{ "model": { "rank": 4905, "code": "thing-q649558", "model_id": "vr.tr.chagas-disease", "name": "Chagas disease", "purpose": "Enable an agent to recognise Chagas disease, assess infection certainty and clinical state, and identify evidence-supported diagnostic, care and transmission-prevention actions.", "family": "Thing Registry", "category": "Cross-cutting context", "status": "research-draft", "kind": "thing", "plane": "XCT", "domain": "XCT.STA", "industry": "", "version": "", "url": "/models/thing/q649558/", "tier": 2, "score": 71, "payload": { "layer": "wikidata", "aliases": [ "Chagas cardiomyopathy" ], "aliasCount": 1, "merged": 1, "knownIn": 71, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": null, "source": { "dataset": "wikidata", "item": "Q649558", "url": "https://www.wikidata.org/wiki/Q649558", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-09T21:15:10Z", "providers": [ "Codex" ], "breadth": "recalled by Codex without web access - no source was read", "missingProviders": [], "pass": 2, "cost": { "grok": { "seconds": 22.3, "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: 01a08805-060e-7693-bda0-7f5307030128\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: Chagas disease\nSense to describe: (none recorded)\nDomain code: XCT.STA\nAlso known as: (none)\n\n\nContext for this batch of 1001 things:\n# Batch 005: 1001 ", "usd": 0, "recall": true }, "codex": { "seconds": 84.9, "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: 01a08805-061e-7873-a833-49c3c996383b\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: Chagas disease\nRegistry id: vr.tr.chagas-disease\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nNames folded into this entry: (no" } } }, "metaModel": { "id": "THING-Q649558", "registryId": "vr.tr.chagas-disease", "name": "Chagas disease", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q649558/", "model": { "registry_id": "vr.tr.chagas-disease", "name": "Chagas disease", "purpose": "Enable an agent to recognise Chagas disease, assess infection certainty and clinical state, and identify evidence-supported diagnostic, care and transmission-prevention actions.", "definition": "Chagas disease is a parasitic infection caused by Trypanosoma cruzi that can persist lifelong and cause chronic cardiac, gastrointestinal or other organ damage after an acute phase that is often mild or unrecognized.", "scope_statement": "This model owns the disease concept Chagas disease (American trypanosomiasis), registry vr.tr.chagas-disease in XCT / XCT.STA, including asymptomatic infection, manifestations and disease-specific decision conditions; individual patients, diagnostic assertions and care episodes remain linked entities.", "in_scope": [ "Evidence attributing infection to Trypanosoma cruzi", "Acute and chronic phases, with reactivation assessed separately", "Cardiac, digestive, neurological and mixed manifestations", "Phase-appropriate diagnostic evidence and versioned case definitions", "Antiparasitic treatment eligibility, response and longitudinal monitoring", "Transmission routes, exposed populations and prevention implications" ], "out_of_scope": [ "The patient's complete medical and demographic record", "The taxonomy and full life cycle of Trypanosoma cruzi", "Triatomine species inventories and vector-control operations", "Clinical encounters, prescriptions and laboratory workflow execution", "Independent models of cardiomyopathy, arrhythmia or digestive disorders", "African trypanosomiasis and other parasitic diseases" ], "distinguishing_features": [ "Require evidence of Trypanosoma cruzi infection; an insect bite or residence in an endemic area establishes exposure plausibility, not disease confirmation. [CDC diagnosis guidance](https://www.cdc.gov/chagas/hcp/diagnosis-testing/index.html)", "Distinguish the infection from its organ manifestations: absence of symptoms does not exclude Chagas disease. [WHO overview](https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis))", "For chronic infection, check for concordant serology using different antigens; a single reactive screening assay does not establish a clinical diagnosis. [CDC diagnosis guidance](https://www.cdc.gov/chagas/hcp/diagnosis-testing/index.html)", "Check the organism attribution before accepting an unspecified trypanosomiasis label: this entry covers T. cruzi infection. [CDC case definition](https://ndc.services.cdc.gov/case-definitions/chagas-disease/)" ], "characteristics": [ { "name": "Infection assertion", "kind": "state", "unit_or_values": "Suspected, confirmed, unresolved, excluded under named criteria; assessment date required", "why_it_matters": "Separates