{
  "vercy": "1.0-draft",
  "publication": {
    "status": "research-draft",
    "adjudicationStatus": "unreviewed",
    "publishableCanonical": false,
    "generatedAt": "2026-09-12T23:35:12Z",
    "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": 3,
    "engine": "claude",
    "enrichment": {
      "pass": 3,
      "engine": "claude",
      "producedAt": "2026-10-06T10:00:00Z",
      "ingestedAt": "2026-10-06T06:59:22+00:00",
      "fields": [
        "agent_conduct",
        "ethics",
        "owners"
      ]
    },
    "revisions": [
      {
        "at": "2026-10-06T22:51:28+00:00",
        "engine": "codex",
        "fields": [
          "definition"
        ],
        "answering_review": "2d76123cc968bba83c503a58c0ceed8f595634b61e5b775c96b3fa70b180fa44"
      }
    ],
    "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-Q41478",
    "registryId": "vr.tr.hemorrhoid",
    "name": "hemorrhoid",
    "version": "0.2.0-wave.3",
    "entryKind": "thing",
    "family": "Thing Registry",
    "domain": [
      "XCT.STA"
    ],
    "status": "research-draft"
  },
  "canonicalUrl": "https://ver.cy/models/thing/q41478/",
  "model": {
    "registry_id": "vr.tr.hemorrhoid",
    "name": "hemorrhoid",
    "purpose": "Let an agent explain haemorrhoids in general terms, relay causes, symptoms and treatment principles from clinical guidelines, identify warning signs that require assessment, and route personal symptoms to clinicians.",
    "definition": "Haemorrhoids are normal vascular structures in the anal canal that contribute to continence; haemorrhoidal disease occurs when these structures become pathologically enlarged or otherwise symptomatic, potentially causing bleeding, itching, discomfort or prolapse, and rectal bleeding can also have other causes.",
    "what_it_is_for": "Not applicable; a condition.",
    "affordances": [
      "explain the condition and kinds",
      "relay causes and treatment principles",
      "identify warning signs",
      "route personal symptoms to clinicians"
    ],
    "distinguishing_features": [
      "Vascular cushions",
      "Internal grades I to IV",
      "Common and usually benign",
      "Bleeding needs assessment"
    ],
    "appearance": "Not a visible object in general; external haemorrhoids appear as swellings at the anus.",
    "visual_identification": [
      "Enlarged anal vascular cushions",
      "Internal, external and mixed kinds",
      "Perianal haematoma, fissures and rectal cancer are other causes of similar symptoms"
    ],
    "physical_properties": [
      {
        "quantity": "lifetime prevalence",
        "typical_range": "about 40-50",
        "unit": "percent",
        "note": "estimates vary"
      }
    ],
    "families_and_kinds": [
      "internal haemorrhoids graded I to IV",
      "external haemorrhoids",
      "mixed haemorrhoids",
      "thrombosed haemorrhoids",
      "perianal haematoma as a related condition"
    ],
    "related_models": [
      {
        "relation": "is a kind of",
        "target": "anal disease",
        "why": "in registry terms"
      },
      {
        "relation": "is a kind of",
        "target": "pelvic varices",
        "why": "in registry terms"
      },
      {
        "relation": "is treated by",
        "target": "colorectal surgery",
        "why": "when needed"
      },
      {
        "relation": "is confused with",
        "target": "anal fissure",
        "why": "another cause of symptoms"
      }
    ],
    "identifiers": [
      {
        "scheme": "ICD-10",
        "value_or_pattern": "K64",
        "note": "haemorrhoids"
      },
      {
        "scheme": "ICD-11",
        "value_or_pattern": "DB60",
        "note": ""
      }
    ],
    "standards_and_regulation": [
      "Clinical guidelines from colorectal societies",
      "Regulation of over-the-counter treatments"
    ],
    "failure_modes_and_hazards": [
      "Missed serious causes of bleeding",
      "Agents giving personal medical advice",
      "Embarrassment delaying care"
    ],
    "in_scope": [],
    "out_of_scope": [],
    "characteristics": [],
    "agent_conduct": {
      "may": [
        "Explain what haemorrhoids are and common factors associated with them, citing medical sources.",
        "Encourage people with rectal bleeding to see a clinician to rule out other causes.",
        "Discuss the condition plainly and without embarrassment."
      ],
      "must_not": [
        "Tell a person their bleeding is just haemorrhoids without clinical assessment.",
        "Recommend procedures or home treatments beyond general, sourced advice.",
        "Mock or shame people about the condition.",
        "Share a person's condition with others without consent."
      ],
      "requires_human": [
        "Decisions about treatment beyond simple self-care.",
        "Assessing rectal bleeding, which may signal serious disease."
      ]
    },
    "ethics": {
      "considerations": [
        "Embarrassment delays care, and bowel cancer can hide behind symptoms blamed on haemorrhoids.",
        "Intimate conditions call for dignity and privacy."
