{ "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-12T10:21:54Z", "providers": [ "Codex" ], "breadth": "recalled by Codex without web access - no source was read", "missingProviders": [], "pass": 2, "cost": { "grok": { "seconds": 19.7, "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: 01a09522-427b-7790-ae3c-463c58e498f6\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: Hydrosalpinx\nSense to describe: (none recorded)\nDomain code: INF.KNW\nAlso known as: (none)\n\n\nContext for this batch of 1001 things:\n# Batch 043: 1001 re", "usd": 0.0, "recall": true }, "codex": { "seconds": 69.7, "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: 01a09522-4277-7790-8b7f-3b4a567560bf\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: Hydrosalpinx\nRegistry id: vr.tr.hydrosalpinx\nPlane / domain: INF / INF.KNW\nRegistry definition: (none recorded)\nNames folded into this entry: (none)\n" } }, "enrichment": { "pass": 3, "engine": "claude", "producedAt": "2026-10-06T12:00:00Z", "ingestedAt": "2026-10-06T08:40:32+00:00", "fields": [ "agent_conduct", "ethics", "owners" ] }, "gate": { "passed": true, "version": "1.0", "at": "2026-10-07T10:10:30+00:00", "evidence": [ "completeness 1.00", "sense: Wikidata description", "2 live sources", "review by codex: pass" ] } }, "metaModel": { "id": "THING-Q4138159", "registryId": "vr.tr.hydrosalpinx", "name": "Hydrosalpinx", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "INF.KNW" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q4138159/", "model": { "registry_id": "vr.tr.hydrosalpinx", "name": "Hydrosalpinx", "purpose": "Enable an agent to recognize hydrosalpinx, record the evidence and condition of each affected fallopian tube, and support clinician-led decisions about symptoms, fertility and intervention.", "definition": "Hydrosalpinx is distension of a fallopian tube by retained, predominantly serous fluid, usually resulting from distal tubal obstruction and commonly associated with prior inflammation and scarring.", "scope_statement": "This model owns the representation of hydrosalpinx under vr.tr.hydrosalpinx: a distally obstructed, fluid-distended fallopian tube, including diagnostic certainty, laterality, clinical consequences and management state; the supplied INF / INF.KNW placement is retained as registry metadata pending classification review.", "in_scope": [ "Identification of fluid-distended, distally obstructed fallopian tubes", "Separate characterization of right and left tubal involvement", "Diagnostic evidence, uncertainty and competing explanations", "Documented antecedents and associated pelvic disease", "Hydrosalpinx-specific symptom and reproductive implications", "Management decisions and subsequent structural and clinical outcomes" ], "out_of_scope": [ "General pelvic inflammatory disease diagnosis and antimicrobial protocols", "Comprehensive infertility evaluation and assisted reproduction protocols", "Ovarian cysts and other adnexal masses as independent conditions", "Ectopic pregnancy diagnosis and treatment", "General endometriosis classification and treatment", "Detailed surgical technique and perioperative care" ], "distinguishing_features": [ "Require evidence that the fluid-containing structure is a fallopian tube rather than an ovarian or paraovarian cyst.", "Distinguish hydrosalpinx from tubal obstruction alone by recording fluid distension and evidence of distal obstruction. [ASRM patient fact sheet](https://prod.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/hydrosalpinx/)", "Record whether the contents and clinical assessment favor hydrosalpinx, pyosalpinx or hematosalpinx; leave unresolved alternatives explicit.", "Do not equate hydrosalpinx with active infection: record historical causes separately from current infection evidence.", "Separate complete distal occlusion from fimbrial narrowing and peritubal adhesions without hydrosalpinx. [ASRM committee opinion](https://www.asrm.org/practice-guidance/practice-committee-documents/role-of-tubal-surgery-in-the-era-of-assisted-reproductive-technology-a-committee-opinion-2021/)" ], "characteristics": [ { "name": "Affected side", "kind": "category", "unit_or_values": "right | left | bilateral | indeterminate", "why_it_matters": "Prevents evidence or treatment for one tube from being assigned to the other." }, { "name": "Diagnostic certainty", "kind": "state", "unit_or_values": "suspected | supported | clinician-confirmed | disputed | excluded; with date and evidence", "why_it_matters": "Separates a provisional imaging interpretation from an established diagnosis." }, { "name": "Tubal dimensions", "kind": "measurement", "unit_or_values": "mm; specify dimension, side, modality and examination date", "why_it_matters": "Supports comparison of distension over time without treating size alone as a severity score." }, { "name": "Tubal morphology", "kind": "category", "unit_or_values": "described wall, folds, shape and contents; each observed | not assessed | indeterminate", "why_it_matters": "Preserves anatomical observations separately from interpretations of damage." }, { "name": "Obstruction and communication", "kind": "state", "unit_or_values": "distal obstruction and uterine communication each demonstrated | suspected | absent | unassessed", "why_it_matters": "Distinguishes the distal blockage from whether the tube communicates with the uterine cavity." }, { "name": "Etiologic attribution", "kind": "relation", "unit_or_values": "links to documented antecedents; suspected | supported | unknown", "why_it_matters": "Prevents an association from becoming an unsupported causal diagnosis." }, { "name": "Clinical presentation", "kind": "category", "unit_or_values": "incidental | fertility investigation | pelvic symptoms | acute presentation; multiple permitted", "why_it_matters": "Records why the finding matters in the current encounter." }, { "name": "Reproductive context", "kind": "relation", "unit_or_values": "links to patient goals, contralateral tube assessment and fertility care plan", "why_it_matters": "Provides decision context without duplicating the wider infertility model." }, { "name": "Management state", "kind": "state", "unit_or_values": "assessment pending | observation | intervention discussed | intervention planned | treated | follow-up", "why_it_matters": "Distinguishes a proposed intervention from a completed action." }, { "name": "Post-management anatomical state", "kind": "state", "unit_or_values": "persistent | no longer demonstrated | recurrent | tube removed | proximally occluded | unknown", "why_it_matters": "Avoids treating removal, isolation and apparent resolution as equivalent outcomes." } ], "affordances": [ "Assemble a side-specific evidence summary for suspected hydrosalpinx.", "Identify missing observations needed to distinguish a tubal lesion from another adnexal finding.", "Flag conflicting examinations and preserve uncertainty for clinician review.", "Prepare a management discussion using symptoms, reproductive goals and documented tubal condition.", "Track intervention and follow-up while separating anatomical findings from fertility outcomes." ], "agent_conduct": { "may": [ "Explain hydrosalpinx, its usual causes and its link to fertility, citing medical sources.", "Advise a person with pelvic pain or fertility concerns to see a clinician." ], "must_not": [ "Diagnose the condition from symptoms or a scan report.", "Advise on surgery or fertility treatment choices for a person.", "Imply that a past infection reflects on a person's sexual behaviour or morals.", "Share a person's fertility or gynaecological records without consent." ], "requires_human": [ "Any decision on surgery or assisted reproduction." ] }, "ethics": { "considerations": [ "Fertility problems carry grief and stigma; careless words add to them.", "Reproductive health data is highly sensitive." ], "affected_parties": [ "Patients", "Couples seeking to conceive" ] }, "owners": { "steward": "Nobody owns the condition; clinicians answer for each patient's care.", "master_systems": [] }, "what_it_is_for": [ "Hydrosalpinx is encountered during gynecological assessment, pelvic imaging and investigations of infertility or pelvic pain.", "Recording the affected side and supporting evidence helps clinicians assess tubal disease and discuss fertility care." ], "standards_and_regulation": [ "The International Classification of Diseases, Tenth Revision, issued by the World Health Organization includes hydrosalpinx under N70.1 for chronic salpingitis and oophoritis." ], "visual_identification": [ "Ultrasound may show an elongated fluid-filled tubular structure distinguishable from the adjacent ovary.", "A folded tube may produce incomplete internal septa or opposing wall indentations rather than the rounded outline of a simple ovarian cyst.", "Small mural nodules may create a beads-on-a-string appearance