{ "model": { "rank": 6124, "code": "thing-q816422", "model_id": "vr.tr.dysmenorrhea", "name": "dysmenorrhea", "purpose": "Enable an AI agent to recognise menstrual pain, assess its burden and clinical uncertainty, and support appropriate monitoring, care review or escalation.", "family": "Thing Registry", "category": "Information and virtual systems", "status": "research-draft", "kind": "thing", "plane": "INF", "domain": "INF.KNW", "industry": "", "version": "", "url": "/models/thing/q816422/", "tier": 2, "score": 62, "payload": { "layer": "wikidata", "aliases": [ "psychogenic dysmenorrhea" ], "aliasCount": 1, "merged": 1, "knownIn": 62, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": null, "source": { "dataset": "wikidata", "item": "Q816422", "url": "https://www.wikidata.org/wiki/Q816422", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-07T11:43:23Z", "providers": [ "Codex", "Grok" ], "missingProviders": [], "pass": 2, "cost": { "grok": { "usd": 0.0054349, "turns": 1, "seconds": 78.9, "error": null }, "codex": { "seconds": 84.8, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.3\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: 01a07baa-1b53-7801-a14d-739cc0f5d6f8\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: dysmenorrhea\nRegistry id: vr.tr.dysmenorrhea\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nNames folded into this entry: (none)\n" } } }, "metaModel": { "id": "THING-Q816422", "registryId": "vr.tr.dysmenorrhea", "name": "dysmenorrhea", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q816422/", "model": { "registry_id": "vr.tr.dysmenorrhea", "name": "dysmenorrhea", "purpose": "Enable an AI agent to recognise menstrual pain, assess its burden and clinical uncertainty, and support appropriate monitoring, care review or escalation.", "definition": "Dysmenorrhea is cyclic, menstruation-associated pelvic or lower-abdominal pain arising from uterine contractions and prostaglandin-mediated ischemia, classified in practice as primary when no pelvic pathology is found and secondary when pain is caused by an identifiable gynecologic disease.", "scope_statement": "This model owns dysmenorrhea as a person-specific menstrual pain state, including individual episodes, recurrence across cycles, functional effects, attribution confidence and response to care; underlying diseases and treatments remain linked neighbouring models.", "in_scope": [ "Pain timing relative to menstruation and recurrence across cycles", "Pain location, quality, intensity, duration and associated symptoms", "Effects on daily activities, sleep and participation", "Primary or secondary attribution, supporting evidence and unresolved alternatives", "Episode-specific escalation needs and response to an agreed care plan" ], "out_of_scope": [ "The complete menstrual cycle and abnormal uterine bleeding models", "Endometriosis, adenomyosis, fibroids and other underlying disease models", "Premenstrual syndrome and premenstrual dysphoric disorder", "Nonmenstrual pelvic pain and acute abdominal or pregnancy-related conditions", "Medication prescribing, contraceptive management and procedure specifications" ], "distinguishing_features": [ "Establish whether pain occurs before or during menstruation; bleeding without pain does not establish dysmenorrhea. [ACOG](https://www.acog.org/womens-health/faqs/dysmenorrhea-painful-periods)", "Record the timing of pain separately from premenstrual mood and behavioural symptoms; a premenstrual symptom cluster alone does not identify dysmenorrhea. [ACOG PMS guidance](https://www.acog.org/womens-health/faqs/premenstrual-syndrome)", "Identify whether pain also occurs outside menstruation, so a menstrual component can coexist with a broader pelvic pain presentation. [MedlinePlus](https://medlineplus.gov/ency/article/003150.htm)", "Separate the symptom from its cause: secondary dysmenorrhea requires attribution to a condition, while primary dysmenorrhea describes menstrual pain without identified pelvic pathology; symptom intensity alone does not distinguish them. [ACOG Committee Opinion](https://doi.org/10.1097/AOG.0000000000002978)", "Check whether an episode has sudden severe pain, fever or possible pregnancy requiring assessment beyond a familiar period-pain pattern. [MedlinePlus](https://medlineplus.gov/ency/article/003150.htm)" ], "characteristics": [ { "name": "Menstrual timing", "kind": "measurement", "unit_or_values": "Hours or days relative to bleeding onset, with timing uncertainty", "why_it_matters": "Establishes the menstrual relationship and exposes changes in the person's usual pattern." }, { "name": "Pain intensity", "kind": "measurement", "unit_or_values": "Patient-reported scale and anchors, such as 0-10; peak