{ "model": { "rank": 6550, "code": "thing-q16483", "model_id": "vr.tr.toxic-diffuse-goiter", "name": "toxic diffuse goiter", "purpose": "Let an agent explain Graves disease in general terms, relay mechanism, symptoms, eye disease, treatment options and pregnancy considerations from endocrinology sources, route emergencies, describe the named forms, and distinguish Graves disease from toxic nodular goitre, thyroiditis, Hashimoto thyroiditis and hyperthyroidism as a broader state, without diagnosing or advising individual treatment.", "family": "Thing Registry", "category": "Cross-cutting context", "status": "research-draft", "kind": "thing", "plane": "XCT", "domain": "XCT.STA", "industry": "", "version": "", "url": "/models/thing/q16483/", "tier": 2, "score": 60, "payload": { "layer": "wikidata", "aliases": [ "Graves' ophthalmopathy", "euthyroid Graves orbitopathy", "Marine-Lenhart syndrome" ], "aliasCount": 3, "merged": 3, "knownIn": 60, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": null, "source": { "dataset": "wikidata", "item": "Q16483", "url": "https://www.wikidata.org/wiki/Q16483", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-14T00:45:21Z", "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": 4, "engine": "claude" }, "metaModel": { "id": "THING-Q16483", "registryId": "vr.tr.toxic-diffuse-goiter", "name": "toxic diffuse goiter", "version": "0.2.0-wave.4", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q16483/", "model": { "registry_id": "vr.tr.toxic-diffuse-goiter", "name": "toxic diffuse goiter", "purpose": "Let an agent explain Graves disease in general terms, relay mechanism, symptoms, eye disease, treatment options and pregnancy considerations from endocrinology sources, route emergencies, describe the named forms, and distinguish Graves disease from toxic nodular goitre, thyroiditis, Hashimoto thyroiditis and hyperthyroidism as a broader state, without diagnosing or advising individual treatment.", "definition": "An autoimmune disease in which antibodies stimulate the thyroid-stimulating hormone receptor, causing overproduction of thyroid hormone and a diffuse goitre, the most common cause of hyperthyroidism in many countries, named after Robert Graves, who described it in 1835, and Karl von Basedow; forms and complications the registry aliases name include Graves ophthalmopathy or thyroid eye disease, with bulging eyes and double vision, euthyroid Graves orbitopathy, with eye disease but normal thyroid levels, and Marine-Lenhart syndrome, Graves disease combined with autonomous thyroid nodules. Treatment options include antithyroid drugs, radioactive iodine and surgery, chosen with specialists, and thyroid storm or sudden vision loss needs emergency care.", "what_it_is_for": "Not applicable; a disease.", "affordances": [ "explain mechanism and symptoms", "relay treatment options in general terms", "describe named forms", "route emergencies" ], "distinguishing_features": [ "TSH receptor antibodies", "Diffuse goitre", "Eye disease", "Pretibial myxoedema in some" ], "appearance": "Possible visible goitre, bulging eyes, weight loss and tremor.", "visual_identification": [ "Autoimmune hyperthyroidism with diffuse goitre", "Graves ophthalmopathy, euthyroid Graves orbitopathy, Marine-Lenhart syndrome", "Toxic nodular goitre comes from nodules; thyroiditis causes temporary release; Hashimoto thyroiditis usually causes hypothyroidism; hyperthyroidism is the broader state" ], "physical_properties": [ { "quantity": "Graves description", "typical_range": "1835", "unit": "year", "note": "Robert Graves" }, { "quantity": "key antibody", "typical_range": "TSH receptor antibody", "unit": "note", "note": "TRAb" }, { "quantity": "sex ratio", "typical_range": "more common in women", "unit": "note", "note": "attributed to epidemiology sources" } ], "families_and_kinds": [ "Graves hyperthyroidism", "Graves ophthalmopathy", "euthyroid Graves orbitopathy", "Marine-Lenhart syndrome", "neonatal Graves disease" ], "related_models": [ { "relation": "is a kind of", "target": "hyperthyroidism", "why": "in registry terms" }, { "relation": "causes", "target": "thyroid eye disease", "why": "" }, { "relation": "is treated with", "target": "radioactive iodine therapy", "why": "option" }, { "relation": "is contrasted with", "target": "Hashimoto s thyroiditis", "why": "" } ], "identifiers": [], "standards_and_regulation": [ "American Thyroid Association guidelines", "European Thyroid Association guidelines", "Radiation protection rules for radioiodine" ], "failure_modes_and_hazards": [ "Thyroid storm", "Vision loss from optic neuropathy", "Antithyroid drug side effects such as agranulocytosis" ], "in_scope": [], "out_of_scope": [], "characteristics": [] }, "sources": [], "structure": { "bundles": [ { "id": "understand", "name": "Understand", "description": "What Graves disease is.", "rationale": "Science.", "layers": [ { "id": "definition", "name": "Definition", "description": "Definition.", "findings": [ { "id": "definition-finding", "name": "Definition", "description": "Definition.", "questions": [ { "text": "Is there high fever, a very fast heartbeat, confusion or vomiting with known hyperthyroidism, sudden vision loss, or fever and sore throat on antithyroid drugs, in which case seek emergency care?", "kind": "boundary" }, { "text": "What is Graves disease, and how does it differ from toxic nodular goitre, thyroiditis, Hashimoto thyroiditis and hyperthyroidism?", "kind": "definition" } ] } ] }, { "id": "forms", "name": "Forms", "description": "Named forms.", "findings": [ { "id": "forms-finding", "name": "Forms", "description": "Forms.", "questions": [ { "text": "What are Graves ophthalmopathy, euthyroid Graves orbitopathy and Marine-Lenhart syndrome?", "kind": "definition" }, { "text": "Which entry fits the specific form?", "kind": "action" } ] } ] } ] }, { "id": "mechanism", "name": "Mechanism", "description": "Mechanism.", "rationale": "Science.", "layers": [ { "id": "antibodies", "name": "Antibodies", "description": "TSH receptor antibodies.", "findings": [ { "id": "antibodies-finding", "name": "Antibodies", "description": "Antibodies.", "questions": [ { "text": "How do TSH receptor antibodies drive thyroid overactivity?", "kind": "provenance" }, { "text": "Which references are standard?", "kind": "provenance" } ] } ] }, { "id": "eyes", "name": "Eyes", "description": "Eye disease.", "findings": [ { "id": "eyes-finding", "name": "Eyes", "description": "Eyes.", "questions": [ { "text": "Why does orbital tissue swell in thyroid eye disease, and how does smoking affect it?", "kind": "provenance" }, { "text": "Which sources are cited?", "kind": "provenance" } ] } ] } ] }, { "id": "treatment", "name": "Treatment", "description": "Treatment options.", "rationale": "Attribution.", "layers": [ { "id": "options", "name": "Options", "description": "Treatment options.", "findings": [ { "id": "options-finding", "name": "Options", "description": "Options.", "questions": [ { "text": "How do guidelines compare antithyroid drugs, radioactive iodine and surgery, in general terms with recommendations attributed?", "kind": "provenance" }, { "text": "Is the information current?", "kind": "boundary" } ] } ] }, { "id": "pregnancy", "name": "Pregnancy", "description": "Pregnancy.", "findings": [ { "id": "pregnancy-finding", "name": "Pregnancy", "description": "Pregnancy.", "questions": [ { "text": "Why does Graves disease in pregnancy need specialist care?", "kind": "provenance" }, { "text": "Which entry fits neonatal thyrotoxicosis?", "kind": "action" } ] } ] } ] }, { "id": "context", "name": "Context", "description": "History.", "rationale": "Sources.", "layers": [ { "id": "history", "name": "History", "description": "Graves and Basedow.", "findings": [ { "id": "history-finding", "name": "History", "description": "History.", "questions": [ { "text": "How did Graves and Basedow describe the disease?", "kind": "provenance" }, { "text": "Which entry fits Robert James Graves?", "kind": "action" } ] } ] }, { "id": "research", "name": "Research", "description": "New therapies.", "findings": [ { "id": "research-finding", "name": "Research", "description": "Research.", "questions": [ { "text": "What newer therapies for thyroid eye disease have regulators approved, checked against current sources?", "kind": "provenance" }, { "text": "Is the presentation neutral and attributed?", "kind": "boundary" } ] } ] } ] } ] }, "openQuestions": [ "Should Graves ophthalmopathy be a separate entry?", "How should thyroid guidelines be linked and kept current?", "Should Marine-Lenhart syndrome be a separate entry?" ], "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 toxic diffuse goiter, record what state it is in, and decide what may be done with it.", "whatItIs": "Let an agent explain Graves disease in general terms, relay mechanism, symptoms, eye disease, treatment options and pregnancy considerations from endocrinology sources, route emergencies, describe the named forms, and distinguish Graves disease from toxic nodular goitre, thyroiditis, Hashimoto thyroiditis and hyperthyroidism as a broader state, without diagnosing or advising individual treatment.", "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: Graves' ophthalmopathy, euthyroid Graves orbitopathy, Marine-Lenhart syndrome.", "3 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 60 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 toxic diffuse goiter, 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": [ "Graves' ophthalmopathy", "euthyroid Graves orbitopathy", "Marine-Lenhart syndrome" ] } ], "standing": "Described in 60 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is. 3 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 toxic diffuse goiter from another, and a toxic diffuse goiter 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 toxic diffuse goiter, 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 toxic diffuse goiter, 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 toxic diffuse goiter 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 toxic diffuse goiter, 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 toxic diffuse goiter, 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 toxic diffuse goiter 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 toxic diffuse goiter 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 toxic diffuse goiter, 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 toxic diffuse goiter, 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 toxic diffuse goiter 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 toxic diffuse goiter from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a toxic diffuse goiter, 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 toxic diffuse goiter, 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 toxic diffuse goiter 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 toxic diffuse goiter 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 toxic diffuse goiter between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a toxic diffuse goiter, 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 toxic diffuse goiter, 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 toxic diffuse goiter 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 toxic diffuse goiter, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a toxic diffuse goiter 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 toxic diffuse goiter, 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 toxic diffuse goiter, 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 toxic diffuse goiter 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 toxic diffuse goiter 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 toxic diffuse goiter 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 toxic diffuse goiter 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 toxic diffuse goiter 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 toxic diffuse goiter?", "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 toxic diffuse goiter?", "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 toxic diffuse goiter 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 toxic diffuse goiter and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a toxic diffuse goiter, 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 toxic diffuse goiter, 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 toxic diffuse goiter 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 toxic diffuse goiter is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a toxic diffuse goiter, 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 toxic diffuse goiter, 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 toxic diffuse goiter 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 } } } }