exposure, screening results and established infection." }, { "name": "Disease phase", "kind": "category", "unit_or_values": "Acute, chronic, uncertain; onset estimate and assignment criteria", "why_it_matters": "Determines how diagnostic evidence and treatment decisions should be interpreted." }, { "name": "Reactivation assessment", "kind": "state", "unit_or_values": "Not assessed, no evidence, suspected, confirmed; dated evidence", "why_it_matters": "Keeps renewed parasite activity distinct from ordinary chronic progression." }, { "name": "Organ involvement", "kind": "category", "unit_or_values": "None detected after specified assessment, cardiac, digestive, neurological, mixed, incompletely assessed", "why_it_matters": "Prevents missing investigations from being interpreted as absence of organ disease." }, { "name": "Diagnostic evidence", "kind": "relation", "unit_or_values": "Linked specimens, assay identities, results, dates, laboratory reports and interpretation", "why_it_matters": "Makes confirmation and discordance reviewable." }, { "name": "Acquisition route", "kind": "category", "unit_or_values": "Vector-associated, congenital, oral, transfusion, transplantation, laboratory exposure, unknown; suspected or supported", "why_it_matters": "Connects disease recognition to route-specific investigation." }, { "name": "Cardiac functional assessment", "kind": "measurement", "unit_or_values": "Left ventricular ejection fraction in percent, with method and date; linked rhythm and conduction findings", "why_it_matters": "Supports assessment of cardiac involvement without reducing it to one measurement." }, { "name": "Antiparasitic treatment status", "kind": "state", "unit_or_values": "Not assessed, considered, deferred, underway, completed, interrupted; rationale and dates", "why_it_matters": "Separates treatment delivery from evidence of treatment success." }, { "name": "Classification mapping", "kind": "relation", "unit_or_values": "Verified ICD-10, ICD-11 or SNOMED CT concept, release, jurisdiction and mapping scope", "why_it_matters": "Prevents unversioned codes from silently changing the meaning of a disease assertion." }, { "name": "Population prevalence", "kind": "measurement", "unit_or_values": "Percent or cases per stated population denominator, with geography, observation year, method and uncertainty", "why_it_matters": "Makes estimates comparable without treating screened samples as whole populations." } ], "affordances": [ "Identify missing evidence needed to resolve suspected T. cruzi infection.", "Check whether the diagnostic pathway fits the disease phase and testing purpose.", "Assemble a dated assessment of organ involvement and possible reactivation.", "Support clinician review of antiparasitic eligibility and monitoring needs.", "Identify congenital, donation-related or shared-exposure investigation pathways.", "Compare disease assertions and population estimates only when definitions and versions align." ] }, "sources": [], "structure": { "bundles": [ { "id": "infection-identity-and-classification", "name": "Infection identity and classification", "description": "Establish what the Chagas disease assertion means and how it is represented.", "rationale": "Exposure, infection, organ disease and a coded encounter can otherwise be conflated.", "layers": [ { "id": "etiological-boundary", "name": "Etiological boundary", "description": "Anchor this entry to the causal infection.", "findings": [ { "id": "trypanosoma-cruzi-attribution", "name": "Trypanosoma cruzi attribution", "description": "Record the evidence supporting T. cruzi attribution and its uncertainty.", "questions": [ { "text": "What evidence attributes this condition to T. cruzi?", "kind": "provenance", "id": "trypanosoma-cruzi-attribution-q01" }, { "text": "Does the record describe exposure, established infection or an attributed complication?", "kind": "boundary", "id": "trypanosoma-cruzi-attribution-q02" } ] } ] }, { "id": "versioned-disease-assertions", "name": "Versioned disease assertions", "description": "Preserve the purpose and authority of diagnostic and classification labels.", "findings": [ { "id": "clinical-and-surveillance-meaning", "name": "Clinical and surveillance meaning", "description": "Surveillance classification must retain its separate purpose from clinical diagnosis. [CDC 2025 case definition](https://ndc.services.cdc.gov/case-definitions/chagas-disease/)", "questions": [ { "text": "Which issuing body, document version and jurisdiction govern this assertion?", "kind": "provenance", "id": "clinical-and-surveillance-meaning-q01" }, { "text": "Is the label a clinical