and typical scores recorded separately", "why_it_matters": "Supports comparison while preserving how and when the person assessed pain." }, { "name": "Episode duration", "kind": "measurement", "unit_or_values": "Hours or days, distinguishing continuous pain from intermittent bouts", "why_it_matters": "Distinguishes a brief peak from prolonged burden." }, { "name": "Pain distribution and quality", "kind": "category", "unit_or_values": "Reported location, laterality, radiation and descriptors; multiple values allowed", "why_it_matters": "Preserves the presentation and identifies departures from previous episodes." }, { "name": "Observed recurrence", "kind": "measurement", "unit_or_values": "Painful cycles divided by observed cycles over a stated interval; unobserved cycles identified", "why_it_matters": "Prevents missing records from being interpreted as pain-free cycles." }, { "name": "Functional interference", "kind": "measurement", "unit_or_values": "Hours of activity missed or reduced, sleep disrupted and patient-rated interference", "why_it_matters": "Represents burden that pain intensity alone may miss." }, { "name": "Attribution state", "kind": "state", "unit_or_values": "Unassessed; provisional primary; suspected secondary; clinically attributed secondary; unresolved", "why_it_matters": "Keeps working interpretations distinct from established causal conclusions." }, { "name": "Suspected or established cause", "kind": "relation", "unit_or_values": "Linked condition with attribution status, assessor, date and supporting evidence", "why_it_matters": "Connects menstrual pain to a neighbouring disease model without duplicating it." }, { "name": "Current escalation state", "kind": "state", "unit_or_values": "Not assessed; monitoring under plan; routine review indicated; urgent assessment indicated; assessment underway", "why_it_matters": "Makes the next care step and its rationale explicit." }, { "name": "Response to care", "kind": "state", "unit_or_values": "Not tried; insufficient observation; improved; unchanged; worsened; mixed benefit and harm", "why_it_matters": "Supports review without interpreting an undocumented or incomplete trial as treatment failure." } ], "affordances": [ "Build a cycle-linked pain diary and summarise changes from the person's baseline.", "Compare pain and functional burden across observed cycles.", "Identify missing information needed to assess menstrual association or causal attribution.", "Flag features requiring clinical review using an applicable, sourced care pathway.", "Summarise use, benefit and adverse effects of an agreed care plan for review.", "Prepare a referral summary linking unresolved menstrual pain to relevant investigations and suspected conditions." ] }, "sources": [ { "id": "who-icd11-ga343", "title": "ICD-11 for Mortality and Morbidity Statistics: GA34.3 Dysmenorrhoea", "url": "https://icd.who.int/browse/2025-01/mms/en#1681911684", "what_it_supports": "WHO diagnostic coding and the official international disease name.", "url_status": "live" }, { "id": "wikidata-q1049408", "title": "dysmenorrhea (Q1049408)", "url": "https://www.wikidata.org/wiki/Q1049408", "what_it_supports": "Cross-identifiers (ICD, MeSH, SNOMED) and the canonical Wikidata item for this condition.", "url_status": "live" }, { "id": "nih-medlineplus", "title": "Period Pain (Dysmenorrhea)", "url": "https://medlineplus.gov/periodpain.html", "what_it_supports": "Patient-facing description of symptoms, primary vs secondary causes, and typical self-care and when to seek care.", "url_status": "live" } ], "structure": { "bundles": [ { "id": "menstrual-pain-recognition", "name": "Menstrual pain recognition", "description": "Establish what pain is being described and how it relates to menstruation.", "rationale": "The agent must recognise a menstrual pain presentation without treating every pelvic symptom as dysmenorrhea.", "layers": [ { "id": "cycle-relationship", "name": "Cycle relationship", "description": "Locate pain episodes relative to bleeding and other cycle observations.", "findings": [ { "id": "pain-bleeding-sequence", "name": "Pain-bleeding sequence", "description": "Record pain onset, peak and resolution relative to bleeding, including uncertain or irregular timing.", "questions": [ { "text": "When did pain start, peak and stop relative to the beginning and end of bleeding?", "kind": "measurement", "id": "pain-bleeding-sequence-q01" }, { "text": "Which timing observations come from contemporaneous records, recall or clinical documentation?", "kind": "provenance", "id": "pain-bleeding-sequence-q02" } ] } ] }, { "id": "pain-presentation", "name": "Pain presentation", "description": "Describe the pain itself and separate it from accompanying