{ "model": { "rank": 18745, "code": "thing-q916398", "model_id": "vr.tr.lymphedema", "name": "lymphedema", "purpose": "Let an agent explain lymphedema and its forms, relay causes, staging and general management from lymphology and oncology sources, describe the forms the registry aliases name, and distinguish lymphedema from lipedema, venous oedema, deep vein thrombosis and heart or kidney-related swelling, routing urgent symptoms first.", "family": "Thing Registry", "category": "Cross-cutting context", "status": "research-draft", "kind": "thing", "plane": "XCT", "domain": "XCT.STA", "industry": "", "version": "", "url": "/models/thing/q916398/", "tier": 2, "score": 29, "payload": { "layer": "wikidata", "aliases": [ "Chyloderma", "Esthiomene", "elephantiasis", "Bullous lymphedema", "Factitial lymphedema", "syndromic lymphedema", "German syndrome", "Primary lymphedema", "Secondary lymphedema", "Bilateral lower extremity inflammatory lymphedema", "elephantiasis nostras", "podoconiosis", "Lymphedema tarda", "Lymphedema praecox", "primary lymphedema with associated anomalies", "Meige lymphedema", "breast cancer lymphedema" ], "aliasCount": 17, "merged": 17, "knownIn": 29, "facets": null, "markers": [], "lexicalClass": "", "senseRank": null, "alsoRegisteredAs": null, "source": { "dataset": "wikidata", "item": "Q916398", "url": "https://www.wikidata.org/wiki/Q916398", "license": "CC0 1.0" } }, "research": { "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-13T18:46:32Z", "providers": [ "Claude" ], "breadth": "written by Claude from model knowledge without web access - no source was read, every claim is a lead to verify", "pass": 2, "wave": 4, "engine": "claude" }, "metaModel": { "id": "THING-Q916398", "registryId": "vr.tr.lymphedema", "name": "lymphedema", "version": "0.2.0-wave.4", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q916398/", "model": { "registry_id": "vr.tr.lymphedema", "name": "lymphedema", "purpose": "Let an agent explain lymphedema and its forms, relay causes, staging and general management from lymphology and oncology sources, describe the forms the registry aliases name, and distinguish lymphedema from lipedema, venous oedema, deep vein thrombosis and heart or kidney-related swelling, routing urgent symptoms first.", "definition": "Chronic swelling of body tissues, usually an arm or leg, caused by impaired lymphatic drainage, either primary from congenital lymphatic abnormalities, including syndromic lymphedema, or secondary from cancer treatment, surgery, infection or injury, with advanced forms known as elephantiasis, which in tropical regions is often caused by lymphatic filariasis; rarer terms include chyloderma, esthiomene of the genitals, bullous lymphedema and factitial lymphedema from self-applied constriction. Sudden painful swelling of one limb can indicate a blood clot and needs urgent care. The model routes people to clinicians.", "what_it_is_for": "Not applicable; a condition.", "affordances": [ "route urgent symptoms first", "explain forms and causes", "relay management", "distinguish related conditions" ], "distinguishing_features": [ "Lymphatic cause", "Chronic and progressive", "Primary or secondary", "Compression-based care" ], "appearance": "Not a visible object; persistent swelling, sometimes with thickened skin.", "visual_identification": [ "Chronic swelling from lymphatic failure", "Primary, secondary and syndromic lymphedema, elephantiasis, chyloderma, esthiomene, bullous and factitial lymphedema", "Lipedema is fat disorder; venous oedema is from veins; DVT is a clot; systemic oedema has heart or kidney causes" ], "physical_properties": [ { "quantity": "after breast cancer treatment", "typical_range": "about 20", "unit": "percent", "note": "estimates vary" }, { "quantity": "lymphatic filariasis cases", "typical_range": "about 50", "unit": "million", "note": "infected, WHO estimates" }, { "quantity": "staging", "typical_range": "ISL stages 0 to III", "unit": "note", "note": "" } ], "families_and_kinds": [ "primary lymphedema including syndromic forms", "cancer-related secondary lymphedema", "filarial lymphedema and elephantiasis", "genital lymphedema including esthiomene", "bullous and factitial lymphedema", "chyloderma" ], "related_models": [ { "relation": "is a kind of", "target": "lymphatic system disease", "why": "in registry terms" }, { "relation": "may be caused by", "target": "lymphatic filariasis", "why": "" }, { "relation": "is contrasted with", "target": "lipedema", "why": "" }, { "relation": "is managed by", "target": "complete decongestive therapy", "why": "" } ], "identifiers": [ { "scheme": "ICD-10", "value_or_pattern": "I89.0", "note": "lymphoedema, not elsewhere classified" }, { "scheme": "MeSH", "value_or_pattern": "D008209", "note": "Lymphedema" } ], "standards_and_regulation": [ "International Society of Lymphology consensus", "WHO lymphatic filariasis elimination programme" ], "failure_modes_and_hazards": [ "Missing deep vein thrombosis or cellulitis", "Agents giving personal medical advice", "Stigmatising language about elephantiasis" ], "in_scope": [], "out_of_scope": [], "characteristics": [] }, "sources": [], "structure": { "bundles": [ { "id": "understand", "name": "Understand", "description": "What lymphedema is.", "rationale": "Clinical.", "layers": [ { "id": "definition", "name": "Definition", "description": "Definition.", "findings": [ { "id": "definition-finding", "name": "Definition", "description": "Definition.", "questions": [ { "text": "What is lymphedema, and