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Allow symptoms to be highlighted to image readers #1386

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194faa5
Allow symptoms to be highlighted to image readers
swebberuk Apr 28, 2026
addf244
Only set heading_description for symptoms that use it
swebberuk Apr 30, 2026
e193146
Add symptoms_summary for displaying symptoms
swebberuk May 1, 2026
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18 changes: 18 additions & 0 deletions manage_breast_screening/mammograms/forms/symptom_forms.py
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Original file line number Diff line number Diff line change
Expand Up @@ -19,6 +19,7 @@
from manage_breast_screening.nhsuk_forms.forms import FormWithConditionalFields
from manage_breast_screening.nhsuk_forms.utils import YesNo, yes_no, yes_no_field
from manage_breast_screening.participants.models.symptom import (
HighlightToReaderChoices,
NippleChangeChoices,
RelativeDateChoices,
SkinChangeChoices,
Expand Down Expand Up @@ -80,6 +81,13 @@ class CommonFields:
widget=Textarea(attrs={"rows": 5}),
error_messages={"required": "Enter details of any investigations"},
)
highlight_to_readers = ChoiceField(
choices=HighlightToReaderChoices,
label="Highlight this symptom to readers?",
error_messages={
"required": "Select whether this symptom should be highlighted to image readers"
},
)
additional_information = CharField(
required=False,
label="Additional info (optional)",
Expand Down Expand Up @@ -151,6 +159,9 @@ def initial_values(self, instance):
"when_resolved": instance.when_resolved,
"investigated": yes_no(instance.investigated),
"investigation_details": instance.investigation_details,
"highlight_to_readers": HighlightToReaderChoices.YES
if instance.highlight_to_readers
else HighlightToReaderChoices.NO,
"additional_information": instance.additional_information,
}

Expand Down Expand Up @@ -184,6 +195,10 @@ def model_values(self):
intermittent = self.cleaned_data.get("intermittent", False)
recently_resolved = self.cleaned_data.get("recently_resolved", False)
when_resolved = self.cleaned_data.get("when_resolved", "")
highlight_to_readers = (
self.cleaned_data.get("highlight_to_readers", HighlightToReaderChoices.YES)
== HighlightToReaderChoices.YES
)
additional_information = self.cleaned_data.get("additional_information", "")

return dict(
Expand All @@ -199,6 +214,7 @@ def model_values(self):
intermittent=intermittent,
recently_resolved=recently_resolved,
when_resolved=when_resolved,
highlight_to_readers=highlight_to_readers,
additional_information=additional_information,
)

Expand Down Expand Up @@ -470,6 +486,7 @@ class OtherSymptomForm(SymptomForm):
when_resolved = CommonFields.when_resolved
investigated = CommonFields.investigated
investigation_details = CommonFields.investigation_details
highlight_to_readers = CommonFields.highlight_to_readers
additional_information = CommonFields.additional_information

def __init__(self, instance=None, **kwargs):
Expand Down Expand Up @@ -514,6 +531,7 @@ class BreastPainForm(SymptomForm):
when_resolved = CommonFields.when_resolved
investigated = CommonFields.investigated
investigation_details = CommonFields.investigation_details
highlight_to_readers = CommonFields.highlight_to_readers
additional_information = CommonFields.additional_information

def __init__(self, instance=None, **kwargs):
Expand Down
22 changes: 19 additions & 3 deletions manage_breast_screening/mammograms/jinja2/mammograms/medical_information/section_cards.jinja
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Expand Up @@ -97,9 +97,7 @@
{% set symptom_rows = presented_medical_info.read_only_symptom_rows if read_only else presented_medical_info.symptom_rows %}
<p {%- if not read_only and not symptom_rows %} class="nhsuk-u-margin-bottom-3"{% endif %}>Any problems or symptoms, including lumps, swelling, rashes or nipple changes</p>
{% if symptom_rows %}
{{ summaryList({
"rows": symptom_rows
}) }}
{{ symptoms_summary(symptom_rows) }}
{% else %}
{% set insetHtml %}
<p>No symptoms have been recorded for this participant.</p>
Expand Down Expand Up @@ -244,3 +242,21 @@
]
}) }}
{% endmacro %}

{% macro symptoms_summary(symptom_rows, classes='') %}
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Contributor Author

@swebberuk swebberuk May 1, 2026

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symptoms_summary adds "Highlight to image readers" tag if required, then calls summaryList.

