{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.hiccups","code":"thing-q58952","url":"https://ver.cy/models/thing/q58952/","name":"hiccups","alternateNames":["chronic hiccup"],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Information and virtual systems","entryKind":"thing","plane":"INF","domain":["INF.KNW"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"Hiccups (singultus) are stereotyped involuntary inspiratory myoclonic contractions of the diaphragm and intercostal muscles, immediately followed by glottic closure that interrupts airflow and produces the 'hic' sound, generated by a reflex arc whose afferents run in the phrenic and vagus nerves and T6-T12 sympathetics and whose putative centre lies in the medulla and C3-C5 cord.","purpose":"Enable an AI agent to recognise a reported or observed hiccup episode, assess its course and impact, and identify what observation, support or further assessment may be appropriate.","scope":{"in":["Reported or observed hiccup events and the evidence supporting their identification","Grouping events into episodes, including interruptions and recurrence","Episode timing, event frequency and changes in pattern","Possible triggers, associated symptoms and relevant contextual changes","Effects on eating, drinking, sleeping, breathing, speaking and daily activity","Actions attempted, observed responses and assessment status"],"out":["Diagnosis and management of diseases that may underlie hiccups","Complete models of coughing, belching, sneezing, reflux or vomiting","General respiratory physiology and unrelated breathing disorders","Medication prescribing, dosing and comprehensive medication records","The person's complete medical history or overall functional status"],"boundaries":[]},"distinguishingFeatures":["Determine whether the event includes an abrupt involuntary inspiratory jerk with a characteristic catch or 'hic'; record which components were reported or observed.","Distinguish the inspiratory catch from an expulsive cough; sound alone may leave the event uncertain.","Distinguish the jerk-and-catch event from a belch dominated by release of gas, while allowing both events to occur together.","Distinguish hiccups from retching or vomiting by recording whether retching movements or expulsion of stomach contents occur as separate accompanying events.","Distinguish individual hiccups from a sustained breathing disturbance; record accompanying breathing difficulty separately rather than assuming hiccups explain it."],"structure":{"bundles":[{"id":"hiccup-recognition","name":"Hiccup recognition","description":"Establish what was experienced or observed and how securely it can be identified as hiccups.","layers":[{"id":"jerk-and-catch","name":"Jerk and catch","description":"Capture the event components that support recognition.","findings":[{"id":"event-signature","name":"Event signature","description":"Record the abrupt inspiratory movement, associated catch or sound, and whether the event felt involuntary.","questions":[{"text":"What inspiratory jerk, catch, sound or visible movement was present during the suspected hiccup?","id":"event-signature-q01","kind":"definition"},{"text":"Who observed or reported these components, and through what observation method?","id":"event-signature-q02","kind":"provenance"}]}]},{"id":"neighbouring-events","name":"Neighbouring events","description":"Resolve or preserve ambiguity with coughs, belches, retching and other movements.","findings":[{"id":"alternative-event-check","name":"Alternative event check","description":"Keep competing event identities and separately occurring symptoms explicit.","questions":[{"text":"What distinguishes the event from coughing, belching, retching or another involuntary movement in this observation?","id":"alternative-event-check-q01","kind":"boundary"},{"text":"Are these other events occurring alongside recognisable hiccups, or does their presence leave the hiccup identification uncertain?","id":"alternative-event-check-q02","kind":"boundary"}]}]}]},{"id":"episode-course","name":"Episode course","description":"Describe how individual hiccups form bouts and how those bouts continue, pause or recur.","layers":[{"id":"onset-and-boundaries","name":"Onset and boundaries","description":"Anchor episode timing and distinguish a pause from a new episode.","findings":[{"id":"episode-continuity","name":"Episode continuity","description":"Represent onset, latest activity and hiccup-free intervals without filling gaps in observation.","questions":[{"text":"When did this episode begin, when was the latest hiccup, and how certain are those times?","id":"episode-continuity-q01","kind":"measurement"},{"text":"What hiccup-free interval supports treating later events as a recurrence rather than continuation, and was that interval observed or assumed?","id":"episode-continuity-q02","kind":"boundary"}]}]},{"id":"frequency-and-variation","name":"Frequency and variation","description":"Track event density and its changes within and between bouts.","findings":[{"id":"measured-hiccup-pattern","name":"Measured hiccup pattern","description":"Record counts and spacing within stated windows, including changes around sleep and waking when observed.","questions":[{"text":"How many hiccups occurred during a stated observation window, and how regular was their spacing?","id":"measured-hiccup-pattern-q01","kind":"measurement"},{"text":"How did frequency and pauses change across the episode, including any observed sleep period?","id":"measured-hiccup-pattern-q02","kind":"measurement"}]}]}]},{"id":"precipitants-and-associations","name":"Precipitants and associations","description":"Connect hiccup episodes to relevant circumstances while keeping suspected causes provisional.","layers":[{"id":"immediate-context","name":"Immediate context","description":"Capture activities and exposures around onset or changes in frequency.","findings":[{"id":"onset-linked-events","name":"Onset-linked