how does it differ from lipedema, venous oedema, DVT and systemic oedema?", "kind": "definition" }, { "text": "Does the user have sudden, painful, red or hot swelling, fever or breathlessness, which needs urgent care?", "kind": "boundary" } ] } ] }, { "id": "forms", "name": "Forms", "description": "Forms.", "findings": [ { "id": "forms-finding", "name": "Forms", "description": "Forms.", "questions": [ { "text": "What are primary, secondary and syndromic lymphedema, elephantiasis, chyloderma, esthiomene, bullous and factitial forms?", "kind": "definition" }, { "text": "Which entry fits the specific form?", "kind": "action" } ] } ] } ] }, { "id": "causes", "name": "Causes", "description": "Causes.", "rationale": "Clinical.", "layers": [ { "id": "secondary", "name": "Secondary", "description": "Secondary causes.", "findings": [ { "id": "secondary-finding", "name": "Secondary", "description": "Secondary.", "questions": [ { "text": "How do cancer treatment, surgery, infection and filariasis cause lymphedema?", "kind": "provenance" }, { "text": "Which references are standard?", "kind": "provenance" } ] } ] }, { "id": "primary", "name": "Primary", "description": "Primary and genetic.", "findings": [ { "id": "primary-finding", "name": "Primary", "description": "Primary.", "questions": [ { "text": "What genetic and syndromic causes exist?", "kind": "provenance" }, { "text": "Which sources are cited?", "kind": "provenance" } ] } ] } ] }, { "id": "care", "name": "Care", "description": "Management.", "rationale": "Clinical.", "layers": [ { "id": "therapy", "name": "Therapy", "description": "Therapy.", "findings": [ { "id": "therapy-finding", "name": "Therapy", "description": "Therapy.", "questions": [ { "text": "What do guidelines say about compression, drainage, exercise and skin care, in general terms?", "kind": "provenance" }, { "text": "Which entry fits complete decongestive therapy?", "kind": "action" } ] } ] }, { "id": "surgery", "name": "Surgery", "description": "Surgery.", "findings": [ { "id": "surgery-finding", "name": "Surgery", "description": "Surgery.", "questions": [ { "text": "What surgical options exist, and for whom?", "kind": "provenance" }, { "text": "Which entry fits lymphatic surgery?", "kind": "action" } ] } ] } ] }, { "id": "context", "name": "Context", "description": "Global health and living.", "rationale": "Context.", "layers": [ { "id": "global", "name": "Global", "description": "Filariasis.", "findings": [ { "id": "global-finding", "name": "Global", "description": "Global.", "questions": [ { "text": "How is lymphatic filariasis being eliminated, as WHO reports?", "kind": "provenance" }, { "text": "Which entry fits lymphatic filariasis?", "kind": "action" } ] } ] }, { "id": "living", "name": "Living", "description": "Living with lymphedema.", "findings": [ { "id": "living-finding", "name": "Living", "description": "Living.", "questions": [ { "text": "What support organisations exist, and how can stigma be reduced?", "kind": "provenance" }, { "text": "Which entry fits patient support organisations?", "kind": "action" } ] } ] } ] } ] }, "openQuestions": [ "Should elephantiasis and syndromic lymphedema be separate primary entries?", "How should lymphology sources be linked?", "The registry entry has merged aliases naming rare forms; should they be split off?" ], "statistics": { "bundles": 4, "layers": 8, "findings": 8, "questions": 16 } }, "draft": { "generator": "vr.draft.v3", "status": "draft-generated", "researched": false, "archetype": "abstract concept", "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 lymphedema, record what state it is in, and decide what may be done with it.", "whatItIs": "Let an agent explain lymphedema and its forms, relay causes, staging and general management from lymphology and oncology sources, describe the forms the registry aliases name, and distinguish lymphedema from lipedema, venous oedema, deep vein thrombosis and heart or kidney-related swelling, routing urgent symptoms first.", "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: Chyloderma, Esthiomene, elephantiasis, Bullous lymphedema, Factitial lymphedema, syndromic lymphedema, German syndrome, Primary lymphedema, Secondary lymphedema, Bilateral lower extremity inflammatory lymphedema, elephantiasis nostras, podoconiosis.", "17 finer distinctions are held as aliases rather than separate entries, because telling them apart needs a task that asks for it.", "Described in 29 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 lymphedema, 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": [ "Nothing to see. What is recognised is an instance of it, and which instances count is exactly what is argued about." ], "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": [ "Chyloderma", "Esthiomene", "elephantiasis", "Bullous lymphedema", "Factitial lymphedema", "syndromic lymphedema", "German syndrome", "Primary lymphedema", "Secondary lymphedema", "Bilateral lower extremity inflammatory lymphedema", "elephantiasis nostras", "podoconiosis" ] } ], "standing": "Described in 29 Wikipedia languages, which measures how widely it is written about rather than how important or how common it is. 17 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 lymphedema from another, and a lymphedema 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 lymphedema, 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 lymphedema, 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 lymphedema 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 