{ "model": { "rank": 6717, "code": "thing-q335555", "model_id": "vr.tr.sj-gren-s-syndrome", "name": "Sjögren's syndrome", "purpose": "Enable an AI agent to recognise evidence relevant to Sjögren's syndrome, describe its glandular and systemic state, and identify appropriate assessment and care options for clinician review.", "family": "Thing Registry", "category": "Information and virtual systems", "status": "research-draft", "kind": "thing", "plane": "INF", "domain": "INF.KNW", "industry": "", "version": "", "url": "/models/thing/q335555/", "tier": 2, "score": 59, "payload": { "layer": "wikidata", "aliases": [ "sicca syndrome" ], "aliasCount": 1, "merged": 1, "knownIn": 59, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": null, "source": { "dataset": "wikidata", "item": "Q335555", "url": "https://www.wikidata.org/wiki/Q335555", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-09T23:21:31Z", "providers": [ "Codex" ], "breadth": "recalled by Codex without web access - no source was read", "missingProviders": [], "pass": 2, "cost": { "grok": { "seconds": 24, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.4\n--------\nworkdir: R:\\02_PROJECTS\\02_Meta_Models_Platforms\\Ver.cy\\current\\thing-registry-backlog\nmodel: gpt-6-astra\nprovider: openai\napproval: never\nsandbox: read-only\nreasoning effort: none\nreasoning summaries: none\nsession id: 01a08878-fb30-7e93-a124-8c0ca035ebcd\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: Sjögren's syndrome\nSense to describe: (none recorded)\nDomain code: XCT.STA\nAlso known as: (none)\n\n\nContext for this batch of 1001 things:\n# Batch 007: 1", "usd": 0, "recall": true }, "codex": { "seconds": 66.5, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.4\n--------\nworkdir: R:\\02_PROJECTS\\02_Meta_Models_Platforms\\Ver.cy\\current\\thing-registry-backlog\nmodel: gpt-6-astra\nprovider: openai\napproval: never\nsandbox: read-only\nreasoning effort: none\nreasoning summaries: none\nsession id: 01a08878-fb39-7592-b4d4-91fae19d3b36\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: Sjögren's syndrome\nRegistry id: vr.tr.sj-gren-s-syndrome\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nNames folded into this en" } } }, "metaModel": { "id": "THING-Q335555", "registryId": "vr.tr.sj-gren-s-syndrome", "name": "Sjögren's syndrome", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q335555/", "model": { "registry_id": "vr.tr.sj-gren-s-syndrome", "name": "Sjögren's syndrome", "purpose": "Enable an AI agent to recognise evidence relevant to Sjögren's syndrome, describe its glandular and systemic state, and identify appropriate assessment and care options for clinician review.", "definition": "Sjögren's syndrome is a chronic systemic autoimmune disease characterised by lymphocytic inflammation and dysfunction of exocrine glands, especially the salivary and lacrimal glands, commonly causing dry mouth and dry eyes and sometimes affecting other organs.", "scope_statement": "This model owns the disease-specific evidence, manifestations, activity, accumulated damage and management constraints associated with registry entry vr.tr.sj-gren-s-syndrome, while distinguishing the condition from a diagnostic assertion, the person affected and an episode of care.", "in_scope": [ "Evidence supporting or challenging Sjögren's syndrome, including diagnostic reasoning and versioned classification criteria", "Lacrimal and salivary dysfunction, associated symptoms and glandular consequences", "Systemic manifestations, symptom burden, disease activity and accumulated damage", "Disease relationships, alternative explanations and overlapping autoimmune conditions", "Longitudinal monitoring, treatment targets, response and escalation considerations" ], "out_of_scope": [ "The patient's complete demographic and medical record", "Appointment, referral, admission and billing workflows", "Standalone models of rheumatoid arthritis, systemic lupus erythematosus and other associated conditions", "General pharmacology and prescribing rules for individual medicines", "Laboratory instrument specifications and assay manufacturing", "Independent models of dental disease, ocular disease and lymphoma" ], "distinguishing_features": [ "Test whether dryness has objective glandular evidence and an evaluated cause; dry eyes or dry mouth alone should not establish the disease identity.", "Separate anti-SSA/Ro results, other antibody findings, gland histology and functional tests instead of treating all positive investigations as interchangeable.", "Distinguish a clinician's diagnostic conclusion from fulfilment of a named, dated classification framework.", "Assess systemic features even when dryness is limited, absent or poorly documented.", "Represent Sjögren's syndrome alongside another autoimmune disease without automatically attributing every manifestation to either condition." ], "characteristics": [ { "name": "Diagnostic assertion", "kind": "state", "unit_or_values": "Suspected, clinician-diagnosed, uncertain, reconsidered; assessor and date", "why_it_matters": "Preserves the distinction between the disease and a revisable conclusion about its presence." }, { "name": "Classification assessment", "kind": "category", "unit_or_values": "Framework, issuer, version, eligibility, exclusions, component results and met/not met/not assessable outcome", "why_it_matters": "Makes criteria-based conclusions reproducible without equating classification with diagnosis." }, { "name": "Autoantibody