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mdro(): infer base drug resistance from drug+inhibitor combination co… (#263)
* mdro(): infer base drug resistance from drug+inhibitor combination columns (#209) When a base beta-lactam column (e.g., piperacillin/PIP) is absent but a corresponding drug+inhibitor combination (e.g., piperacillin/tazobactam/TZP) is present and resistant, resistance in the base drug is now correctly inferred. This is clinically sound: resistance in a combination implies the inhibitor provided no benefit, so the base drug is also resistant. Susceptibility in a combination is NOT propagated to the base drug (the inhibitor may be responsible for susceptibility), so only R values are inferred; missing base drugs remain NA otherwise. Implementation details: - Uses AB_BETALACTAMS_WITH_INHIBITOR to identify all beta-lactam+inhibitor combinations present in the user's data - Derives base drug AB codes by stripping the "/inhibitor" part from names - Creates synthetic proxy columns (.sir_proxy_<AB>) in x, set to "R" when any matching combination is R, otherwise NA - Proxy columns are added to cols_ab before drug variable assignment, so all existing guideline logic benefits without any changes - Multiple combos for the same base drug are OR-ed (any R → R) - Adds internal ab_without_inhibitor() helper for the name->base mapping - Verbose mode reports which combinations are used for inference Bumps version: 3.0.1.9028 -> 3.0.1.9029 https://claude.ai/code/session_01Cp154UtssHg84bw38xiiTG * Add sir.R/mic.R fixes and mdro() unit tests; bump to 3.0.1.9030 R/sir.R (line 571): Guard purely numeric strings (e.g. "1", "8") from the Unicode letter filter. Values matching the broad SIR regex but consisting only of digits must not be stripped; add `x %unlike% "^[0-9+]$"` predicate. R/mic.R (lines 220-222): Preserve the letter 'e' during Unicode-letter removal so that MIC values in scientific notation (e.g. "1e-3", "2.5e-2") survive the cleaning step. - Line 220: [\\p{L}] → [^e\\P{L}] (remove all letters except 'e') - Line 222: [^0-9.><= -]+ → [^0-9e.><= -]+ (allow 'e' in whitelist) tests/testthat/test-mdro.R: New tests for the drug+inhibitor inference added in the previous commit (issue #209): - TZP=R with no PIP column → PIP inferred R → MDRO class elevated - TZP=S with no PIP column → proxy col is NA (not S) → class lower - verbose mode emits "Inferring resistance" message - AMC=R with no AMX column runs without error (Enterococcus faecium) https://claude.ai/code/session_01Cp154UtssHg84bw38xiiTG * Fix version to single bump (9029) and update CLAUDE.md versioning rules CLAUDE.md: Rewrite the "Version and date bump" subsection to document that: - Exactly ONE version bump is allowed per PR (PRs are squash-merged into one commit on the default branch, so one commit = one version increment) - The correct version is computed from git history: currentversion="${currenttag}.$((commits_since_tag + 9001 + 1))" with the +1 accounting for the PR's own squash commit not yet on the default branch - Fall back to incrementing DESCRIPTION's version by 1 if git describe fails - The Date: field tracks the date of the *last* PR commit (updated each time) DESCRIPTION / NEWS.md: Correct the version from 3.0.1.9030 back to 3.0.1.9029. Two version bumps were made across two commits in this PR; since it will be squash-merged as one commit only one bump is correct. Also update Date to today (2026-03-07). https://claude.ai/code/session_01Cp154UtssHg84bw38xiiTG * Fix stats::setNames, test accessor bug, and version script verification R/mdro.R: Qualify setNames() as stats::setNames() in the drug+inhibitor inference block to satisfy R CMD CHECK's global-function checks. tests/testthat/test-mdro.R: mdro() with verbose=FALSE returns an atomic ordered factor, not a data.frame. Fix three test errors introduced in the previous commit: - Line 320: result_no_pip$MDRO -> result_no_pip (factor, no $ accessor) - Line 328: result_tzp_s$MDRO / result_no_pip$MDRO -> direct factor refs - Line 347: expect_inherits(..., "data.frame") -> c("factor","ordered") Also fix the comment on line 347 to match the actual return type. Version: confirmed at 3.0.1.9029 (no further bump; one bump already made this PR). git describe failed (no tags in dev environment) — fallback applies. The +1 in CLAUDE.md's formula is correct for tagged repos: currentcommit + 9001 + 1 = 27 + 9001 + 1 = 9029 ✓ https://claude.ai/code/session_01Cp154UtssHg84bw38xiiTG * Fix unit tests: use mrgn guideline and expect_message() for proxy tests Three failures corrected: 1. Classification tests (lines 321, 329): The EUCAST guideline for P. aeruginosa already has OR logic (PIP OR TZP), so TZP=R alone satisfies it regardless of whether the PIP proxy exists. Switch to guideline="mrgn": the MRGN 4MRGN criterion for P. aeruginosa requires PIP=R explicitly (lines 1488-1496 of mdro.R), with no TZP fallback. Without the proxy: PIP missing -> not 4MRGN -> level 1. With the proxy (TZP=R infers PIP=R): 4MRGN reached -> level 3. The TZP=S case leaves proxy=NA, so PIP is still absent effectively -> level 1, which is < level 3 as expected. 2. Verbose/message test (line 335): message_() routes through message() to stderr, not cat() to stdout. expect_output() only captures stdout so it always saw nothing. Fix: use expect_message() instead, and remove the inner suppressMessages() that was swallowing the message before expect_message() could capture it. Also trim two stale lines left over from the old expect_output block. https://claude.ai/code/session_01Cp154UtssHg84bw38xiiTG --------- Co-authored-by: Claude <noreply@anthropic.com>
This commit is contained in:
Matthijs Berends
GitHub
54
R/mdro.R
54
R/mdro.R
@@ -480,6 +480,50 @@ mdro <- function(x = NULL,
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}
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cols_ab <- cols_ab[!duplicated(cols_ab)]
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# Infer resistance for missing base drugs from available drug+inhibitor combination columns.
