{ "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-12T08:59:29Z", "providers": [ "Codex" ], "breadth": "recalled by Codex without web access - no source was read", "missingProviders": [], "pass": 2, "cost": { "grok": { "seconds": 26.1, "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: 01a094d6-c84c-7e83-9144-a3e871e61ec2\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: cytopenia\nSense to describe: (none recorded)\nDomain code: XCT.STA\nAlso known as: (none)\n\n\nContext for this batch of 1001 things:\n# Batch 043: 1001 regis", "usd": 0.0, "recall": true }, "codex": { "seconds": 70.3, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.4\n--------\nworkdir: R:\\02_PROJECTS\\02_Meta_Models_Platforms\\Ver.cy\\current\\thing-registry-backlog\nmodel: gpt-6-astra\nprovider: openai\napproval: never\nsandbox: read-only\nreasoning effort: none\nreasoning summaries: none\nsession id: 01a094d6-c857-7790-9e74-889118c95466\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: cytopenia\nRegistry id: vr.tr.cytopenia\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nNames folded into this entry: (none)\n\n\nCont" } }, "enrichment": { "pass": 3, "engine": "claude", "producedAt": "2026-10-06T12:00:00Z", "ingestedAt": "2026-10-06T08:38:45+00:00", "fields": [ "agent_conduct", "ethics", "failure_modes_and_hazards", "owners" ] }, "gate": { "passed": true, "version": "1.0", "at": "2026-10-07T10:10:29+00:00", "evidence": [ "completeness 1.00", "sense: Wikidata description", "2 live sources", "review by codex: pass" ] } }, "metaModel": { "id": "THING-Q246147", "registryId": "vr.tr.cytopenia", "name": "cytopenia", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q246147/", "model": { "registry_id": "vr.tr.cytopenia", "name": "cytopenia", "purpose": "Enable an agent to recognise, characterise and track cytopenia while distinguishing verified blood-cell deficits from measurement artefacts and separating the observed state from its possible causes.", "definition": "Cytopenia is a reduction below the applicable reference interval in the number of cells of one or more blood-cell lineages in peripheral blood.", "scope_statement": "This model owns cytopenia as a context-dependent reduction in one or more circulating blood-cell lineages, including its evidential basis, lineage pattern, trajectory and implications for assessment; it does not own the diseases or treatments that may cause or resolve it.", "in_scope": [ "Affected blood-cell lineages and combinations of lineage deficits", "Measured counts or lineage-appropriate indicators, their units and applicable reference limits", "Sample validity, repeat confirmation and suspected falsely low results", "Onset, persistence, fluctuation and recovery", "Evidence for possible mechanisms and associated clinical consequences" ], "out_of_scope": [ "Complete models of causal diseases such as marrow disorders, infections or autoimmune disease", "Detailed models of individual subtypes such as neutropenia, anaemia and thrombocytopenia", "Laboratory instruments, assay engineering and specimen-processing procedures", "Blood-cell dysfunction without a quantitative deficit", "Individual treatment protocols, transfusion prescribing and drug dosing" ], "distinguishing_features": [ "A quantitative blood-cell deficit must be supported by an applicable measurement and comparator; symptoms alone do not establish cytopenia.", "An absolute cell count can be low even when its percentage is normal, and a low percentage alone need not establish a lineage deficit.", "Cytopenia describes an observed state and does not by itself identify a causal disease or mechanism.", "An isolated lineage deficit, a two-lineage deficit and pancytopenia have different coverage; pancytopenia requires involvement of all three major blood-cell lineages.", "Apparent cytopenia caused by specimen or analytical artefacts must be distinguished from a confirmed circulating-cell deficit." ], "characteristics": [ { "name": "Affected lineage pattern", "kind": "category", "unit_or_values": "Erythroid, leukocyte or specified leukocyte subtype, platelet; isolated, two-lineage or three-lineage involvement", "why_it_matters": "Identifies what is reduced without counting overlapping leukocyte subtypes as separate major lineages." }, { "name": "Observed blood measurements", "kind": "measurement", "unit_or_values": "Cell counts in explicitly recorded units such as ×10^9/L or ×10^12/L; haemoglobin in g/L or g/dL when characterising the erythroid component", "why_it_matters": "Preserves the distinction between cell counts and related indicators rather than treating them as interchangeable." }, { "name": "Applicable lower reference