evidence", "kind": "measurement", "unit_or_values": "Antibody specificity, assay, result, laboratory units, reference interval and collection date", "why_it_matters": "Prevents loss of distinctions between anti-SSA/Ro, anti-SSB/La and other serological evidence." }, { "name": "Lacrimal function and ocular surface findings", "kind": "measurement", "unit_or_values": "Schirmer result in mm over the recorded duration; ocular staining score with named scale; eye and date", "why_it_matters": "Separates tear production from ocular surface injury and subjective discomfort." }, { "name": "Salivary function", "kind": "measurement", "unit_or_values": "Flow in mL/min, stimulated or unstimulated protocol, collection conditions and date", "why_it_matters": "Supports interpretation of gland function and comparison over time." }, { "name": "Salivary gland histopathology", "kind": "measurement", "unit_or_values": "Biopsy site, tissue adequacy, histological interpretation and focus score per 4 mm² when reported", "why_it_matters": "Keeps the numerical result attached to the specimen quality and pathological interpretation needed to assess it." }, { "name": "Systemic involvement", "kind": "state", "unit_or_values": "Organ domain, manifestation, severity, attribution confidence and assessment date", "why_it_matters": "Supports decisions beyond management of dryness." }, { "name": "Patient-reported symptom burden", "kind": "measurement", "unit_or_values": "Dryness, fatigue and pain scores with instrument, version, range and date", "why_it_matters": "Captures burden that may differ from measured systemic disease activity." }, { "name": "Activity and damage", "kind": "state", "unit_or_values": "Active, stable, improving, worsening, residual damage or uncertain; supporting observations", "why_it_matters": "Distinguishes potentially treatable activity from persistent consequences." }, { "name": "Associated autoimmune disease", "kind": "relation", "unit_or_values": "Linked condition, diagnostic evidence and relationship terminology used by the source", "why_it_matters": "Preserves overlap and attribution uncertainty without creating a duplicate disease model." }, { "name": "Terminology mapping", "kind": "relation", "unit_or_values": "Verified ICD-10, ICD-11 or SNOMED CT concept, edition, jurisdiction and mapping scope", "why_it_matters": "Prevents unversioned codes or approximate mappings from silently changing the represented concept." } ], "affordances": [ "Organise diagnostic evidence and identify missing or conflicting investigations for clinician review.", "Assess a named classification framework only when its eligibility, exclusions and required inputs are available.", "Compare glandular function, systemic findings and patient-reported burden across dated assessments.", "Identify findings requiring review under a sourced, current escalation pathway.", "Connect each proposed intervention to a specific manifestation, treatment target and monitoring requirement.", "Produce a traceable disease-state summary that preserves uncertainty and links to original evidence." ] }, "sources": [], "structure": { "bundles": [ { "id": "disease-identity-and-evidence", "name": "Disease identity and evidence", "description": "Establish what supports Sjögren's syndrome and how the diagnostic conclusion was reached.", "rationale": "Dryness, serological findings and classification outcomes must not collapse into an unsupported disease label.", "layers": [ { "id": "diagnosis-and-classification", "name": "Diagnosis and classification", "description": "Separate clinical judgment from formal classification and terminology mappings.", "findings": [ { "id": "basis-of-disease-identification", "name": "Basis of disease identification", "description": "Record the diagnostic assertion, its evidence and any separately assessed classification outcome.", "questions": [ { "text": "Who asserted Sjögren's syndrome, when, and with what supporting evidence and degree of certainty?", "kind": "provenance", "id": "basis-of-disease-identification-q01" }, { "text": "Which classification framework, issuing body and version were used, and were eligibility and exclusion conditions assessed?", "kind": "definition", "id": "basis-of-disease-identification-q02" }, { "text": "Which verified terminology concepts map to this disease, and which instead describe a manifestation or encounter?", "kind": "boundary", "id": "basis-of-disease-identification-q03" } ] } ] }, { "id": "serology-histology-and-alternatives", "name": "Serology, histology and alternatives", "description": "Interpret autoimmune and tissue evidence alongside competing explanations.", "findings": [ { "id": "evidence-concordance", "name": "Evidence concordance", "description": "Preserve agreement, disagreement and limitations across antibody testing, biopsy and differential assessment.", "questions": [ { "text": "What do anti-SSA/Ro testing and any salivary gland biopsy show, including assay details, tissue adequacy and specialist interpretation?", "kind": "measurement", "id": "evidence-concordance-q01" }, { "text": "Which alternative causes of sicca or gland enlargement were assessed, including medication effects and relevant mimicking conditions?", "kind": "boundary", "id": "evidence-concordance-q02" }, { "text": "What further review is justified when clinical findings, serology and histology disagree?", "kind": "action", "id": "evidence-concordance-q03" } ] } ] } ] }, { "id": "lacrimal-and-salivary-state", "name": "Lacrimal and salivary