability
Service Worker Cache: Offline-first strategy for network resilience

TTL Configuration by Category:

ICD Codes: 30 days
Symptoms: 7 days
PubMed Articles: 24 hours
Drug Interactions: 48 hours
Clinical Trials: 12 hours
DSM-5 Assessments: 7 days
FHIR Resources: 24 hours
VINDICATE Analysis: 7 days

Performance Benefits:

70%+ API call reduction
Sub-10ms response times for cached data
Automatic cache warming with common queries
Smart eviction policies to prevent memory overflow

7. Pre-emptive Crawling System

Background Intelligence for Predictive Data Fetching

Priority Queue System:
- HIGH: ICD lookups, DSM assessments, common symptoms
- MEDIUM: PubMed articles, drug interactions
- LOW: Historical searches, rare conditions
Pattern Analysis:
- User search history tracking
- Frequency-based prediction
- Related query scheduling
- Medical knowledge graph traversal
Concurrency Control:
- 2 concurrent background tasks
- Automatic retry with exponential backoff
- Rate limiting to respect API quotas
Common Query Pre-fetching:
- 18 high-frequency symptoms (chest pain, headache, fever, etc.)
- 10 common ICD-10 codes
- 8 prevalent conditions for PubMed searches

8. Medical Research Integration

PubMed E-utilities: Search articles, fetch details, evidence grading (GRADE, Oxford CEBM)
ClinicalTrials.gov API v2: Study search, enrollment status, phase filtering
DrugBank Clinical API: Drug search, interaction checking (minor/moderate/major/contraindicated), formulation lookup

User Management & Security

9. Five Usage Modes

Clinical Setting Mode: Full EHR integration, all clinical tools
Clinical Study Mode: Research data collection, consent management
Student Mode: Educational features, tutorial overlays
Full Hospital Mode: Multi-department workflows, administrative tools
Self Exploration Mode: Patient-facing, simplified interface

10. Advanced Security Features

Multi-Factor Authentication: TOTP, SMS, Email, Biometric support
Role-Based Access Control (RBAC): 8 predefined roles with granular permissions
Security Audit Logs: Comprehensive event tracking with HIPAA/GDPR compliance
Encryption Management: AES-256-GCM, RSA-4096 key lifecycle
Privacy Controls: Consent management, data sharing agreements, GDPR compliance

Analytics & Monitoring

11. Comprehensive Analytics Suite

Patient Outcomes Tracking: Quality of life metrics, treatment progress visualization
Treatment Efficacy Analysis: Success rates, cost-effectiveness, adverse events
Population Health Monitoring: Epidemiological metrics, demographic analysis
Custom Dashboard Builder: Drag-and-drop widget configuration
Reporting System: Export clinical summaries, quality measures (JSON, CSV, PDF)

12. Real-Time Monitoring

Vital Signs Dashboard: 6 vital sign types with 3-second live updates
Alert Management: Threshold-based warnings, critical event simulation
Patient Switching: Multi-patient monitoring support

13. Cache Metrics Dashboard

Real-Time Performance Monitoring: Hit rates, storage usage, request statistics
Memory & Persistent Cache Analytics: Detailed breakdown by cache tier
Crawler Status: Queue size, active tasks, search pattern history
Storage Estimation: Usage percentage, quota tracking
Cache Management: Clear by category, clean expired entries

AI & Advanced Features

14. Multi-Provider AI Integration

Supported Providers: OpenAI GPT-4, Anthropic Claude, Google Gemini, Ollama (local)
Medical Prompt Templates: Differential diagnosis, treatment planning, drug interactions, clinical summaries, patient education, literature review, risk assessment
Cost Tracking: Token usage monitoring per provider
Automatic Failover: Local LLM fallback on API failure

15. Progressive Web App (PWA)

Offline Support: Full functionality without internet connection
Push Notifications: Medication reminders, appointment alerts, critical updates
Voice Assistant: Medical note dictation, voice commands, SOAP templates
Service Worker: Background sync, cache management, update notifications

Technology Stack

Frontend

React 18: Latest React with Concurrent Mode
TypeScript: Full type safety across codebase
Vite: Lightning-fast build tool with HMR
Tailwind CSS: Utility-first styling with glassmorphism design
React Router v6: Client-side routing
IndexedDB (idb): Persistent storage layer
Lucide Icons: Professional SVG icon library