limit", "kind": "relation", "unit_or_values": "Measurement linked to a laboratory interval or named diagnostic criterion, with relevant population and physiological context", "why_it_matters": "Whether a result is low depends on the comparator used." }, { "name": "Confirmation status", "kind": "state", "unit_or_values": "Unconfirmed, repeat-confirmed, artefact suspected, artefact demonstrated, unresolved", "why_it_matters": "Prevents a questionable result from becoming an established patient state." }, { "name": "Magnitude of deficit", "kind": "measurement", "unit_or_values": "Observed value and distance below the applicable lower limit; severity grade only with a named grading system", "why_it_matters": "Supports comparison without imposing one severity scale across different lineages." }, { "name": "Temporal course", "kind": "state", "unit_or_values": "Newly detected, persistent, intermittent, worsening, stable, recovering or resolved; supported by dated results", "why_it_matters": "Distinguishes a single observation from a sustained or changing state." }, { "name": "Mechanism assessment", "kind": "category", "unit_or_values": "Reduced production, increased destruction, consumption, sequestration, dilution, mixed or undetermined", "why_it_matters": "Organises causal hypotheses while retaining their uncertainty." }, { "name": "Associated manifestations", "kind": "relation", "unit_or_values": "Links to documented bleeding, infection, impaired oxygen-delivery manifestations, or an explicit absence of assessed manifestations", "why_it_matters": "Connects the laboratory state to clinical significance without assuming that symptoms are caused by it." } ], "affordances": [ "Classify the affected lineage pattern from validated measurements.", "Identify missing reference limits, ambiguous units or unresolved sample artefacts.", "Compare serial results while accounting for method changes and intervening treatments.", "Organise supported causal hypotheses and identify evidence that would distinguish them.", "Flag findings for clinical review using a cited, applicable escalation rule.", "Link the state to neighbouring subtype, disease and treatment models." ], "agent_conduct": { "may": [ "Explain what cytopenia means and its general causes from clinical sources.", "Flag a reported low count against the laboratory reference interval for clinician review." ], "must_not": [ "Diagnose the cause of a cytopenia or rule out serious disease for a user.", "Advise changing medicines such as chemotherapy because of a low count.", "Disclose a patient's blood results beyond the care team without consent.", "Apply one reference interval to every population without noting the differences." ], "requires_human": [ "Deciding on transfusion, treatment or further tests.", "Telling a patient that a low count may indicate a serious disease." ] }, "ethics": { "considerations": [ "Reference intervals differ by ancestry, age and sex; one-size limits can wrongly label healthy people.", "Low counts can mean infection or bleeding risk that needs prompt care." ], "affected_parties": [ "Patients", "Clinicians", "Families and carers" ] }, "owners": { "steward": "The treating clinician answers for interpretation; the laboratory answers for the measurement.", "master_systems": [ "Patient health records", "Laboratory information systems" ] }, "failure_modes_and_hazards": [ "Low white cells raise infection risk; low platelets raise bleeding risk.", "Severe anaemia can strain the heart." ], "what_it_is_for": [ "Cytopenia is encountered when blood counts show a deficit in one or more blood-cell lineages relative to applicable reference intervals.", "It is assessed in clinical investigation and monitoring, with interpretation depending on the affected lineages, persistence and wider clinical context." ], "standards_and_regulation": [ "The International Classification of Diseases, issued by the World Health Organization, classifies specific blood-cell deficiency disorders according to their documented type and cause." ], "facets_not_applicable": { "recognition": "Cytopenia is a laboratory-defined state that cannot be identified reliably by visual appearance." } }, "sources": [ { "id": "wikidata", "title": "Wikidata item Q246147: cytopenia", "url": "https://www.wikidata.org/wiki/Q246147", "url_status": "live", "what_it_supports": "identity and sense of the item", "checked_by": "wikidata-api" }, { "id": "wikipedia-en", "title": "Wikipedia: Cytopenia", "url": "https://en.wikipedia.org/wiki/Cytopenia", "url_status": "live", "what_it_supports": "general description of the item", "checked_by": "wikidata-api sitelink" } ], "structure": { "bundles": [ { "id": "lineage-and-boundary", "name": "Lineage and