state", "description": "Describe tear and saliva function, symptoms and local consequences.", "rationale": "Sjögren's assessment needs separate accounts of perceived dryness, measured secretion and tissue injury.", "layers": [ { "id": "ocular-function-and-injury", "name": "Ocular function and injury", "description": "Connect ocular symptoms with tear testing and ocular surface examination.", "findings": [ { "id": "ocular-sicca-profile", "name": "Ocular sicca profile", "description": "Record each eye's symptoms, functional results and surface findings without assuming that they track together.", "questions": [ { "text": "What are the dated Schirmer and ocular staining results, including protocol, scoring system and eye tested?", "kind": "measurement", "id": "ocular-sicca-profile-q01" }, { "text": "How do discomfort, visual interference and examination findings compare, and what other ocular causes remain plausible?", "kind": "boundary", "id": "ocular-sicca-profile-q02" } ] } ] }, { "id": "oral-function-and-gland-state", "name": "Oral function and gland state", "description": "Assess salivary output, gland changes and consequences for oral function.", "findings": [ { "id": "salivary-dysfunction-profile", "name": "Salivary dysfunction profile", "description": "Link measured secretion and gland findings with eating, swallowing, speaking and oral health.", "questions": [ { "text": "What salivary flow was measured, under which stimulation and collection conditions, and with which potential confounders?", "kind": "measurement", "id": "salivary-dysfunction-profile-q01" }, { "text": "What gland swelling, oral discomfort, dental deterioration or swallowing difficulty is documented, and how confidently is it attributed to Sjögren's syndrome?", "kind": "boundary", "id": "salivary-dysfunction-profile-q02" } ] } ] } ] }, { "id": "systemic-involvement-and-complications", "name": "Systemic involvement and complications", "description": "Represent manifestations beyond the exocrine glands and findings needing additional investigation.", "rationale": "A dryness-only model cannot describe systemic disease or support appropriate escalation.", "layers": [ { "id": "organ-manifestations-and-attribution", "name": "Organ manifestations and attribution", "description": "Assess involvement across relevant organs while retaining competing explanations.", "findings": [ { "id": "systemic-manifestation-assessment", "name": "Systemic manifestation assessment", "description": "Capture suspected or established pulmonary, renal, neurological, cutaneous, articular and haematological involvement.", "questions": [ { "text": "Which systemic manifestations are present, what objective evidence supports them, and how severe are they?", "kind": "measurement", "id": "systemic-manifestation-assessment-q01" }, { "text": "Could each manifestation reflect an associated autoimmune condition, infection, treatment effect or unrelated disease?", "kind": "boundary", "id": "systemic-manifestation-assessment-q02" } ] } ] }, { "id": "lymphoproliferative-and-other-alerts", "name": "Lymphoproliferative and other alerts", "description": "Track unexplained changes requiring evaluation without treating them as confirmed complications.", "findings": [ { "id": "complication-review-triggers", "name": "Complication review triggers", "description": "Connect concerning glandular, lymphatic or systemic changes to a sourced assessment pathway.", "questions": [ { "text": "Are persistent or asymmetric gland enlargement, lymphadenopathy, unexplained constitutional symptoms or relevant laboratory changes documented?", "kind": "measurement", "id": "complication-review-triggers-q01" }, { "text": "Which current clinical pathway determines the urgency and type of assessment, and has that assessment occurred?", "kind": "action", "id": "complication-review-triggers-q02" } ] } ] } ] }, { "id": "burden-activity-and-course", "name": "Burden, activity and course", "description": "Track the relationship between symptoms, systemic activity and accumulated consequences over time.", "rationale": "Patient burden, inflammatory activity and irreversible damage support different judgments and care targets.", "layers": [ { "id": "symptoms-and-daily-function", "name": "Symptoms and daily function", "description": "Represent dryness, fatigue, pain and their effects on daily life.", "findings": [ { "id": "patient-experienced-burden", "name": "Patient-experienced burden", "description": "Record symptom scores and practical limitations together with potential contributors.", "questions": [ { "text": "How severe are dryness, fatigue and pain using a named instrument such as ESSPRI, with its version and assessment date?", "kind": "measurement", "id": "patient-experienced-burden-q01" }, { "text": "Which daily activities are affected, and which concurrent conditions or exposures may contribute to the reported burden?", "kind": "boundary", "id": "patient-experienced-burden-q02" } ] } ] }, { "id": "activity-damage-and-trajectory", "name": "Activity, damage and trajectory", "description": "Compare dated assessments without imposing an unsupported universal stage sequence.", "findings": [ { "id": "longitudinal-disease-state", "name": "Longitudinal disease state", "description": "Separate current systemic activity, persistent dysfunction and uncertain change.", "questions": [ { "text": "What systemic activity is recorded using a named instrument such as ESSDAI, including version, domain evidence and