{
    "model": {
        "rank": 13215,
        "code": "thing-q622427",
        "model_id": "vr.tr.ptosis",
        "name": "ptosis",
        "purpose": "Let an agent explain eyelid ptosis and its causes in general terms from ophthalmic sources, identify urgent presentations, describe treatment, distinguish ptosis from other eyelid and brow conditions, and route personal questions to clinicians.",
        "family": "Thing Registry",
        "category": "Information and virtual systems",
        "status": "research-draft",
        "kind": "thing",
        "plane": "INF",
        "domain": "INF.KNW",
        "industry": "",
        "version": "",
        "url": "/models/thing/q622427/",
        "tier": 2,
        "score": 38,
        "payload": {
            "layer": "wikidata",
            "aliases": [
                "Borjeson-Forssman-Lehmann syndrome",
                "dopamine beta-hydroxylase deficiency",
                "jaw-winking syndrome",
                "mucopolysaccharidosis II",
                "Jacobsen syndrome",
                "myotonic dystrophy",
                "congenital ptosis",
                "Char syndrome",
                "Oculopharyngodistal myopathy",
                "ptosis-strabismus-ectopic pupils syndrome",
                "ptosis-vocal cord paralysis syndrome",
                "blepharophimosis-ptosis-esotropia-syndactyly-short stature syndrome",
                "Acrootoocular syndrome",
                "oculogastrointestinal muscular dystrophy",
                "atrioventricular defect-blepharophimosis-radial and anal defect syndrome",
                "blepharophimosis-radioulnar synostosis syndrome",
                "ptosis-upper ocular movement limitation-absence of lacrimal punctum syndrome",
                "Marin-Amat syndrome",
                "Inverse Marcus-Gunn phenomenon",
                "mucopolysaccharidosis type 2, severe form",
                "mucopolysaccharidosis type 2, attenuated form",
                "oculopharyngodistal myopathy 4"
            ],
            "aliasCount": 22,
            "merged": 22,
            "knownIn": 38,
            "facets": null,
            "markers": [],
            "lexicalClass": "",
            "senseRank": null,
            "alsoRegisteredAs": null,
            "source": {
                "dataset": "wikidata",
                "item": "Q622427",
                "url": "https://www.wikidata.org/wiki/Q622427",
                "license": "CC0 1.0"
            }
        },
        "research": {
            "vercy": "1.0-draft",
            "publication": {
                "status": "research-draft",
                "adjudicationStatus": "unreviewed",
                "publishableCanonical": false,
                "generatedAt": "2026-09-13T03:59:38Z",
                "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-Q622427",
                "registryId": "vr.tr.ptosis",
                "name": "ptosis",
                "version": "0.2.0-wave.3",
                "entryKind": "thing",
                "family": "Thing Registry",
                "domain": [
                    "INF.KNW"
                ],
                "status": "research-draft"
            },
            "canonicalUrl": "https://ver.cy/models/thing/q622427/",
            "model": {
                "registry_id": "vr.tr.ptosis",
                "name": "ptosis",
                "purpose": "Let an agent explain eyelid ptosis and its causes in general terms from ophthalmic sources, identify urgent presentations, describe treatment, distinguish ptosis from other eyelid and brow conditions, and route personal questions to clinicians.",
                "definition": "Drooping of the upper eyelid, present from birth as congenital ptosis or acquired through ageing, muscle or nerve disorders such as myasthenia gravis, third nerve palsy, Horner syndrome and myotonic dystrophy, trauma or long-term contact lens use, and occurring as a feature of syndromes such as Borjeson-Forssman-Lehmann, Jacobsen syndrome, mucopolysaccharidosis II and dopamine beta-hydroxylase deficiency, or with unusual movement as in jaw-winking syndrome; ptosis can block vision in children and is treated by surgery when needed.",
                "what_it_is_for": "Not applicable; a clinical sign.",
                "affordances": [
                    "explain causes",
                    "identify urgent presentations",
                    "relay treatment",
                    "route personal questions"
                ],
                "distinguishing_features": [
                    "Eyelid drooping",
                    "Many causes",
                    "Congenital and acquired",
                    "Vision impact in children"
                ],
                "appearance": "A drooping upper eyelid covering part of the eye.",
                "visual_identification": [
                    "Drooping upper eyelid",
                    "Congenital, aponeurotic, myogenic, neurogenic and mechanical ptosis; syndromic ptosis; jaw-winking",
                    "Dermatochalasis is excess skin; brow ptosis is a drooping brow; the word ptosis also names drooping of other organs"
                ],
                "physical_properties": [
                    {
                        "quantity": "congenital ptosis incidence",
                        "typical_range": "about 1 in 800",
                        "unit": "births",
                        "note": "estimates"
                    },
                    {
                        "quantity": "normal upper lid position",
                        "typical_range": "about 1-2 mm below the limbus",
                        "unit": "measure",
                        "note": ""
                    }
                ],
                "families_and_kinds": [
                    "congenital ptosis",
                    "aponeurotic or involutional ptosis of ageing",
                    "myogenic ptosis in myasthenia gravis and myotonic dystrophy",
                    "neurogenic ptosis in third nerve palsy and Horner syndrome",
                    "mechanical and traumatic ptosis",
