{
  "vercy": "1.0-draft",
  "publication": {
    "status": "research-draft",
    "adjudicationStatus": "unreviewed",
    "publishableCanonical": false,
    "generatedAt": "2026-09-12T11:04:15Z",
    "providers": [
      "Codex"
    ],
    "breadth": "recalled by Codex without web access - no source was read",
    "missingProviders": [],
    "pass": 2,
    "cost": {
      "grok": {
        "seconds": 22.1,
        "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: 01a09549-0243-7de0-bec4-6a4c34216801\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: lung neoplasm\nSense to describe: (none recorded)\nDomain code: PHY.LIV\nAlso known as: (none)\n\n\nContext for this batch of 1001 things:\n# Batch 044: 1001 r",
        "usd": 0.0,
        "recall": true
      },
      "codex": {
        "seconds": 70.6,
        "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: 01a09549-0243-76d0-80a2-930221e48c1b\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: lung neoplasm\nRegistry id: vr.tr.lung-neoplasm\nPlane / domain: PHY / PHY.LIV\nRegistry definition: (none recorded)\nNames folded into this entry: (none"
      }
    },
    "enrichment": {
      "pass": 3,
      "engine": "claude",
      "producedAt": "2026-10-06T12:00:00Z",
      "ingestedAt": "2026-10-06T08:08:55+00:00",
      "fields": [
        "agent_conduct",
        "ethics",
        "failure_modes_and_hazards",
        "owners",
        "standards_and_regulation"
      ]
    },
    "gate": {
      "passed": true,
      "version": "1.0",
      "at": "2026-10-07T10:10:26+00:00",
      "evidence": [
        "completeness 1.00",
        "sense: Wikidata description",
        "2 live sources",
        "review by codex: pass"
      ]
    }
  },
  "metaModel": {
    "id": "THING-Q15124212",
    "registryId": "vr.tr.lung-neoplasm",
    "name": "lung neoplasm",
    "version": "0.1.0-research.1",
    "entryKind": "thing",
    "family": "Thing Registry",
    "domain": [
      "PHY.LIV"
    ],
    "status": "research-draft"
  },
  "canonicalUrl": "https://ver.cy/models/thing/q15124212/",
  "model": {
    "registry_id": "vr.tr.lung-neoplasm",
    "name": "lung neoplasm",
    "purpose": "Enable an AI agent to distinguish a lung neoplasm from its mimics, represent its supported biological and clinical state, and identify evidence needed for appropriate clinical review.",
    "definition": "A lung neoplasm is an abnormal proliferation of cells forming a tumour in the lung, encompassing benign and malignant growths that may originate there or spread there from another primary site.",
    "scope_statement": "This model owns the identity, location, neoplastic behavior, origin, characterization, extent and observed course of a neoplasm involving the lung; primary pulmonary tumors and secondary deposits remain explicitly distinguished.",
    "in_scope": [
      "Suspected or established neoplasms involving pulmonary tissue, with diagnostic certainty recorded",
      "Benign, in situ, malignant and uncertain-behavior classifications when supported by evidence",
      "Primary pulmonary origin versus metastatic involvement from another site",
      "Lesion-level anatomy, pathology, molecular characterization and relationships among multiple lesions",
      "Disease extent, longitudinal observations and lesion-related consequences",
      "Evidence dependencies and unresolved distinctions that affect clinical interpretation"
    ],
    "out_of_scope": [
      "Non-neoplastic pulmonary nodules, infections and inflammatory lesions except as differential diagnoses",
      "Primary pleural, mediastinal and chest-wall neoplasms except for their relationship to lung involvement",
      "The complete model of an extrapulmonary primary cancer",
      "Patient-wide fitness, comorbidities, preferences and care decisions",
      "Population screening programs and exposure epidemiology",
      "Detailed models of imaging equipment, biopsy procedures and treatment regimens"
    ],
    "distinguishing_features": [
      "A pulmonary nodule or mass is an imaging finding; its appearance alone does not establish that it is a neoplasm.",
      "Lung neoplasm is broader than lung cancer: the model must distinguish neoplastic behavior rather than presume malignancy.",
      "A tumor originating in pulmonary tissue differs from an extrapulmonary tumor metastatic to the lung, even when both occupy the same lung region.",
      "A pleural or mediastinal tumor extending into the lung differs from a primary pulmonary neoplasm; the site of origin must be supported separately from the sites involved.",
      "Multiple pulmonary lesions may represent independent neoplasms, related tumor deposits or a mixture of neoplastic and non-neoplastic findings; multiplicity alone does not settle their relationship."