diagnosis, surveillance classification or administrative code?", "kind": "boundary", "id": "clinical-and-surveillance-meaning-q02" }, { "text": "Which verified ICD or SNOMED release represents its phase and manifestations?", "kind": "definition", "id": "clinical-and-surveillance-meaning-q03" } ] } ] } ] }, { "id": "acquisition-and-exposed-populations", "name": "Acquisition and exposed populations", "description": "Represent plausible acquisition and the population context of infection.", "rationale": "Chagas investigation must accommodate vector and non-vector transmission.", "layers": [ { "id": "transmission-evidence", "name": "Transmission evidence", "description": "Separate route hypotheses from demonstrated links.", "findings": [ { "id": "route-and-exposure-window", "name": "Route and exposure window", "description": "Consider vector-associated contamination, congenital, oral, transfusion, transplantation and laboratory routes. [WHO transmission overview](https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis))", "questions": [ { "text": "Which route is supported, and what exposure dates or locations constrain it?", "kind": "provenance", "id": "route-and-exposure-window-q01" }, { "text": "What distinguishes a demonstrated transmission link from a plausible exposure?", "kind": "boundary", "id": "route-and-exposure-window-q02" } ] } ] }, { "id": "population-and-geography", "name": "Population and geography", "description": "Keep acquisition history separate from present residence and population estimates.", "findings": [ { "id": "denominator-and-acquisition-context", "name": "Denominator and acquisition context", "description": "Attach population, time and ascertainment details to burden estimates.", "questions": [ { "text": "What residence, birth, maternal or travel history supports the acquisition assessment?", "kind": "provenance", "id": "denominator-and-acquisition-context-q01" }, { "text": "What population, observation year, denominator and testing strategy produced the prevalence estimate?", "kind": "measurement", "id": "denominator-and-acquisition-context-q02" } ] } ] } ] }, { "id": "phase-appropriate-confirmation", "name": "Phase-appropriate confirmation", "description": "Organise laboratory evidence around the clinical context and testing purpose.", "rationale": "Acute and chronic infection require different approaches to confirmation.", "layers": [ { "id": "parasite-detection-context", "name": "Parasite detection context", "description": "Capture direct detection evidence alongside timing and host context.", "findings": [ { "id": "acute-and-reactivation-testing", "name": "Acute and reactivation testing", "description": "Acute infection can be diagnosed by blood microscopy; interpretation must retain phase and specimen context. [CDC diagnosis guidance](https://www.cdc.gov/chagas/hcp/diagnosis-testing/index.html)", "questions": [ { "text": "Which direct or molecular test was performed, on what specimen and at what time?", "kind": "measurement", "id": "acute-and-reactivation-testing-q01" }, { "text": "Which protocol governs interpretation in acute, congenital or suspected reactivated infection?", "kind": "provenance", "id": "acute-and-reactivation-testing-q02" } ] } ] }, { "id": "chronic-serological-confirmation", "name": "Chronic serological confirmation", "description": "Assess independent serological evidence and unresolved discordance.", "findings": [ { "id": "assay-concordance-and-purpose", "name": "Assay concordance and purpose", "description": "Record the assays supporting chronic diagnosis and distinguish donor screening from clinical confirmation. [CDC testing protocol](https://www.cdc.gov/chagas/hcp/diagnosis-testing/index.html)", "questions": [ { "text": "Which assays using different antigens support the chronic infection assertion?", "kind": "measurement", "id": "assay-concordance-and-purpose-q01" }, { "text": "What further testing does the applicable algorithm require for discordant results?", "kind": "action", "id": "assay-concordance-and-purpose-q02" }, { "text": "Was testing intended for donor screening or clinical diagnosis?", "kind": "boundary", "id": "assay-concordance-and-purpose-q03" } ] } ] } ] }, { "id": "clinical-course-and-organ-involvement", "name": "Clinical course and organ involvement", "description": "Represent disease evolution, assessed manifestations and reactivation.", "rationale": "Infection duration, symptoms and organ injury are separate dimensions.", "layers": [ { "id": "phase-and-reactivation", "name": "Phase and reactivation", "description": "Track phase assignments and evidence of renewed activity.", "findings": [ { "id": "dated-course-assessment", "name": "Dated course assessment", "description": "Record acute or chronic phase and assess reactivation in the context of immunosuppression. [WHO disease course](https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis))", "questions": [ { "text": "What evidence and estimated infection timing support the assigned phase?", "kind": "provenance", "id": "dated-course-assessment-q01" }, { "text": "What findings support suspected reactivation rather than chronic organ progression?", "kind": "boundary", "id": "dated-course-assessment-q02" } ] } ] }, { "id": "manifestation-attribution", "name": "Manifestation attribution", "description": "Describe organ findings and the evidence linking them to Chagas disease.", "findings": [ { "id": "cardiac-and-digestive-assessment", "name": "Cardiac and digestive assessment", "description": "Evaluate cardiac conduction and structural findings alongside digestive megasyndromes. [CDC clinical care](https://www.cdc.gov/chagas/hcp/clinical-care/index.html)", "questions": [ { "text": "Which dated cardiac and digestive investigations establish involvement and severity?", "kind": "measurement", "id": "cardiac-and-digestive-assessment-q01" }, { "text": "Which competing causes were assessed before attributing these abnormalities to Chagas disease?", "kind": "boundary", "id": "cardiac-and-digestive-assessment-q02" } ] }, { "id": "unassessed-and-neurological-involvement", "name": "Unassessed and neurological involvement", "description": "Retain neurological findings and assessment gaps without defaulting to an asymptomatic classification.", "questions": [ { "text": "Which neurological findings require specialist attribution or investigation?", "kind": "action", "id": "unassessed-and-neurological-involvement-q01" }, { "text": "Which required assessments support an indeterminate chronic form, and which remain incomplete?", "kind": "definition", "id": "unassessed-and-neurological-involvement-q02" } ] } ] } ] }, { "id": "treatment-and-response", "name": "Treatment and response", "description": "Support treatment review and separate therapeutic aims from observed outcomes.", "rationale": "Parasite-directed treatment and management of established damage require distinct judgments.", "layers": [ { "id": "antiparasitic-decision", "name": "Antiparasitic decision", "description": "Record the basis for treatment selection or deferral.", "findings": [ { "id": "eligibility-and-regimen-authority", "name": "Eligibility and regimen authority", "description": "Benznidazole and nifurtimox are antiparasitic options; eligibility depends on clinical context and applicable guidance. [CDC treatment guidance](https://www.cdc.gov/chagas/hcp/clinical-care/index.html)", "questions": [ { "text": "How do age, phase, pregnancy or lactation, organ function and cardiac severity affect the decision?", "kind": "action", "id": "eligibility-and-regimen-authority-q01" }, { "text": "Which guideline and local prescribing authority support the selected regimen or deferral?", "kind": "provenance", "id": "eligibility-and-regimen-authority-q02" } ] } ] }, { "id": "response-and-continuing-care", "name": "Response and continuing care", "description": "Distinguish completion, tolerability, infection response and organ outcomes.", "findings": [ { "id": "separate-treatment-endpoints", "name": "Separate treatment endpoints", "description": "Treatment completion is not a cure criterion, and established organ pathology requires separate follow-up. [CDC care precautions](https://www.cdc.gov/chagas/hcp/clinical-care/index.html)", "questions": [ { "text": "What treatment exposure, interruptions and adverse effects were documented?", "kind": "measurement", "id": "separate-treatment-endpoints-q01" }, { "text": "Which tests, observation period and criteria support a response or cure assertion?", "kind": "definition", "id": "separate-treatment-endpoints-q02" }, { "text": "What organ-specific care remains necessary regardless of antiparasitic response?", "kind": "action", "id": "separate-treatment-endpoints-q03" } ] } ] } ] }, { "id": "congenital-and-transmission-prevention", "name": "Congenital and transmission prevention", "description": "Translate confirmed or suspected infection into linked prevention assessments.", "rationale": "Detection can reveal preventable transmission and additional people needing evaluation.", "layers": [ { "id": "maternal-and-infant-linkage", "name": "Maternal and infant linkage", "description": "Connect maternal infection evidence to infant and sibling evaluation.", "findings": [ { "id": "congenital-exposure-resolution", "name": "Congenital exposure