test(recall): verify-recall.sql 同步 gap 核心六类修复 — 新增 4 个解释桶

扫描器独立重实现召回逻辑,不补会把新排除误报成"真·无法解释 FN"。
- 拆线→surgical、ICD K00→K08:数据层改动,reparse 后扫描器自动读到,无需改 SQL;
- 固定桥/检查文本/无意愿/外院:补 vt_bridge / vt_norestor / vt_refusal / vt_external
  四张解释表,接入 §C3/§C4/§C6 归因桶(7a/7b/7c/7d、3b)。
本地 21 人跑通无错,新桶正确归类(7a 固定桥 3、7b 检查文本 3)。

Co-Authored-By: Claude Fable 5 <noreply@anthropic.com>

apps/pac-service/sql/verify-recall.sql

@@ -89,6 +89,53 @@ CREATE TEMP TABLE vt_ortho_pt AS
   UNION SELECT DISTINCT patient_id FROM patient_facts WHERE type='treatment_record' AND content->>'category'='orthodontic';
 CREATE INDEX ON vt_ortho_pt(patient_id); ANALYZE vt_ortho_pt;
 
+-- ── 新排除解释表(对齐 gap 核心 2026-06 六类修复;拆线/ICD 已随 reparse 自动正确,无需表)──
+-- (2) 固定桥跨度:同一牙弓 ≥2 颗 prosthodontic actual → 基牙跨度区间内全牙位计入已修复
+CREATE TEMP TABLE vt_bridge AS
+WITH bt AS (
+  SELECT t.patient_id,
+    CASE substr(tk,1,1) WHEN '1' THEN 9-substr(tk,2,1)::int WHEN '2' THEN 8+substr(tk,2,1)::int
+                        WHEN '4' THEN 9-substr(tk,2,1)::int WHEN '3' THEN 8+substr(tk,2,1)::int END AS idx,
+    CASE WHEN substr(tk,1,1) IN('1','2') THEN 'U' ELSE 'L' END AS arch
+  FROM patient_facts t
+  CROSS JOIN LATERAL unnest(string_to_array(regexp_replace(coalesce(t.content->>'tooth_position',''),'[^0-9;]+',';','g'),';')) tk
+  WHERE t.type='treatment_record' AND t.kind='actual' AND t.status IN('active','fulfilled')
+    AND t.content->>'category'='prosthodontic' AND tk ~ '^[1-4][1-8]$'
+), span AS (SELECT patient_id, arch, min(idx) mi, max(idx) ma FROM bt GROUP BY patient_id, arch HAVING count(*)>=2)
+SELECT s.patient_id,
+  CASE WHEN s.arch='U' THEN CASE WHEN gi<=8 THEN '1'||(9-gi)::text ELSE '2'||(gi-8)::text END
+       ELSE CASE WHEN gi<=8 THEN '4'||(9-gi)::text ELSE '3'||(gi-8)::text END END AS tooth
+FROM span s CROSS JOIN generate_series(s.mi, s.ma) gi;
+CREATE INDEX ON vt_bridge(patient_id, tooth); ANALYZE vt_bridge;
+
+-- (3) 检查文本无修复指征:emr exam_findings 牙位 message "缺牙+间隙关闭/无修复间隙/间隙不足"
+CREATE TEMP TABLE vt_norestor AS
+SELECT src.patient_id, tk AS tooth
+FROM (SELECT patient_id, content->>'exam_findings' AS ef_text FROM patient_facts
+      WHERE type='emr_record' AND status IN('active','fulfilled')
+        AND content->>'exam_findings' ~ '^\[' AND content->>'exam_findings' ~ '缺[牙失]'
+        AND content->>'exam_findings' ~ '间隙关闭|间隙已关闭|无修复间隙|间隙不足') src
+CROSS JOIN LATERAL jsonb_array_elements(src.ef_text::jsonb) ef
+CROSS JOIN LATERAL unnest(string_to_array(regexp_replace(coalesce(ef->>'toothPosition',''),'[^0-9;]+',';','g'),';')) tk