Build & Optimization

Code Splitting: 12 optimized chunks for lazy loading
Tree Shaking: Dead code elimination
Terser Minification: Console.log removal, aggressive optimization
Gzip & Brotli Compression: Reduced bundle sizes
Bundle Analyzer: Visual size inspection

Testing & Quality

Jest: Unit testing framework
React Testing Library: Component testing
@testing-library/jest-dom: Custom matchers
ts-jest: TypeScript support for Jest
70% Coverage Threshold: Branches, functions, lines, statements

Code Quality Tools

ESLint: Strict TypeScript linting
Prettier: Consistent code formatting
Husky: Git hooks for pre-commit validation
Lint-staged: Run linters on staged files only

Installation

Prerequisites

Node.js 18+ and pnpm 8+
Modern browser with IndexedDB support
(Optional) WHO ICD-API credentials
(Optional) DrugBank Clinical API key
(Optional) OpenAI/Anthropic/Google AI API keys

Quick Start

# Clone the repository
git clone <repository-url>
cd diagnosticox

# Install workspace dependencies (frontend + backend)
pnpm install

# Configure frontend environment variables
cd apps/frontend
cp .env.example .env
# Edit .env with your API credentials, then return to repo root
cd ../../

# Start development server
pnpm --filter diagnosticox-frontend dev

# Access at http://localhost:5173

Backend (optional prototype)

cd apps/backend
pnpm install
pnpm dev

Build for Production

# Production build
pnpm --filter diagnosticox-frontend run build:prod

# Analyze bundle size
pnpm --filter diagnosticox-frontend run build:analyze

# Preview production build
pnpm --filter diagnosticox-frontend run preview

Environment Configuration

Create a .env file in apps/frontend/:

# WHO ICD-API (ICD-10/ICD-11)
VITE_ICD_CLIENT_ID=your_client_id_here
VITE_ICD_CLIENT_SECRET=your_client_secret_here

# DrugBank Clinical API
VITE_DRUGBANK_API_KEY=your_drugbank_key_here

# OpenAI API
VITE_OPENAI_API_KEY=your_openai_key_here

# Anthropic Claude API
VITE_ANTHROPIC_API_KEY=your_anthropic_key_here

# Google Gemini API
VITE_GOOGLE_API_KEY=your_google_key_here

# ClinicalTrials.gov (no key required - public API)
# PubMed E-utilities (no key for basic use, email recommended)
VITE_PUBMED_EMAIL=your_email@example.com

Usage

Default Login Credentials

Email: dr.smith@clinic.com
Password: demo123

Key Navigation Routes

Clinical Tools:

/clinical/symptom-checker - Comprehensive symptom search and analysis
/clinical/icd-lookup - ICD-10/ICD-11 code lookup
/clinical/dsm5-assessments - Psychiatric screening tools
/clinical/vindicate-m - Diagnostic framework and Bayesian calculator
/clinical/fhir - FHIR resource creation

Settings & Management:

/settings/features - Usage mode switching and feature toggles
/settings/ai-providers - AI provider configuration
/settings/adaptive-management - Cost tracking and data controls
/settings/cache-metrics - Cache performance monitoring

Analytics:

/analytics - Main analytics dashboard
/analytics/patient-outcomes - Patient outcome tracking
/analytics/treatment-efficacy - Treatment effectiveness analysis
/analytics/population-health - Public health metrics

Security:

/security - Security center hub
/security/mfa - Multi-factor authentication setup
/security/permissions - Role and permission management
/security/audit-logs - Security event monitoring

Research:

/research - PubMed, ClinicalTrials, DrugBank integration

Cache System Usage

Automatic Caching

All API calls are automatically cached. No code changes required for basic usage.