complaints.", "findings": [ { "id": "menstrual-pain-boundary", "name": "Menstrual pain boundary", "description": "Preserve location and quality while distinguishing menstrual pain from bleeding concerns, premenstrual symptoms and pain between periods.", "questions": [ { "text": "Where is the pain, what does it feel like, and does it spread elsewhere?", "kind": "definition", "id": "menstrual-pain-boundary-q01" }, { "text": "Which symptoms occur with menstrual pain, and which also occur independently between periods?", "kind": "boundary", "id": "menstrual-pain-boundary-q02" } ] } ] } ] }, { "id": "episode-burden-and-course", "name": "Episode burden and course", "description": "Represent the severity of each episode and its pattern across cycles.", "rationale": "A single pain score cannot show the duration, recurrence or practical consequences of dysmenorrhea.", "layers": [ { "id": "experienced-burden", "name": "Experienced burden", "description": "Capture pain and the person's ability to carry out valued activities.", "findings": [ { "id": "pain-and-interference", "name": "Pain and interference", "description": "Record intensity, time in pain and activity disruption as separate observations.", "questions": [ { "text": "What were typical and worst pain scores, using which scale, and for how long?", "kind": "measurement", "id": "pain-and-interference-q01" }, { "text": "How much did pain interrupt sleep, mobility, school, work, care responsibilities or other valued activities?", "kind": "measurement", "id": "pain-and-interference-q02" } ] } ] }, { "id": "cross-cycle-trajectory", "name": "Cross-cycle trajectory", "description": "Compare observed cycles against the person's previous menstrual pain pattern.", "findings": [ { "id": "recurrence-and-change", "name": "Recurrence and change", "description": "Distinguish stable recurrence, new onset, progression and improvement without assuming that unrecorded cycles were symptom-free.", "questions": [ { "text": "Across how many observed cycles has pain occurred, and how have its timing, duration and burden changed?", "kind": "measurement", "id": "recurrence-and-change-q01" }, { "text": "When did menstrual pain first appear relative to menarche, previous painless cycles and changes in treatment or reproductive context?", "kind": "provenance", "id": "recurrence-and-change-q02" } ] } ] } ] }, { "id": "primary-secondary-attribution", "name": "Primary or secondary attribution", "description": "Represent the evidence and uncertainty behind a working explanation of menstrual pain.", "rationale": "Recognising dysmenorrhea does not settle whether an underlying condition accounts for it.", "layers": [ { "id": "working-classification", "name": "Working classification", "description": "Keep symptom recognition separate from clinician-assessed causal classification.", "findings": [ { "id": "attribution-basis", "name": "Attribution basis", "description": "Record the proposed primary or secondary classification, who made it and what supports it.", "questions": [ { "text": "Is attribution unassessed, provisionally primary, suspected secondary or clinically attributed secondary?", "kind": "definition", "id": "attribution-basis-q01" }, { "text": "Who made this assessment, when, and which history, examination or investigation findings support it?", "kind": "provenance", "id": "attribution-basis-q02" } ] } ] }, { "id": "secondary-cause-evaluation", "name": "Secondary cause evaluation", "description": "Connect relevant symptoms and investigations to unresolved explanations.", "findings": [ { "id": "evidence-and-residual-uncertainty", "name": "Evidence and residual uncertainty", "description": "Record evaluation status and limitations. Normal examination or ultrasound does not exclude endometriosis. [NICE NG73](https://www.nice.org.uk/guidance/ng73/chapter/Recommendations)", "questions": [ { "text": "Are progressive symptoms, pain with sex, cycle-related bowel or urinary symptoms, or pain outside menstruation documented?", "kind": "measurement", "id": "evidence-and-residual-uncertainty-q01" }, { "text": "Which suspected causes remain unresolved after completed investigations, and what can those investigations actually exclude?", "kind": "boundary", "id": "evidence-and-residual-uncertainty-q02" } ] } ] } ] }, { "id": "episode-triage-and-review", "name": "Episode triage and review", "description": "Determine whether the current presentation fits an existing care plan or needs reassessment.", "rationale": "A history of dysmenorrhea must not make an agent overlook a new acute presentation or persistent unmet care needs.", "layers": [ { "id": "acute-pattern-departure", "name": "Acute pattern departure", "description": "Identify features that