Alternative to formatting HTML in SymptomPresenter.

{% set rows = [] %}
{% for row in symptom_rows %}
{% set key_html %}
{{ row.symptom_name }}
{% if row.highlight_to_readers %}
<br><strong class="nhsuk-tag app-nowrap nhsuk-tag--yellow">Highlight to image readers</strong>
{% endif %}
{% endset %}
{% set _ = rows.append({
"key": {"html": key_html},
"value": {"html": row.html},
"actions": row.actions if row.actions else {"items": []}
}) %}
{% endfor %}
{{ summaryList({"rows": rows, "classes": classes}) }}
{% endmacro %}
7 changes: 2 additions & 5 deletions ...ening/mammograms/jinja2/mammograms/medical_information/symptoms/confirm_delete_lump.jinja
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@@ -1,12 +1,9 @@
{% extends "layout-confirmation.jinja" %}
{% from 'nhsuk/components/summary-list/macro.jinja' import summaryList %}
{% from "mammograms/medical_information/section_cards.jinja" import symptoms_summary %}
{% from 'nhsuk/components/inset-text/macro.jinja' import insetText %}

{% block details %}
{{ summaryList({
"rows": [summary_list_row],
"classes": "nhsuk-summary-list--no-border"
}) }}
{{ symptoms_summary([summary_list_row], classes="nhsuk-summary-list--no-border") }}

{% set insetTextHtml %}
<p>This action is final and cannot be undone.</p>
Expand Down
2 changes: 2 additions & 0 deletions ...reening/mammograms/jinja2/mammograms/medical_information/symptoms/forms/breast_pain.jinja
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Expand Up @@ -30,6 +30,8 @@

{{ form.investigated.as_field_group() }}

{{ form.highlight_to_readers.as_field_group() }}

{{ form.additional_information.as_field_group() }}

<div class="nhsuk-button-group">
Expand Down
6 changes: 6 additions & 0 deletions ...ening/mammograms/jinja2/mammograms/medical_information/symptoms/forms/nipple_change.jinja
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Expand Up @@ -3,6 +3,12 @@
{% from "nhsuk/components/fieldset/macro.jinja" import fieldset %}

{% block form %}
{% if heading_description %}
<div class="nhsuk-inset-text nhsuk-u-margin-top-0 nhsuk-u-margin-bottom-4">
<p>{{ heading_description }}</p>
</div>
{% endif %}

{% do form.symptom_sub_type.add_conditional_html('NIPPLE_CHANGE_OTHER', form.symptom_sub_type_details.as_field_group()) %}

{% do form.when_started.add_divider_after("OVER_THREE_YEARS", "or") %}
Expand Down
2 changes: 2 additions & 0 deletions ...ast_screening/mammograms/jinja2/mammograms/medical_information/symptoms/forms/other.jinja
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Original file line number Diff line number Diff line change
Expand Up @@ -32,6 +32,8 @@

{{ form.investigated.as_field_group() }}

{{ form.highlight_to_readers.as_field_group() }}

{{ form.additional_information.as_field_group() }}

<div class="nhsuk-button-group">
Expand Down
6 changes: 6 additions & 0 deletions ...reening/mammograms/jinja2/mammograms/medical_information/symptoms/forms/skin_change.jinja
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Expand Up @@ -3,6 +3,12 @@
{% from "nhsuk/components/fieldset/macro.jinja" import fieldset %}

{% block form %}
{% if heading_description %}
<div class="nhsuk-inset-text nhsuk-u-margin-top-0 nhsuk-u-margin-bottom-4">
<p>{{ heading_description }}</p>
</div>
{% endif %}

{% include "mammograms/medical_information/symptoms/forms/inline_area_radios.jinja" %}