+WHERE ef->>'message' ~ '缺[牙失]' AND ef->>'message' ~ '间隙关闭|间隙已关闭|无修复间隙|间隙不足' AND tk ~ '^[0-9]{2}$';
+CREATE INDEX ON vt_norestor(patient_id, tooth); ANALYZE vt_norestor;
+
+-- (4) 患者无意愿(按牙位):treatment subtype 含无意愿/不愿/拒绝(任意 kind)
+CREATE TEMP TABLE vt_refusal AS
+SELECT t.patient_id, t.content->>'category' AS cat, tk AS tooth, COALESCE(t.occurred_at,t.planned_for) AS at
+FROM patient_facts t
+CROSS JOIN LATERAL unnest(string_to_array(regexp_replace(coalesce(t.content->>'tooth_position',''),'[^0-9;]+',';','g'),';')) tk
+WHERE t.type='treatment_record' AND t.status IN('active','fulfilled')
+  AND t.content->>'subtype' ~ '无意愿|不愿|拒绝' AND tk ~ '^[0-9]{2}$';
+CREATE INDEX ON vt_refusal(patient_id, tooth); ANALYZE vt_refusal;
+
+-- (5) 外院已治疗(回访记录 result,患者级 + 治疗日)
+CREATE TEMP TABLE vt_external AS
+SELECT DISTINCT patient_id, task_date AS at FROM patient_return_visits
+WHERE result ~ '(外院|他院|别院|别的医院|其他医院|换了医院)[^，；。]{0,3}(治疗|种植|矫正|矫治|修复|根管|补牙|做了|做过)|(治疗|种植|矫正|矫治|修复|根管|补牙|做了|做过)[^，；。]{0,3}(外院|他院|别院|别的医院|其他医院)'
+  AND result !~ '(建议|打算|考虑|可能|拟|会去|要去|去咨询|去看|咨询了|不考虑)[^，；。]{0,8}(外院|他院|别院|别的?医院|其他医院)';
+CREATE INDEX ON vt_external(patient_id); ANALYZE vt_external;
+
 -- ── 分类(EXISTS 全打索引临时表,秒级)──
 CREATE TEMP TABLE vt_final AS
 SELECT d.patient_id, d.code, d.sub, d.tooth, d.dx_at, d.name_zh,
@@ -104,7 +151,12 @@ SELECT d.patient_id, d.code, d.sub, d.tooth, d.dx_at, d.name_zh,
   (d.code='K08' AND d.tooth ~ '^[1-4]8$') AS x_thirdmolar,
   (d.code='K08' AND COALESCE(d.name_zh,'') LIKE '%先天%') AS x_congenital,
   (d.code='K08' AND d.patient_id IN (SELECT patient_id FROM vt_ortho_pt)
-     AND EXISTS(SELECT 1 FROM vt_treat t WHERE t.patient_id=d.patient_id AND t.tooth=d.tooth AND t.cat='surgical')) AS x_orthoextract
+     AND EXISTS(SELECT 1 FROM vt_treat t WHERE t.patient_id=d.patient_id AND t.tooth=d.tooth AND t.cat='surgical')) AS x_orthoextract,
+  -- 2026-06 六类修复对齐(固定桥/检查文本/无意愿/外院)
+  EXISTS(SELECT 1 FROM vt_bridge b WHERE b.patient_id=d.patient_id AND b.tooth=d.tooth) AS x_bridge,
+  EXISTS(SELECT 1 FROM vt_norestor n WHERE n.patient_id=d.patient_id AND n.tooth=d.tooth) AS x_norestor,
+  EXISTS(SELECT 1 FROM vt_refusal rf WHERE rf.patient_id=d.patient_id AND rf.tooth=d.tooth AND rf.cat=ANY(d.resolver) AND rf.at>=d.dx_at) AS x_refusal,
+  EXISTS(SELECT 1 FROM vt_external xe WHERE xe.patient_id=d.patient_id AND xe.at>=d.dx_at::date) AS x_external
 FROM vt_diag d;
 ANALYZE vt_final;
 