    ],
    "characteristics": [
      {
        "name": "Neoplasm identification status",
        "kind": "state",
        "unit_or_values": "suspected | established | indeterminate | excluded; evidence and date attached",
        "why_it_matters": "Prevents an imaging suspicion from becoming an unqualified tumor diagnosis."
      },
      {
        "name": "Pulmonary location",
        "kind": "category",
        "unit_or_values": "side, lobe, segment when known, central or peripheral position, and airway relationship",
        "why_it_matters": "Supports lesion matching, sampling interpretation and assessment of local effects."
      },
      {
        "name": "Neoplastic behavior",
        "kind": "category",
        "unit_or_values": "benign | in situ | malignant | uncertain or unspecified behavior, using the cited classification",
        "why_it_matters": "Separates the broad registry concept from malignant lung disease alone."
      },
      {
        "name": "Tumor origin",
        "kind": "relation",
        "unit_or_values": "primary pulmonary | secondary from an identified primary | secondary from an unknown primary | unresolved",
        "why_it_matters": "Determines which disease model owns interpretation of the tumor's overall extent and course."
      },
      {
        "name": "Histopathological classification",
        "kind": "category",
        "unit_or_values": "reported tumor family, type, subtype and grade where applicable, with classification edition",
        "why_it_matters": "Preserves distinctions among pulmonary tumor types without imposing one classification on all neoplasms."
      },
      {
        "name": "Lesion dimensions",
        "kind": "measurement",
        "unit_or_values": "mm for reported dimensions; mm³ for volume when available; method and date required",
        "why_it_matters": "Supports comparison over time while preserving differences between imaging and pathological measurements."
      },
      {
        "name": "Imaging composition",
        "kind": "category",
        "unit_or_values": "reported solid, part-solid, ground-glass or other appearance, including measured solid component when applicable",
        "why_it_matters": "Retains pulmonary imaging distinctions without equating appearance with histology."
      },
      {
        "name": "Molecular and protein-marker results",
        "kind": "state",
        "unit_or_values": "marker-specific result, assay, specimen, adequacy, date and interpretation; not tested distinguished from negative",
        "why_it_matters": "Allows results to be evaluated in their tumor and specimen context."
      },
      {
        "name": "Disease extent",
        "kind": "state",
        "unit_or_values": "local involvement, regional nodes and distant involvement; applicable stage with system, edition, date and clinical or pathological basis",
        "why_it_matters": "Avoids applying a primary lung-cancer staging framework to every lung neoplasm."
      },
      {
        "name": "Relationship among lesions",
        "kind": "relation",
        "unit_or_values": "independent primary | related deposit | direct extension | unresolved, with supporting evidence",
        "why_it_matters": "Prevents separate lesions from being incorrectly merged into one disease process."
      },
      {
        "name": "Observed course",
        "kind": "state",
        "unit_or_values": "newly observed | stable | growing | regressing | recurrent | indeterminate, with comparison interval and assessment method",
        "why_it_matters": "Separates observed change from assumptions about progression or treatment response."
      }
    ],
    "affordances": [
      "Assemble lesion-specific imaging, pathology and clinical evidence while preserving uncertainty and provenance.",
      "Compare serial observations and flag uncertain lesion matching or incompatible measurement methods.",
      "Identify missing evidence needed to distinguish a primary pulmonary neoplasm, metastasis and non-neoplastic mimic.",
      "Check whether a recorded classification, stage or biomarker interpretation applies to the documented tumor type.",
      "Prepare a clinician-review summary of extent, local effects, observed change and unresolved findings."
    ],
    "agent_conduct": {
      "may": [
        "Explain what lung neoplasms are in general terms, citing medical sources.",
        "Support clinicians by summarising records and guidelines they have access to.",
        "Encourage a person with symptoms to see a doctor."
      ],
      "must_not": [
        "Diagnose or rule out a lung tumour in a specific person.",
        "Recommend, start or stop treatment for a person.",
        "Share a patient's diagnosis or images without consent or legal basis.",
        "Blame a patient for their illness or stigmatise them because of smoking history.",
        "Promote unproven cures as alternatives to medical care."