{% do form.symptom_sub_type.add_conditional_html('SKIN_CHANGE_OTHER', form.symptom_sub_type_details.as_field_group()) %}
Expand Down
5 changes: 3 additions & 2 deletions manage_breast_screening/mammograms/presenters/symptom_presenter.py
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Expand Up @@ -140,8 +140,9 @@ def build_summary_list_row(self, include_actions=True):
)

result = {
"key": {"text": self._symptom.symptom_type.name},
"value": {"html": html},
"symptom_name": self._symptom.symptom_type.name,
"highlight_to_readers": self._symptom.highlight_to_readers,
"html": html,
}

if include_actions:
Expand Down
13 changes: 13 additions & 0 deletions manage_breast_screening/mammograms/tests/forms/test_symptom_forms.py
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Expand Up @@ -19,6 +19,7 @@
)
from manage_breast_screening.nhsuk_forms.choices import YesNo
from manage_breast_screening.participants.models.symptom import (
HighlightToReaderChoices,
NippleChangeChoices,
SkinChangeChoices,
SymptomAreas,
Expand Down Expand Up @@ -588,6 +589,7 @@ def test_valid_form(self):
"symptom_sub_type": SkinChangeChoices.COLOUR_CHANGE,
"when_started": RelativeDateChoices.LESS_THAN_THREE_MONTHS,
"investigated": YesNo.NO,
"highlight_to_readers": HighlightToReaderChoices.YES,
}
)
)
Expand All @@ -603,6 +605,9 @@ def test_missing_required_fields(self):
"symptom_sub_type_details": ["Enter a description of the symptom"],
"investigated": ["Select whether the symptom has been investigated or not"],
"area": ["Select the location of the symptom"],
"highlight_to_readers": [
"Select whether this symptom should be highlighted to image readers"
],
}

def test_missing_conditionally_required_fields(self):
Expand All @@ -614,6 +619,7 @@ def test_missing_conditionally_required_fields(self):
"symptom_sub_type_details": "abc symptom",
"when_started": RelativeDateChoices.SINCE_A_SPECIFIC_DATE,
"investigated": YesNo.YES,
"highlight_to_readers": HighlightToReaderChoices.YES,
}
)
)
Expand Down Expand Up @@ -641,6 +647,7 @@ def test_valid_form_with_conditionally_required_fields(self):
"specific_date_0": "2",
"specific_date_1": "2025",
"investigation_details": "def",
"highlight_to_readers": HighlightToReaderChoices.YES,
}
)
)
Expand All @@ -658,6 +665,7 @@ def test_valid_form(self):
"area_description_left_breast": "uoq",
"when_started": RelativeDateChoices.LESS_THAN_THREE_MONTHS,
"investigated": YesNo.NO,
"highlight_to_readers": HighlightToReaderChoices.YES,
}
)
)
Expand All @@ -672,6 +680,9 @@ def test_missing_required_fields(self):
"when_started": ["Select how long the symptom has existed"],
"investigated": ["Select whether the symptom has been investigated or not"],
"area": ["Select the location of the pain"],
"highlight_to_readers": [
"Select whether this symptom should be highlighted to image readers"
],
}

def test_missing_conditionally_required_fields(self):
Expand All @@ -683,6 +694,7 @@ def test_missing_conditionally_required_fields(self):
"when_started": RelativeDateChoices.SINCE_A_SPECIFIC_DATE,
"investigated": YesNo.YES,
"recently_resolved": True,
"highlight_to_readers": HighlightToReaderChoices.YES,
}
)
)
Expand Down Expand Up @@ -712,6 +724,7 @@ def test_valid_form_with_conditionally_required_fields(self):
"investigation_details": "def",
"recently_resolved": True,
"when_resolved": "3 months ago",
"highlight_to_readers": HighlightToReaderChoices.YES,
}
)
)
Expand Down
61 changes: 51 additions & 10 deletions manage_breast_screening/mammograms/tests/presenters/test_medical_information_presenter.py
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Expand Up @@ -51,6 +51,23 @@ def test_formats_symptoms_summary_list(self):
area=SymptomAreas.BOTH_BREASTS,
)

symptom3 = SymptomFactory.create(
other=True,
appointment=appointment,
when_started=RelativeDateChoices.LESS_THAN_THREE_MONTHS,
area=SymptomAreas.RIGHT_BREAST,
symptom_sub_type_details="abc",
)

