Preventive Care Recommendation

Demographics plus history drive everything here: age and sex select rows in the screening tables, the familyHistory and riskFactors arrays feed the risk table, and firstName and lastName are recombined into the patient name in the final summary while lastCheckup rides along as context.

Five age bands each emit four recommendations into recommendations.ageBasedRecommendations, primary through quaternary. Under 18 centers on annual physicals, immunizations, vision, and six-month dental checkups; 18 to 39 adds depression and skin cancer screening with cholesterol every 5 years; 40 to 49 introduces diabetes screening every 3 years; 50 to 64 adds colorectal cancer screening and moves cholesterol to annual; 65 and older makes diabetes screening annual and adds a fall risk assessment. The bands are mutually exclusive, so the collect hit policy still yields exactly one matching row.

The milestones track published preventive guidance: colorectal screening entering at midlife, cholesterol checks intensifying with age, and fall risk assessment from 65 mirror USPSTF-style recommendations and routine geriatric practice. Band edges are simplified for the template, which is why colorectal screening appears at 50 here even though current US guidance has moved the start age to 45.

Sex and an age interval combine in every row, and collect gathers whichever applies. Women aged [21..30) get cervical cancer screening every 3 years plus annual chlamydia screening, [30..40) swaps in HPV testing every 5 years, [40..50) starts mammograms every 1-2 years framed as a discussion with the doctor, and [50..75) moves to mammograms every 2 years with bone density screening noted for 65 plus. Men have two bands: [40..55) pairs a prostate health discussion with a testicular exam, and [55..70) adds prostate cancer screening plus abdominal aortic aneurysm screening for those who ever smoked.

The intervals map closely onto real US screening guidance: cervical cytology from age 21, HPV testing options in the 30s, biennial mammography from 50 with an individualized-decision window in the 40s, shared decision-making on prostate screening from 55, and AAA screening reserved for older men with a smoking history. Upper bounds like 75 reflect the evidence-based stopping ages in those same recommendations rather than arbitrary limits.

Seven independent contains() checks run under a collect policy, so every matching history or lifestyle item appends its own line to recommendations.riskBasedRecommendations. Family history of diabetes, heart disease, colorectal cancer, or breast cancer each pull the relevant screening earlier and make it more frequent, with the colorectal row explicitly targeting screening before age 45, while riskFactors entries add lung cancer screening for smoking, extra diabetes and heart checks for obesity, and liver function tests for alcohol abuse.

First-degree family history genuinely shifts screening start ages in clinical guidelines, most visibly for colorectal and breast cancer where earlier surveillance is standard in affected families, and low-dose CT lung screening is indicated by smoking history rather than age alone. Collect is the right policy because risk factors stack: a smoker with a family history of diabetes should see both recommendations, not whichever row sits higher.

Consolidation folds the age, sex, and risk outputs into one flat summarizedRecommendations list by flattening values(recommendations), counts it into totalRecommendations, and formats patientName from firstName and lastName alongside a recommendationDate stamped from the current date. A testResults key is set to null as a placeholder, and with passThrough off the response is the summary alone rather than the nested intermediate structure.