require assessment beyond routine menstrual pain monitoring.", "findings": [ { "id": "urgent-assessment-signals", "name": "Urgent assessment signals", "description": "Record sudden severe pain, fever, abnormal discharge and pregnancy possibility as inputs to an applicable urgent-care pathway. [MedlinePlus](https://medlineplus.gov/ency/article/003150.htm)", "questions": [ { "text": "Is this episode suddenly severe or different from usual, and are fever, abnormal discharge or possible pregnancy present, absent or unknown?", "kind": "measurement", "id": "urgent-assessment-signals-q01" }, { "text": "What assessment urgency and destination follow from the applicable clinical pathway, and has that assessment been arranged?", "kind": "action", "id": "urgent-assessment-signals-q02" } ] } ] }, { "id": "persistent-burden-review", "name": "Persistent burden review", "description": "Recognise when ongoing menstrual pain warrants further clinical evaluation.", "findings": [ { "id": "review-trigger-and-follow-through", "name": "Review trigger and follow-through", "description": "Track unresolved impairment, worsening symptoms or inadequate relief and the resulting review plan.", "questions": [ { "text": "Which persistent symptoms, functional losses or changes from baseline meet the agreed criteria for reassessment?", "kind": "boundary", "id": "review-trigger-and-follow-through-q01" }, { "text": "Who will review the unresolved pain, by when, and what information or referral is still needed?", "kind": "action", "id": "review-trigger-and-follow-through-q02" } ] } ] } ] }, { "id": "care-fit-and-response", "name": "Care fit and response", "description": "Connect an agreed menstrual pain care plan to its actual use and observed outcomes.", "rationale": "The agent needs to distinguish unsuitable care, barriers to use, insufficient observation and inadequate benefit.", "layers": [ { "id": "care-plan-context", "name": "Care plan context", "description": "Record menstrual pain goals and the constraints affecting an existing or proposed plan.", "findings": [ { "id": "plan-suitability-and-use", "name": "Plan suitability and use", "description": "Link medication, hormonal and nonmedication care to the person's preferences, relevant safety review and actual use.", "questions": [ { "text": "What improvement does the person prioritise, and how do pregnancy intentions, preferences and documented contraindications constrain the plan?", "kind": "action", "id": "plan-suitability-and-use-q01" }, { "text": "What care was actually used, when relative to pain or bleeding, and what access or tolerability barriers affected use?", "kind": "provenance", "id": "plan-suitability-and-use-q02" } ] } ] }, { "id": "observed-care-outcome", "name": "Observed care outcome", "description": "Compare outcomes over an explicitly stated observation period.", "findings": [ { "id": "benefit-harm-and-next-step", "name": "Benefit, harm and next step", "description": "Record changes in pain and function alongside adverse effects, without treating improvement as proof of a particular cause.", "questions": [ { "text": "Over which observed cycles did pain, duration, activity interference and adverse effects change compared with baseline?", "kind": "measurement", "id": "benefit-harm-and-next-step-q01" }, { "text": "Does the documented response support continuing the agreed plan, reviewing its use or requesting clinical reassessment?", "kind": "action", "id": "benefit-harm-and-next-step-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-kinds", "name": "Kinds and varieties", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "primary dysmenorrhea (no pelvic pathology)", "secondary dysmenorrhea (endometriosis, adenomyosis, leiomyoma, adenomyoma, obstruction, infection, or IUD-related)", "spasmodic (colicky, onset with bleeding)", "congestive (dull, premenstrual, pelvic-congestion pattern; older clinical usage)", "membranous dysmenorrhea (rare shedding of endometrium as a cast)", "adolescent-onset primary dysmenorrhea", "adult-onset or late-onset (often secondary until proven otherwise)" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of dysmenorrhea this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-identifiers", "name": "Identifiers and schemes", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "scheme": "Wikidata", "value_or_pattern": "Q1049408", "note": "Item for dysmenorrhea / painful menstruation." }, { "scheme": "ICD-10", "value_or_pattern": "N94.4 (primary), N94.5 (secondary), N94.6 (unspecified)", "note": "WHO ICD-10 chapter XIV, N94 Pain and other conditions associated with female genital organs and menstrual cycle." }, { "scheme": "ICD-11", "value_or_pattern": "GA34.3", "note": "Dysmenorrhoea