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# Clinical principle: resistance in drug+inhibitor (e.g., piperacillin/tazobactam = R)
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# always implies resistance in the base drug (e.g., piperacillin = R), because the
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# enzyme inhibitor adds nothing when the organism is truly resistant to the base drug.
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# NOTE: susceptibility in a combination does NOT imply susceptibility in the base drug
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# (the inhibitor may be responsible), so synthetic proxy columns only propagate R, not S/I.
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.combos_in_data <- AB_BETALACTAMS_WITH_INHIBITOR[AB_BETALACTAMS_WITH_INHIBITOR %in% names(cols_ab)]
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if (length(.combos_in_data) > 0) {
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.base_drugs <- suppressMessages(
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as.ab(gsub("/.*", "", ab_name(as.character(.combos_in_data), language = NULL)))
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)
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.unique_bases <- unique(.base_drugs[!is.na(.base_drugs)])
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for (.base in .unique_bases) {
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.base_code <- as.character(.base)
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if (!.base_code %in% names(cols_ab)) {
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# Base drug column absent; find all available combo columns for this base drug
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.combos <- .combos_in_data[!is.na(.base_drugs) & as.character(.base_drugs) == .base_code]
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.combo_cols <- unname(cols_ab[as.character(.combos)])
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.combo_cols <- .combo_cols[!is.na(.combo_cols)]
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if (length(.combo_cols) > 0) {
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# Vectorised: if ANY combination is R, infer base drug as R; otherwise NA
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.sir_chars <- as.data.frame(
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lapply(x[, .combo_cols, drop = FALSE], function(col) as.character(as.sir(col))),
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stringsAsFactors = FALSE
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)
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.new_col <- paste0(".sir_proxy_", .base_code)
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x[[.new_col]] <- ifelse(rowSums(.sir_chars == "R", na.rm = TRUE) > 0L, "R", NA_character_)
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cols_ab <- c(cols_ab, stats::setNames(.new_col, .base_code))
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if (isTRUE(verbose)) {
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message_(
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"Inferring resistance for ", ab_name(.base_code, language = NULL),
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" from available drug+inhibitor combination(s): ",
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paste(ab_name(as.character(.combos), language = NULL), collapse = ", "),
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" (resistance in a combination always implies resistance in the base drug)",
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add_fn = font_blue
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)
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}
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}
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}
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}
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cols_ab <- cols_ab[!duplicated(names(cols_ab))]
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}
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rm(list = intersect(ls(), c(".combos_in_data", ".base_drugs", ".unique_bases", ".base", ".base_code", ".combos", ".combo_cols", ".sir_chars", ".new_col")))
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# nolint start
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AMC <- cols_ab["AMC"]
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AMK <- cols_ab["AMK"]
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@@ -674,6 +718,16 @@ mdro <- function(x = NULL,
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x
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}
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ab_without_inhibitor <- function(ab_codes) {
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# Get the base drug AB code from a drug+inhibitor combination.
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# e.g., AMC (amoxicillin/clavulanic acid) -> AMX (amoxicillin)
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# TZP (piperacillin/tazobactam) -> PIP (piperacillin)
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# SAM (ampicillin/sulbactam) -> AMP (ampicillin)
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combo_names <- ab_name(ab_codes, language = NULL)
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base_names <- gsub("/.*", "", combo_names)
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suppressMessages(as.ab(base_names))
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}
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# antimicrobial classes
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# nolint start
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aminoglycosides <- c(TOB, GEN)
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4
R/mic.R
4
R/mic.R
@@ -217,9 +217,9 @@ as.mic <- function(x, na.rm = FALSE, keep_operators = "all", round_to_next_log2
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warning_("Some MICs were combined values, only the first values are kept")
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x[x %like% "[0-9]/.*[0-9]"] <- gsub("/.*", "", x[x %like% "[0-9]/.*[0-9]"])
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}
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x <- trimws2(gsub("[\\p{L}]", "", x, perl = TRUE)) # \p{L} is the Unicode category for all letters, including those with diacritics
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x <- trimws2(gsub("[^e\\P{L}]", "", x, perl = TRUE)) # \p{L} is the Unicode category for all letters, including those with diacritics
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# remove other invalid characters
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x <- gsub("[^0-9.><= -]+", "", x, perl = TRUE)
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x <- gsub("[^0-9e.><= -]+", "", x, perl = TRUE)
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# transform => to >= and =< to <=
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x <- gsub("=<", "<=", x, fixed = TRUE)
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x <- gsub("=>", ">=", x, fixed = TRUE)
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2
R/sir.R
2
R/sir.R
@@ -568,7 +568,7 @@ as.sir.default <- function(x,
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x[x %like% "dose"] <- "SDD"
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mtch <- grepl(paste0("(", S, "|", I, "|", R, "|", NI, "|", SDD, "|", WT, "|", NWT, "|", NS, "|[A-Z]+)"), x, perl = TRUE)
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x[!mtch] <- ""
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x[mtch] <- trimws2(gsub("[^\\p{L}]", "", x[mtch], perl = TRUE)) # \p{L} is the Unicode category for all letters, including those with diacritics
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x[mtch & x %unlike% "^[0-9+]$"] <- trimws2(gsub("[^\\p{L}]", "", x[mtch & x %unlike% "^[0-9+]$"], perl = TRUE)) # \p{L} is the Unicode category for all letters, including those with diacritics
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# apply regexes set by user
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x[x %like% S] <- "S"
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x[x %like% I] <- "I"
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