Merge pull request #22 from inferno-framework/fi-3154-full-ehr-adapti…

…ve-questionnaire-tests

FI-3154: Full EHR Adaptive Questionnaire Tests

.env.development

@@ -1,3 +1,4 @@
 FHIR_RESOURCE_VALIDATOR_URL=http://localhost/hl7validatorapi
 REDIS_URL=redis://localhost:6379/0
 FHIR_REFERENCE_SERVER=http://localhost:8080/reference-server/r4
+FHIRPATH_URL=http://localhost/fhirpath

.env.production

@@ -1,3 +1,4 @@
 REDIS_URL=redis://redis:6379/0
 FHIR_RESOURCE_VALIDATOR_URL=http://hl7_validator_service:3500
 FHIR_REFERENCE_SERVER=https://inferno.healthit.gov/reference-server/r4
+FHIRPATH_URL=http://fhirpath:6789

.env.test

@@ -1,3 +1,4 @@
 FHIR_RESOURCE_VALIDATOR_URL=https://example.com/validatorapi
 ASYNC_JOBS=false
 FHIR_REFERENCE_SERVER=http://example.com/reference-server/r4
+FHIRPATH_URL=https://example.com/fhirpath

config/nginx.background.conf

@@ -68,5 +68,20 @@ http {
 
       proxy_pass http://hl7_validator_service:3500/;
     }
+
+    location /fhirpath/ {
+      proxy_set_header X-Forwarded-For $proxy_add_x_forwarded_for;
+      proxy_set_header Host $http_host;
+      proxy_set_header X-Forwarded-Proto $scheme;
+      proxy_set_header X-Forwarded-Port $server_port;
+      proxy_redirect off;
+      proxy_set_header Connection '';
+      proxy_http_version 1.1;
+      chunked_transfer_encoding off;
+      proxy_buffering off;
+      proxy_cache off;
+
+      proxy_pass http://fhirpath:6789/;
+    }
   }
 }

docker-compose.background.yml

@@ -23,6 +23,10 @@ services:
       # To let the service share your local FHIR package cache,
       # uncomment the below line
       # - ~/.fhir:/home/ktor/.fhir
+  fhirpath:
+    image: infernocommunity/fhirpath-service
+    ports:
+      - "6789:6789"
   nginx:
     image: nginx
     volumes:
@@ -32,6 +36,7 @@ services:
     command: [nginx, '-g', 'daemon off;']
     depends_on:
       - hl7_validator_service
+      - fhirpath
       # - fhir_validator_app
   redis:
     image: redis

docker-compose.yml

@@ -28,6 +28,10 @@ services:
     extends:
       file: docker-compose.background.yml
       service: hl7_validator_service
+  fhirpath:
+    extends:
+      file: docker-compose.background.yml
+      service: fhirpath
   nginx:
     extends:
       file: docker-compose.background.yml

lib/davinci_dtr_test_kit/client_groups/dinner_adaptive/dtr_adaptive_questionnaire_completion_group.rb

@@ -0,0 +1,23 @@
+require_relative 'dtr_adaptive_questionnaire_next_question_retrieval_group'
+
+module DaVinciDTRTestKit
+  class DTRAdaptiveQuestionnaireCompletionGroup < Inferno::TestGroup
+    id :dtr_adaptive_questionnaire_completion
+    title 'Completing the Adaptive Questionnaire'
+    description %(
+      The client makes a final $next-question call, including the answers to all required questions asked so far.
+      Inferno will validate that the request conforms to the [next question operation input parameters profile](http://hl7.org/fhir/uv/sdc/StructureDefinition/parameters-questionnaire-next-question-in)
+      and will update the status of the QuestionnaireResponse resource parameter to `complete`.
+      Inferno will also validate the completed QuestionnaireResponse conformance.
+    )
+
+    config(
+      options: {
+        next_question_prompt_title: 'Last Next Question Request'
+      }
+    )
+    run_as_group
+
+    group from: :dtr_adaptive_questionnaire_next_question_retrieval
+  end
+end

lib/davinci_dtr_test_kit/client_groups/dinner_adaptive/dtr_adaptive_questionnaire_followup_questions_group.rb