                    "syndromic ptosis in conditions such as Borjeson-Forssman-Lehmann, Jacobsen, mucopolysaccharidosis II and dopamine beta-hydroxylase deficiency",
                    "Marcus Gunn jaw-winking syndrome"
                ],
                "related_models": [
                    {
                        "relation": "is a kind of",
                        "target": "eyelid disease",
                        "why": "in registry terms"
                    },
                    {
                        "relation": "is a kind of",
                        "target": "general symptom",
                        "why": "in registry terms"
                    },
                    {
                        "relation": "is a kind of",
                        "target": "eye disease",
                        "why": "in registry terms"
                    },
                    {
                        "relation": "is caused by",
                        "target": "myasthenia gravis",
                        "why": "among other conditions"
                    }
                ],
                "identifiers": [
                    {
                        "scheme": "ICD-11",
                        "value_or_pattern": "9A01.3",
                        "note": "ptosis of eyelid"
                    },
                    {
                        "scheme": "MeSH",
                        "value_or_pattern": "D001763",
                        "note": "blepharoptosis"
                    }
                ],
                "standards_and_regulation": [
                    "Ophthalmology guidelines on ptosis assessment and surgery",
                    "Paediatric vision screening guidance"
                ],
                "failure_modes_and_hazards": [
                    "Missing sudden ptosis from aneurysm or stroke",
                    "Amblyopia in children with untreated ptosis",
                    "Agents giving personal medical advice",
                    "Registry aliases naming whole syndromes as ptosis"
                ],
                "in_scope": [],
                "out_of_scope": [],
                "characteristics": []
            },
            "sources": [],
            "structure": {
                "bundles": [
                    {
                        "id": "help",
                        "name": "Help",
                        "description": "Urgent signs first.",
                        "rationale": "Safety.",
                        "layers": [
                            {
                                "id": "urgent",
                                "name": "Urgent",
                                "description": "Sudden ptosis.",
                                "findings": [
                                    {
                                        "id": "urgent-finding",
                                        "name": "Urgent",
                                        "description": "Urgent.",
                                        "questions": [
                                            {
                                                "text": "Why does sudden ptosis with double vision, an enlarged pupil, headache or weakness need emergency care?",
                                                "kind": "action"
                                            },
                                            {
                                                "text": "Is the user describing sudden ptosis with such signs, which need emergency services now?",
                                                "kind": "boundary"
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "id": "assessment",
                                "name": "Assessment",
                                "description": "Assessment.",
                                "findings": [
                                    {
                                        "id": "assessment-finding",
                                        "name": "Assessment",
                                        "description": "Assessment.",
                                        "questions": [
                                            {
                                                "text": "How do clinicians assess ptosis and find its cause, in general terms?",
                                                "kind": "provenance"
                                            },
                                            {
                                                "text": "Is the user asking about their own eyelid, which needs a clinician?",
                                                "kind": "boundary"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    },
                    {
                        "id": "understand",
                        "name": "Understand",
                        "description": "The sign.",
                        "rationale": "Clinical.",
                        "layers": [
                            {
                                "id": "definition",
                                "name": "Definition",
                                "description": "Definition.",
                                "findings": [
                                    {
                                        "id": "definition-finding",
                                        "name": "Definition",
                                        "description": "Definition.",
                                        "questions": [
                                            {
                                                "text": "What is ptosis, and how does it differ from dermatochalasis and brow ptosis?",
                                                "kind": "definition"
                                            },
                                            {
                                                "text": "Is the question about eyelid ptosis or drooping of another organ?",
                                                "kind": "boundary"
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "id": "causes",
                                "name": "Causes",
                                "description": "Causes.",
                                "findings": [
                                    {