@@ -139,6 +191,10 @@ SELECT *,
     WHEN x_inelig OR x_decid               THEN '4_废用牙/乳牙'
     WHEN x_thirdmolar OR x_congenital OR x_orthoextract THEN '5_§E剔除(智齿/先天/正畸减数)'
     WHEN x_superseded                      THEN '6_同牙更晚诊断取代'
+    WHEN x_bridge                          THEN '7a_固定桥跨度修复'
+    WHEN x_norestor                        THEN '7b_检查文本无修复指征'
+    WHEN x_refusal                         THEN '7c_患者无意愿(拒绝该类)'
+    WHEN x_external                        THEN '7d_外院已治疗(回访)'
     ELSE                                        '9_真·无法解释'
   END AS bucket
 FROM vt_final WHERE NOT resolved AND NOT recalled;
@@ -163,14 +219,14 @@ SELECT
 FROM vt_final
 WHERE NOT resolved AND NOT recalled
   AND (x_future OR x_recent)
-  AND NOT (x_inelig OR x_decid OR x_thirdmolar OR x_congenital OR x_orthoextract OR x_superseded);
+  AND NOT (x_inelig OR x_decid OR x_thirdmolar OR x_congenital OR x_orthoextract OR x_superseded OR x_bridge OR x_norestor OR x_refusal OR x_external);
 \echo '---- 可疑漏召样例(人审:这颗牙的诊断,该次到诊/未来预约是否真处理?)----'
 SELECT code, sub, substr(patient_id::text,1,8) pid, tooth, dx_at::date, name_zh,
   CASE WHEN x_future THEN '未来预约⑤b' ELSE '近期到诊⑤f' END AS 豁免来源
 FROM vt_final
 WHERE NOT resolved AND NOT recalled
   AND (x_future OR x_recent)
-  AND NOT (x_inelig OR x_decid OR x_thirdmolar OR x_congenital OR x_orthoextract OR x_superseded)
+  AND NOT (x_inelig OR x_decid OR x_thirdmolar OR x_congenital OR x_orthoextract OR x_superseded OR x_bridge OR x_norestor OR x_refusal OR x_external)
 ORDER BY code, tooth LIMIT 30;
 
 \echo '════════ §D 全口码 治疗后复发被压(excludeIfEverTreated)════════'
@@ -256,7 +312,11 @@ SELECT d.patient_id, d.code, d.sub, d.tooth, d.dx_at, d.name_zh,
   (d.code='K08' AND d.tooth ~ '^[1-4]8$') AS x_thirdmolar,
   (d.code='K08' AND COALESCE(d.name_zh,'') LIKE '%先天%') AS x_congenital,
   (d.code='K08' AND d.patient_id IN (SELECT patient_id FROM vt_ortho_pt)
-     AND EXISTS(SELECT 1 FROM vt_treat t WHERE t.patient_id=d.patient_id AND t.tooth=d.tooth AND t.cat='surgical')) AS x_orthoextract
+     AND EXISTS(SELECT 1 FROM vt_treat t WHERE t.patient_id=d.patient_id AND t.tooth=d.tooth AND t.cat='surgical')) AS x_orthoextract,
+  EXISTS(SELECT 1 FROM vt_bridge b WHERE b.patient_id=d.patient_id AND b.tooth=d.tooth) AS x_bridge,
+  EXISTS(SELECT 1 FROM vt_norestor n WHERE n.patient_id=d.patient_id AND n.tooth=d.tooth) AS x_norestor,
+  EXISTS(SELECT 1 FROM vt_refusal rf WHERE rf.patient_id=d.patient_id AND rf.tooth=d.tooth AND rf.cat=ANY(d.resolver) AND rf.at>=d.dx_at) AS x_refusal,
+  EXISTS(SELECT 1 FROM vt_external xe WHERE xe.patient_id=d.patient_id AND xe.at>=d.dx_at::date) AS x_external
 FROM vt_diag_raw d;
 ANALYZE vt_final_raw;
 
@@ -273,6 +333,7 @@ SELECT *,
     WHEN x_compliance                                   THEN '1_合规闸(已故/勿扰/停用)'
     WHEN x_inelig OR x_decid                             THEN '2_废用牙/乳牙'
     WHEN x_thirdmolar OR x_congenital OR x_orthoextract  THEN '3_§E剔除(智齿/先天/正畸减数)'
+    WHEN x_bridge OR x_norestor OR x_refusal OR x_external THEN '3b_六类修复(桥跨度/无修复指征/无意愿/外院)'
     WHEN x_cooldown                                      THEN '4_冷静期内(页面可见,未到召回时机)'
     WHEN x_future                                        THEN '5_⚠软豁免·未来预约⑤b(患者级blanket,不证明本牙被处理)'
     WHEN x_recent                                        THEN '6_⚠软豁免·近期到诊⑤f(患者级,同上)'