@@ -0,0 +1,26 @@
+require_relative 'dtr_adaptive_questionnaire_next_question_retrieval_group'
+
+module DaVinciDTRTestKit
+  class DTRAdaptiveQuestionnaireFollowupQuestionsGroup < Inferno::TestGroup
+    id :dtr_adaptive_questionnaire_followup_questions
+    title 'Retrieving the Next Question'
+    description %(
+      The client makes a subsequent call to request the next question or set of questions
+      using the $next-question operation, and including the answers to all required questions
+      in the questionnaire to this point.
+      Inferno will validate that the request conforms to the [next question operation input parameters profile](http://hl7.org/fhir/uv/sdc/StructureDefinition/parameters-questionnaire-next-question-in)
+      and will provide the next questions accordingly for the tester to complete and attest to pre-population
+      and questionnaire rendering.
+    )
+
+    config(
+      options: {
+        next_question_prompt_title: 'Follow-up Next Question Request'
+      }
+    )
+
+    run_as_group
+
+    group from: :dtr_adaptive_questionnaire_next_question_retrieval
+  end
+end

lib/davinci_dtr_test_kit/client_groups/dinner_adaptive/dtr_adaptive_questionnaire_next_question_request_test.rb

@@ -0,0 +1,93 @@
+require_relative '../../urls'
+
+module DaVinciDTRTestKit
+  class DTRAdaptiveQuestionnaireNextQuestionRequestTest < Inferno::Test
+    include URLs
+
+    id :dtr_adaptive_questionnaire_next_question_request
+    title 'Invoke the $next-question operation'
+    description %(
+      Inferno will wait for the client to invoke the $next-question operation to retrieve the next question
+      or set of questions.
+      Inferno will validate the request body and update the contained Questionnaire to include
+      the next question or set of questions.
+    )
+
+    input :access_token
+
+    def example_client_jwt_payload_part
+      Base64.strict_encode64({ inferno_client_id: access_token }.to_json).delete('=')
+    end
+
+    def request_identification
+      if config.options[:smart_app]
+        "eyJhbGciOiJub25lIn0.#{example_client_jwt_payload_part}"
+      else
+        access_token
+      end
+    end
+
+    def cont_test_description
+      <<~DESCRIPTION
+        ### Continuing the Tests
+
+        When the DTR application has finished loading the Questionnaire,
+        including any clinical data requests to support pre-population,
+        [Click here](#{resume_pass_url}?token=#{access_token}) to continue.
+      DESCRIPTION
+    end
+
+    def next_question_prompt_title
+      config.options[:next_question_prompt_title]
+    end
+
+    def next_question_prompt
+      if next_question_prompt_title&.include?('Initial')
+        'Invoke the $next-question operation by sending a POST request to'
+      elsif next_question_prompt_title&.include?('Last')
+        'Answer the remaining questions and then make a final next-question request by sending a POST request to'
+      else
+        "Answer the 'What do you want for dinner' question and then make a next-question request by sending a POST " \
+          'request to'
+      end
+    end
+
+    def prompt_cont
+      if next_question_prompt_title&.include?('Initial')
+        %(Upon receipt, Inferno will provide the first set of questions to complete.)
+      elsif next_question_prompt_title&.include?('Last')
+        %(Upon receipt, Inferno will update the status of the QuestionnaireResponse
+        resource parameter to `complete`.)
+      else
+        %(Upon receipt, Inferno will provide the next set of questions to complete
+        based on previous answers.)
+      end
+    end
+
+    run do
+      wait(
+        identifier: access_token,
+        message: <<~MESSAGE
+          ### #{next_question_prompt_title}
+
+          #{next_question_prompt}
+
+          `#{next_url}`
+
+          #{prompt_cont}
+
+          ### Request Identification
+
+          In order to identify requests for this session, Inferno will look for
+          an `Authorization` header with value:
+
+          ```
+          Bearer #{request_identification}
+          ```
+
+          #{cont_test_description if config.options[:accepts_multiple_requests]}
+        MESSAGE
+      )
+    end
+  end
+end

lib/davinci_dtr_test_kit/client_groups/dinner_adaptive/dtr_adaptive_questionnaire_next_question_request_validation_test.rb