resolution", "description": "Record infant follow-up and family screening implications of maternal infection. [WHO prevention guidance](https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis))", "questions": [ { "text": "What maternal evidence establishes congenital exposure risk?", "kind": "provenance", "id": "congenital-exposure-resolution-q01" }, { "text": "Which age-specific testing and follow-up protocol resolves the infant's infection status?", "kind": "action", "id": "congenital-exposure-resolution-q02" }, { "text": "Which siblings require evaluation under the applicable guidance?", "kind": "action", "id": "congenital-exposure-resolution-q03" } ] } ] }, { "id": "donation-and-shared-exposure", "name": "Donation and shared exposure", "description": "Link disease evidence to blood, transplant and exposure investigations.", "findings": [ { "id": "route-specific-prevention-review", "name": "Route-specific prevention review", "description": "Identify relevant prevention pathways while retaining the authority responsible for each decision.", "questions": [ { "text": "Does the evidence require blood-bank, transplant-service or shared-exposure review?", "kind": "action", "id": "route-specific-prevention-review-q01" }, { "text": "Which current jurisdictional rules govern notification, donation eligibility and investigation?", "kind": "provenance", "id": "route-specific-prevention-review-q02" } ] } ] } ] }, { "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 recall-based information; no sources were consulted.", "Verify current PAHO diagnostic guidance, congenital testing algorithms and the applicable ICD or SNOMED CT edition before operational use.", "Prevalence estimates require a specified population and year; none are supplied here." ], "questions": [ { "id": "evidence-confidence-notes-q01", "text": "Which of these check these first hold for the sense of Chagas disease 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": [ "Acute Chagas disease", "Chronic indeterminate Chagas disease", "Chronic cardiac Chagas disease", "Chronic digestive Chagas disease", "Chronic mixed cardiac and digestive Chagas disease", "Reactivated Chagas disease in immunosuppressed people" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of Chagas disease 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": "B57", "note": "Chagas disease category; subcategories distinguish acute and chronic disease and organ involvement. Record the applicable national modification and revision." }, { "scheme": "SNOMED CT", "value_or_pattern": "Numeric concept identifier", "note": "The exact concept identifier and edition require verification." } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of Chagas disease 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": [ "Pan American Health Organization guidelines for the diagnosis and treatment of Chagas disease.", "World Health Organization International Classification of Diseases, ICD-10 category B57." ], "questions": [ { "id": "evidence-standards-and-regulation-q01", "text": "Which of these standards and regulation hold for the sense of Chagas disease 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": [ "Acute and congenital infection assessment uses direct parasite detection or molecular methods according to clinical context and age.", "Chronic infection diagnosis generally requires two serological tests using different antigen preparations or methods, with further testing for discordant results.", "Evaluation of confirmed infection includes assessment for cardiac involvement and, when indicated, digestive involvement.", "Blood and organ donor screening helps prevent transmission.", "Benznidazole and nifurtimox are used for antiparasitic treatment; treatment decisions depend on disease phase, age and clinical circumstances." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of Chagas disease 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": [ "An initially silent infection can remain undiagnosed for decades before organ damage becomes apparent.", "Cardiac involvement can cause conduction abnormalities, serious arrhythmias, heart failure, thromboembolism and sudden death.", "Digestive involvement can cause megaesophagus or megacolon, with swallowing difficulties or severe constipation.", "Immunosuppression can permit reactivation, including severe myocarditis or central nervous system disease.", "Transmission can occur through infected triatomine feces, contaminated food or drink, congenital transmission, transfusion or transplantation; vector transmission is not ordinarily through the insect's saliva." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of Chagas disease 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": [ "Vector-borne transmission is historically concentrated in continental Latin America; migration has made diagnosis and prevention relevant in other regions.", "The relative importance of domestic vectors, sylvatic vectors and foodborne outbreaks varies geographically.", "Digestive manifestations are reported more frequently in some southern South American populations than in many northern endemic populations." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of Chagas disease 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": "African trypanosomiasis", "difference": "Caused by human-infective Trypanosoma brucei subspecies and transmitted by tsetse flies, whereas Chagas disease is caused by Trypanosoma cruzi." }, { "name": "Chagas cardiomyopathy", "difference": "The cardiac manifestation of Chagas disease; infection can exist without cardiomyopathy." }, { "name": "Congenital Chagas disease", "difference": "Chagas disease acquired through maternal transmission; this specifies the route of acquisition rather than a separate causative disease." }, { "name": "Positive Trypanosoma cruzi antibody test", "difference": "A laboratory result rather than the disease itself; chronic infection ordinarily requires confirmation using an appropriate testing algorithm." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of Chagas disease this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Which exact ICD-10, ICD-11 and SNOMED CT concepts and releases map this entry and its manifestations without conflating infection, diagnosis and encounter?", "Which issuing-body algorithms should govern discordant serology, congenital testing schedules and molecular evidence of reactivation in each intended jurisdiction?", "Which operational criteria and staging systems should define indeterminate chronic infection and cardiac, digestive or neurological severity?", "Which validated endpoints and follow-up periods justify cure or treatment-failure assertions in chronic infection?", "Which population studies provide defensible prevalence estimates by geography, observation year and acquisition route, with denominators and uncertainty?" ], "statistics": { "bundles": 7, "layers": 13, "findings": 21, "questions": 38 } }, "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 Chagas disease, record what state it is in, and decide what may be done with it.", "whatItIs": "Enable an agent to recognise Chagas disease, assess infection certainty and clinical state, and identify evidence-supported diagnostic, care and transmission-prevention actions.", "characteristics": { "substance": "abstract", "origin": "conceptual", "agency": "inert" }, "whatYouCanDoWithIt": [ "observed and measured" ], "distinguishingFeatures": [ "Names folded into this entry, which a task may need to split apart again: Chagas cardiomyopathy.", "1 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 71 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 Chagas disease, and on what evidence are they told apart?" ], "whatItIsMadeOf": "an abstraction with no physical instance", "physicalCharacter": [ "Does nothing on its own; everything it does, something else did to it.", "These come from the domain this entry sits in rather than from the entry itself, so treat them as a first guess about the whole domain applied to one thing." ], "whatCanBeDoneWithIt": [ "observe it, measure it, record its state" ], "howItIsRecognised": [ "Recognised by criteria applied to signs and findings, not by appearance. Two conditions can look identical and be distinguished only by test." ], "relatedModels": [ { "relation": "covers", "note": "Finer kinds folded into this entry because telling them apart needs a task that asks for it. Each is a model waiting to be split out when one does.", "targets": [ "Chagas cardiomyopathy" ] } ], "standing": "Described in 71 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 Chagas disease from another, and a Chagas disease from things that resemble it.", "rationale": "Recognition comes before every other claim. Without stable identity nothing else in the model can be trusted to be about the same thing twice.", "layers": [ { "id": "naming-and-identifiers", "name": "Names and identifiers", "description": "The names this thing goes by and the identifiers that survive translation and time.", "findings": [ { "id": "preferred-name-and-aliases", "name": "Preferred name, aliases and local names", "description": "Which name to use, which names mean the same thing, and which merely sound similar.", "questions": [ { "id": "preferred-name-and-aliases-q01", "text": "What identifies and describes the name of a Chagas disease, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "preferred-name-and-aliases-q02", "text": "Who or what asserted this about the name of a Chagas disease, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "preferred-name-and-aliases-q03", "text": "What may an agent decide or do once the name of a Chagas disease is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "stable-identifiers", "name": "Stable identifiers and external keys", "description": "Identifiers that keep pointing at this kind of thing across systems and languages.", "questions": [ { "id": "stable-identifiers-q01", "text": "What identifies and describes an identifier for a Chagas disease, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stable-identifiers-q02", "text": "Who or what asserted this about an identifier for a Chagas disease, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stable-identifiers-q03", "text": "What may an agent decide or do once an identifier for a Chagas disease is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "classification-and-granularity", "name": "Classification and granularity", "description": "Where a Chagas disease sits among kinds, and how finely a task needs to cut it.", "findings": [ { "id": "kind-and-parents", "name": "Kind, parents and neighbouring kinds", "description": "The classes this thing belongs to and the ones it is next to.", "questions": [ { "id": "kind-and-parents-q01", "text": "What identifies and describes the kind of a Chagas disease, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "kind-and-parents-q02", "text": "Who or what asserted this about the kind of a Chagas disease, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "kind-and-parents-q03", "text": "What may an agent decide or do once the kind of a Chagas disease is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] }, { "id": "distinguishing-features", "name": "Distinguishing features", "description": "What separates a Chagas disease from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a Chagas disease, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "distinguishing-features-q02", "text": "Who or what asserted this about what distinguishes a Chagas disease, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "distinguishing-features-q03", "text": "What may an agent decide or do once what distinguishes a Chagas disease is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "state-and-lifecycle", "name": "State and lifecycle", "description": "The states a Chagas disease passes through and the events that move it between them.", "rationale": "Most decisions about a thing depend on what state it is in now, which is a claim with a time on it, not a property.", "layers": [ { "id": "lifecycle-stages", "name": "Lifecycle stages", "description": "From coming into existence to ceasing to be one of these.", "findings": [ { "id": "stages-and-transitions", "name": "Stages and transitions", "description": "The stages worth naming and what moves a Chagas disease between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a Chagas disease, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "stages-and-transitions-q02", "text": "Who or what asserted this about the lifecycle of a Chagas disease, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "stages-and-transitions-q03", "text": "What may an agent decide or do once the lifecycle of a Chagas disease is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "observations-and-status", "name": "Observations and current status", "description": "What is observed about a Chagas disease, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a Chagas disease is recorded so that it can be superseded rather than overwritten.", "questions": [ { "id": "observation-record-q01", "text": "What identifies and describes an observation of a Chagas disease, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "observation-record-q02", "text": "Who or what asserted this about an observation of a Chagas disease, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "observation-record-q03", "text": "What may an agent decide or do once an observation of a Chagas disease is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "diagnosis-and-criteria", "name": "Diagnosis, criteria and coding", "description": "What makes a case of Chagas disease a case, and under which revision.", "rationale": "Criteria change between revisions, so a diagnosis without its coding revision cannot be compared with a later one.", "layers": [ { "id": "criteria", "name": "Diagnostic criteria", "description": "The