boundary", "description": "Establishes which blood-cell deficit the cytopenia assertion denotes.", "rationale": "Cytopenia is an umbrella state whose meaning depends on the affected lineage and the operational definition used.", "layers": [ { "id": "lineage-coverage", "name": "Lineage coverage", "description": "Identifies affected major lineages and relevant leukocyte subtypes.", "findings": [ { "id": "deficit-pattern", "name": "Deficit pattern", "description": "Record whether the deficit is isolated or involves multiple major lineages, retaining subtype detail.", "questions": [ { "text": "Which major lineages and leukocyte subtypes have independently supported deficits?", "kind": "measurement", "id": "deficit-pattern-q01" }, { "text": "Does the asserted pattern avoid counting neutropenia and leukopenia as two separate major-lineage deficits?", "kind": "boundary", "id": "deficit-pattern-q02" } ] } ] }, { "id": "operational-definition", "name": "Operational definition", "description": "Makes the criteria underlying the cytopenia label explicit.", "findings": [ { "id": "criterion-for-low", "name": "Criterion for low", "description": "Attach each deficit assertion to a defined measurement and an applicable threshold.", "questions": [ { "text": "Which reference interval or diagnostic criterion establishes that each recorded result is low?", "kind": "definition", "id": "criterion-for-low-q01" }, { "text": "For erythroid involvement, does the adopted convention use haemoglobin, red-cell count or another indicator, and how does it relate cytopenia to anaemia?", "kind": "boundary", "id": "criterion-for-low-q02" } ] } ] } ] }, { "id": "measurement-and-confirmation", "name": "Measurement and confirmation", "description": "Establishes whether the reported deficit reliably represents circulating blood.", "rationale": "Sample problems, counting artefacts and inappropriate interpretation can produce a false cytopenia assertion.", "layers": [ { "id": "measurement-context", "name": "Measurement context", "description": "Preserves the information needed to interpret the reported result.", "findings": [ { "id": "interpretable-count", "name": "Interpretable count", "description": "Retain specimen time, measurement identity, units, method and relevant reference context.", "questions": [ { "text": "What were the measured values, units, collection time and reporting laboratory?", "kind": "provenance", "id": "interpretable-count-q01" }, { "text": "Are leukocyte subtype deficits supported by absolute counts rather than percentages alone?", "kind": "measurement", "id": "interpretable-count-q02" } ] } ] }, { "id": "artefact-resolution", "name": "Artefact resolution", "description": "Separates possible analytical or specimen effects from confirmed deficits.", "findings": [ { "id": "confirmation-evidence", "name": "Confirmation evidence", "description": "Record flags, specimen concerns and the outcome of any repeat or supplementary assessment.", "questions": [ { "text": "Were platelet clumping, specimen clotting, collection-related dilution or analyser flags reported?", "kind": "provenance", "id": "confirmation-evidence-q01" }, { "text": "What repeat count, blood-film assessment or alternative specimen evidence confirmed or challenged the result?", "kind": "measurement", "id": "confirmation-evidence-q02" } ] } ] } ] }, { "id": "course-and-comparability", "name": "Course and comparability", "description": "Represents the deficit as a changing state rather than an isolated number.", "rationale": "Persistence, rate of change and recovery across lineages affect interpretation, while interventions can obscure the underlying course.", "layers": [ { "id": "onset-and-persistence", "name": "Onset and persistence", "description": "Establishes the observed time window and prior baseline.", "findings": [ { "id": "documented-time-course", "name": "Documented time course", "description": "Distinguish first detection from known onset and record persistence only where observations support it.", "questions": [ { "text": "When was the deficit first detected, and what is the most recent preceding comparable result?", "kind": "provenance", "id": "documented-time-course-q01" }, { "text": "Which dated measurements establish persistence, intermittency or resolution?", "kind": "measurement", "id": "documented-time-course-q02" } ] } ] }, { "id": "trajectory-and-interventions", "name": "Trajectory and interventions", "description": "Interprets serial lineage measurements in their intervening context.", "findings": [ { "id": "comparable-lineage-trends", "name": "Comparable lineage trends", "description": "Track nadirs and recovery separately for each lineage and annotate factors that alter