clinical-safety-review

name: clinical-safety-review description: "Validate clinical/medical content for patient safety — correct visual hierarchy, no truncated safety information, proper tier assignment. Use this skill whenever touching clinical content in PANaCEa: reference configs, drug information, lab values, scoring systems, procedure details, clinical calculators, or any component that displays medical information a PA student might act on. Also trigger when the user mentions safety review, clinical audit, content review, or patient safety."

Clinical Safety Review

PANaCEa is a medical education platform used by PA students during clinical rotations and PANCE preparation. Content displayed in this app may directly inform clinical decisions. This skill ensures every piece of safety-critical information is visually distinct, never truncated, and correctly categorized.

Why This Matters

A PA student reviewing a drug reference card during a rotation might glance at it for 3 seconds. If "contraindicated in pregnancy" is rendered with the same visual weight as "commonly tested on PANCE," that's not a styling preference — it's a patient safety failure. The three-tier visual hierarchy exists specifically to prevent this.

Safety Content Classification

When reviewing or creating clinical content, classify every field into one of these categories:

CRITICAL (Tier 1) — Must use detailSectionCritical() or detailListCritical()

Content where missing it could lead to patient harm:

• Contraindications — absolute and relative (drugs, procedures, imaging)
• Critical lab values — values requiring immediate clinical action
• Emergency/acute management — what to do RIGHT NOW
• Decompensation signs — signals a patient is deteriorating
• Red flag responses — history findings that demand urgent workup
• "When NOT to use" — scoring system misapplication warnings
• Drug interactions — major/life-threatening interactions
• Black box warnings — FDA-mandated safety warnings
• Complications — serious procedural complications

Visual signature: red left-border (#ef4444), AlertTriangle icon, tinted background.

CLINICAL (Tier 2) — Standard detailSection() / detailList()

Factual clinical information that's important but not immediately dangerous if missed:

• Descriptions, mechanisms, pathophysiology
• Indications, typical use, clinical context
• Technique, procedure steps
• Interpretation guidance
• Reference ranges (non-critical)
• Sensitivity/specificity, diagnostic accuracy
• Associated conditions, differential diagnosis

STUDY (Tier 3) — studyPanel() accordion

Board-prep material that helps learning but isn't clinical reference:

• Board yield facts, clinical pearls
• Test question tips, common mistakes
• Mnemonics, memory aids
• PANCE-specific study notes

Review Checklist

When reviewing any file that renders clinical content, check each of these:

1. Tier Assignment Audit

For every field rendered in a detailRenderer, verify the correct tier:

• Grep for safety-relevant terms: contraindic, critical, emergency, acute, decompensation, red.flag, when.not, black.box, complication, interaction
• Each match should use detailSectionCritical() or detailListCritical(), NOT detailSection() or detailList()
• If a field name contains these terms but uses standard rendering, flag it as a HIGH severity issue

2. Truncation Audit

No expanded clinical content should ever be clipped:

• Search for overflow: hidden, textOverflow, ellipsis, max-height, line-clamp in detail renderers
• These are ONLY acceptable on collapsed card previews (inside !expanded conditionals)
• In detailRenderer, detailSection, detailSectionCritical, detailList — content must be unbounded

3. Completeness Audit

Safety fields that exist in the data type but aren't rendered:

• Compare the TypeScript interface fields against what the detailRenderer actually displays
• Any safety-classified field that exists on the type but is missing from the renderer is a HIGH severity gap
• Pay special attention to optional arrays — contraindications?: string[] might exist but never get rendered if the config was written before the data was populated

4. Ordering Audit

Within each detail view, content should follow this order:

1. Study panel (PANCE Focus accordion) — at the very top
2. Critical sections (Tier 1) — immediately visible
3. Clinical sections (Tier 2) — main body
4. Cross-reference hints — at the bottom

If critical sections are buried below 5+ clinical sections, flag it. Students scanning quickly should see safety information without scrolling past routine content.

Common Mistakes to Catch

1. New entity config copies from existing one but drops safety fields — when a developer copies procedureConfig to create a new config, they may remove fields they think are irrelevant, accidentally dropping safety sections.

2. Pluralization confusion — contraindication (singular) vs contraindications (plural) vs absoluteContraindications + relativeContraindications. Make sure the grep catches all variants.

3. JSON-stringified safety data — some fields arrive as string | string[] or even nested objects. If the renderer does JSON.stringify(field) for a safety field, flag it — raw JSON is not a safe way to display clinical warnings.

4. Conditional rendering hides safety content — {data.contraindications && detailSectionCritical(...)} is correct, but {showAdvanced && data.contraindications && ...} behind a toggle is dangerous — safety content should never be behind an extra click.

Integration with Other Skills

This skill stacks with:

• panacea-style-system — provides the actual rendering helpers and tier definitions
• panacea-verify — after making changes, verify transpilation passes
• panacea-component-sprint — during improvement sprints, run this review on every modified config