events","description":"Record potentially relevant meals, drinks and activities, including their timing and recurrence.","questions":[{"text":"What eating, drinking or other activity immediately preceded onset or a marked change in hiccups?","id":"onset-linked-events-q01","kind":"provenance"},{"text":"Has the same sequence occurred in other episodes, and has that activity also occurred without hiccups?","id":"onset-linked-events-q02","kind":"boundary"}]}]},{"id":"clinical-context","name":"Clinical context","description":"Link relevant health changes without embedding an underlying disease model.","findings":[{"id":"health-change-associations","name":"Health-change associations","description":"Preserve the timing and attribution of associated symptoms, illnesses, procedures and medication changes.","questions":[{"text":"Which symptoms, illnesses, procedures or medication changes preceded or accompanied this episode, and by how long?","id":"health-change-associations-q01","kind":"provenance"},{"text":"Is any proposed cause a person's suspicion, a repeated association or a documented clinical assessment?","id":"health-change-associations-q02","kind":"provenance"}]}]}]},{"id":"burden-and-response","name":"Burden and response","description":"Represent the practical consequences of hiccups and the evidence available for choosing or evaluating a next action.","layers":[{"id":"interference-and-assessment","name":"Interference and assessment","description":"Make disruption and any need for further assessment explicit.","findings":[{"id":"episode-impact","name":"Episode impact","description":"Record what hiccups interrupt or prevent, with accompanying symptoms evaluated separately.","questions":[{"text":"How are hiccups affecting eating, drinking, sleeping, speaking, breathing and usual activities?","id":"episode-impact-q01","kind":"measurement"},{"text":"What accompanying symptoms or consequences require separate assessment rather than attribution to hiccups?","id":"episode-impact-q02","kind":"boundary"},{"text":"Under the applicable sourced guidance, do the episode's duration, interference or accompanying symptoms warrant further assessment?","id":"episode-impact-q03","kind":"action"}]}]},{"id":"attempts-and-follow-up","name":"Attempts and follow-up","description":"Track actions already taken and distinguish immediate changes from sustained outcomes.","findings":[{"id":"observed-action-response","name":"Observed action response","description":"Connect each attempted measure to its timing, observed benefit or harm, and subsequent recurrence.","questions":[{"text":"What action was attempted, when was it attempted, and what was its recommendation source?","id":"observed-action-response-q01","kind":"provenance"},{"text":"What changed in hiccup frequency, interference or adverse symptoms afterward, and for how long was the outcome observed?","id":"observed-action-response-q02","kind":"measurement"},{"text":"What follow-up observation or assessment is needed before treating the episode as resolved or deciding on another action?","id":"observed-action-response-q03","kind":"action"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-kinds","name":"Kinds and varieties","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these kinds and varieties hold for the sense of hiccups this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-identifiers","name":"Identifiers and schemes","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these identifiers and schemes hold for the sense of hiccups this model covers, and on what evidence?","id":"evidence-identifiers-q01","kind":"provenance"}]},{"id":"evidence-standards-and-regulation","name":"Standards and regulation","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these standards and regulation hold for the sense of hiccups this model covers, and on what evidence?","id":"evidence-standards-and-regulation-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these real-world use hold for the sense of hiccups this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-measurements","name":"Typical measurements","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these typical measurements hold for the sense of hiccups this model covers, and on what evidence?","id":"evidence-measurements-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of hiccups this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-regional-variation","name":"Regional variation","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these regional variation hold for the sense of hiccups this model covers, and on what evidence?","id":"evidence-regional-variation-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Reported by the breadth pass; each item needs checking against its source before it becomes normative.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of hiccups this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Share common, safe advice for short bouts of hiccups.","Advise seeing a clinician when hiccups last more than two days or come with other symptoms."],"mustNot":["Recommend frightening, choking or holding a person's breath forcefully to stop hiccups.","Present persistent hiccups as harmless without medical assessment.","Recommend medicines for hiccups for a particular person."],"requiresHuman":["Treating persistent hiccups, which can signal underlying disease."]