in chronic disease, although imaging findings require clinical interpretation." ], "failure_modes_and_hazards": [ "Tubal obstruction and damage can impair fertility.", "Associated tubal damage can increase the risk of ectopic pregnancy.", "Hydrosalpinx can reduce implantation and pregnancy success during in vitro fertilization.", "Misidentification as an ovarian cyst or another pelvic lesion can delay appropriate assessment." ] }, "sources": [ { "id": "wikidata", "title": "Wikidata item Q4138159: Hydrosalpinx", "url": "https://www.wikidata.org/wiki/Q4138159", "url_status": "live", "what_it_supports": "identity and sense of the item", "checked_by": "wikidata-api" }, { "id": "wikipedia-en", "title": "Wikipedia: Hydrosalpinx", "url": "https://en.wikipedia.org/wiki/Hydrosalpinx", "url_status": "live", "what_it_supports": "general description of the item", "checked_by": "wikidata-api sitelink" } ], "structure": { "bundles": [ { "id": "tubal-identity-and-extent", "name": "Tubal identity and extent", "description": "Establish which tube is involved and what supports the hydrosalpinx designation.", "rationale": "A generic adnexal fluid collection or blocked tube does not adequately identify this condition.", "layers": [ { "id": "tubal-origin", "name": "Tubal origin", "description": "Locate the abnormality and preserve the evidence for its anatomical identity.", "findings": [ { "id": "fluid-distended-tube", "name": "Fluid-distended tube", "description": "Record the observed structure, its side and the interpretation that it represents a fluid-distended fallopian tube.", "questions": [ { "text": "What examination supports fallopian tube origin, and how was an ovarian or paraovarian origin assessed?", "kind": "boundary", "id": "fluid-distended-tube-q01" }, { "text": "Which side is affected, and was the opposite tube assessed or merely not visualized?", "kind": "measurement", "id": "fluid-distended-tube-q02" } ] } ] }, { "id": "obstruction-and-distension", "name": "Obstruction and distension", "description": "Describe blockage, dimensions and communication without collapsing them into one severity label.", "findings": [ { "id": "anatomical-configuration", "name": "Anatomical configuration", "description": "Keep distal occlusion, uterine communication and measured distension as separate observations.", "questions": [ { "text": "What supports distal occlusion, and is communication with the uterine cavity demonstrated or unknown?", "kind": "measurement", "id": "anatomical-configuration-q01" }, { "text": "What dimensions and wall or fold observations were recorded for each affected tube?", "kind": "measurement", "id": "anatomical-configuration-q02" } ] } ] } ] }, { "id": "diagnostic-evidence-and-alternatives", "name": "Diagnostic evidence and alternatives", "description": "Connect diagnostic interpretations to their examinations and unresolved alternatives.", "rationale": "Different examinations answer different questions, and an uncertain result must remain distinguishable from confirmation.", "layers": [ { "id": "examination-support", "name": "Examination support", "description": "Preserve the method, date, observations and interpreting clinician.", "findings": [ { "id": "diagnostic-support", "name": "Diagnostic support", "description": "Ultrasound, hysterosalpingography and operative assessment can contribute evidence; HSG may be difficult to interpret or falsely suggest blockage. [ASRM patient fact sheet](https://prod.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/hydrosalpinx/)", "questions": [ { "text": "Which report supports the diagnosis, and what did it directly observe rather than infer?", "kind": "provenance", "id": "diagnostic-support-q01" }, { "text": "Do examinations disagree about side, distension or obstruction, and how has that disagreement been assessed?", "kind": "boundary", "id": "diagnostic-support-q02" } ] } ] }, { "id": "content-and-mimic-assessment", "name": "Content and mimic assessment", "description": "Capture competing explanations for a fluid-containing adnexal structure.", "findings": [ { "id": "unresolved-differential", "name": "Unresolved differential", "description": "Require explicit assessment of alternative origin or contents when the report does not securely establish hydrosalpinx.", "questions": [ { "text": "What supports hydrosalpinx rather than pus, blood or another cystic adnexal lesion?", "kind": "boundary", "id": "unresolved-differential-q01" }, { "text": "What