I strongly believe medalling is not enough, she will need to go clean or near clean to avoid test skate.
You are probably right, but I remember last season a lot of people were expecting her to bomb at Europeans and then she actually wound up skating quite well, with her best SP of the season (clean) and quite a strong FS (no falls, both 3-3s landed well, 7 triples landed/rotated in total, and 2 step outs on jumps as her only real mistakes). She was way behind Elena and Liza score wise (some of that was likely due to skate order in both SP and FS though), but she was also way, way ahead of Joshi in 4th place, so I tend to think if she can perform at Euros like she did last season then she should be fine.
I think if Anna has 2 solid skates and wins bronze convincingly, she should be fine and get the nod for Worlds (though please have monitoring prior if she gets injured again), but if she were to get bronze by the skin of her teeth over someone like Joshi or Nicole due to PCS after not skating that well, then yeah, I think they may have a test skate. Realistically, though, I think Anna and Liza are the only 2 who should really be considered for Worlds. Yes, they may bomb, but from a technical standpoint, we know they can do the hard tricks and have a chance to do well at Worlds if they deliver. Julia and Adelina don't seem ready technically for the Worlds stage yet, maybe they could get it together in time for Worlds, but I tend to think they will need until next season to really get back in the form they'd need to challenge for a medal.
If Anna replicated the skates she had at Nationals at Worlds, I tend to think she'd have a good shot at medaling, even with the event being in Boston. Ashley and Gracie would probably get PCS a little higher, but the margin would likely only be a few points meaning they would have to skate pretty darn well in both programs to come out ahead. I also wonder if a different judging panel would have scored Anna higher than Elena in the FS, I personally would have had Anna slightly ahead in the FS. Tuk with her reputation could also have a good chance at medaling in Boston. So I think realistically, the last spot is between these two, though I feel Anna should be given the nod if she can deliver at Euros.
Ironically, Anna probably should have been replaced for Worlds last season due to her injury, but she was given a pass I guess after doing well at Europeans (though she had also made GPF that season and beaten Julia there, and Alena was the alternate so realistically she may not have done much better at Worlds than an injured Anna, as the point spread was less than 5 points between Zijun in 9th and Anna in 13th, but Polina in 8th was over 12 points ahead of Zijun in 9th. Both last year and this year, the 3rd Russian lady's placement won't matter much as the top 2 should have no issue keeping 3 spots. But I'm sure Russia is hoping for a podium sweep and with that in mind I think Anna and Liza are the only 2 logical choices for the 3rd spot. If Sotskova had competed on the senior GP this season I would also consider her, but with no reputation she doesn't have much chance to medal at Worlds.