Manual Cache Control

import { cachedICDService, getCacheStatistics, clearCategoryCache } from './services/cacheIntegration';

// Use cached service (automatic)
const results = await cachedICDService.searchEntities('diabetes');

// Force refresh (bypass cache)
const fresh = await cachedICDService.searchEntities('diabetes', true);

// Get cache statistics
const stats = getCacheStatistics();
console.log(`Hit rate: ${stats.cache.hitRate}%`);

// Clear specific category
await clearCategoryCache(CacheCategory.ICD);

Pre-emptive Crawling

import crawlerService, { CrawlPriority } from './services/crawlerService';

// Schedule high-priority crawl
crawlerService.scheduleCrawl('chest pain', CacheCategory.SYMPTOMS, CrawlPriority.HIGH);

// Get crawler status
const status = crawlerService.getStatus();
console.log(`Queue size: ${status.queueSize}`);

Performance Metrics

Production Benchmarks

Cache Hit Rate: 70-85% (target: >70%)
Memory Cache Hit Rate: 85-95%
Cached Response Time: <10ms
Uncached Response Time: 200-800ms (API dependent)
Total Bundle Size: 4.4 MB (optimized)
Initial Load Time: <3s (3G network)
Time to Interactive: <5s

Cache Statistics (Example)

Total Requests: 1,247
Cache Hits: 891 (71.4%)
Memory Hits: 743 (83.4% of hits)
Persistent Hits: 148 (16.6% of hits)
API Reduction: 71.4%
Storage Used: 12.3 MB / 250 MB (4.9%)

Architecture

Service Layer

src/services/
├── cacheService.ts           # Multi-layer caching (memory + IndexedDB)
├── crawlerService.ts          # Pre-emptive background crawler
├── cacheIntegration.ts        # Automatic caching wrapper
├── expandedSymptomDatabase.ts # 2000+ symptom definitions
├── icdService.ts              # WHO ICD-API integration
├── dsm5Service.ts             # Psychiatric assessments
├── symptomService.ts          # Symptom analysis
├── vindicatemService.ts       # VINDICATE-M framework
├── fhirService.ts             # FHIR R4 resources
├── pubmedService.ts           # PubMed E-utilities
├── clinicalTrialsService.ts   # ClinicalTrials.gov API
├── drugBankService.ts         # DrugBank Clinical API
└── aiProviderService.ts       # Multi-provider AI

Page Components

src/pages/
├── CacheMetricsDashboard.tsx  # Cache performance monitoring
├── SymptomCheckerPage.tsx     # Symptom search and analysis
├── VindicatemDiagnosisPage.tsx # Diagnostic framework
├── FHIRInteroperabilityPage.tsx # FHIR resource creation
├── AdaptiveManagementPage.tsx  # Cost and data management
└── [29 additional clinical pages]

Development

Available Scripts

# Frontend development
pnpm --filter diagnosticox-frontend run dev           # Start dev server with HMR
pnpm --filter diagnosticox-frontend run build         # Production build
pnpm --filter diagnosticox-frontend run build:prod    # Production build with optimization
pnpm --filter diagnosticox-frontend run build:analyze # Bundle analyzer
pnpm --filter diagnosticox-frontend run preview       # Preview production build

# Backend development
pnpm --filter diagnosticox-backend run dev            # Start API in watch mode
pnpm --filter diagnosticox-backend run build          # Compile TypeScript
pnpm --filter diagnosticox-backend run start          # Run compiled API

# Testing (frontend)
pnpm --filter diagnosticox-frontend run test          # Run Jest tests
pnpm --filter diagnosticox-frontend run test:watch    # Watch mode
pnpm --filter diagnosticox-frontend run test:coverage # Coverage report
pnpm --filter diagnosticox-frontend run test:ci       # CI mode (no watch)

# Code Quality (frontend)
pnpm --filter diagnosticox-frontend run lint          # Run ESLint
pnpm --filter diagnosticox-frontend run format        # Run Prettier
pnpm --filter diagnosticox-frontend run format:check  # Check formatting
pnpm --filter diagnosticox-frontend run validate      # Type check + lint + format

# Documentation
pnpm --filter diagnosticox-frontend run docs:generate # Generate JSDoc documentation
pnpm --filter diagnosticox-frontend run docs:serve    # Serve documentation locally

Code Quality Standards

TypeScript Strict Mode: Enabled
ESLint: Airbnb TypeScript config
Test Coverage: 70% minimum (branches, functions, lines)
Bundle Size: <5MB total
Performance Budget: <3s initial load, <100ms interactions

Contributing

Development Workflow

Fork the repository
Create a feature branch: git checkout -b feature/amazing-feature
Commit changes: git commit -m 'Add amazing feature'
Push to branch: git push origin feature/amazing-feature
Open a Pull Request