under female pelvic pain associated with genital organs or menstrual cycle." }, { "scheme": "MeSH", "value_or_pattern": "D004412", "note": "National Library of Medicine Medical Subject Heading Dysmenorrhea." }, { "scheme": "SNOMED CT", "value_or_pattern": "266599000", "note": "Dysmenorrhea (finding); related concepts include primary and secondary subtypes." }, { "scheme": "UMLS CUI", "value_or_pattern": "C0013390", "note": "Unified Medical Language System concept for dysmenorrhea." } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of dysmenorrhea this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-standards-and-regulation", "name": "Standards and regulation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "ACOG Committee Opinion No. 760 (American College of Obstetricians and Gynecologists): clinical guidance on dysmenorrhea and endometriosis in adolescents.", "NICE NG73 Endometriosis: diagnosis and management (National Institute for Health and Care Excellence, UK): governs work-up when secondary dysmenorrhea is suspected to be endometriosis.", "WHO ICD-10 / ICD-11 (World Health Organization): disease classification used for mortality, morbidity, and billing coding of dysmenorrhea.", "SOGC clinical practice guidance on primary dysmenorrhea (Society of Obstetricians and Gynaecologists of Canada): NSAID-first and combined hormonal contraception pathways." ], "questions": [ { "id": "evidence-standards-and-regulation-q01", "text": "Which of these standards and regulation hold for the sense of dysmenorrhea this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-real-world-use", "name": "Real-world use", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Recorded as a presenting complaint in primary care, school health, and gynecology when cyclic pelvic pain interferes with work, school, or sport.", "Used as an indication for NSAIDs, combined oral contraceptives, LNG-IUS, and, if secondary, for laparoscopy or treatment of endometriosis/adenomyosis/fibroids.", "Captured in menstrual-tracking apps, occupational sick-leave coding, and disability or quality-of-life research as a leading cause of lost productive days in people who menstruate.", "Screened in adolescents as a sentinel symptom that may precede a later endometriosis diagnosis." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of dysmenorrhea this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-measurements", "name": "Typical measurements", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "quantity": "pain intensity (peak menstrual pain)", "typical_range": "4-10 on a 0-10 numeric rating scale in clinically significant cases; many primary cases 6-9", "unit": "NRS 0-10 or VAS mm" }, { "quantity": "duration of pain per cycle", "typical_range": "8-72 hours, usually starting shortly before or at onset of bleeding", "unit": "hours" }, { "quantity": "menstrual blood loss (associated, not diagnostic)", "typical_range": "normal menses ~20-80 mL; heavy bleeding raises suspicion of secondary causes", "unit": "mL per cycle" }, { "quantity": "work or school absence", "typical_range": "0-3 days per cycle in moderate-severe primary dysmenorrhea", "unit": "days per cycle" }, { "quantity": "age at symptom onset", "typical_range": "primary: 6-24 months after menarche; secondary: any time, often after years of relatively painless cycles", "unit": "years of age / months after menarche" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of dysmenorrhea this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-failure-modes-and-hazards", "name": "Failure modes and hazards", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Undertreatment as 'normal period pain' leading to avoidable school/work loss and delayed diagnosis of endometriosis or outflow obstruction.", "NSAID gastrointestinal bleeding, renal injury, or cardiovascular risk when high-dose NSAIDs are used chronically without gastroprotection or comorbidity review.", "Hormonal suppression masking rather than diagnosing secondary disease.", "Missing obstructive Müllerian anomalies (e.g. obstructed hemivagina, cervical agenesis) in adolescents with severe pain soon after menarche.", "Confusion with acute abdomen (appendicitis, ovarian torsion, PID, ectopic pregnancy) if pain is atypical, unilateral, or occurs outside the menstrual window.", "Infertility risk is not from primary dysmenorrhea itself but from untreated underlying secondary causes such as endometriosis or PID sequelae." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of dysmenorrhea this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-regional-variation", "name": "Regional variation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Spelling: dysmenorrhea (US) vs dysmenorrhoea (WHO ICD, UK, Australia).", "Access to prescription NSAIDs, combined hormonal contraception, and LNG-IUS varies widely; in some regions over-the-counter mefenamic acid or traditional herbal regimens are first-line by custom.", "Japan and parts of East Asia historically used a congestive/spasmodic clinical split more than Anglo-American primary/secondary coding.", "Cultural normalization of severe menstrual pain delays care-seeking in many settings; some health systems still do not code N94.x in primary care, so incidence is under-recorded.", "Legal and insurance coverage of endometriosis work-up (ultrasound, MRI, laparoscopy) after failed NSAIDs differs by country and payer." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of dysmenorrhea this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-neighbours", "name": "Neighbouring kinds and how to tell them apart", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "name": "endometriosis-associated pain", "difference": "Dysmenorrhea is the symptom; endometriosis is a disease. Secondary dysmenorrhea plus dyspareunia, infertility, or cyclic bowel/bladder pain, and lesions on imaging or laparoscopy, separate endometriosis from isolated primary dysmenorrhea." }, { "name": "adenomyosis", "difference": "Typically later reproductive years, bulky tender uterus, heavy menstrual bleeding; TVUS or MRI showing junctional-zone thickening separates it from primary dysmenorrhea with a normal uterus." }, { "name": "premenstrual syndrome / PMDD", "difference": "Affective and somatic symptoms peak before bleeding and remit after onset; dysmenorrhea pain peaks with flow. Timing relative to bleeding is the practical test." }, { "name": "pelvic inflammatory disease", "difference": "Fever, mucopurulent discharge, cervical motion tenderness, and non-cyclic or post-coital pain; pregnancy test, microscopy/NAAT, and inflammatory signs distinguish PID from cyclic primary dysmenorrhea." }, { "name": "irritable bowel syndrome", "difference": "Pain related to defecation and change in stool form/frequency (Rome criteria), not strictly locked to menstruation, though IBS often flares perimenstrually." }, { "name": "mittelschmerz (mid-cycle ovulatory pain)", "difference": "Unilateral, mid-cycle, lasting hours; dysmenorrhea is bilateral or suprapubic and coincident with menses." }, { "name": "chronic pelvic pain unrelated to menses", "difference": "Pain present most days of the month and not markedly worse only during bleeding; a menstrual calendar showing cyclic confinement supports dysmenorrhea." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of dysmenorrhea this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Which pain and functional-interference measures offer useful comparability across ages, languages and care settings without obscuring individual experience?", "What minimum evidence and terminology should distinguish provisional primary dysmenorrhea from an incompletely investigated secondary presentation?", "How should menstrual association be represented during irregular cycles, hormonal suppression or withdrawal bleeding when bleeding is an unreliable timing anchor?", "Which jurisdiction-specific pathways should supply urgent assessment criteria, referral thresholds and review intervals?", "How many observed cycles and what treatment-use information are sufficient to interpret improvement or inadequate response for each care option?" ], "statistics": { "bundles": 6, "layers": 11, "findings": 18, "questions": 28 } }, "draft": { "generator": "vr.draft.v3", "status": "draft-generated", "researched": false, "archetype": "discipline or field of knowledge", "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 dysmenorrhea, record what state it is in, and decide what may be done with it.", "whatItIs": "Enable an AI agent to recognise menstrual pain, assess its burden and clinical uncertainty, and support appropriate monitoring, care review or escalation.", "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: psychogenic dysmenorrhea.", "1 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 62 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 dysmenorrhea, 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": [], "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": [ "psychogenic dysmenorrhea" ] } ], "standing": "Described in 62 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 dysmenorrhea from another, and a dysmenorrhea 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 dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea 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 dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea 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 