      ],
      "requires_human": [
        "Telling a person or family about a diagnosis or prognosis.",
        "Any decision about investigation, surgery or treatment."
      ]
    },
    "ethics": {
      "considerations": [
        "A diagnosis changes a life, and must be given by a clinician with care and accuracy.",
        "Lung cancer carries stigma linked to smoking that can deter people from seeking help."
      ],
      "affected_parties": [
        "Patients",
        "Families and carers",
        "Clinicians"
      ]
    },
    "owners": {
      "steward": "The treating clinician answers for each case; the patient owns their health information.",
      "master_systems": [
        "Cancer registries",
        "Patient health records"
      ]
    },
    "failure_modes_and_hazards": [
      "A missed or delayed diagnosis lets a malignant tumour progress.",
      "A false alarm causes distress and invasive tests."
    ],
    "standards_and_regulation": [
      "WHO Classification of Tumours, World Health Organization International Agency for Research on Cancer."
    ],
    "what_it_is_for": [
      "Lung neoplasms are encountered in respiratory medicine, radiology, pathology and oncology during investigation of symptoms or incidental imaging findings.",
      "The term supports documentation and assessment of abnormal lung growths before their origin and benign or malignant nature are fully established."
    ],
    "visual_identification": [
      "Chest imaging may reveal a persistent focal nodule or mass, although infection and scarring can produce similar appearances.",
      "Irregular or spiculated margins can raise suspicion for malignancy but do not establish a neoplasm by themselves.",
      "Microscopic tissue examination can reveal a neoplastic cell population and its architecture, helping distinguish a tumour from reactive changes."
    ]
  },
  "sources": [
    {
      "id": "wikidata",
      "title": "Wikidata item Q15124212: lung neoplasm",
      "url": "https://www.wikidata.org/wiki/Q15124212",
      "url_status": "live",
      "what_it_supports": "identity and sense of the item",
      "checked_by": "wikidata-api"
    },
    {
      "id": "wikipedia-en",
      "title": "Wikipedia: Lung tumor",
      "url": "https://en.wikipedia.org/wiki/Lung_tumor",
      "url_status": "live",
      "what_it_supports": "general description of the item",
      "checked_by": "wikidata-api sitelink"
    }
  ],
  "structure": {
    "bundles": [
      {
        "id": "pulmonary-lesion-identity",
        "name": "Pulmonary lesion identity",
        "description": "Establish what pulmonary finding is being modeled and whether its neoplastic nature is supported.",
        "rationale": "Pulmonary imaging abnormalities must not silently become confirmed tumor entities.",
        "layers": [
          {
            "id": "neoplasm-versus-mimic",
            "name": "Neoplasm versus mimic",
            "description": "Separate the observed abnormality from the interpretation that it is neoplastic.",
            "findings": [
              {
                "id": "basis-for-neoplastic-identification",
                "name": "Basis for neoplastic identification",
                "description": "Record the evidence and certainty behind identifying this finding as a lung neoplasm.",
                "questions": [
                  {
                    "text": "What evidence supports a neoplasm rather than an infectious, inflammatory or other non-neoplastic pulmonary finding?",
                    "kind": "definition",
                    "id": "basis-for-neoplastic-identification-q01"
                  },
                  {
                    "text": "Which report establishes the current diagnostic status, and does it describe suspicion, confirmation or unresolved uncertainty?",
                    "kind": "provenance",
                    "id": "basis-for-neoplastic-identification-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "anatomical-localization",
            "name": "Anatomical localization",
            "description": "Identify the lesion's pulmonary location and boundaries with adjacent compartments.",
            "findings": [
              {
                "id": "pulmonary-site-and-lesion-matching",
                "name": "Pulmonary site and lesion matching",
                "description": "Maintain a stable lesion identity across reports, images and specimens.",
                "questions": [
                  {
                    "text": "Which side, lobe and segment contain the lesion, and what is its relationship to the bronchi and pleura?",
                    "kind": "measurement",
                    "id": "pulmonary-site-and-lesion-matching-q01"
                  },
                  {
                    "text": "What evidence distinguishes a pulmonary origin from extension of a pleural, mediastinal or chest-wall tumor?",
                    "kind": "boundary",
                    "id": "pulmonary-site-and-lesion-matching-q02"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "origin-and-tumor-classification",
        "name": "Origin and tumor classification",
        "description": "Represent where the neoplasm arose and how its biological identity has been classified.",
        "rationale": "The same pulmonary location can contain biologically distinct primary tumors or secondary deposits.",
        "layers": [
          {
            "id": "primary-versus-secondary",
            "name": "Primary versus secondary",
            "description": "Assess pulmonary origin and relationships to other tumors.",
            "findings": [
              {
                "id": "origin-and-clonal-relationship",
                "name": "Origin and relationship to other lesions",
