{ "model": { "rank": 3033, "code": "thing-q147778", "model_id": "vr.tr.liver-cirrhosis", "name": "liver cirrhosis", "purpose": "Let an agent explain cirrhosis in general terms, route symptoms and complications to care, describe causes, prevention and management with attribution, and support people living with cirrhosis without individual medical advice.", "family": "Thing Registry", "category": "Activities and processes", "status": "research-draft", "kind": "thing", "plane": "ACT", "domain": "ACT.PRC", "industry": "", "version": "", "url": "/models/thing/q147778/", "tier": 2, "score": 92, "payload": { "layer": "wikidata", "aliases": [ "primary biliary cholangitis", "Silvestrini-Corda syndrome", "secondary biliary cirrhosis", "Familial cirrhosis", "alcoholic liver cirrhosis", "cirrhosis, familial, with antigenemia" ], "aliasCount": 6, "merged": 6, "knownIn": 92, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": null, "source": { "dataset": "wikidata", "item": "Q147778", "url": "https://www.wikidata.org/wiki/Q147778", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-11T22:19:13Z", "providers": [ "Claude" ], "breadth": "written by Claude from model knowledge without web access - no source was read, every claim is a lead to verify", "pass": 2, "wave": 2, "engine": "claude" }, "metaModel": { "id": "THING-Q147778", "registryId": "vr.tr.liver-cirrhosis", "name": "liver cirrhosis", "version": "0.2.0-wave.2", "entryKind": "thing", "family": "Thing Registry", "domain": [ "ACT.PRC" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q147778/", "model": { "registry_id": "vr.tr.liver-cirrhosis", "name": "liver cirrhosis", "purpose": "Let an agent explain cirrhosis in general terms, route symptoms and complications to care, describe causes, prevention and management with attribution, and support people living with cirrhosis without individual medical advice.", "definition": "Advanced scarring of the liver in which normal tissue is replaced by fibrous tissue and regenerative nodules, impairing liver function, caused by chronic alcohol use, viral hepatitis, fatty liver disease, autoimmune and biliary conditions such as primary biliary cholangitis, and rare familial forms; cirrhosis can lead to complications such as bleeding, fluid accumulation, confusion and liver cancer, and is managed by treating causes and complications, with transplantation for advanced disease.", "what_it_is_for": "End-stage liver scarring.", "affordances": [ "explain causes and course", "route complications to care", "describe management in general terms", "support patients and carers" ], "distinguishing_features": [ "Advanced fibrosis", "Regenerative nodules", "Loss of function", "Serious complications" ], "appearance": "Not visible in early stages; later jaundice, swelling and other signs.", "visual_identification": [ "Fibrosis with nodules in the liver", "Impaired liver function", "Fibrosis without nodules is an earlier stage" ], "physical_properties": [], "families_and_kinds": [ "alcohol-related cirrhosis", "viral hepatitis cirrhosis", "fatty liver disease cirrhosis", "biliary cirrhosis including primary biliary cholangitis", "familial and rare cirrhosis" ], "related_models": [ { "relation": "is a kind of", "target": "liver disease", "why": "category" }, { "relation": "is a kind of", "target": "cirrosis", "why": "category" }, { "relation": "results from", "target": "fibrosis", "why": "the underlying process" }, { "relation": "is related to", "target": "abstinence", "why": "alcohol abstinence in management" } ], "identifiers": [], "standards_and_regulation": [ "Hepatology clinical guidelines", "Alcohol policy and public health guidance", "Transplant allocation rules" ], "failure_modes_and_hazards": [ "Life-threatening complications such as variceal bleeding", "Agents diagnosing or advising on treatment", "Stigma toward patients" ], "in_scope": [], "out_of_scope": [], "characteristics": [] }, "sources": [], "structure": { "bundles": [ { "id": "urgent", "name": "Urgent", "description": "Complications.", "rationale": "Routing.", "layers": [ { "id": "redflags", "name": "Red flags", "description": "Emergency signs.", "findings": [ { "id": "redflags-finding", "name": "Red flags", "description": "Red flags.", "questions": [ { "text": "Are there signs such as vomiting blood, black stools, confusion, severe abdominal swelling or fever that need urgent care?", "kind": "boundary" }, { "text": "Should emergency services be called now?", "kind": "action" } ] } ] }, { "id": "monitor", "name": "Monitor", "description": "Ongoing monitoring.", "findings": [ { "id": "monitor-finding", "name": "Monitor", "description": "Monitoring.", "questions": [ { "text": "How is cirrhosis monitored, including surveillance for liver cancer, according to guidelines?", "kind": "provenance" }, { "text": "Is the user asking for individual medical advice?", "kind": "boundary" } ] } ] } ] }, { "id": "understand", "name": "Understand", "description": "Causes and course.", "rationale": "General information.", "layers": [ { "id": "causes", "name": "Causes", "description": "Causes.", "findings": [ { "id": "causes-finding", "name": "Causes", "description": "Causes.", "questions": [ { "text": "What causes cirrhosis, from alcohol and viral hepatitis to fatty liver and biliary diseases, according to clinical sources?", "kind": "provenance" }, { "text": "Which entry fits a specific cause?", "kind": "action" } ] } ] }, { "id": "course", "name": "Course", "description": "Stages and complications.", "findings": [ { "id": "course-finding", "name": "Course", "description": "Course.", "questions": [ { "text": "How does cirrhosis progress from compensated to decompensated disease, and what complications arise?", "kind": "definition" }, { "text": "How is severity scored?", "kind": "provenance" } ] } ] } ] }, { "id": "manage", "name": "Manage", "description": "Management and living.", "rationale": "Attribution.", "layers": [ { "id": "treatment", "name": "Treatment", "description": "Management approaches.", "findings": [ { "id": "treatment-finding", "name": "Treatment", "description": "Treatment.", "questions": [ { "text": "Which management approaches do guidelines describe, including treating the cause, managing complications and transplantation, in general terms?", "kind": "provenance" }, { "text": "How does alcohol abstinence affect outcomes, according to evidence?", "kind": "provenance" } ] } ] }, { "id": "living", "name": "Living", "description": "Living with cirrhosis.", "findings": [ { "id": "living-finding", "name": "Living", "description": "Living.", "questions": [ { "text": "Which diet, medication and lifestyle guidance do health bodies give, in general terms, and which support organisations exist?", "kind": "provenance" }, { "text": "How is stigma addressed?", "kind": "provenance" } ] } ] } ] }, { "id": "learn", "name": "Learn", "description": "Prevention and research.", "rationale": "Context.", "layers": [ { "id": "prevent", "name": "Prevent", "description": "Prevention.", "findings": [ { "id": "prevent-finding", "name": "Prevent", "description": "Prevention.", "questions": [ { "text": "How can cirrhosis be prevented at individual and population levels, according to public health guidance?", "kind": "provenance" }, { "text": "Which screening exists for hepatitis and fatty liver?", "kind": "provenance" } ] } ] }, { "id": "research", "name": "Research", "description": "Research.", "findings": [ { "id": "research-finding", "name": "Research", "description": "Research.", "questions": [ { "text": "What are current research directions in cirrhosis?", "kind": "provenance" }, { "text": "How can people participate in research?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Should each cause be a separate entry?", "How should guidelines be linked?", "How should support organisations be localised?" ], "statistics": { "bundles": 4, "layers": 8, "findings": 8, "questions": 16 } }, "draft": { "generator": "vr.draft.v3", "status": "draft-generated", "researched": false, "archetype": "disease or condition", "method": "Written from the archetype playbook - what this kind of thing needs beyond identity and provenance - and from the structure that recurred across 6,333 models already researched by two engines. Applied to this entry by rule. No source was read for this thing and no claim here is researched. This entry carries no facets of its own, so they were inferred from its domain - a guess about a whole domain applied to one thing.", "facetsInferred": true, "nextPass": "A researcher replaces this draft with a sourced specification. Treat every sentence below as a proposal to argue with.", "purpose": "Give an agent a durable, checkable way to recognise a liver cirrhosis, record what state it is in, and decide what may be done with it.", "whatItIs": "Let an agent explain cirrhosis in general terms, route symptoms and complications to care, describe causes, prevention and management with attribution, and support people living with cirrhosis without individual medical advice.", "characteristics": { "substance": "activity", "origin": "conceptual", "agency": "inert" }, "whatYouCanDoWithIt": [ "observed and measured" ], "distinguishingFeatures": [ "Names folded into this entry, which a task may need to split apart again: primary biliary cholangitis, Silvestrini-Corda syndrome, secondary biliary cirrhosis, Familial cirrhosis, alcoholic liver cirrhosis, cirrhosis, familial, with antigenemia.", "6 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 92 Wikipedia languages, which is a measure of how widely the thing is known, not of how important it is." ], "openQuestionsForResearch": [ "Which of the bundles below does a real task actually need, and which are ceremony?", "What does this thing have that the facets do not capture at all?", "Which neighbouring kind is most often confused with a liver cirrhosis, and on what evidence are they told apart?" ], "whatItIsMadeOf": "something that happens over time", "physicalCharacter": [ "Does nothing on its own; everything it does, something else did to it.", "These come from the domain this entry sits in rather than from the entry itself, so treat them as a first guess about the whole domain applied to one thing." ], "whatCanBeDoneWithIt": [ "observe it, measure it, record its state" ], "howItIsRecognised": [ "Recognised by criteria applied to signs and findings, not by appearance. Two conditions can look identical and be distinguished only by test." ], "relatedModels": [ { "relation": "covers", "note": "Finer kinds folded into this entry because telling them apart needs a task that asks for it. Each is a model waiting to be split out when one does.", "targets": [ "primary biliary cholangitis", "Silvestrini-Corda syndrome", "secondary biliary cirrhosis", "Familial cirrhosis", "alcoholic liver cirrhosis", "cirrhosis, familial, with antigenemia" ] } ], "standing": "Described in 92 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is. 6 finer distinctions are held inside this entry as names rather than as separate models.", "structure": { "bundles": [ { "id": "identity-and-classification", "name": "Identity, naming