},"ethics":{"considerations":["Folk cures can hurt people, especially children and older people.","Long-lasting hiccups disrupt eating, sleep and work."],"affectedParties":["People with persistent hiccups","Children","Patients"]},"owners":{"steward":"The person who has them; clinicians advise on persistent cases.","roles":[],"masterSystems":[]},"relations":[{"target":"Q169872","type":"parent","note":"registry parent class"},{"target":"Q42183538","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.hiccups","Wikidata: Q58952 (https://www.wikidata.org/wiki/Q58952)"]},"properties":{"applicability":"not-applicable","items":["Recognition evidence: Person's report; witness report; direct observation; audio or video; clinical assessment; recognition uncertain","Observed event components: Inspiratory jerk; audible catch; visible chest or abdominal movement; components absent or unobserved","Episode duration: Minutes, hours or days from reported onset to cessation or latest observation, with uncertainty","Hiccup frequency: Events per minute over a stated observation window; range if variable","Episode course: Ongoing; intermittent; apparently ceased; recurred; current state unknown","Hiccup-free intervals: Minutes, hours or days, distinguishing observed absence from missing observation","Possible precipitant: Time-linked meal, drink, activity, procedure, medication change or other event; suspected, repeatedly associated or clinically attributed","Associated symptoms: Linked symptom observations with onset, severity and timing relative to hiccups","Functional interference: For eating, drinking, sleeping, speaking, breathing and activity: none reported; disrupted; prevented; unknown","Response to an attempted action: No observed change; reduced frequency; temporary cessation; sustained cessation during follow-up; worsened; adverse effect; unclear"]},"recognition":{"applicability":"optional","items":["Brief, repeated jerks of the chest or upper abdomen coincide with abruptly interrupted inspiration.","A characteristic short hic sound often accompanies each contraction.","Episodes consist of separated inspiratory spasms rather than the forceful outward airflow typical of coughing."]},"capabilities":{"applicability":"required","items":["Characterise a suspected hiccup event and record uncertainty when competing explanations remain.","Track episode duration, frequency, pauses and recurrence using explicit observation windows.","Compare episodes for repeated associations with meals, activities or other contextual changes.","Summarise interference and accompanying symptoms for a person or clinician assessing the episode.","Record attempted actions and their outcomes without treating a single apparent response as proof of efficacy.","Apply an explicitly sourced assessment policy to the recorded duration, burden and accompanying symptoms, or flag that the policy is missing."]},"hazards":{"applicability":"required","items":["Exhaustion and weight loss from persistent hiccups.","Masking of serious underlying conditions.","Injury from forceful home remedies."]},"interfaces":{"applicability":"required","items":["ICD-10, issued by the World Health Organization, classifies hiccough under code R06.6."]},"context":{"applicability":"required","items":["Hiccups are encountered as brief involuntary episodes in everyday life and as symptoms documented in clinical assessment.","Their duration, recurrence and effects on eating, sleeping or communication help describe their practical impact."]}},"sources":[{"title":"Singultus","url":"https://www.ncbi.nlm.nih.gov/books/NBK538225/","note":"Specialist definition, duration classes, reflex-arc anatomy, frequency 4-60/min, epidemiology, evaluation, treatment including FDA status of chlorpromazine, complications, and the absence of a dedicated guideline."},{"title":"Hiccups - Merck Manual Professional Edition","url":"https://www.merckmanuals.com/professional/gastrointestinal-disorders/symptoms-of-gastrointestinal-disorders/hiccups","note":"Clinical definition as diaphragmatic spasm plus glottic closure; persistent (>2 days) versus intractable (>1 month); gastric distention and alcohol as common transient triggers."},{"title":"Hiccups, Causes & Treatment","url":"https://my.clevelandclinic.org/health/diseases/17672-hiccups","note":"Practice classification into transient, persistent, intractable and recurrent hiccups; synonyms hiccough and singultus; advice to seek care after two days."},{"title":"2026 ICD-10-CM Diagnosis Code R06.6: Hiccough","url":"https://www.icd10data.com/ICD10CM/Codes/R00-R99/R00-R09/R06-/R06.6","note":"ICD-10-CM code R06.6 for hiccough/hiccup/singultus as a coded respiratory symptom."},{"title":"Chronic hiccup (Concept Id: C0744898)","url":"https://www.ncbi.nlm.nih.gov/medgen/900733","note":"SNOMED CT 716771000, Orphanet ORPHA396, MONDO:0018334, and the >48-hour definition of chronic hiccup as a rare movement disorder."},{"title":"hiccup (Q58952)","url":"https://www.wikidata.org/wiki/Q58952","note":"Crosswalk of Wikidata Q58952 to ICD-10 R06.6, ICD-11 MD11.6, MeSH D006606, UMLS C0019521 and related identifiers."},{"title":"Wikipedia: Hiccup","url":"https://en.wikipedia.org/wiki/Hiccup","note":"general description of the item"}],"openQuestions":["Which authoritative guidance should define duration categories and assessment thresholds, and how do these vary by age or clinical context?","What minimum evidence supports reliable recognition when hiccups are silent, only self-reported or difficult to distinguish from other involuntary movements?","What hiccup-free interval should separate episodes for this registry's intended uses, and should that rule vary between clinical assessment and personal tracking?","Which measures of hiccup burden and frequency are sufficiently validated and practical for repeated agent-assisted recording?","Which proposed interventions have adequate evidence, contraindication information and population-specific guidance to support agent recommendations?"],"resources":{"spec":"/models/things/publications/thing-q58952/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q58952/spec.json"],"providers":["Codex","Grok"],"researchStatus":"unreviewed","generatedAt":"2026-09-07T15:03:34Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"filled","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T10:10:31+00:00: completeness 1.00; sense: Wikidata description; 7 live sources; review by codex: pass","interaction.properties":"Plane INF: no invented physical properties."},"score":1.0}}