criteria in force and who issues them.", "findings": [ { "id": "criteria-record", "name": "Criteria, issuer and revision", "description": "What must be true for a diagnosis, according to whom.", "questions": [ { "id": "criteria-record-q01", "text": "What criteria define Chagas disease, issued by which body, in which revision?", "kind": "definition" }, { "id": "criteria-record-q02", "text": "What changed between revisions that would reclassify existing cases?", "kind": "boundary" } ] } ] }, { "id": "coding", "name": "Coding and terminology", "description": "The codes used to record it and their mapping.", "findings": [ { "id": "coding-record", "name": "Codes and mappings", "description": "Which classification codes apply and how they map.", "questions": [ { "id": "coding-record-q01", "text": "Which classification and terminology codes cover Chagas disease, and how do they map to each other?", "kind": "definition" }, { "id": "coding-record-q02", "text": "What is lost when a case is mapped from one scheme to another?", "kind": "boundary" } ] } ] } ] }, { "id": "course-and-population", "name": "Course, population and care", "description": "How Chagas disease develops, whom it affects, and what is done about it.", "rationale": "The condition, the diagnosis and the episode of care are three different things, and an agent must not merge them.", "layers": [ { "id": "course", "name": "Course and stages", "description": "Onset, progression, remission and outcome.", "findings": [ { "id": "course-record", "name": "Stages and transitions", "description": "The stages recorded and what moves a case between them.", "questions": [ { "id": "course-record-q01", "text": "What course does Chagas disease typically take, and what marks each stage?", "kind": "definition" }, { "id": "course-record-q02", "text": "What separates the condition itself from an episode of care for it?", "kind": "boundary" } ] } ] }, { "id": "population", "name": "Affected populations", "description": "Who is affected, how often, and on what evidence.", "findings": [ { "id": "epidemiology", "name": "Prevalence and its basis", "description": "Rates with their population, period and source.", "questions": [ { "id": "epidemiology-q01", "text": "What prevalence or incidence is reported for Chagas disease, in which population and period?", "kind": "measurement" }, { "id": "epidemiology-q02", "text": "What may an agent not conclude about an individual from a population rate?", "kind": "action" } ] } ] } ] }, { "id": "provenance-and-evidence", "name": "Provenance, evidence and time", "description": "Where every claim about a Chagas disease came from and when it held.", "rationale": "A claim without a source and a time cannot be superseded, only overwritten, and an agent that overwrites loses the ability to explain itself.", "layers": [ { "id": "source-and-authority", "name": "Source and authority", "description": "Who said it, on what evidence, and how strongly.", "findings": [ { "id": "claim-provenance", "name": "Claim provenance and confidence", "description": "The authority behind each claim about a Chagas disease and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a Chagas disease, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "claim-provenance-q02", "text": "Who or what asserted this about a claim about a Chagas disease, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "claim-provenance-q03", "text": "What may an agent decide or do once a claim about a Chagas disease is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] }, { "id": "time-and-versions", "name": "Time, versions and supersession", "description": "When a claim was true, when it was learnt, and what replaced it.", "findings": [ { "id": "validity-and-supersession", "name": "Validity period and supersession", "description": "How an old claim about a Chagas disease is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a Chagas disease, and in what units or vocabulary?", "kind": "definition", "answer_data": [ "identifiers", "types and classes", "values with units", "explicit unknowns" ] }, { "id": "validity-and-supersession-q02", "text": "Who or what asserted this about the validity of a claim about a Chagas disease, by which method, and when was it true?", "kind": "provenance", "answer_data": [ "authority", "method", "evidence", "event time", "knowledge time" ] }, { "id": "validity-and-supersession-q03", "text": "What may an agent decide or do once the validity of a claim about a Chagas disease is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] } ] }, "statistics": { "bundles": 5, "layers": 10, "findings": 12, "questions": 32 } } } }