                                        "id": "causes-finding",
                                        "name": "Causes",
                                        "description": "Causes.",
                                        "questions": [
                                            {
                                                "text": "What causes ptosis, from ageing and nerve palsies to myasthenia and syndromes such as Borjeson-Forssman-Lehmann and Jacobsen?",
                                                "kind": "provenance"
                                            },
                                            {
                                                "text": "Which entry fits the specific cause?",
                                                "kind": "action"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    },
                    {
                        "id": "treat",
                        "name": "Treat",
                        "description": "Treatment.",
                        "rationale": "Clinical.",
                        "layers": [
                            {
                                "id": "treatment",
                                "name": "Treatment",
                                "description": "Treatment.",
                                "findings": [
                                    {
                                        "id": "treatment-finding",
                                        "name": "Treatment",
                                        "description": "Treatment.",
                                        "questions": [
                                            {
                                                "text": "How is ptosis treated by surgery or by treating the cause, per guidelines?",
                                                "kind": "provenance"
                                            },
                                            {
                                                "text": "Which references are standard?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "id": "children",
                                "name": "Children",
                                "description": "Children.",
                                "findings": [
                                    {
                                        "id": "children-finding",
                                        "name": "Children",
                                        "description": "Children.",
                                        "questions": [
                                            {
                                                "text": "Why does congenital ptosis need monitoring for amblyopia, and when is surgery done?",
                                                "kind": "provenance"
                                            },
                                            {
                                                "text": "Which sources are cited?",
                                                "kind": "provenance"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    },
                    {
                        "id": "context",
                        "name": "Context",
                        "description": "Special forms and history.",
                        "rationale": "Context.",
                        "layers": [
                            {
                                "id": "special",
                                "name": "Special",
                                "description": "Jaw-winking and syndromes.",
                                "findings": [
                                    {
                                        "id": "special-finding",
                                        "name": "Special",
                                        "description": "Special.",
                                        "questions": [
                                            {
                                                "text": "What are Marcus Gunn jaw-winking syndrome and the syndromes that include ptosis?",
                                                "kind": "provenance"
                                            },
                                            {
                                                "text": "Which entry fits the specific syndrome?",
                                                "kind": "action"
                                            }
                                        ]
                                    }
                                ]
                            },
                            {
                                "id": "history",
                                "name": "History",
                                "description": "History.",
                                "findings": [
                                    {
                                        "id": "history-finding",
                                        "name": "History",
                                        "description": "History.",
                                        "questions": [
                                            {
                                                "text": "How has ptosis surgery developed?",
                                                "kind": "provenance"
                                            },
                                            {
                                                "text": "Which entry fits the history of ophthalmology?",
                                                "kind": "action"
                                            }
                                        ]
                                    }
                                ]
                            }
                        ]
                    }
                ]
            },
            "openQuestions": [
                "Should congenital ptosis and myasthenia gravis be separate primary entries?",
                "How should clinical guidelines be linked?",
                "The registry entry has merged aliases naming syndromes in which ptosis is one feature; should they be split off?"