comparability.", "questions": [ { "text": "What are the observed nadir and subsequent direction of change for each affected lineage?", "kind": "measurement", "id": "comparable-lineage-trends-q01" }, { "text": "Which transfusions, fluid shifts, treatments or laboratory-method changes complicate interpretation of that trend?", "kind": "provenance", "id": "comparable-lineage-trends-q02" } ] } ] } ] }, { "id": "mechanism-and-causal-evidence", "name": "Mechanism and causal evidence", "description": "Connects the observed deficit to explicitly qualified mechanism and cause assessments.", "rationale": "Similar counts can arise through different processes, and cytopenia alone cannot establish which process is responsible.", "layers": [ { "id": "mechanism-discrimination", "name": "Mechanism discrimination", "description": "Organises evidence concerning production, peripheral loss and distribution.", "findings": [ { "id": "supported-mechanisms", "name": "Supported mechanisms", "description": "Record supporting and conflicting evidence for each proposed mechanism, allowing mixed and unresolved states.", "questions": [ { "text": "What available reticulocyte, blood-film, haemolysis, spleen or marrow evidence supports or challenges the proposed mechanism?", "kind": "provenance", "id": "supported-mechanisms-q01" }, { "text": "Does the evidence distinguish reduced production from destruction, consumption, sequestration or dilution, or do several remain plausible?", "kind": "boundary", "id": "supported-mechanisms-q02" } ] } ] }, { "id": "cause-attribution", "name": "Cause attribution", "description": "Links candidate causes without converting temporal association into established causation.", "findings": [ { "id": "qualified-causal-links", "name": "Qualified causal links", "description": "Represent each proposed cause with its evidence, timing and assessment status.", "questions": [ { "text": "Which diseases, exposures, nutritional states or treatments are proposed as causes, and who made each attribution?", "kind": "provenance", "id": "qualified-causal-links-q01" }, { "text": "What evidence supports the timing and causal relationship, and which alternatives remain unresolved?", "kind": "boundary", "id": "qualified-causal-links-q02" } ] } ] } ] }, { "id": "clinical-significance-and-response", "name": "Clinical significance and response", "description": "Relates lineage-specific deficits to documented manifestations and applicable review decisions.", "rationale": "The same numerical deficit can have different implications depending on lineage, trajectory and clinical context.", "layers": [ { "id": "lineage-specific-consequences", "name": "Lineage-specific consequences", "description": "Records manifestations relevant to the affected lineage without assuming causation from the count.", "findings": [ { "id": "manifestations-and-modifiers", "name": "Manifestations and modifiers", "description": "Keep observed symptoms, assessed risks and modifying circumstances distinct.", "questions": [ { "text": "What bleeding, infection or impaired oxygen-delivery manifestations are documented, and when were they assessed?", "kind": "provenance", "id": "manifestations-and-modifiers-q01" }, { "text": "Which coexisting conditions, medicines or planned procedures modify the significance of the affected lineage deficit?", "kind": "boundary", "id": "manifestations-and-modifiers-q02" } ] } ] }, { "id": "review-and-follow-up", "name": "Review and follow-up", "description": "Supports traceable assessment and escalation without embedding a universal treatment protocol.", "findings": [ { "id": "applicable-next-action", "name": "Applicable next action", "description": "Link the current state to a sourced review rule and an accountable follow-up plan.", "questions": [ { "text": "Which applicable clinical or laboratory rule determines whether this result requires routine follow-up, prompt review or urgent escalation?", "kind": "action", "id": "applicable-next-action-q01" }, { "text": "Who is responsible for the next assessment, what will it clarify, and when is it due?", "kind": "action", "id": "applicable-next-action-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": [ "Cytopenia is a hematologic finding or condition category, not a single disease with one cause.", "Verify thresholds against age, pregnancy status, laboratory reference intervals, and the relevant clinical context; the intervals above are illustrative adult values.", "Exact terminology identifiers and the applicable CTCAE version require checking; no external sources were consulted." ], "questions": [ { "id": "evidence-confidence-notes-q01", "text": "Which of these check these first hold for the sense of cytopenia 