/**
 * Comprehensive Palliative Care and Pain Management Module
 *
 * ╔═══════════════════════════════════════════════════════════════════════════════╗
 * ║  PALLIATIVE CARE - COMFORT AND QUALITY OF LIFE FOR ALL PATIENTS             ║
 * ╠═══════════════════════════════════════════════════════════════════════════════╣
 * ║  This module provides:                                                        ║
 * ║  - Comprehensive pain management (nociceptive, neuropathic, visceral)        ║
 * ║  - Symptom cluster management by cancer type                                 ║
 * ║  - Refractory symptom escalation protocols                                   ║
 * ║  - End-of-life care and hospice transition                                   ║
 * ║  - Goals of care communication frameworks                                    ║
 * ║  - Advance care planning integration                                         ║
 * ╚═══════════════════════════════════════════════════════════════════════════════╝
 */
export interface PainAssessment {
    location: string[];
    intensity: number;
    quality: PainQuality[];
    temporalPattern: 'Constant' | 'Intermittent' | 'Breakthrough' | 'Incident';
    aggravatingFactors: string[];
    relievingFactors: string[];
    functionalImpact: FunctionalImpact;
    psychologicalImpact: string[];
    painType: PainType[];
}
export type PainQuality = 'Sharp' | 'Dull' | 'Aching' | 'Burning' | 'Shooting' | 'Stabbing' | 'Throbbing' | 'Cramping' | 'Pressure' | 'Tingling' | 'Numbness';
export type PainType = 'Nociceptive-Somatic' | 'Nociceptive-Visceral' | 'Neuropathic-Peripheral' | 'Neuropathic-Central' | 'Mixed' | 'Bone' | 'Inflammatory';
export interface FunctionalImpact {
    sleepDisturbance: 0 | 1 | 2 | 3;
    mobilityImpairment: 0 | 1 | 2 | 3;
    selfCareImpairment: 0 | 1 | 2 | 3;
    socialImpairment: 0 | 1 | 2 | 3;
    overallQoL: number;
}
export interface PainManagementProtocol {
    painType: PainType;
    severity: 'Mild' | 'Moderate' | 'Severe';
    firstLine: PainIntervention[];
    secondLine: PainIntervention[];
    thirdLine: PainIntervention[];
    adjuvants: AdjuvantTherapy[];
    interventional: InterventionalProcedure[];
    monitoring: PainMonitoring;
}
export interface PainIntervention {
    medication: string;
    class: string;
    startingDose: string;
    titrationSchedule: string;
    maxDose: string;
    routeOptions: string[];
    precautions: string[];
    contraindications: string[];
    monitoringRequired: string[];
}
export interface AdjuvantTherapy {
    medication: string;
    indication: string;
    dose: string;
    mechanism: string;
    evidence: string;
}
export interface InterventionalProcedure {
    procedure: string;
    indication: string;
    technique: string;
    expectedBenefit: string;
    duration: string;
    risks: string[];
    contraindications: string[];
}
export interface PainMonitoring {
    assessmentFrequency: string;
    tools: string[];
    escalationCriteria: string[];
    deescalationCriteria: string[];
}
export declare const WHO_PAIN_LADDER: PainManagementProtocol[];
export declare const NEUROPATHIC_PAIN_PROTOCOLS: PainManagementProtocol[];
export interface CIPNProtocol {
    causingAgent: string;
    riskFactors: string[];
    prevention: PreventionStrategy[];
    treatment: PainIntervention[];
    doseModification: DoseModificationGuideline[];
    prognosis: string;
}
export interface PreventionStrategy {
    intervention: string;
    evidence: string;
    recommendation: 'Recommended' | 'May Consider' | 'Not Recommended';
}
export interface DoseModificationGuideline {
    grade: number;
    description: string;
    action: string;
}
export declare const CIPN_PROTOCOLS: CIPNProtocol[];
export interface BonePainProtocol {
    indication: string;
    pharmacological: PainIntervention[];
    boneTargeted: BoneTargetedTherapy[];
    radiation: RadiationForPain[];
    interventional: InterventionalProcedure[];
    surgical: string[];
}
export interface BoneTargetedTherapy {
    agent: string;
    class: string;
    dose: string;
    frequency: string;
    painBenefit: string;
    skeletalEventReduction: string;
    precautions: string[];
}
export interface RadiationForPain {
    technique: string;
    dose: string;
    fractionation: string;
    responseRate: string;
    timeToResponse: string;
    retreatmentOption: boolean;
}
export declare const BONE_PAIN_PROTOCOL: BonePainProtocol;
export interface SymptomCluster {
    cancerType: string;
    commonSymptoms: SymptomManagement[];
    psychologicalSymptoms: string[];
    interventions: ClusterIntervention[];
}
export interface SymptomManagement {
    symptom: string;
    prevalence: string;
    firstLineManagement: string[];
    secondLineManagement: string[];
    refractory: string[];
}
export interface ClusterIntervention {
    type: string;
    intervention: string;
    evidence: string;
}
export declare const CANCER_SYMPTOM_CLUSTERS: SymptomCluster[];
export interface EndOfLifeProtocol {
    phase: 'Last weeks' | 'Last days' | 'Actively dying';
    clinicalIndicators: string[];
    symptomPriorities: string[];
    medicationChanges: MedicationTransition;
    familySupport: string[];
    practicalConsiderations: string[];
}
export interface MedicationTransition {
    currentRoute: string;
    alternativeRoutes: string[];
    essentialMedications: string[];
    medicationsToDiscontinue: string[];
    prnProtocols: PRNProtocol[];
}
export interface PRNProtocol {
    symptom: string;
    medication: string;
    dose: string;
    route: string;
    frequency: string;
    maxDose24h: string;
}
export declare const END_OF_LIFE_PROTOCOLS: EndOfLifeProtocol[];
export interface PalliativeSedationProtocol {
    indications: string[];
    prerequisites: string[];
    sedationTypes: SedationType[];
    medications: SedationMedication[];
    monitoring: string[];
    documentation: string[];
    ethicalConsiderations: string[];
}
export interface SedationType {
    type: string;
    description: string;
    indication: string;
}
export interface SedationMedication {
    medication: string;
    startingDose: string;
    titration: string;
    maxDose: string;
    notes: string;
}
export declare const PALLIATIVE_SEDATION_PROTOCOL: PalliativeSedationProtocol;
export interface OpioidEquivalence {
    opioid: string;
    oralMorphineEquivalent: number;
    routes: RouteConversion[];
    specialConsiderations: string[];
}
export interface RouteConversion {
    from: string;
    to: string;
    ratio: number;
}
export declare const OPIOID_EQUIVALENCE_TABLE: OpioidEquivalence[];
export declare class PalliativeCareEngine {
    assessPain(assessment: PainAssessment): PainManagementProtocol | undefined;
    getCIPNProtocol(agent: string): CIPNProtocol | undefined;
    getBonePainProtocol(): BonePainProtocol;
    getSymptomCluster(cancerType: string): SymptomCluster | undefined;
    getEndOfLifeProtocol(phase: EndOfLifeProtocol['phase']): EndOfLifeProtocol | undefined;
    calculateOpioidConversion(fromOpioid: string, fromDose: number, fromRoute: string, toOpioid: string, toRoute: string): {
        dose: number;
        notes: string[];
    };
    getPalliativeSedationProtocol(): PalliativeSedationProtocol;
}
export declare const palliativeCareEngine: PalliativeCareEngine;
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