CLiTICAL for Android

日本語版 README はこちら

CLiTICAL is a risk calculator for patients with chronic limb-threatening ischaemia (CLTI) who are scheduled for revascularisation. From routine bedside data — demographics, nutrition, comorbidities, lesion distribution and Rutherford class — it predicts peri-procedural and mid-term outcomes using prediction models derived from the JCLIMB registry of the Japanese Society for Vascular Surgery (JSVS).

This repository holds the Android app. An iOS counterpart (clitical-ios) exists, and the Android UI deliberately mirrors its structure so both platforms present the same information in the same order.

Important

The predicted values are reference information intended to support clinical judgement. They do not replace diagnosis or treatment decisions, which remain the responsibility of the attending clinician.

What it predicts

Output	Meaning
GNRI	Geriatric Nutritional Risk Index, with a four-level nutritional risk classification (No / Low / Moderate / Major)
30-day amputation or death	Risk of major amputation and/or death within 30 days of revascularisation
30-day MALE	Risk of a major adverse limb event within 30 days (above-ankle amputation of the index limb, or major reintervention)
2-year OS	Predicted 2-year overall survival after revascularisation, classified as Low / Medium / High risk
2-year AFS	Predicted 2-year amputation-free survival after revascularisation

GNRI is computed first and then feeds the survival models as a covariate, so nutritional status influences every downstream prediction.

Screens

The app has three destinations in a bottom navigation bar:

• Risk Assessment — the patient data form (basic info, social history, clinical info, artery lesion sites, other vascular lesions, complications), and the results screen it pushes to.
• References — the two source papers, opened in a Custom Tab.
• Settings — language switcher, terms of service, and app info.

Input is validated before calculation: the numeric fields must all be filled, and at least one arterial lesion site must be selected. Otherwise the form reports the specific problem instead of producing a number.

References

1. Miyata T. et al. Risk prediction model for early outcomes of revascularization for chronic limb-threatening ischaemia. Br J Surg. 2022 Oct 14;109(11):1123. https://doi.org/10.1093/bjs/znab036
2. Miyata T. et al. Prediction Models for Two Year Overall Survival and Amputation Free Survival After Revascularisation for Chronic Limb Threatening Ischaemia. Eur J Vasc Endovasc Surg. 2022 Jun 7;S1078-5884(22)00340-9. https://doi.org/10.1016/j.ejvs.2022.05.038

Privacy

Patient data entered into the form stays in memory on the device. The app declares no network permission, writes no patient data to storage, and sends nothing to a server. Closing the app discards whatever was entered.

Requirements

Minimum Android version	14 (API 34)
Target SDK	36
Compile SDK	37 — required by AndroidX 2026.06; targetSdk stays at 36 because raising it opts into new runtime behaviour that needs device testing
JDK	11 source/target compatibility
Android Gradle Plugin	9.3.1
Kotlin	2.2.10
Gradle	9.5.0 (via the wrapper)
UI toolkit	Jetpack Compose, Material 3 (Compose BOM 2026.06.01)

Dependency versions live in gradle/libs.versions.toml; nothing is declared with a literal version in build.gradle.kts.

Building

./gradlew assembleDebug

Install onto a connected device or emulator:

./gradlew installDebug

Build the Play release bundle (output is written to app/release, which is git-ignored):

./gradlew bundleRelease

Release builds keep R8 optimization disabled (optimization { enable = false }) — the app is small and shipping unobfuscated keeps crash reports readable.

The bundle also disables Play's per-language resource splitting. The in-app language switcher lets a user pick Japanese or English regardless of the system locale, so every locale has to be present on the device.

Testing

Unit and Compose UI tests run on the JVM through Robolectric, so no device is needed:

./gradlew test

Instrumented tests, if you want them on a real device or emulator:

./gradlew connectedAndroidTest

The test suite covers the prediction maths (PatientRiskTest), the form and its validation (QuestionFormTest), the results screen (ResultScreenTest), the settings and references screens (SettingsScreensTest), and navigation (MainActivityTest). Robolectric resolves strings from the real resource table (isIncludeAndroidResources = true), so tests can assert on localized text.

Development follows Red/Green TDD: add the failing test first, then the code that makes it pass.

Project structure

app/src/main/java/org/studiomexx/clitical_android/
├── MainActivity.kt          Bottom-navigation shell; swaps in the result screen when a risk exists
├── model/
│   ├── PatientData.kt       Immutable data class holding one patient's inputs
│   ├── PatientRisk.kt       All five predictions, plus the published model coefficients
│   ├── Enums.kt             Sex, Activity, CKD, MalignantNeoplasm, Rutherford, risk levels
│   ├── Labeled.kt           Maps enum cases to string resources for the pickers
│   └── ValidationError.kt   Empty fields / no lesion selected
└── ui/
    ├── MainViewModel.kt     Form state, text buffers for numeric input, calculation entry point
    ├── QuestionForm.kt      The patient data form
    ├── ResultScreen.kt      Predicted risks
    ├── SettingsScreens.kt   Settings (language, terms, about) and References
    ├── SectionCard.kt       Shared grouped-list container
    ├── Utils.kt             localizedString(): resolves strings in the user-chosen locale
    └── theme/               Material 3 colour, typography, theme

MainViewModel keeps numeric input as text buffers separate from PatientData so a partially typed value stays editable; the strings are parsed only when the user asks for a prediction.

Localization

The app ships Japanese (values-ja/strings.xml) and English (values/strings.xml). The language is chosen in Settings rather than following the system locale, so strings are resolved through the localizedString(id, locale) helper instead of stringResource. When adding a string, add it to both files.

Versioning

versionName and versionCode live in app/build.gradle.kts. The Settings screen shows the bare versionName via BuildConfig, so a release only needs the two values bumped there. versionCode must increase for every build uploaded to Play.

License

Released under the MIT License.

© 2022 Kazuhiro Miyahara, Japanese Society for Vascular Surgery (JSVS), JCLIMB Committee.

The MIT License covers this source code. It does not extend to the published prediction models and the papers they come from — see References — nor does it waive the clinical disclaimer above. Use of the distributed app is additionally governed by its terms of service.