                "description": "Capture the supported interpretation of origin without inferring it from location alone.",
                "questions": [
                  {
                    "text": "What clinical, morphological or molecular evidence supports primary pulmonary origin versus metastasis from another organ?",
                    "kind": "provenance",
                    "id": "origin-and-clonal-relationship-q01"
                  },
                  {
                    "text": "If multiple tumors are present, what supports treating them as independent primaries or related deposits?",
                    "kind": "boundary",
                    "id": "origin-and-clonal-relationship-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "behavior-and-histology",
            "name": "Behavior and histology",
            "description": "Preserve the reported behavior and pathological classification.",
            "findings": [
              {
                "id": "supported-pathological-classification",
                "name": "Supported pathological classification",
                "description": "Record tumor type and behavior at the specificity justified by available material.",
                "questions": [
                  {
                    "text": "What tumor type and behavior are reported, and which classification and edition supply those terms?",
                    "kind": "definition",
                    "id": "supported-pathological-classification-q01"
                  },
                  {
                    "text": "Does the specimen support the stated subtype and any invasion or grade assessment, or does the report qualify them?",
                    "kind": "boundary",
                    "id": "supported-pathological-classification-q02"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "diagnostic-material-and-markers",
        "name": "Diagnostic material and markers",
        "description": "Connect tissue, cytology and other test results to their sampled targets and interpretive limits.",
        "rationale": "A test result can characterize only the lesion and material it adequately represents.",
        "layers": [
          {
            "id": "sampling-and-representativeness",
            "name": "Sampling and representativeness",
            "description": "Track which lesion or site was sampled and whether material was adequate.",
            "findings": [
              {
                "id": "specimen-to-lesion-link",
                "name": "Specimen-to-lesion link",
                "description": "Relate diagnostic material to the pulmonary lesion or associated disease site.",
                "questions": [
                  {
                    "text": "Which pulmonary lesion, lymph node or other site produced the specimen, and when was it collected relative to treatment?",
                    "kind": "provenance",
                    "id": "specimen-to-lesion-link-q01"
                  },
                  {
                    "text": "What limitations in adequacy, tumor content or sampling restrict the conclusions, especially for a negative or nondiagnostic result?",
                    "kind": "boundary",
                    "id": "specimen-to-lesion-link-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "ancillary-characterization",
            "name": "Ancillary characterization",
            "description": "Represent immunophenotypic, molecular and protein-marker evidence in context.",
            "findings": [
              {
                "id": "assay-specific-marker-interpretation",
                "name": "Assay-specific marker interpretation",
                "description": "Preserve marker results and their stated diagnostic or clinical relevance.",
                "questions": [
                  {
                    "text": "Which markers were assessed, by which assays and on which specimens, and what exact results and adequacy statements were reported?",
                    "kind": "measurement",
                    "id": "assay-specific-marker-interpretation-q01"
                  },
                  {
                    "text": "What evidence supports each marker's interpretation for this tumor type, and which unresolved results require specialist review?",
                    "kind": "action",
                    "id": "assay-specific-marker-interpretation-q02"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "extent-and-pulmonary-effects",
        "name": "Extent and pulmonary effects",
        "description": "Describe anatomical spread and attributable effects on pulmonary structures.",
        "rationale": "Tumor extent and local functional consequences are distinct dimensions of a lung neoplasm's state.",
        "layers": [
          {
            "id": "distribution-and-stage",
            "name": "Distribution and stage",
            "description": "Record local, nodal and distant findings under an applicable framework.",
            "findings": [
              {
                "id": "supported-extent-assessment",
                "name": "Supported extent assessment",
                "description": "Separate observed or suspected involvement from the resulting stage assignment.",
                "questions": [
                  {
                    "text": "Which local structures, nodal stations and distant sites are involved or suspected, and what evidence supports each assessment?",
                    "kind": "provenance",
                    "id": "supported-extent-assessment-q01"
                  },
                  {
                    "text": "Does a staging system apply to this tumor, and what system, edition, date and clinical or pathological basis underlie the recorded stage?",