and classification", "description": "How an agent tells one liver cirrhosis from another, and a liver cirrhosis from things that resemble it.", "rationale": "Recognition comes before every other claim. Without stable identity nothing else in the model can be trusted to be about the same thing twice.", "layers": [ { "id": "naming-and-identifiers", "name": "Names and identifiers", "description": "The names this thing goes by and the identifiers that survive translation and time.", "findings": [ { "id": "preferred-name-and-aliases", "name": "Preferred name, aliases and local names", "description": "Which name to use, which names mean the same thing, and which merely sound similar.", "questions": [ { "id": "preferred-name-and-aliases-q01", "text": "What identifies and describes the name of a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "preferred-name-and-aliases-q02", "text": "Who or what asserted this about the name of a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "preferred-name-and-aliases-q03", "text": "What may an agent decide or do once the name of a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "stable-identifiers", "name": "Stable identifiers and external keys", "description": "Identifiers that keep pointing at this kind of thing across systems and languages.", "questions": [ { "id": "stable-identifiers-q01", "text": "What identifies and describes an identifier for a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stable-identifiers-q02", "text": "Who or what asserted this about an identifier for a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stable-identifiers-q03", "text": "What may an agent decide or do once an identifier for a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "classification-and-granularity", "name": "Classification and granularity", "description": "Where a liver cirrhosis sits among kinds, and how finely a task needs to cut it.", "findings": [ { "id": "kind-and-parents", "name": "Kind, parents and neighbouring kinds", "description": "The classes this thing belongs to and the ones it is next to.", "questions": [ { "id": "kind-and-parents-q01", "text": "What identifies and describes the kind of a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "kind-and-parents-q02", "text": "Who or what asserted this about the kind of a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "kind-and-parents-q03", "text": "What may an agent decide or do once the kind of a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "distinguishing-features", "name": "Distinguishing features", "description": "What separates a liver cirrhosis from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "distinguishing-features-q02", "text": "Who or what asserted this about what distinguishes a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "distinguishing-features-q03", "text": "What may an agent decide or do once what distinguishes a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "state-and-lifecycle", "name": "State and lifecycle", "description": "The states a liver cirrhosis passes through and the events that move it between them.", "rationale": "Most decisions about a thing depend on what state it is in now, which is a claim with a time on it, not a property.", "layers": [ { "id": "lifecycle-stages", "name": "Lifecycle stages", "description": "From coming into existence to ceasing to be one of these.", "findings": [ { "id": "stages-and-transitions", "name": "Stages and transitions", "description": "The stages worth naming and what moves a liver cirrhosis between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stages-and-transitions-q02", "text": "Who or what asserted this about the lifecycle of a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stages-and-transitions-q03", "text": "What may an agent decide or do once the lifecycle of a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "observations-and-status", "name": "Observations and current status", "description": "What is observed about a liver cirrhosis, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a liver cirrhosis is recorded so that it can be superseded rather than overwritten.", "questions": [ { "id": "observation-record-q01", "text": "What identifies and describes an observation of a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "observation-record-q02", "text": "Who or what asserted this about an observation of a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "observation-record-q03", "text": "What may an agent decide or do once an observation of a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "process-and-outcome", "name": "Process, inputs and outcome", "description": "How a liver cirrhosis proceeds, what it needs and what it leaves behind.", "rationale": "An activity is known by its steps and its results, and both have to be recordable while it is still running.", "layers": [ { "id": "steps-and-sequence", "name": "Steps and sequence", "description": "The steps of a liver cirrhosis, their order and what may run in parallel.", "findings": [ { "id": "steps-and-preconditions", "name": "Steps, preconditions and completion", "description": "What has to be true before each step of a liver cirrhosis and what marks it done.", "questions": [ { "id": "steps-and-preconditions-q01", "text": "What identifies and describes a step of a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "steps-and-preconditions-q02", "text": "Who or what asserted this about a step of a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "steps-and-preconditions-q03", "text": "What