date?", "kind": "measurement", "id": "longitudinal-disease-state-q01" }, { "text": "Which changes represent active disease, established damage, treatment effects or unresolved attribution?", "kind": "boundary", "id": "longitudinal-disease-state-q02" }, { "text": "Are apparent trends interpretable given changes in tests, assessors, treatment and observation intervals?", "kind": "provenance", "id": "longitudinal-disease-state-q03" } ] } ] } ] }, { "id": "manifestation-directed-care", "name": "Manifestation-directed care", "description": "Relate potential care actions to disease manifestations, patient priorities and observed outcomes.", "rationale": "Local dryness care and management of systemic involvement require distinct indications and measures of benefit.", "layers": [ { "id": "local-care-and-prevention", "name": "Local care and prevention", "description": "Connect ocular and oral care to functional deficits and preventable consequences.", "findings": [ { "id": "glandular-care-targets", "name": "Glandular care targets", "description": "Record clinician-reviewed options, intended benefits and follow-up for ocular and oral manifestations.", "questions": [ { "text": "Which ocular or oral problem is each intervention intended to address, and what current guidance supports its use?", "kind": "action", "id": "glandular-care-targets-q01" }, { "text": "What symptom, examination or oral-health outcome will indicate benefit, intolerance or need for specialist reassessment?", "kind": "measurement", "id": "glandular-care-targets-q02" } ] } ] }, { "id": "systemic-care-and-response", "name": "Systemic care and response", "description": "Link systemic treatment decisions to attributed manifestations and monitored outcomes.", "findings": [ { "id": "systemic-treatment-justification", "name": "Systemic treatment justification", "description": "Preserve the indication, supporting guidance, constraints and response for clinician-directed systemic care.", "questions": [ { "text": "Which attributed manifestation and severity justify consideration of systemic treatment under the applicable guideline?", "kind": "action", "id": "systemic-treatment-justification-q01" }, { "text": "What disease outcomes and treatment safety observations determine continuation, adjustment or escalation?", "kind": "measurement", "id": "systemic-treatment-justification-q02" }, { "text": "Which associated conditions, current medicines or patient priorities materially constrain the proposed option?", "kind": "boundary", "id": "systemic-treatment-justification-q03" } ] } ] } ] }, { "id": "evidence-and-external-alignment", "name": "Evidence and external alignment", "description": "What the world already says about this thing, gathered so the model can be checked against it.", "rationale": "A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.", "layers": [ { "id": "reported-evidence", "name": "Reported evidence", "description": "Findings from the breadth pass, kept separate from the structural claims.", "findings": [ { "id": "evidence-confidence-notes", "name": "Check these first", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "This is a recall-based description; no sources were consulted. Verify exact criteria wording, exclusions and applicable coding revisions before publication.", "The cause is incompletely established, the course is heterogeneous, and no single universal staging sequence applies; disease, diagnostic classification and an episode of care are distinct.", "The disease predominantly affects women and is often recognised in middle adulthood, but occurs across ages and sexes; population-specific prevalence and current terminology should be checked." ], "questions": [ { "id": "evidence-confidence-notes-q01", "text": "Which of these check these first hold for the sense of Sjögren's syndrome this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-kinds", "name": "Kinds and varieties", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "Primary Sjögren's syndrome", "Sjögren's syndrome associated with another systemic autoimmune disease, traditionally called secondary Sjögren's syndrome" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of Sjögren's syndrome this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-identifiers", "name": "Identifiers and schemes", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ { "scheme": "WHO ICD-10", "value_or_pattern": "M35.0", "note": "Sicca syndrome [Sjögren]; national clinical modifications may add subcodes, so the jurisdiction and revision must accompany the code." } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of Sjögren's syndrome this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-standards-and-regulation", "name": "Standards and regulation", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "2016 American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjögren's syndrome: a weighted score of at least 4 in eligible individuals after specified exclusions; classification criteria support research consistency and are not a substitute for clinical diagnosis.", "EULAR recommendations for management of Sjögren's syndrome with topical and systemic therapies." ], "questions": [ { "id": "evidence-standards-and-regulation-q01", "text": "Which of these standards and regulation hold for the sense of Sjögren's syndrome this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-real-world-use", "name": "Real-world use", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "Clinical evaluation of persistent eye and mouth dryness, gland swelling, fatigue or systemic manifestations.", "Selection of sufficiently comparable participants for research using explicitly versioned classification criteria.", "Assessment of systemic disease activity and patient-reported symptom burden.", "Coordination of rheumatology, ophthalmology and dental care.", "Longitudinal monitoring for organ involvement and lymphoma." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of Sjögren's syndrome this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-measurements", "name": "Typical measurements", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ { "quantity": "Schirmer test tear production", "typical_range": "2016 classification threshold: 5 or less in at least one eye over 5 minutes; this is a criterion threshold, not a typical patient range.", "unit": "mm of strip wetting" }, { "quantity": "Unstimulated whole salivary flow", "typical_range": "2016 classification threshold: 0.1 or less; this is a criterion threshold, not a typical patient range.", "unit": "mL/min" }, { "quantity": "Labial salivary gland biopsy focus score", "typical_range": "2016 classification threshold: at least 1 in the presence of focal lymphocytic sialadenitis; a focus contains at least 50 mononuclear cells.", "unit": "foci per 4 mm² of glandular tissue" }, { "quantity": "EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI)", "typical_range": "0-10 instrument scale, averaging patient ratings of dryness, fatigue and pain.", "unit": "score" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of Sjögren's syndrome this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-failure-modes-and-hazards", "name": "Failure modes and hazards", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "Mistaking medication-related or other non-autoimmune dryness for Sjögren's syndrome.", "Excluding the disease solely because anti-SSA/Ro antibodies are absent, or diagnosing it solely from a positive antibody result.", "Dental caries, oral candidiasis and ocular surface injury associated with impaired secretions.", "Extraglandular disease, including interstitial lung disease, peripheral neuropathy and renal tubular involvement.", "Increased risk of B-cell non-Hodgkin lymphoma, particularly mucosa-associated lymphoid tissue lymphoma." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of Sjögren's syndrome this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-regional-variation", "name": "Regional variation", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ "Prevalence estimates depend on population, ascertainment method and classification criteria; estimates from different regions are not automatically comparable.", "Administrative coding varies between WHO ICD-10 and national clinical modifications." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of Sjögren's syndrome this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-neighbours", "name": "Neighbouring kinds and how to tell them apart", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ { "name": "Sicca symptoms", "difference": "Dry eyes and dry mouth are symptoms with multiple causes; Sjögren's syndrome requires evidence supporting an autoimmune disease." }, { "name": "IgG4-related disease", "difference": "It can cause lacrimal and salivary gland enlargement, but its characteristic tissue pathology and clinicopathological findings distinguish it; it is an exclusion in the 2016 classification criteria." }, { "name": "Systemic lupus erythematosus", "difference": "It has a distinct clinical and immunological pattern; anti-SSA/Ro antibodies can occur in both, and the diseases may coexist." }, { "name": "Rheumatoid arthritis", "difference": "Persistent inflammatory synovitis defines its principal clinical pattern; associated Sjögren's syndrome describes an additional autoimmune disease rather than the arthritis itself." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of Sjögren's syndrome this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Which current diagnostic guidance and classification frameworks should be represented, and how do their applicability and evidence differ for adults, children and seronegative presentations?", "What exact ICD-10, ICD-11 and SNOMED CT concepts match this registry entry in the intended editions and jurisdictions, including terminology changes between syndrome and disease?", "How should salivary gland ultrasound contribute to diagnostic reasoning and follow-up under the selected guidance, and which acquisition and scoring protocols are supported?", "Which complication predictors and escalation pathways have sufficient evidence for the intended population, particularly for lymphoproliferative disease?", "What prevalence estimates, affected-population patterns and longitudinal outcomes are supported by sources that specify geography, ascertainment method, criteria and study year?" ], "statistics": { "bundles": 6, "layers": 11, "findings": 19, "questions": 33 } }, "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 Sjögren's syndrome, record what state it is in, and decide what may be done with it.", "whatItIs": "Enable an AI agent to recognise evidence relevant to Sjögren's syndrome, describe its glandular and systemic state, and identify appropriate assessment and care options for clinician review.", "characteristics": { "substance": "information", "origin": "conceptual", "agency": "inert" }, "whatYouCanDoWithIt": [ "read and interpreted" ], "distinguishingFeatures": [ "Names folded into