@@ -0,0 +1,62 @@
+require_relative '../../urls'
+
+module DaVinciDTRTestKit
+  class DTRAdaptiveQuestionnaireNextQuestionRequestValidationTest < Inferno::Test
+    include URLs
+
+    id :dtr_next_question_request_validation
+    title '$next-question request is valid'
+    description %(
+      Per the [OperationDefinition: Adaptive questionnaire next question](https://build.fhir.org/ig/HL7/sdc/OperationDefinition-Questionnaire-next-question.html#root)
+      section in the [Structured Data Capture IG](http://hl7.org/fhir/uv/sdc/ImplementationGuide/hl7.fhir.uv.sdc),
+      the request body for the `$next-question` operation should be a FHIR Parameters resource containing a
+      single parameter with:
+        - name: `questionnaire-response`
+        - resource: A `QuestionnaireResponse` resource
+
+      As outlined in the [FHIR Operation Request](https://hl7.org/fhir/r4/operations.html#request) section of the
+      FHIR specification, if an operation has exactly one input parameter of type Resource, it can also be invoked via
+      a POST request using that resource as the body (with no additional URL parameters).
+
+      This test validates the structure of the `$next-question` request body. It confirms that the body is either a
+      Parameters resource or a QuestionnaireResponse resource.
+
+      If it is a Parameters resource, it must contain one parameter named `questionnaire-response`
+      with a `resource` attribute set to a FHIR QuestionnaireResponse instance, as specified above.
+
+      The QuestionnaireResponse resource's structure and conformance will be validated
+      in the following test ('Adaptive QuestionnaireResponse is valid').
+    )
+
+    def assert_valid_resource_type(resource)
+      type = resource.resourceType
+      valid = ['Parameters', 'QuestionnaireResponse'].include?(type)
+      assert valid, "Request body not valid. Expected Parameters or QuestionnaireResponse, got #{type}"
+    end
+
+    def next_request_tag
+      config.options[:next_tag]
+    end
+
+    run do
+      load_tagged_requests next_request_tag
+      skip_if request.blank?, 'A $next-question request must be made prior to running this test'
+
+      assert request.url == next_url, "Request made to wrong URL: #{request.url}. Should instead be to #{next_url}"
+      assert_valid_json(request.request_body)
+      input_params = FHIR.from_contents(request.request_body)
+      assert input_params.present?, 'Request does not contain a recognized FHIR object'
+      assert_valid_resource_type(input_params)
+
+      if input_params.is_a?(FHIR::Parameters)
+        questionnaire_response_params = input_params.parameter.select { |param| param.name == 'questionnaire-response' }
+        qr_params_count = questionnaire_response_params.length
+        assert qr_params_count == 1,
+               "Input parameter must contain one `parameter:questionnaire-response` slice. Found #{qr_params_count}"
+
+        questionnaire_response =  questionnaire_response_params.first.resource
+        assert_resource_type(:questionnaire_response, resource: questionnaire_response)
+      end
+    end
+  end
+end

lib/davinci_dtr_test_kit/client_groups/dinner_adaptive/dtr_adaptive_questionnaire_next_question_retrieval_group.rb

