{
  "vercy": "1.0-draft",
  "publication": {
    "status": "research-draft",
    "adjudicationStatus": "unreviewed",
    "publishableCanonical": false,
    "generatedAt": "2026-09-13T12:55:08Z",
    "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",
    "enrichment": {
      "pass": 3,
      "engine": "claude",
      "producedAt": "2026-10-06T10:00:00Z",
      "ingestedAt": "2026-10-06T07:12:21+00:00",
      "fields": [
        "agent_conduct",
        "ethics",
        "owners"
      ]
    }
  },
  "metaModel": {
    "id": "THING-Q1164529",
    "registryId": "vr.tr.renal-cell-carcinoma",
    "name": "renal cell carcinoma",
    "version": "0.2.0-wave.4",
    "entryKind": "thing",
    "family": "Thing Registry",
    "domain": [
      "XCT.STA"
    ],
    "status": "research-draft"
  },
  "canonicalUrl": "https://ver.cy/models/thing/q1164529/",
  "model": {
    "registry_id": "vr.tr.renal-cell-carcinoma",
    "name": "renal cell carcinoma",
    "purpose": "Let an agent explain renal cell carcinoma and its subtypes, relay risk factors, diagnosis, staging and treatment from oncology guidelines in general terms, route people with symptoms or a diagnosis to clinicians, and distinguish renal cell carcinoma from urothelial carcinoma of the renal pelvis, Wilms tumour and benign kidney masses.",
    "definition": "The most common kidney cancer in adults, arising from the lining of the renal tubules, with clear cell carcinoma the main subtype alongside papillary, chromophobe and rarer forms such as multilocular cystic clear cell carcinoma, occurring sporadically or in hereditary syndromes such as von Hippel-Lindau disease, rarely in children, and staged from localised to metastatic; treatment ranges from surveillance and surgery to targeted and immune therapies, and anyone with blood in the urine, flank pain or a mass needs medical assessment.",
    "what_it_is_for": "Not applicable; a disease.",
    "affordances": [
      "explain subtypes",
      "relay diagnosis and treatment",
      "route to clinicians",
      "distinguish related tumours"
    ],
    "distinguishing_features": [
      "Tubular epithelial origin",
      "Clear cell dominance",
      "VHL pathway",
      "Immunotherapy responsive"
    ],
    "appearance": "Not a visible object; a kidney mass on imaging.",
    "visual_identification": [
      "Cancer of the renal tubular epithelium",
      "Clear cell, papillary, chromophobe, multilocular cystic, hereditary and sporadic, metastatic, childhood forms",
      "Urothelial carcinoma arises in the collecting system; Wilms tumour is a childhood embryonal tumour; oncocytoma is benign"
    ],
    "physical_properties": [
      {
        "quantity": "share of kidney cancers in adults",
        "typical_range": "about 90",
        "unit": "percent",
        "note": ""
      },
      {
        "quantity": "clear cell share",
        "typical_range": "about 75",
        "unit": "percent",
        "note": ""
      },
      {
        "quantity": "new cases worldwide",
        "typical_range": "about 430000",
        "unit": "per year",
        "note": "kidney cancer, estimates"
      }
    ],
    "families_and_kinds": [
      "clear cell renal cell carcinoma",
      "papillary renal cell carcinoma",
      "chromophobe renal cell carcinoma",
      "multilocular cystic and other rare subtypes",
      "hereditary forms in VHL and other syndromes",
      "sporadic forms",
      "childhood renal cell carcinoma",
      "metastatic renal cell carcinoma"
    ],
    "related_models": [
      {
        "relation": "is a kind of",
        "target": "renal carcinoma",
        "why": "in registry terms"
      },
      {
        "relation": "is associated with",
        "target": "von Hippel-Lindau disease",
        "why": "in hereditary cases"
      },
      {
        "relation": "is contrasted with",
        "target": "Wilms tumour",
        "why": "a childhood kidney cancer"
      },
      {
        "relation": "is treated with",
        "target": "immunotherapy",
        "why": "among other approaches"
      }
    ],
    "identifiers": [
      {
        "scheme": "ICD-10",
        "value_or_pattern": "C64",
        "note": "malignant neoplasm of kidney"
      },
      {
        "scheme": "MeSH",
        "value_or_pattern": "D002292",
        "note": "Carcinoma, Renal Cell"
      }
    ],
    "standards_and_regulation": [
      "ESMO, NCCN and EAU guidelines for kidney cancer",
      "Drug approvals for targeted and immune therapies",
      "Cancer registration rules"
    ],
    "failure_modes_and_hazards": [
      "Agents giving personal medical advice",
      "Confusing subtypes and other kidney tumours",
      "Stale treatment information"
    ],
    "in_scope": [],
    "out_of_scope": [],
    "characteristics": [],
    "agent_conduct": {
      "may": [
        "Describe renal cell carcinoma and its subtypes in general terms.",
        "Point people to clinicians, cancer services and patient organisations."