                    "kind": "boundary",
                    "id": "supported-extent-assessment-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "local-pulmonary-consequences",
            "name": "Local pulmonary consequences",
            "description": "Represent effects on airways, lung tissue and adjacent structures without presuming causation.",
            "findings": [
              {
                "id": "lesion-attributable-effects",
                "name": "Lesion-attributable effects",
                "description": "Link documented obstruction, collapse, bleeding or other effects to the lesion with appropriate certainty.",
                "questions": [
                  {
                    "text": "What airway obstruction, atelectasis, bleeding or adjacent-structure involvement is documented, and how confidently is it attributed to this neoplasm?",
                    "kind": "measurement",
                    "id": "lesion-attributable-effects-q01"
                  },
                  {
                    "text": "Which documented consequences have an existing clinical escalation or follow-up instruction that an agent should surface?",
                    "kind": "action",
                    "id": "lesion-attributable-effects-q02"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "longitudinal-course-and-review",
        "name": "Longitudinal course and review",
        "description": "Track comparable observations, treatment context and unresolved interpretations over time.",
        "rationale": "Apparent pulmonary lesion change requires comparison methods and context before it can support a disease-state conclusion.",
        "layers": [
          {
            "id": "serial-lesion-assessment",
            "name": "Serial lesion assessment",
            "description": "Compare the same lesion across dated observations.",
            "findings": [
              {
                "id": "comparable-size-and-composition-change",
                "name": "Comparable size and composition change",
                "description": "Preserve measured changes and the limits of cross-study comparison.",
                "questions": [
                  {
                    "text": "How have lesion dimensions, volume when available, and solid or ground-glass components changed between specified examinations?",
                    "kind": "measurement",
                    "id": "comparable-size-and-composition-change-q01"
                  },
                  {
                    "text": "Are lesion matching, imaging technique and measurement method sufficiently comparable to support the stated change?",
                    "kind": "boundary",
                    "id": "comparable-size-and-composition-change-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "post-intervention-interpretation",
            "name": "Post-intervention interpretation",
            "description": "Connect observed course to treatment history and the next documented review.",
            "findings": [
              {
                "id": "residual-recurrent-or-treatment-related-finding",
                "name": "Residual, recurrent or treatment-related finding",
                "description": "Distinguish supported disease assessments from unresolved post-treatment abnormalities.",
                "questions": [
                  {
                    "text": "What evidence distinguishes viable residual or recurrent neoplasm from scar, inflammation or other treatment-related change?",
                    "kind": "boundary",
                    "id": "residual-recurrent-or-treatment-related-finding-q01"
                  },
                  {
                    "text": "What clinician-documented review or evidence-gathering step addresses the remaining uncertainty, and when is it due?",
                    "kind": "action",
                    "id": "residual-recurrent-or-treatment-related-finding-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": [
                  "No registry sense was supplied; this description uses the broad meaning of neoplasm, including benign, primary malignant and secondary malignant tumours.",
                  "The kinds listed are illustrative and not an exhaustive or uniformly ranked histological classification.",
                  "Terminology, coding applicability and current staging editions require verification; no sources were consulted for this recall-only description."
                ],
                "questions": [
                  {
                    "id": "evidence-confidence-notes-q01",
                    "text": "Which of these check these first hold for the sense of lung neoplasm 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": [
                  "Benign pulmonary neoplasms, including pulmonary hamartoma",
                  "Primary lung adenocarcinoma",
                  "Primary lung squamous cell carcinoma",
                  "Small-cell lung carcinoma",
                  "Pulmonary carcinoid tumours",
                  "Secondary malignant neoplasms metastatic to the lung"
                ],
                "questions": [
                  {
                    "id": "evidence-kinds-q01",
                    "text": "Which of these kinds and varieties hold for the sense of lung neoplasm 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": "ICD-10",
                    "value_or_pattern": "C34",
                    "note": "Malignant neoplasm of bronchus and lung; does not encompass all lung neoplasms."
                  },
                  {
                    "scheme": "ICD-10",
                    "value_or_pattern": "D14.3",
                    "note": "Benign neoplasm of bronchus and lung."