@@ -0,0 +1,23 @@
+require_relative 'dtr_adaptive_questionnaire_next_question_request_test'
+require_relative 'dtr_adaptive_questionnaire_next_question_request_validation_test'
+require_relative 'dtr_adaptive_questionnaire_response_validation_test'
+
+module DaVinciDTRTestKit
+  class DTRAdaptiveQuestionnaireNextQuestionRetrievalGroup < Inferno::TestGroup
+    id :dtr_adaptive_questionnaire_next_question_retrieval
+    title 'Next Question Request and Validation'
+    description %(
+      Inferno will wait for the client system to request the next question (or set of questions) using the
+      $next-question operation and will return an updated QuestionnaireResponse with a contained Questionnaire
+      that includes the next question (or set of questions) for the tester to complete.
+      Inferno will then validate the conformance of the request.
+    )
+
+    # Test 1: wait for the $next-question request
+    test from: :dtr_adaptive_questionnaire_next_question_request
+    # Test 2: validate the $next-question request
+    test from: :dtr_next_question_request_validation
+    # Test 3: validate the QuestionnaireResponse in the input parameter
+    test from: :dtr_adaptive_questionnaire_response_validation
+  end
+end

lib/davinci_dtr_test_kit/client_groups/dinner_adaptive/dtr_adaptive_questionnaire_response_validation_test.rb

@@ -0,0 +1,66 @@
+require_relative '../../urls'
+require_relative '../../dtr_questionnaire_response_validation'
+
+module DaVinciDTRTestKit
+  class DTRAdaptiveQuestionnaireResponseValidationTest < Inferno::Test
+    include URLs
+    include DTRQuestionnaireResponseValidation
+
+    id :dtr_adaptive_questionnaire_response_validation
+    title 'Adaptive QuestionnaireResponse is valid'
+    description %(
+      This test validates the conformance of the Adative QuestionnaireResponse to the
+      [SDCQuestionnaireResponseAdapt](http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt)
+      structure. It verifies the presence of mandatory elements and that elements
+      with required bindings contain appropriate values.
+
+       It also ensures that all required questions are answered, and that the `origin.source`
+      extension is correct for each answer:
+        - `PBD.1` (Last Name) and `LOC.1` (Location): `auto`
+        - `PBD.2` (First Name): `override`
+        - `3` (all nested dinner questions): `manual`
+
+      Note: For the initial next-question request, only the conformance to the profile is checked
+      since neither the QuestionnaireResponse nor the contained Questionnaire will have any items,
+      as no questions are yet known.
+    )
+
+    def profile_url
+      'http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt'
+    end
+
+    def next_request_tag
+      config.options[:next_tag]
+    end
+
+    run do
+      load_tagged_requests next_request_tag
+      skip_if request.blank?, 'A $next-question request must be made prior to running this test'
+
+      assert request.url == next_url, "Request made to wrong URL: #{request.url}. Should instead be to #{next_url}"
+      assert_valid_json(request.request_body)
+      input_params = FHIR.from_contents(request.request_body)
+      skip_if input_params.blank?, 'Request does not contain a recognized FHIR object'
+
+      questionnaire_response = nil
+      if input_params.is_a?(FHIR::QuestionnaireResponse)
+        questionnaire_response = input_params
+      elsif input_params.is_a?(FHIR::Parameters)
+        questionnaire_response = input_params.parameter&.find do |param|
+          param.name == 'questionnaire-response'
+        end&.resource
+      end
+
+      skip_if questionnaire_response.nil?, 'QuestionnaireResponse resource not provided.'
+      verify_basic_conformance(questionnaire_response.to_json, profile_url)
+
+      questionnaire = questionnaire_response.contained.find { |res| res.resourceType == 'Questionnaire' }
+      check_origin_sources(questionnaire.item, questionnaire_response.item, expected_overrides: ['PBD.2'])
+
+      required_link_ids = extract_required_link_ids(questionnaire.item)
+      check_answer_presence(questionnaire_response.item, required_link_ids)
+
+      assert(messages.none? { |m| m[:type] == 'error' }, 'QuestionnaireResponse is not correct, see error message(s)')
+    end
+  end
+end