additional clinician assessment, if any, is needed before the diagnosis can guide management?", "kind": "action", "id": "unresolved-differential-q02" } ] } ] } ] }, { "id": "clinical-and-reproductive-context", "name": "Clinical and reproductive context", "description": "Relate the tubal finding to documented antecedents, present symptoms and reproductive goals.", "rationale": "The same anatomical finding can occur in different clinical situations and does not establish its own cause or consequences.", "layers": [ { "id": "antecedents-and-current-presentation", "name": "Antecedents and current presentation", "description": "Separate historical explanations from current symptoms and active disease.", "findings": [ { "id": "cause-and-symptom-attribution", "name": "Cause and symptom attribution", "description": "Recognized antecedents include previous infection, surgery, adhesions and endometriosis; some people have no symptoms beyond fertility problems. [ASRM patient fact sheet](https://prod.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/hydrosalpinx/)", "questions": [ { "text": "Which antecedent is documented, and what supports attributing this hydrosalpinx to it?", "kind": "provenance", "id": "cause-and-symptom-attribution-q01" }, { "text": "Which current symptoms are attributed to the tube, and which require separate evaluation?", "kind": "boundary", "id": "cause-and-symptom-attribution-q02" }, { "text": "Does the current presentation require urgent clinical assessment rather than routine follow-up?", "kind": "action", "id": "cause-and-symptom-attribution-q03" } ] } ] }, { "id": "fertility-relevance", "name": "Fertility relevance", "description": "Record how the lesion intersects with pregnancy goals and the wider reproductive assessment.", "findings": [ { "id": "reproductive-consequences", "name": "Reproductive consequences", "description": "Hydrosalpinx can impair fertility and IVF outcomes and is associated with ectopic pregnancy risk. Individual implications require clinical assessment. [ASRM patient fact sheet](https://prod.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/hydrosalpinx/)", "questions": [ { "text": "Is pregnancy desired, and is natural conception or assisted reproduction being considered?", "kind": "action", "id": "reproductive-consequences-q01" }, { "text": "What is known about the other tube and other fertility factors, without assuming that unilateral disease establishes overall infertility?", "kind": "boundary", "id": "reproductive-consequences-q02" } ] } ] } ] }, { "id": "management-and-follow-up", "name": "Management and follow-up", "description": "Represent the rationale for a chosen approach and the evidence of its subsequent effects.", "rationale": "Tubal repair, removal and isolation have different anatomical endpoints that must not be reported as interchangeable cures.", "layers": [ { "id": "management-selection", "name": "Management selection", "description": "Record clinician recommendations, patient preferences and the intended treatment objective.", "findings": [ { "id": "option-specific-rationale", "name": "Option-specific rationale", "description": "Selected cases may be considered for repair; salpingectomy or proximal occlusion may address adverse IVF effects when repair is unsuitable. Selection depends on tubal disease and broader fertility circumstances. [ASRM committee opinion](https://www.asrm.org/practice-guidance/practice-committee-documents/role-of-tubal-surgery-in-the-era-of-assisted-reproductive-technology-a-committee-opinion-2021/)", "questions": [ { "text": "Is the intended objective symptom relief, restoration of tubal passage or management before embryo transfer?", "kind": "action", "id": "option-specific-rationale-q01" }, { "text": "What anatomical evidence, reproductive context and patient preferences support the proposed approach?", "kind": "provenance", "id": "option-specific-rationale-q02" }, { "text": "Which alternatives were discussed, and what decision remains pending?", "kind": "action", "id": "option-specific-rationale-q03" } ] } ] }, { "id": "anatomical-and-clinical-outcomes", "name": "Anatomical and clinical outcomes", "description": "Track what happened to the tube separately from symptoms and reproductive outcomes.", "findings": [ { "id": "verified-follow-up-state", "name": "Verified follow-up state", "description": "Record persistence, recurrence, removal or