{ "model": { "rank": 6436, "code": "thing-q223591", "model_id": "vr.tr.gastroesophageal-reflux-disease", "name": "gastroesophageal reflux disease", "purpose": "Let an agent explain gastroesophageal reflux disease and its variants in neutral clinical terms, relay causes, diagnosis and management in general from gastroenterology guidelines, describe warning signs, and route people with persistent or alarming symptoms to clinicians.", "family": "Thing Registry", "category": "Cross-cutting context", "status": "research-draft", "kind": "thing", "plane": "XCT", "domain": "XCT.STA", "industry": "", "version": "", "url": "/models/thing/q223591/", "tier": 2, "score": 60, "payload": { "layer": "wikidata", "aliases": [ "Sandifer syndrome", "gastric reflux finding", "Laryngopharyngeal reflux", "nonerosive reflux disease", "biliary reflux", "infant regurgitation" ], "aliasCount": 6, "merged": 6, "knownIn": 60, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": null, "source": { "dataset": "wikidata", "item": "Q223591", "url": "https://www.wikidata.org/wiki/Q223591", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-13T06:04:01Z", "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-Q223591", "registryId": "vr.tr.gastroesophageal-reflux-disease", "name": "gastroesophageal reflux disease", "version": "0.2.0-wave.3", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q223591/", "model": { "registry_id": "vr.tr.gastroesophageal-reflux-disease", "name": "gastroesophageal reflux disease", "purpose": "Let an agent explain gastroesophageal reflux disease and its variants in neutral clinical terms, relay causes, diagnosis and management in general from gastroenterology guidelines, describe warning signs, and route people with persistent or alarming symptoms to clinicians.", "definition": "A chronic condition in which stomach contents flow back into the oesophagus, causing heartburn, regurgitation and sometimes chest pain, cough or hoarseness, ranging from nonerosive reflux disease to erosive oesophagitis and complications such as strictures and Barrett s oesophagus, with variants including laryngopharyngeal reflux affecting the throat, biliary reflux of bile, infant regurgitation, which is usually benign, and Sandifer syndrome, in which reflux causes abnormal posturing in infants; it is managed by lifestyle measures, acid-suppressing medication and, in some cases, surgery.", "what_it_is_for": "Not applicable; a condition.", "affordances": [ "explain the condition and variants", "relay diagnosis and management", "describe warning signs", "route to clinicians" ], "distinguishing_features": [ "Chronic reflux", "Heartburn and regurgitation", "Erosive and nonerosive forms", "Complications over time" ], "appearance": "Not a visible object; heartburn and regurgitation.", "visual_identification": [ "Chronic reflux of stomach contents", "Nonerosive reflux disease, erosive oesophagitis, laryngopharyngeal reflux, biliary reflux, infant regurgitation, Sandifer syndrome", "Occasional heartburn is not disease; peptic ulcers and heart disease can mimic symptoms" ], "physical_properties": [ { "quantity": "prevalence", "typical_range": "about 10-20", "unit": "percent", "note": "Western populations" }, { "quantity": "main mechanism", "typical_range": "lower oesophageal sphincter dysfunction", "unit": "note", "note": "" }, { "quantity": "main drug classes", "typical_range": "proton pump inhibitors, H2 blockers", "unit": "list", "note": "" } ], "families_and_kinds": [ "nonerosive reflux disease", "erosive oesophagitis", "laryngopharyngeal reflux", "biliary or duodenogastric reflux", "infant regurgitation and paediatric reflux including Sandifer syndrome", "complicated disease with strictures and Barrett s oesophagus" ], "related_models": [ { "relation": "is a kind of", "target": "esophagitis", "why": "in registry terms, in erosive forms" }, { "relation": "is a kind of", "target": "stomach disease", "why": "in registry terms" }, { "relation": "is a kind of", "target": "genetic disease", "why": "in registry terms, a parent that fits only a heritable component" }, { "relation": "can lead to", "target": "Barrett s esophagus", "why": "as a complication" } ], "identifiers": [ { "scheme": "ICD-11", "value_or_pattern": "DA22", "note": "gastro-oesophageal reflux disease" }, { "scheme": "MeSH", "value_or_pattern": "D005764", "note": "gastroesophageal reflux" } ], "standards_and_regulation": [ "Gastroenterology guidelines such as those of the ACG and ESPGHAN", "Medicines regulation for acid suppressants", "Endoscopy standards" ], "failure_modes_and_hazards": [ "Agents giving personal medical advice", "Missing cardiac causes of chest pain", "Long-term medication effects, which clinicians weigh", "Registry parent genetic disease is misleading" ], "in_scope": [], "out_of_scope": [], "characteristics": [] }, "sources": [], "structure": { "bundles": [ { "id": "help", "name": "Help", "description": "Symptoms first.", "rationale": "Safety.", "layers": [ { "id": "alarm", "name": "Alarm", "description": "Alarm symptoms.", "findings": [ { "id": "alarm-finding", "name": "Alarm", "description": "Alarm.", "questions": [ { "text": "Why do chest pain, difficulty swallowing, vomiting blood, weight loss or anaemia need urgent medical assessment?", "kind": "action" }, { "text": "Is the user describing these symptoms now, which needs urgent