                  },
                  {
                    "scheme": "ICD-10",
                    "value_or_pattern": "C78.0",
                    "note": "Secondary malignant neoplasm of lung."
                  },
                  {
                    "scheme": "ICD-O",
                    "value_or_pattern": "Topography C34.x, combined with morphology and behaviour codes",
                    "note": "Records anatomical site and tumour characteristics; anatomical site alone does not establish histological type."
                  }
                ],
                "questions": [
                  {
                    "id": "evidence-identifiers-q01",
                    "text": "Which of these identifiers and schemes hold for the sense of lung neoplasm 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": [
                  "WHO Classification of Thoracic Tumours, published by the International Agency for Research on Cancer, defines tumour entities and diagnostic criteria.",
                  "TNM classification, maintained through UICC and AJCC staging frameworks with lung-specific contributions from IASLC, describes anatomical extent for applicable malignancies.",
                  "College of American Pathologists cancer protocols standardize pathology reporting for applicable lung tumour specimens."
                ],
                "questions": [
                  {
                    "id": "evidence-standards-and-regulation-q01",
                    "text": "Which of these standards and regulation hold for the sense of lung neoplasm 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": [
                  "Clinical classification of pulmonary tumours by origin, histology and biological behaviour.",
                  "Pathology reporting and cancer registry coding.",
                  "Staging and treatment planning for malignant tumours.",
                  "Selection of molecular testing and biomarker-directed therapies for appropriate cancer subtypes.",
                  "Monitoring tumour growth, treatment response and recurrence."
                ],
                "questions": [
                  {
                    "id": "evidence-real-world-use-q01",
                    "text": "Which of these real-world use hold for the sense of lung neoplasm 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": [
                  "Malignant tumours can invade adjacent structures and metastasize.",
                  "Airway obstruction can cause atelectasis or post-obstructive infection, including with some benign tumours.",
                  "Tumours can cause haemoptysis, breathing impairment or pleural involvement.",
                  "Some malignant subtypes produce paraneoplastic syndromes.",
                  "Misclassifying a metastasis as a primary lung tumour, or an inflammatory lesion as a neoplasm, can lead to inappropriate management."
                ],
                "questions": [
                  {
                    "id": "evidence-failure-modes-and-hazards-q01",
                    "text": "Which of these failure modes and hazards hold for the sense of lung neoplasm 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": [
                  "National modifications of ICD may differ in coding detail and reporting requirements.",
                  "Access to tissue diagnosis, molecular testing and specialist treatment varies across healthcare systems."
                ],
                "questions": [
                  {
                    "id": "evidence-regional-variation-q01",
                    "text": "Which of these regional variation hold for the sense of lung neoplasm 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": "Lung cancer",
                    "difference": "Denotes malignant disease, whereas lung neoplasm also includes benign tumours."
                  },
                  {
                    "name": "Pulmonary nodule",
                    "difference": "An imaging descriptor for a focal pulmonary opacity; a nodule may be neoplastic, infectious, inflammatory or otherwise non-neoplastic."
                  },
                  {
                    "name": "Pulmonary metastasis",
                    "difference": "A malignant deposit originating from a primary tumour elsewhere; it is a subset of lung neoplasms rather than a primary lung tumour."
                  },
                  {
                    "name": "Pleural mesothelioma",
                    "difference": "Originates in the pleural mesothelium rather than lung tissue, although it can invade the lung."
                  }
                ],
                "questions": [
                  {
                    "id": "evidence-neighbours-q01",
                    "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of lung neoplasm this model covers, and on what evidence?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          }
        ]
      }
    ]
  },
  "openQuestions": [
    "Does the registry intend lung neoplasm to include secondary pulmonary deposits and benign tumors, and what authoritative terminology mapping should establish that boundary?",
    "Does an existing Vercy world model already own this concept or its core tumor behavior, requiring linkage rather than a duplicate publication?",
    "Which pathology classifications and staging systems, with their editions, should govern the different pulmonary tumor families?",
    "What evidence standards should govern linking multiple pulmonary lesions to one neoplasm versus representing independent primary tumors?",
    "Which tumor-specific testing, longitudinal assessment and clinical review standards should be researched before this structural draft becomes a sourced publication?"
  ],
  "statistics": {
    "bundles": 6,
    "layers": 11,
    "findings": 18,
    "questions": 28
  }
}