lymphedema, 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 lymphedema, 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 lymphedema 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 lymphedema 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 lymphedema, 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 lymphedema, 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 lymphedema 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 lymphedema from the things most often confused with it.", "questions": [ { "id": "distinguishing-features-q01", "text": "What identifies and describes what distinguishes a lymphedema, 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 lymphedema, 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 lymphedema 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 lymphedema 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 lymphedema between them.", "questions": [ { "id": "stages-and-transitions-q01", "text": "What identifies and describes the lifecycle of a lymphedema, 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 lymphedema, 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 lymphedema 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 lymphedema, how often and by whom.", "findings": [ { "id": "observation-record", "name": "Observation record", "description": "How an observation of a lymphedema 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 lymphedema, 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 lymphedema, 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 lymphedema is known, and what must it refuse?", "kind": "action", "answer_data": [ "permitted actions", "preconditions", "refusals", "escalation" ] } ] } ] } ] }, { "id": "definitions-in-contest", "name": "Definitions and who holds them", "description": "What lymphedema is taken to mean, and by whom.", "rationale": "When a field disagrees about a concept, the disagreement is the content. A model that picks one definition silently destroys the information.", "layers": [ { "id": "competing-definitions", "name": "Competing definitions", "description": "The main readings and the traditions behind them.", "findings": [ { "id": "definition-map", "name": "Definitions and their holders", "description": "Each definition with the school or body that holds it.", "questions": [ { "id": "definition-map-q01", "text": "Which definitions of lymphedema are in use, and which tradition or body holds each?", "kind": "definition" }, { "id": "definition-map-q02", "text": "What turns on the difference between them in practice?", "kind": "boundary" } ] } ] }, { "id": "operationalisation", "name": "Operationalisation", "description": "How it is measured or applied when it has to be.", "findings": [ { "id": "operational-record", "name": "Measures and proxies", "description": "Instruments and indicators used to stand in for it.", "questions": [ { "id": "operational-record-q01", "text": "How is lymphedema operationalised or measured in practice, and by what instrument?", "kind": "measurement" }, { "id": "operational-record-q02", "text": "What does that operationalisation leave out, and when does that matter?", "kind": "boundary" } ] } ] } ] }, { "id": "instances-and-use", "name": "Instances, use and consequence", "description": "What counts as an instance of lymphedema and what follows from calling something that.", "rationale": "Applying a concept is an act with consequences, so a model must say what the label licenses and what it does not.", "layers": [ { "id": "instances", "name": "What counts as an instance", "description": "Clear cases, borderline cases and non-cases.", "findings": [ { "id": "instance-tests", "name": "Tests for an instance", "description": "What would settle whether something falls under it.", "questions": [ { "id": "instance-tests-q01", "text": "What would settle whether something is an instance of lymphedema?", "kind": "boundary" }, { "id": "instance-tests-q02", "text": "Which borderline cases are argued about, and on what grounds?", "kind": "definition" } ] } ] }, { "id": "consequence", "name": "Consequence of application", "description": "Rights, duties or decisions that follow from the label.", "findings": [ { "id": "consequence-record", "name": "What the label licenses", "description": "What an agent may do once something is classified this way.", "questions": [ { "id": "consequence-record-q01", "text": "What follows practically once something is treated as lymphedema?", "kind": "action" }, { "id": "consequence-record-q02", "text": "What must an agent not infer from the label alone?", "kind": "action" } ] } ] } ] }, { "id": "provenance-and-evidence", "name": "Provenance, evidence and time", "description": "Where every claim about a lymphedema 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 lymphedema and how confident it is.", "questions": [ { "id": "claim-provenance-q01", "text": "What identifies and describes a claim about a lymphedema, 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 lymphedema, 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 lymphedema 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 lymphedema is retired without being erased.", "questions": [ { "id": "validity-and-supersession-q01", "text": "What identifies and describes the validity of a claim about a lymphedema, 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 lymphedema, 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 lymphedema 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 } } } }