      ],
      "must_not": [
        "Diagnose or stage a person's kidney cancer.",
        "Recommend or discourage a specific treatment for a person.",
        "Present outdated treatment information as current.",
        "Disclose a person's diagnosis or genetic syndrome without consent."
      ],
      "requires_human": [
        "Any decision about testing, surgery or drug treatment."
      ]
    },
    "ethics": {
      "considerations": [
        "Cancer patients are vulnerable to false hope and unproven treatments.",
        "Hereditary syndromes affect relatives who have not been tested."
      ],
      "affected_parties": [
        "Patients",
        "Families with hereditary syndromes",
        "Clinicians"
      ]
    },
    "owners": {
      "steward": "The patient; clinicians and cancer registries hold the records.",
      "master_systems": [
        "Cancer registries"
      ]
    }
  },
  "sources": [],
  "structure": {
    "bundles": [
      {
        "id": "understand",
        "name": "Understand",
        "description": "What renal cell carcinoma is.",
        "rationale": "Clinical.",
        "layers": [
          {
            "id": "definition",
            "name": "Definition",
            "description": "Definition and subtypes.",
            "findings": [
              {
                "id": "definition-finding",
                "name": "Definition",
                "description": "Definition.",
                "questions": [
                  {
                    "text": "What is renal cell carcinoma, and how do clear cell, papillary, chromophobe and rare subtypes differ?",
                    "kind": "definition"
                  },
                  {
                    "text": "Is the user asking about their own symptoms or diagnosis, which need a clinician?",
                    "kind": "boundary"
                  }
                ]
              }
            ]
          },
          {
            "id": "causes",
            "name": "Causes",
            "description": "Risk factors and genetics.",
            "findings": [
              {
                "id": "causes-finding",
                "name": "Causes",
                "description": "Causes.",
                "questions": [
                  {
                    "text": "What are the risk factors and hereditary syndromes, in general terms?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits von Hippel-Lindau disease?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "care",
        "name": "Care",
        "description": "Diagnosis and treatment.",
        "rationale": "Clinical.",
        "layers": [
          {
            "id": "diagnosis",
            "name": "Diagnosis",
            "description": "Diagnosis and staging.",
            "findings": [
              {
                "id": "diagnosis-finding",
                "name": "Diagnosis",
                "description": "Diagnosis.",
                "questions": [
                  {
                    "text": "How is renal cell carcinoma detected, imaged, biopsied and staged, as guidelines describe?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which references are standard?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          },
          {
            "id": "treatment",
            "name": "Treatment",
            "description": "Treatment.",
            "findings": [
              {
                "id": "treatment-finding",
                "name": "Treatment",
                "description": "Treatment.",
                "questions": [
                  {
                    "text": "What treatments do guidelines recommend for localised and metastatic disease, in general terms?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which sources are cited?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "support",
        "name": "Support",
        "description": "Living with the disease.",
        "rationale": "Application.",
        "layers": [
          {
            "id": "followup",
            "name": "Follow-up",
            "description": "Follow-up and survivorship.",
            "findings": [
              {
                "id": "followup-finding",
                "name": "Follow-up",
                "description": "Follow-up.",
                "questions": [
                  {
                    "text": "What does follow-up after treatment involve, as guidelines state?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits cancer survivorship?",
                    "kind": "action"
                  }
                ]
              }
            ]
          },
          {
            "id": "organisations",
            "name": "Organisations",
            "description": "Support organisations.",
            "findings": [
              {
                "id": "organisations-finding",
                "name": "Organisations",
                "description": "Organisations.",
                "questions": [
                  {
                    "text": "Where can patients find kidney cancer organisations and trials?",
                    "kind": "action"
                  },
                  {
                    "text": "Which entry fits cancer support organisations?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "context",
        "name": "Context",
        "description": "Research and epidemiology.",
        "rationale": "Context.",
        "layers": [
          {
            "id": "research",
            "name": "Research",
            "description": "Research.",
            "findings": [
              {
                "id": "research-finding",
                "name": "Research",
                "description": "Research.",
                "questions": [
                  {
                    "text": "What research directions exist in kidney cancer, with findings attributed?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits cancer immunotherapy?",
                    "kind": "action"
                  }
                ]
              }
            ]
          },
          {
            "id": "epidemiology",
            "name": "Epidemiology",
            "description": "Epidemiology.",
            "findings": [
              {
                "id": "epidemiology-finding",
                "name": "Epidemiology",
                "description": "Epidemiology.",
                "questions": [
                  {
                    "text": "How common is renal cell carcinoma, and how do rates vary?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits the epidemiology of cancer?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      }
    ]
  },
  "openQuestions": [
    "Should clear cell carcinoma and hereditary forms be separate primary entries?",
    "How should oncology guidelines be linked?",
    "The registry entry has merged aliases naming subtypes and settings; should they be split off?"
  ],
  "statistics": {
    "bundles": 4,
    "layers": 8,
    "findings": 8,
    "questions": 16
  }
}