{ "model": { "rank": 7395, "code": "thing-q160796", "model_id": "vr.tr.delirium", "name": "delirium", "purpose": "Let an agent explain delirium and its forms in general terms from clinical guidelines, describe causes, recognition and management, present the excited delirium controversy with attribution, and route anyone affected to urgent medical care.", "family": "Thing Registry", "category": "Cross-cutting context", "status": "research-draft", "kind": "thing", "plane": "XCT", "domain": "XCT.STA", "industry": "", "version": "", "url": "/models/thing/q160796/", "tier": 2, "score": 55, "payload": { "layer": "wikidata", "aliases": [ "excited delirium", "subacute delirium", "delirium acutum", "drug-induced delirium", "delirium tremens", "psychopharmacological delirium", "Intensive care unit delirium", "sundowning", "muttering delirium", "oneirism" ], "aliasCount": 10, "merged": 10, "knownIn": 55, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": "vr.tr.delirium", "source": { "dataset": "wikidata", "item": "Q160796", "url": "https://www.wikidata.org/wiki/Q160796", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-13T02:10:35Z", "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": 3, "engine": "claude" }, "metaModel": { "id": "THING-Q160796", "registryId": "vr.tr.delirium", "name": "delirium", "version": "0.2.0-wave.3", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q160796/", "model": { "registry_id": "vr.tr.delirium", "name": "delirium", "purpose": "Let an agent explain delirium and its forms in general terms from clinical guidelines, describe causes, recognition and management, present the excited delirium controversy with attribution, and route anyone affected to urgent medical care.", "definition": "An acute disturbance of attention, awareness and cognition that develops over hours or days and fluctuates, caused by medical conditions, drugs, withdrawal or surgery, presenting as hyperactive, hypoactive or mixed forms, including delirium tremens from alcohol withdrawal, drug-induced delirium and subacute forms; delirium is common in hospitalised older people, is a medical emergency signalling an underlying cause, and is treated by addressing the cause and supportive care, while the term excited delirium is contested and rejected by several medical bodies.", "what_it_is_for": "Not applicable; a clinical syndrome.", "affordances": [ "explain the syndrome and forms", "relay causes and management", "present contested terms with attribution", "route to urgent care" ], "distinguishing_features": [ "Acute onset and fluctuation", "Inattention", "Underlying cause", "Preventable in part" ], "appearance": "Not a visible object; acute confusion and altered awareness.", "visual_identification": [ "Acute fluctuating confusion", "Hyperactive, hypoactive, mixed, delirium tremens, drug-induced", "Dementia is chronic; psychosis has other features; excited delirium is a contested label" ], "physical_properties": [ { "quantity": "prevalence in hospitalised older adults", "typical_range": "about 20-30", "unit": "percent", "note": "estimates" }, { "quantity": "ICU delirium prevalence", "typical_range": "up to about 80", "unit": "percent", "note": "ventilated patients" } ], "families_and_kinds": [ "hyperactive delirium", "hypoactive delirium", "mixed delirium", "delirium tremens", "drug-induced and psychopharmacological delirium", "postoperative and ICU delirium", "subacute delirium", "excited delirium as a contested term" ], "related_models": [ { "relation": "is a kind of", "target": "cognitive disorder", "why": "in registry terms" }, { "relation": "is a kind of", "target": "mental confusion", "why": "in registry terms" }, { "relation": "is caused by", "target": "medical condition", "why": "or drugs and withdrawal" }, { "relation": "is contrasted with", "target": "dementia", "why": "a chronic decline" } ], "identifiers": [ { "scheme": "ICD-11", "value_or_pattern": "6D70", "note": "delirium" }, { "scheme": "MeSH", "value_or_pattern": "D003693", "note": "" } ], "standards_and_regulation": [ "NICE and other delirium guidelines", "DSM-5 and ICD-11 criteria", "Positions of medical bodies rejecting excited delirium as a diagnosis" ], "failure_modes_and_hazards": [ "Missed underlying causes", "Agents giving personal medical advice", "Misuse of excited delirium in custody deaths, as reported", "Confusing with dementia" ], "in_scope": [], "out_of_scope": [], "characteristics": [] }, "sources": [], "structure": { "bundles": [ { "id": "help", "name": "Help", "description": "Getting help first.", "rationale": "Safety.", "layers": [ { "id": "emergency", "name": "Emergency", "description": "Emergency.", "findings": [ { "id": "emergency-finding", "name": "Emergency", "description": "Emergency.", "questions": [ { "text": "Why is sudden confusion a medical emergency, and what should be done?", "kind": "action" }, { "text": "Is the user describing someone acutely confused, which needs urgent medical care now?", "kind": "boundary" } ] } ] }, { "id": "care", "name": "Care", "description": "Hospital care.", "findings": [ { "id": "care-finding", "name": "Care", "description": "Care.", "questions": [ { "text": "How is delirium assessed and managed in hospital, in general terms?", "kind": "provenance" }, { "text": "Is the user asking about a specific patient, which needs their clinicians?", "kind": "boundary" } ] } ] } ] }, { "id": "understand", "name": "Understand", "description": "The syndrome.", "rationale": "Clinical.", "layers": [ { "id": "definition", "name": "Definition", "description": "Definition and forms.", "findings": [ { "id": "definition-finding", "name": "Definition", "description": "Definition.", "questions": [ { "text": "What is delirium, and how do its forms differ?", "kind": "definition" }, { "text": "Is the question about delirium, dementia or psychosis?", "kind": "boundary" } ] } ] }, { "id": "causes", "name": "Causes", "description": "Causes.", "findings": [ { "id": "causes-finding", "name": "Causes", "description": "Causes.", "questions": [ { "text": "What causes delirium, including infection, drugs, withdrawal and surgery?", "kind": "provenance" }, { "text": "Which entry fits the specific form?", "kind": "action" } ] } ] } ] }, { "id": "manage", "name": "Manage", "description": "Prevention and management.", "rationale": "Clinical.", "layers": [ { "id": "prevention", "name": "Prevention", "description": "Prevention.", "findings": [ { "id": "prevention-finding", "name": "Prevention", "description": "Prevention.", "questions": [ { "text": "What prevention measures do guidelines recommend in hospitals and care homes?", "kind": "provenance" }, { "text": "Which references are standard?", "kind": "provenance" } ] } ] }, { "id": "treatment", "name": "Treatment", "description": "Treatment.", "findings": [ { "id": "treatment-finding", "name": "Treatment", "description": "Treatment.", "questions": [ { "text": "How is delirium treated, and what is the role of medication, per guidelines?", "kind": "provenance" }, { "text": "Which sources are cited?", "kind": "provenance" } ] } ] } ] }, { "id": "context", "name": "Context", "description": "Controversy and outcomes.", "rationale": "Attribution.", "layers": [ { "id": "excited", "name": "Excited", "description": "Excited delirium.", "findings": [ { "id": "excited-finding", "name": "Excited", "description": "Excited.", "questions": [ { "text": "What is the controversy over excited delirium, and what have medical bodies and inquiries concluded, with positions attributed?", "kind": "provenance" }, { "text": "Is the presentation attributed and neutral?", "kind": "boundary" } ] } ] }, { "id": "outcomes", "name": "Outcomes", "description": "Outcomes and research.", "findings": [ { "id": "outcomes-finding", "name": "Outcomes", "description": "Outcomes.", "questions": [ { "text": "What are the long-term outcomes of delirium, and what research is ongoing?", "kind": "provenance" }, { "text": "Which entry fits delirium research?", "kind": "action" } ] } ] } ] } ] }, "openQuestions": [ "Should delirium tremens be a separate primary entry?", "How should guidelines be linked?", "The registry entry has merged aliases including a contested term; should it be annotated or split off?" ], "statistics": { "bundles": 4, "layers": 8, "findings": 8, "questions": 16 } }, "draft": { "generator": "vr.draft.v3", "status": "draft-generated", "researched": false, "archetype": "abstract concept", "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 delirium, record what state it is in, and decide what may be done with it.", "whatItIs": "Let an agent explain delirium and its forms in general terms from clinical guidelines, describe causes, recognition and management, present the excited delirium controversy with attribution, and route anyone affected to urgent medical care.", "characteristics": { "substance": "abstract", "origin": "conceptual", "agency": "inert" }, "whatYouCanDoWithIt": [ "observed and measured" ], "distinguishingFeatures": [ "Names folded into this entry, which a task may need to split apart again: excited delirium, subacute delirium, delirium acutum, drug-induced delirium, delirium tremens, psychopharmacological delirium, Intensive care unit delirium, sundowning, muttering delirium, oneirism.", "10 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 55 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 delirium, and on what evidence are they told apart?" ], "whatItIsMadeOf": "an abstraction with no physical instance", "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": [ "Nothing to see. What is recognised is an instance of it, and which instances count is exactly what is argued about." ], "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": [ "excited delirium", "subacute delirium", "delirium acutum", "drug-induced delirium", "delirium tremens", "psychopharmacological delirium", "Intensive care unit delirium", "sundowning", "muttering delirium", "oneirism" ] } ], "standing": "Described in 55 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is. 10 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 delirium from another, and a delirium 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 delirium, 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 delirium, 