this entry, which a task may need to split apart again: sicca syndrome.", "1 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 59 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 Sjögren's syndrome, and on what evidence are they told apart?" ], "whatItIsMadeOf": "content that has to be carried by something else", "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": [ "read it and act on what it says" ], "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": [ "sicca syndrome" ] } ], "standing": "Described in 59 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is. 1 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 Sjögren's syndrome from another, and a Sjögren's syndrome 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 Sjögren's syndrome, 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 Sjögren's syndrome, 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 Sjögren's syndrome 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 Sjögren's syndrome, 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 Sjögren's syndrome, 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 Sjögren's syndrome 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 Sjögren's syndrome 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 Sjögren's syndrome, 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 Sjögren's syndrome, 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 Sjögren's syndrome 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 Sjögren's syndrome from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a Sjögren's syndrome, 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 Sjögren's syndrome, 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 Sjögren's syndrome 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 Sjögren's syndrome 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 Sjögren's syndrome between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a Sjögren's syndrome, 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 Sjögren's syndrome, 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 Sjögren's syndrome 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 Sjögren's syndrome, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a Sjögren's syndrome 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 Sjögren's syndrome, 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 Sjögren's syndrome, 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 Sjögren's syndrome is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "content-and-access", "name": "Content, encoding and access", "description": "What a Sjögren's syndrome says, how it is encoded and who may read it.", "rationale": "An informational thing carries content that can be copied, versioned and withheld, none of which its physical carrier explains.", "layers": [ { "id": "content-and-encoding", "name": "Content and encoding", "description": "The content itself, its format and its language.", "findings": [ { "id": "content-and-format", "name": "Content, format and language", "description": "What a Sjögren's syndrome contains and in what form it is held.", "questions": [ { "id": "content-and-format-q01", "text": "What identifies and describes the content of a Sjögren's syndrome, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "content-and-format-q02", "text": "Who or what asserted this about the content of a Sjögren's syndrome, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "content-and-format-q03", "text": "What may an agent decide or do once the content of a Sjögren's syndrome is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "access-and-rights", "name": "Access, rights and retention", "description": "Who may read, copy or change it, and for how long it is kept.", "findings": [ { "id": "access-rules", "name": "Access rules and retention", "description": "The permissions attached to a Sjögren's syndrome and the period it survives.", "questions": [ { "id": "access-rules-q01", "text": "What identifies and describes access to a Sjögren's syndrome, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "access-rules-q02", "text": "Who or what asserted this about access to a Sjögren's syndrome, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "access-rules-q03", "text": "What may an agent decide or do once access to a Sjögren's syndrome 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 Sjögren's syndrome 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 Sjögren's syndrome, 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 Sjögren's syndrome, 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 Sjögren's syndrome 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 Sjögren's syndrome 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 Sjögren's syndrome, 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 Sjögren's syndrome 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 Sjögren's syndrome and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a Sjögren's syndrome, 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 Sjögren's syndrome, 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 Sjögren's syndrome 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 Sjögren's syndrome is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a Sjögren's syndrome, 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 Sjögren's syndrome, 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 Sjögren's syndrome 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 } } } }