Commit Message Convention

feat: Add new symptom correlation analysis
fix: Resolve cache eviction bug
docs: Update API integration guide
perf: Optimize IndexedDB query performance
test: Add tests for VINDICATE-M service

Troubleshooting

Cache Issues

// Clear all caches
import cacheService from './services/cacheService';
await cacheService.clearAll();

// Clean expired entries
await cacheService.cleanExpiredEntries();

IndexedDB Errors

Check browser support: Chrome 24+, Firefox 16+, Safari 10+, Edge 79+
Clear browser data if corruption suspected
Ensure sufficient storage quota (check in Cache Metrics Dashboard)

API Rate Limiting

PubMed: 3 requests/second without API key, 10/second with key
ClinicalTrials.gov: No explicit limit, use with reasonable rate
WHO ICD-API: Respect OAuth 2.0 token expiration (cache tokens)
DrugBank: Check your plan's rate limits

License

This project is licensed under the MIT License - see the LICENSE file for details.

Acknowledgments

WHO: ICD-10 and ICD-11 classification systems
NCBI: PubMed E-utilities API
NIH: ClinicalTrials.gov database
DrugBank: Clinical drug information
HL7: FHIR R4 healthcare interoperability standards
SNOMED International: Clinical terminology standards
APA: DSM-5-TR psychiatric diagnostic criteria

Contact & Support

For questions, issues, or feature requests, please open an issue on the repository.

DiagnosticoX - Advancing medical diagnosis through intelligent technology.

Project Metrics:

Lines of Code: 11,599+ (production)
Files: 29 core files + 4 new cache/crawler files
Test Coverage: 70%+ (branches, functions, lines)
Bundle Size: 4.4 MB (optimized, gzipped)
Build Time: ~15 seconds
Cache Hit Rate Target: 70%+
Supported Medical Codes: ICD-10, ICD-11, SNOMED CT, LOINC, RxNorm
Symptom Database: 2,000+ symptoms across 11 organ systems

Name		Name	Last commit message	Last commit date
Latest commit History 194 Commits
.github		.github
.husky		.husky
apps		apps
docs		docs
research		research
scripts		scripts
.gitignore		.gitignore
.lintstagedrc.json		.lintstagedrc.json
.prettierrc.json		.prettierrc.json
CODE_OF_CONDUCT.md		CODE_OF_CONDUCT.md
CONTRIBUTING.md		CONTRIBUTING.md
README.md		README.md
SECURITY.md		SECURITY.md
agents.md		agents.md
license.md		license.md
package.json		package.json
pnpm-workspace.yaml		pnpm-workspace.yaml
reassemble-workspace.sh		reassemble-workspace.sh
spec.md		spec.md
todo.md		todo.md

License

supermarsx/diagnosticox

Folders and files

Latest commit

History

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DiagnosticoX

Repository Structure

Quickstart (pnpm workspace)

Features

Core Clinical Capabilities

1. ICD-10/ICD-11 Integration

2. DSM-5-TR Psychiatric Assessments

3. Comprehensive Symptom Database (2000+ Symptoms)

4. VINDICATE-M Diagnostic Framework

5. FHIR R4 Interoperability

Advanced Performance Features

6. Intelligent Multi-Layer Caching System

7. Pre-emptive Crawling System

8. Medical Research Integration

User Management & Security

9. Five Usage Modes

10. Advanced Security Features

Analytics & Monitoring

11. Comprehensive Analytics Suite

12. Real-Time Monitoring

13. Cache Metrics Dashboard

AI & Advanced Features

14. Multi-Provider AI Integration

15. Progressive Web App (PWA)

Technology Stack

Frontend

Build & Optimization

Testing & Quality

Code Quality Tools

Installation

Prerequisites

Quick Start

Backend (optional prototype)

Build for Production

Environment Configuration

Usage

Default Login Credentials

Key Navigation Routes

Cache System Usage

Automatic Caching

Manual Cache Control

Pre-emptive Crawling

Performance Metrics

Production Benchmarks

Cache Statistics (Example)

Architecture

Service Layer

Page Components

Development

Available Scripts

Code Quality Standards

Contributing

Development Workflow

Commit Message Convention

Troubleshooting

Cache Issues

IndexedDB Errors

API Rate Limiting

License

Acknowledgments

Contact & Support

About

Topics

Resources

License

Code of conduct

Contributing

Security policy

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