care?", "kind": "boundary" } ] } ] }, { "id": "persistent", "name": "Persistent", "description": "Persistent symptoms.", "findings": [ { "id": "persistent-finding", "name": "Persistent", "description": "Persistent.", "questions": [ { "text": "Why do frequent heartburn or reflux need a clinician rather than long-term self-treatment?", "kind": "provenance" }, { "text": "Is the user asking about their own or a child s symptoms, which needs a clinician?", "kind": "boundary" } ] } ] } ] }, { "id": "understand", "name": "Understand", "description": "The condition.", "rationale": "Clinical.", "layers": [ { "id": "definition", "name": "Definition", "description": "Definition and variants.", "findings": [ { "id": "definition-finding", "name": "Definition", "description": "Definition.", "questions": [ { "text": "What is gastroesophageal reflux disease, and how do nonerosive, erosive, laryngopharyngeal, biliary and infant forms and Sandifer syndrome differ?", "kind": "definition" }, { "text": "Is the question about reflux disease, occasional heartburn or another condition?", "kind": "boundary" } ] } ] }, { "id": "causes", "name": "Causes", "description": "Causes.", "findings": [ { "id": "causes-finding", "name": "Causes", "description": "Causes.", "questions": [ { "text": "What causes reflux, from sphincter dysfunction and hiatus hernia to diet and obesity?", "kind": "definition" }, { "text": "Which entry fits the specific cause?", "kind": "action" } ] } ] } ] }, { "id": "care", "name": "Care", "description": "Diagnosis and management.", "rationale": "Clinical.", "layers": [ { "id": "diagnosis", "name": "Diagnosis", "description": "Diagnosis.", "findings": [ { "id": "diagnosis-finding", "name": "Diagnosis", "description": "Diagnosis.", "questions": [ { "text": "How is reflux disease diagnosed by symptoms, endoscopy and pH monitoring?", "kind": "provenance" }, { "text": "Which references are standard?", "kind": "provenance" } ] } ] }, { "id": "management", "name": "Management", "description": "Management.", "findings": [ { "id": "management-finding", "name": "Management", "description": "Management.", "questions": [ { "text": "How is reflux managed with lifestyle measures, medication and surgery, in general terms?", "kind": "provenance" }, { "text": "Which sources are cited?", "kind": "provenance" } ] } ] } ] }, { "id": "context", "name": "Context", "description": "Complications and research.", "rationale": "Context.", "layers": [ { "id": "complications", "name": "Complications", "description": "Complications.", "findings": [ { "id": "complications-finding", "name": "Complications", "description": "Complications.", "questions": [ { "text": "What are strictures, Barrett s oesophagus and cancer risk, in general terms?", "kind": "provenance" }, { "text": "Which entry fits Barrett s esophagus?", "kind": "action" } ] } ] }, { "id": "research", "name": "Research", "description": "Research.", "findings": [ { "id": "research-finding", "name": "Research", "description": "Research.", "questions": [ { "text": "What research addresses new treatments and the effects of long-term acid suppression, with findings attributed?", "kind": "provenance" }, { "text": "Which entry fits proton pump inhibitor?", "kind": "action" } ] } ] } ] } ] }, "openQuestions": [ "Should laryngopharyngeal reflux and Barrett s oesophagus be separate primary entries?", "How should guidelines be linked?", "The registry parent genetic disease should be reviewed" ], "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 gastroesophageal reflux disease, record what state it is in, and decide what may be done with it.", "whatItIs": "Let an agent explain gastroesophageal reflux disease and its variants in neutral clinical terms, relay causes, diagnosis and management in general from gastroenterology guidelines, describe warning signs, and route people with persistent or alarming symptoms to clinicians.", "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: Sandifer syndrome, gastric reflux finding, Laryngopharyngeal reflux, nonerosive reflux disease, biliary reflux, infant regurgitation.", "6 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 gastroesophageal reflux disease, 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": [ "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": [ "Sandifer syndrome", "gastric reflux finding", "Laryngopharyngeal reflux", "nonerosive reflux disease", "biliary reflux", "infant regurgitation" ] } ], "standing": "Described in 60 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 gastroesophageal reflux disease from another, and a gastroesophageal reflux disease 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a gastroesophageal reflux disease, 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a gastroesophageal reflux disease, 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a gastroesophageal reflux disease 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a gastroesophageal reflux disease, 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 gastroesophageal reflux disease is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a gastroesophageal reflux disease, 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 gastroesophageal reflux disease, 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 gastroesophageal reflux disease 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 } } } }