isolation with supporting evidence; restored patency alone does not establish restored reproductive function. [ASRM committee opinion](https://www.asrm.org/practice-guidance/practice-committee-documents/role-of-tubal-surgery-in-the-era-of-assisted-reproductive-technology-a-committee-opinion-2021/)", "questions": [ { "text": "What follow-up evidence establishes the current anatomical state on each side?", "kind": "measurement", "id": "verified-follow-up-state-q01" }, { "text": "Were symptoms, recurrence and reproductive outcomes assessed separately, and over what interval?", "kind": "measurement", "id": "verified-follow-up-state-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": [ "Hydrosalpinx is a pathological condition, not a discipline or field of knowledge; the supplied INF.KNW classification warrants review.", "The ICD-10 inclusion and applicable national coding modification should be checked before operational use.", "This is a recall-based description; no sources were consulted, and no universal diagnostic size threshold is asserted." ], "questions": [ { "id": "evidence-confidence-notes-q01", "text": "Which of these check these first hold for the sense of Hydrosalpinx 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": [ "Unilateral hydrosalpinx", "Bilateral hydrosalpinx" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of Hydrosalpinx 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": "N70.1", "note": "Hydrosalpinx is included under chronic salpingitis and oophoritis; this category is broader than hydrosalpinx." } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of Hydrosalpinx 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": [ "A diagnostic finding in investigations of tubal infertility.", "A finding assessed by pelvic ultrasonography, hysterosalpingography or laparoscopy.", "A factor considered when planning in vitro fertilisation because hydrosalpinx is associated with poorer implantation and pregnancy outcomes." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of Hydrosalpinx 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": [ "Impaired fertility from tubal obstruction and damage.", "Increased ectopic pregnancy risk associated with underlying tubal damage.", "Reduced implantation and pregnancy success during in vitro fertilisation.", "Pelvic pain, although many cases are asymptomatic.", "Rare torsion of the distended fallopian tube." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of Hydrosalpinx 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": [ "The relative contribution of causes varies geographically, including the contribution of genital tuberculosis where it is prevalent." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of Hydrosalpinx 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": "Salpingitis", "difference": "Salpingitis denotes inflammation of a fallopian tube; hydrosalpinx denotes fluid-filled distension and may persist without active inflammation." }, { "name": "Pyosalpinx", "difference": "Pyosalpinx contains pus rather than predominantly serous fluid." }, { "name": "Hematosalpinx", "difference": "Hematosalpinx contains blood rather than predominantly serous fluid." }, { "name": "Paraovarian cyst", "difference": "A paraovarian cyst is a separate cyst adjacent to the ovary or tube, rather than distension of the tubal lumen." }, { "name": "Tubal occlusion", "difference": "Tubal occlusion is blockage of the tube; fluid accumulation and distension are additionally required for hydrosalpinx." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of Hydrosalpinx this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Does INF / INF.KNW intentionally classify a knowledge representation here, or should the registry classify hydrosalpinx as a clinical condition?", "Which imaging terminology and diagnostic criteria should govern certainty when ultrasound, HSG and operative findings disagree?", "Which severity or surgical prognosis classification is sufficiently validated for the intended population and use?", "What evidence should guide observation and follow-up of incidental, asymptomatic hydrosalpinx when pregnancy is not a current goal?", "What current comparative evidence resolves treatment choice and timing before IVF for different anatomical presentations, including the durability of aspiration-based approaches?" ], "statistics": { "bundles": 5, "layers": 9, "findings": 15, "questions": 25 } }