Fix HBV Assessment Response

core/hbv_assessment.py

@@ -276,26 +276,29 @@ IMPORTANT JSON FORMATTING:
 - You MUST use "\\n" to indicate line breaks inside the "recommendations" string and format the content as clear bullet lists prefixed with "- ".
 - Do NOT include literal newline characters. Use \\n for every new bullet or line.
 
-STRUCTURE AND CONTENT OF "recommendations":
-- Start with a section title: "Eligibility and Rationale:" followed by bullets.
-- Then sections in this order, each as a header line and bulleted items below (all within the same string, separated by \\n):
-  - "Criteria Met/Not Met:"
-  - "First-line Treatment Options:"
-  - "Monitoring and Follow-up:"
-  - "Special Considerations:"
-  - "Additional Notes:"
-  - "References:"
+STRUCTURE AND CONTENT OF "recommendations" (CONCISE & ORGANIZED):
+- Use ONLY these sections in this exact order, each as a header followed by 1-3 concise bullets:
+  1. "Eligibility and Rationale:" (1-2 bullets max)
+  2. "Treatment Recommendations:" (1-3 bullets: first-line drugs if eligible, or "Not applicable" if not eligible)
+  3. "Monitoring and Follow-up:" (1-2 bullets)
+  4. "Special Considerations:" (0-2 bullets, ONLY if applicable to this patient)
+  5. "References:" (1 line listing pages cited)
+
+- OMIT "Additional Notes" and any other sections.
+- Keep each bullet to ONE sentence (max 25 words per bullet).
+- Total output: aim for 8-12 bullets maximum across all sections.
 
 BULLETING AND CITATIONS RULES:
-- Put citations at the end of each bullet, not after every clause, using "[SASLT 2021, Page X]".
-- Include evidence grade in the bullet when available (e.g., "(Grade A)") if present in the guideline text.
-- Only cite pages present in the provided context (6–10). Cite the page that actually contains the information.
+- Put citations at the end of each bullet using "[SASLT 2021, Page X]".
+- Include evidence grade when available (e.g., "(Grade A)").
+- Only cite pages 6–10 that actually contain the information.
 
 STRICT ACCURACY AND CONSISTENCY RULES:
-- Do NOT contradict yourself. Ensure eligibility conclusion and rationale are consistent with all bullets.
+- Do NOT contradict yourself. Ensure eligibility conclusion matches all bullets.
 - Use ONLY the provided SASLT 2021 content; do NOT add external knowledge.
-- Numeric thresholds and wording must match the guideline text exactly when quoted or summarized.
-- If info is not present in the provided pages, do not state it or cite it.
+- Numeric thresholds must match the guideline text exactly.
+- If info is not in the provided pages, do not state it or cite it.
+- BREVITY: Each bullet = 1 sentence, max 25 words. Total = 8-12 bullets max.
 
 PAGE-TO-TOPIC MAPPING GUIDANCE (for correct citations):
 - Page 6: Initiation of treatment, management algorithm, start of monitoring of untreated patients.
@@ -304,20 +307,19 @@ PAGE-TO-TOPIC MAPPING GUIDANCE (for correct citations):
 - Page 9: Special populations (HBV-HCV, HBV-HDV, HBV-HIV, immunocompromised).
 - Page 10: Pregnancy-related recommendations (late pregnancy prophylaxis, breastfeeding, switching).
 
-EXAMPLE OUTPUT STYLE (illustrative only; adapt to patient data):
-- Eligibility and Rationale:\n- Eligible due to HBV DNA > 2,000 IU/mL with ALT > ULN and/or moderate fibrosis (Grade A) [SASLT 2021, Page 6]\n- Cirrhosis with any detectable HBV DNA warrants treatment regardless of ALT (Grade A) [SASLT 2021, Page 6]
-- Criteria Met/Not Met:\n- HBV DNA level criterion: met (> 2,000 IU/mL) [SASLT 2021, Page 6]\n- ALT criterion: met (> ULN) [SASLT 2021, Page 6]\n- HBeAg-positive >30 years with high DNA and normal ALT (if applicable): met/not met (Grade D) [SASLT 2021, Page 6]
-- First-line Treatment Options:\n- Start monotherapy with ETV, TDF, or TAF (Grade A) [SASLT 2021, Page 8]
-- Monitoring and Follow-up:\n- If untreated, monitor per HBeAg status and DNA thresholds as specified [SASLT 2021, Pages 6–7]
-- Special Considerations:\n- If coinfected with HCV and meeting HBV criteria, treat concurrently or before DAAs (Grade A) [SASLT 2021, Page 8]\n- If immunocompromised, initiate prophylaxis before immunosuppression (Grade A) [SASLT 2021, Page 9]\n- Pregnancy-specific actions per DNA threshold and timing (if applicable) [SASLT 2021, Page 10]
-- References:\n- List all cited pages in ascending order with brief topic labels
-
-IMPORTANT:
-1. Base your assessment ONLY on the SASLT 2021 guidelines provided.
-2. Make recommendations concise, bulleted, and free of contradictions.
-3. Put a proper citation at the end of each bullet using the exact page that contains the information.
-4. End with a "References:" section listing the pages cited in ascending order with short topic labels.
-5. Return ONLY the JSON object, no additional text.
+EXAMPLE OUTPUT (ELIGIBLE PATIENT):
+Eligibility and Rationale:\n- Eligible: HBV DNA > 2,000 IU/mL, ALT > ULN, moderate fibrosis (Grade A) [SASLT 2021, Page 6]\nTreatment Recommendations:\n- Start monotherapy with ETV, TDF, or TAF (Grade A) [SASLT 2021, Page 8]\nMonitoring and Follow-up:\n- Monitor treatment response per SASLT protocol [SASLT 2021, Page 7]\nSpecial Considerations:\n- HBV-HIV coinfection: use TDF- or TAF-based ART (Grade A) [SASLT 2021, Page 9]\nReferences:\n- Pages 6, 7, 8, 9: Treatment criteria, drugs, monitoring, HIV coinfection
+
+EXAMPLE OUTPUT (NOT ELIGIBLE PATIENT):
+Eligibility and Rationale:\n- Not eligible: HBV DNA < 2,000 IU/mL, ALT ≤ ULN, no significant fibrosis [SASLT 2021, Page 6]\nTreatment Recommendations:\n- Treatment not indicated at this time [SASLT 2021, Page 6]\nMonitoring and Follow-up:\n- Monitor every 6-12 months (HBeAg-negative, HBV DNA < 2,000 IU/mL) (Grade B) [SASLT 2021, Page 7]\nReferences:\n- Pages 6, 7: Treatment criteria, monitoring protocols
+
+CRITICAL REQUIREMENTS:
+1. Base assessment ONLY on SASLT 2021 guidelines provided.
+2. Keep output SHORT: 8-12 bullets total, 1 sentence per bullet (max 25 words).
+3. Use ONLY the 5 sections listed above (omit "Additional Notes" and "Criteria Met/Not Met").
+4. Cite exact page at end of each bullet: [SASLT 2021, Page X].
+5. End with "References:" listing pages in ascending order.
+6. Return ONLY valid JSON, no markdown, no extra text.
 """