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 delirium 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 delirium, 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 delirium, 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 delirium 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 delirium 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 delirium, 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 delirium, 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 delirium 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 delirium from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a delirium, 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 delirium, 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 delirium 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 delirium 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 delirium between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a delirium, 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 delirium, 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 delirium 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 delirium, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a delirium 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 delirium, 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 delirium, 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 delirium is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "definitions-in-contest", "name": "Definitions and who holds them", "description": "What delirium is taken to mean, and by whom.", "rationale": "When a field disagrees about a concept, the disagreement is the content. A model that picks one definition silently destroys the information.", "layers": [ { "id": "competing-definitions", "name": "Competing definitions", "description": "The main readings and the traditions behind them.", "findings": [ { "id": "definition-map", "name": "Definitions and their holders", "description": "Each definition with the school or body that holds it.", "questions": [ { "id": "definition-map-q01", "text": "Which definitions of delirium are in use, and which tradition or body holds each?", "kind": "definition" }, { "id": "definition-map-q02", "text": "What turns on the difference between them in practice?", "kind": "boundary" } ] } ] }, { "id": "operationalisation", "name": "Operationalisation", "description": "How it is measured or applied when it has to be.", "findings": [ { "id": "operational-record", "name": "Measures and proxies", "description": "Instruments and indicators used to stand in for it.", "questions": [ { "id": "operational-record-q01", "text": "How is delirium operationalised or measured in practice, and by what instrument?", "kind": "measurement" }, { "id": "operational-record-q02", "text": "What does that operationalisation leave out, and when does that matter?", "kind": "boundary" } ] } ] } ] }, { "id": "instances-and-use", "name": "Instances, use and consequence", "description": "What counts as an instance of delirium and what follows from calling something that.", "rationale": "Applying a concept is an act with consequences, so a model must say what the label licenses and what it does not.", "layers": [ { "id": "instances", "name": "What counts as an instance", "description": "Clear cases, borderline cases and non-cases.", "findings": [ { "id": "instance-tests", "name": "Tests for an instance", "description": "What would settle whether something falls under it.", "questions": [ { "id": "instance-tests-q01", "text": "What would settle whether something is an instance of delirium?", "kind": "boundary" }, { "id": "instance-tests-q02", "text": "Which borderline cases are argued about, and on what grounds?", "kind": "definition" } ] } ] }, { "id": "consequence", "name": "Consequence of application", "description": "Rights, duties or decisions that follow from the label.", "findings": [ { "id": "consequence-record", "name": "What the label licenses", "description": "What an agent may do once something is classified this way.", "questions": [ { "id": "consequence-record-q01", "text": "What follows practically once something is treated as delirium?", "kind": "action" }, { "id": "consequence-record-q02", "text": "What must an agent not infer from the label alone?", "kind": "action" } ] } ] } ] }, { "id": "provenance-and-evidence", "name": "Provenance, evidence and time", "description": "Where every claim about a delirium 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 delirium and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a delirium, 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 delirium, 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 delirium 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 delirium is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a delirium, 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 delirium, 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 delirium is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] } ] }, "statistics": { "bundles": 5, "layers": 10, "findings": 12, "questions": 32 } } } }