may an agent decide or do once a step of a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "inputs-and-results", "name": "Inputs, resources and results", "description": "What a liver cirrhosis consumes and what it produces.", "findings": [ { "id": "inputs-and-outputs", "name": "Inputs, outputs and side effects", "description": "The resources a liver cirrhosis takes and the results it leaves, wanted or not.", "questions": [ { "id": "inputs-and-outputs-q01", "text": "What identifies and describes the inputs and results of a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "inputs-and-outputs-q02", "text": "Who or what asserted this about the inputs and results of a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "inputs-and-outputs-q03", "text": "What may an agent decide or do once the inputs and results of a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "diagnosis-and-criteria", "name": "Diagnosis, criteria and coding", "description": "What makes a case of liver cirrhosis a case, and under which revision.", "rationale": "Criteria change between revisions, so a diagnosis without its coding revision cannot be compared with a later one.", "layers": [ { "id": "criteria", "name": "Diagnostic criteria", "description": "The criteria in force and who issues them.", "findings": [ { "id": "criteria-record", "name": "Criteria, issuer and revision", "description": "What must be true for a diagnosis, according to whom.", "questions": [ { "id": "criteria-record-q01", "text": "What criteria define liver cirrhosis, issued by which body, in which revision?", "kind": "definition" }, { "id": "criteria-record-q02", "text": "What changed between revisions that would reclassify existing cases?", "kind": "boundary" } ] } ] }, { "id": "coding", "name": "Coding and terminology", "description": "The codes used to record it and their mapping.", "findings": [ { "id": "coding-record", "name": "Codes and mappings", "description": "Which classification codes apply and how they map.", "questions": [ { "id": "coding-record-q01", "text": "Which classification and terminology codes cover liver cirrhosis, and how do they map to each other?", "kind": "definition" }, { "id": "coding-record-q02", "text": "What is lost when a case is mapped from one scheme to another?", "kind": "boundary" } ] } ] } ] }, { "id": "course-and-population", "name": "Course, population and care", "description": "How liver cirrhosis develops, whom it affects, and what is done about it.", "rationale": "The condition, the diagnosis and the episode of care are three different things, and an agent must not merge them.", "layers": [ { "id": "course", "name": "Course and stages", "description": "Onset, progression, remission and outcome.", "findings": [ { "id": "course-record", "name": "Stages and transitions", "description": "The stages recorded and what moves a case between them.", "questions": [ { "id": "course-record-q01", "text": "What course does liver cirrhosis typically take, and what marks each stage?", "kind": "definition" }, { "id": "course-record-q02", "text": "What separates the condition itself from an episode of care for it?", "kind": "boundary" } ] } ] }, { "id": "population", "name": "Affected populations", "description": "Who is affected, how often, and on what evidence.", "findings": [ { "id": "epidemiology", "name": "Prevalence and its basis", "description": "Rates with their population, period and source.", "questions": [ { "id": "epidemiology-q01", "text": "What prevalence or incidence is reported for liver cirrhosis, in which population and period?", "kind": "measurement" }, { "id": "epidemiology-q02", "text": "What may an agent not conclude about an individual from a population rate?", "kind": "action" } ] } ] } ] }, { "id": "provenance-and-evidence", "name": "Provenance, evidence and time", "description": "Where every claim about a liver cirrhosis came from and when it held.", "rationale": "A claim without a source and a time cannot be superseded, only overwritten, and an agent that overwrites loses the ability to explain itself.", "layers": [ { "id": "source-and-authority", "name": "Source and authority", "description": "Who said it, on what evidence, and how strongly.", "findings": [ { "id": "claim-provenance", "name": "Claim provenance and confidence", "description": "The authority behind each claim about a liver cirrhosis and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "claim-provenance-q02", "text": "Who or what asserted this about a claim about a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "claim-provenance-q03", "text": "What may an agent decide or do once a claim about a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "time-and-versions", "name": "Time, versions and supersession", "description": "When a claim was true, when it was learnt, and what replaced it.", "findings": [ { "id": "validity-and-supersession", "name": "Validity period and supersession", "description": "How an old claim about a liver cirrhosis is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a liver cirrhosis, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "validity-and-supersession-q02", "text": "Who or what asserted this about the validity of a claim about a liver cirrhosis, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "validity-and-supersession-q03", "text": "What may an agent decide or do once the validity of a claim about a liver cirrhosis is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] } ] }, "statistics": { "bundles": 6, "layers": 12, "findings": 14, "questions": 38 } } } }