dysmenorrhea 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 dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea 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 dysmenorrhea from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea 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 dysmenorrhea 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 dysmenorrhea between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea 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 dysmenorrhea, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a dysmenorrhea 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 dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea 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 dysmenorrhea 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 dysmenorrhea contains and in what form it is held.", "questions": [ { "id": "content-and-format-q01", "text": "What identifies and describes the content of a dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea 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 dysmenorrhea and the period it survives.", "questions": [ { "id": "access-rules-q01", "text": "What identifies and describes access to a dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "subject-and-method", "name": "Subject matter and method", "description": "What dysmenorrhea studies and how it establishes anything.", "rationale": "A field is identified by its questions and its methods, and those are what distinguish it from the fields next to it.", "layers": [ { "id": "subject", "name": "Subject matter", "description": "The questions it takes as its own.", "findings": [ { "id": "subject-record", "name": "Questions and objects of study", "description": "What it is about, stated so a neighbouring field can be told apart.", "questions": [ { "id": "subject-record-q01", "text": "What questions and objects does dysmenorrhea take as its own?", "kind": "definition" }, { "id": "subject-record-q02", "text": "Which questions does it share with a neighbouring field, and who claims them?", "kind": "boundary" } ] } ] }, { "id": "method", "name": "Method and evidence", "description": "How claims are established and what counts as evidence.", "findings": [ { "id": "method-record", "name": "Methods and standards of evidence", "description": "The methods used and what they are taken to establish.", "questions": [ { "id": "method-record-q01", "text": "By what methods does dysmenorrhea establish claims, and what counts as sufficient evidence?", "kind": "provenance" }, { "id": "method-record-q02", "text": "What kind of claim can this field not settle, and where should an agent look instead?", "kind": "action" } ] } ] } ] }, { "id": "institutions-and-classification", "name": "Institutions and classification", "description": "Where dysmenorrhea is practised and how catalogues place it.", "rationale": "The institutional footprint is the evidence that a field exists as a field rather than as a topic.", "layers": [ { "id": "institutions", "name": "Institutional markers", "description": "Societies, journals, degrees and departments.", "findings": [ { "id": "institution-record", "name": "Bodies and venues", "description": "Where the field organises itself.", "questions": [ { "id": "institution-record-q01", "text": "Which societies, journals or degrees mark dysmenorrhea as an established field?", "kind": "provenance" }, { "id": "institution-record-q02", "text": "What would show that it is emerging or dissolving rather than established?", "kind": "boundary" } ] } ] }, { "id": "classification", "name": "Classification schemes", "description": "Where library and research classifications put it.", "findings": [ { "id": "classification-record", "name": "Codes and their disagreements", "description": "The classification codes that place it, and where they differ.", "questions": [ { "id": "classification-record-q01", "text": "Which classification schemes place dysmenorrhea, under what codes?", "kind": "definition" }, { "id": "classification-record-q02", "text": "Where do those schemes disagree about its scope?", "kind": "boundary" } ] } ] } ] }, { "id": "provenance-and-evidence", "name": "Provenance, evidence and time", "description": "Where every claim about a dysmenorrhea 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 dysmenorrhea and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea 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 dysmenorrhea is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a dysmenorrhea, 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 dysmenorrhea, 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 dysmenorrhea 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 } } } }