            ],
            "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 ptosis, record what state it is in, and decide what may be done with it.",
            "whatItIs": "Let an agent explain eyelid ptosis and its causes in general terms from ophthalmic sources, identify urgent presentations, describe treatment, distinguish ptosis from other eyelid and brow conditions, and route personal questions to clinicians.",
            "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: Borjeson-Forssman-Lehmann syndrome, dopamine beta-hydroxylase deficiency, jaw-winking syndrome, mucopolysaccharidosis II, Jacobsen syndrome, myotonic dystrophy, congenital ptosis, Char syndrome, Oculopharyngodistal myopathy, ptosis-strabismus-ectopic pupils syndrome, ptosis-vocal cord paralysis syndrome, blepharophimosis-ptosis-esotropia-syndactyly-short stature syndrome.",
                "22 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.",
                "Described in 38 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 ptosis, 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": [
                        "Borjeson-Forssman-Lehmann syndrome",
                        "dopamine beta-hydroxylase deficiency",
                        "jaw-winking syndrome",
                        "mucopolysaccharidosis II",
                        "Jacobsen syndrome",
                        "myotonic dystrophy",
                        "congenital ptosis",
                        "Char syndrome",
                        "Oculopharyngodistal myopathy",
                        "ptosis-strabismus-ectopic pupils syndrome",
                        "ptosis-vocal cord paralysis syndrome",
                        "blepharophimosis-ptosis-esotropia-syndactyly-short stature syndrome"
                    ]
                }
            ],
            "standing": "Described in 38 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is. 22 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 ptosis from another, and a ptosis 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 ptosis, 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 ptosis, 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 ptosis 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 ptosis, 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 ptosis, 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 ptosis 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 ptosis 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 ptosis, 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 ptosis, 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 ptosis 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 ptosis from the things most often confused with it.",
                                        "questions": [
                                            {
                                                "id": "distinguishing-features-q01",
                                                "text": "What identifies and describes what distinguishes a ptosis, 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 ptosis, 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 ptosis 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 ptosis 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 ptosis between them.",
                                        "questions": [
                                            {
                                                "id": "stages-and-transitions-q01",
                                                "text": "What identifies and describes the lifecycle of a ptosis, 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 ptosis, 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 ptosis 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 ptosis, how often and by whom.",
                                "findings": [
                                    {
                                        "id": "observation-record",
                                        "name": "Observation record",
                                        "description": "How an observation of a ptosis 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 ptosis, 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 ptosis, 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 ptosis 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 ptosis 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 ptosis contains and in what form it is held.",
                                        "questions": [
                                            {
                                                "id": "content-and-format-q01",
                                                "text": "What identifies and describes the content of a ptosis, 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 ptosis, 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 ptosis 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 ptosis and the period it survives.",
                                        "questions": [
                                            {
                                                "id": "access-rules-q01",
                                                "text": "What identifies and describes access to a ptosis, 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 ptosis, 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 ptosis 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 ptosis 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 ptosis, 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 ptosis, 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 ptosis 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 ptosis 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 ptosis, 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 ptosis 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 ptosis and how confident it is.",
                                        "questions": [
                                            {
                                                "id": "claim-provenance-q01",
                                                "text": "What identifies and describes a claim about a ptosis, 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 ptosis, 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 ptosis 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 ptosis is retired without being erased.",
                                        "questions": [
                                            {
                                                "id": "validity-and-supersession-q01",
                                                "text": "What identifies and describes the validity of a claim about a ptosis, 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 ptosis, 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 ptosis 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
            }
        }
    }
}