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": [ "Anemia", "Leukopenia", "Neutropenia", "Thrombocytopenia", "Bicytopenia", "Pancytopenia" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of cytopenia 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": "SNOMED CT", "value_or_pattern": "Numeric concept identifier", "note": "Select the concept for the documented cytopenia or affected lineage; no specific identifier is asserted here." } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of cytopenia 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": [ "National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE): grades specific blood-count abnormalities in clinical trials and treatment safety reporting." ], "questions": [ { "id": "evidence-standards-and-regulation-q01", "text": "Which of these standards and regulation hold for the sense of cytopenia 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": [ "Describing blood-count abnormalities while their cause is investigated.", "Monitoring hematologic toxicity during chemotherapy and other drug treatment.", "Assessing marrow failure, hematologic malignancy, nutritional deficiency, infection, and immune-mediated cell destruction.", "Supporting assessment of infection, bleeding, or impaired oxygen-delivery risk according to the affected lineage." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of cytopenia this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-measurements", "name": "Typical measurements", "description": "Recalled without web access and unsourced; every item is a lead to verify.", "evidence": [ { "quantity": "Absolute neutrophil count", "typical_range": "Common adult reference interval approximately 1.5-7.5; laboratory and population dependent", "unit": "×10^9/L" }, { "quantity": "Platelet count", "typical_range": "Common adult reference interval approximately 150-450; laboratory dependent", "unit": "×10^9/L" }, { "quantity": "Total white blood cell count", "typical_range": "Common adult reference interval approximately 4-11; laboratory dependent", "unit": "×10^9/L" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of cytopenia 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": [ "Severe neutropenia can increase susceptibility to serious infection.", "Severe thrombocytopenia can increase bleeding risk.", "Anemia can impair oxygen delivery; its clinical definition generally uses hemoglobin concentration rather than red-cell count alone.", "Platelet clumping in a collected sample can produce pseudothrombocytopenia and prompt unnecessary investigation or treatment.", "Treating cytopenia as a final etiologic diagnosis can delay recognition of an underlying disorder." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of cytopenia 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": [ "Laboratories and health systems use different reference intervals and reporting units.", "Neutrophil reference intervals can vary with population composition, including the prevalence of the Duffy-null phenotype; geography alone is an inadequate proxy." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of cytopenia 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": "Pancytopenia", "difference": "Specifies reduction across the erythroid, leukocyte, and platelet lineages; cytopenia can involve only one." }, { "name": "Bone marrow failure", "difference": "Describes impaired marrow production; cytopenia is a peripheral blood finding that can also result from destruction, consumption, or sequestration." }, { "name": "Cytosis", "difference": "Describes an increased blood-cell count rather than a decreased count." }, { "name": "Blood-cell dysfunction", "difference": "Describes impaired cellular function, which may occur despite a normal cell count." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of cytopenia this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Which authoritative terminology should govern the erythroid component, particularly the relationship between low red-cell count and haemoglobin-defined anaemia?", "Which population-specific reference intervals and purpose-specific diagnostic thresholds should the model support, and how should conflicting classifications be represented?", "Which lineage-specific severity and escalation frameworks should be linked for each intended clinical setting?", "What evidence is sufficient to mark a suspected artefact as resolved or to classify a deficit as persistent?", "Which existing Vercy models already own cytopenia, its subtypes or its causal mechanisms, and where should this registry entry link to avoid duplicate ownership?" ], "statistics": { "bundles": 6, "layers": 11, "findings": 19, "questions": 29 } }