symptom4 = SymptomFactory.create(
other=True,
appointment=appointment,
when_started=RelativeDateChoices.LESS_THAN_THREE_MONTHS,
area=SymptomAreas.LEFT_BREAST,
highlight_to_readers=False,
symptom_sub_type_details="xyz",
)

presenter = MedicalInformationPresenter(appointment)

assert presenter.symptom_rows == [
Expand All @@ -65,12 +82,39 @@ def test_formats_symptoms_summary_list(self):
},
],
},
"key": {
"text": "Lump",
"symptom_name": "Lump",
"highlight_to_readers": True,
"html": "Left breast<br>Not sure<br>Symptom is intermittent<br>Stopped: resolved date<br>Not investigated<br>Additional information: abc",
},
{
"actions": {
"items": [
{
"text": "Change",
"classes": "nhsuk-link--no-visited-state",
"visuallyHiddenText": "other",
"href": f"/mammograms/{appointment.id}/record-medical-information/other/{symptom3.id}/",
},
],
},
"value": {
"html": "Left breast<br>Not sure<br>Symptom is intermittent<br>Stopped: resolved date<br>Not investigated<br>Additional information: abc",
"symptom_name": "Other",
"highlight_to_readers": True,
"html": "Description: abc<br>Right breast<br>Less than 3 months ago<br>Not investigated",
},
{
"actions": {
"items": [
{
"text": "Change",
"classes": "nhsuk-link--no-visited-state",
"visuallyHiddenText": "other",
"href": f"/mammograms/{appointment.id}/record-medical-information/other/{symptom4.id}/",
}
]
},
"symptom_name": "Other",
"highlight_to_readers": False,
"html": "Description: xyz<br>Left breast<br>Less than 3 months ago<br>Not investigated",
},
{
"actions": {
Expand All @@ -83,12 +127,9 @@ def test_formats_symptoms_summary_list(self):
},
],
},
"key": {
"text": "Swelling or shape change",
},
"value": {
"html": "Both breasts<br>Less than 3 months ago<br>Not investigated",
},
"symptom_name": "Swelling or shape change",
"highlight_to_readers": True,
"html": "Both breasts<br>Less than 3 months ago<br>Not investigated",
},
]

Expand Down
36 changes: 30 additions & 6 deletions manage_breast_screening/mammograms/tests/presenters/test_symptom_presenter.py
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Expand Up @@ -135,7 +135,7 @@ def test_formats_intermittent_stopped_and_additional_information(self):
assert presenter.intermittent_line == "Symptom is intermittent"
assert presenter.additional_information_line == "Additional information: abc"

def test_formats_for_summary_list(self):
def test_formats_lump_for_summary_list(self):
symptom = SymptomFactory.create(
lump=True,
when_started=RelativeDateChoices.NOT_SURE,
Expand All @@ -158,12 +158,36 @@ def test_formats_for_summary_list(self):
},
],
},
"key": {
"text": "Lump",
},
"value": {
"html": "Left breast<br>Not sure<br>Symptom is intermittent<br>Stopped: resolved date<br>Not investigated<br>Additional information: abc",
"symptom_name": "Lump",
"highlight_to_readers": True,
"html": "Left breast<br>Not sure<br>Symptom is intermittent<br>Stopped: resolved date<br>Not investigated<br>Additional information: abc",
}

@pytest.mark.parametrize("highlight_to_readers", [True, False])
def test_formats_other_for_summary_list(self, highlight_to_readers):
symptom = SymptomFactory.create(
breast_pain=True,
when_started=RelativeDateChoices.LESS_THAN_THREE_MONTHS,
area=SymptomAreas.LEFT_BREAST,
highlight_to_readers=highlight_to_readers,
)

presenter = SymptomPresenter(symptom)

assert presenter.summary_list_row == {
"actions": {
"items": [
{
"text": "Change",
"classes": "nhsuk-link--no-visited-state",
"visuallyHiddenText": "breast pain",
"href": f"/mammograms/{symptom.appointment_id}/record-medical-information/breast-pain/{symptom.id}/",
}
]
},
"symptom_name": "Breast pain",
"highlight_to_readers": highlight_to_readers,
"html": "Left breast<br>Less than 3 months ago<br>Not investigated",
}

def test_delete_message_html(self):
Expand Down
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