      ],
      "affected_parties": [
        "Patients",
        "Clinicians"
      ]
    },
    "owners": {
      "steward": "The patient's treating clinician; the record belongs in the patient's health record.",
      "master_systems": [
        "Patient health records"
      ]
    }
  },
  "sources": [
    {
      "id": "wikidata",
      "title": "Wikidata item Q41478: hemorrhoid",
      "url": "https://www.wikidata.org/wiki/Q41478",
      "url_status": "live",
      "what_it_supports": "identity and sense of the item",
      "checked_by": "wikidata-api"
    },
    {
      "id": "wikipedia-en",
      "title": "Wikipedia: Hemorrhoid",
      "url": "https://en.wikipedia.org/wiki/Hemorrhoid",
      "url_status": "live",
      "what_it_supports": "general description of the item",
      "checked_by": "wikidata-api sitelink"
    }
  ],
  "structure": {
    "bundles": [
      {
        "id": "understand",
        "name": "Understand",
        "description": "What haemorrhoids are.",
        "rationale": "General information.",
        "layers": [
          {
            "id": "definition",
            "name": "Definition",
            "description": "Definition and kinds.",
            "findings": [
              {
                "id": "definition-finding",
                "name": "Definition",
                "description": "Definition.",
                "questions": [
                  {
                    "text": "What are haemorrhoids, and what kinds and grades exist?",
                    "kind": "definition"
                  },
                  {
                    "text": "Is the user describing bleeding or symptoms, which need assessment by a clinician?",
                    "kind": "boundary"
                  }
                ]
              }
            ]
          },
          {
            "id": "causes",
            "name": "Causes",
            "description": "Causes and risk factors.",
            "findings": [
              {
                "id": "causes-finding",
                "name": "Causes",
                "description": "Causes.",
                "questions": [
                  {
                    "text": "What causes haemorrhoids, and who is at risk?",
                    "kind": "definition"
                  },
                  {
                    "text": "Which entry fits the specific kind?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "clinical",
        "name": "Clinical",
        "description": "Assessment and treatment.",
        "rationale": "Clinical.",
        "layers": [
          {
            "id": "assessment",
            "name": "Assessment",
            "description": "Assessment.",
            "findings": [
              {
                "id": "assessment-finding",
                "name": "Assessment",
                "description": "Assessment.",
                "questions": [
                  {
                    "text": "How are haemorrhoids assessed, and why is rectal bleeding investigated?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Is the presentation free of personal medical advice?",
                    "kind": "boundary"
                  }
                ]
              }
            ]
          },
          {
            "id": "treatment",
            "name": "Treatment",
            "description": "Treatment principles.",
            "findings": [
              {
                "id": "treatment-finding",
                "name": "Treatment",
                "description": "Treatment.",
                "questions": [
                  {
                    "text": "What treatment principles do guidelines describe, from diet to procedures, in general terms?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which references are standard?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "prevent",
        "name": "Prevent",
        "description": "Prevention.",
        "rationale": "Practice.",
        "layers": [
          {
            "id": "prevention",
            "name": "Prevention",
            "description": "Prevention.",
            "findings": [
              {
                "id": "prevention-finding",
                "name": "Prevention",
                "description": "Prevention.",
                "questions": [
                  {
                    "text": "What prevention measures do health sources recommend?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits constipation?",
                    "kind": "action"
                  }
                ]
              }
            ]
          },
          {
            "id": "special",
            "name": "Special",
            "description": "Pregnancy and other groups.",
            "findings": [
              {
                "id": "special-finding",
                "name": "Special",
                "description": "Special.",
                "questions": [
                  {
                    "text": "How are haemorrhoids managed in pregnancy and other groups, in general terms?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which sources are cited?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "context",
        "name": "Context",
        "description": "Burden and history.",
        "rationale": "Context.",
        "layers": [
          {
            "id": "burden",
            "name": "Burden",
            "description": "Burden.",
            "findings": [
              {
                "id": "burden-finding",
                "name": "Burden",
                "description": "Burden.",
                "questions": [
                  {
                    "text": "How common are haemorrhoids, and what do studies report, with sources?",
                    "kind": "measurement"
                  },
                  {
                    "text": "Which entry fits colorectal health?",
                    "kind": "action"
                  }
                ]
              }
            ]
          },
          {
            "id": "history",
            "name": "History",
            "description": "History.",
            "findings": [
              {
                "id": "history-finding",
                "name": "History",
                "description": "History.",
                "questions": [
                  {
                    "text": "How were haemorrhoids treated historically?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits the history of surgery?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      }
    ]
  },
  "openQuestions": [
    "Should perianal haematoma be a separate entry?",
    "How should guidelines be linked?",
    "The registry entry has merged aliases naming kinds and a related condition; should they be split off?"
  ],
  "statistics": {
    "bundles": 4,
    "layers": 8,
    "findings": 8,
    "questions": 16
  }
}