{
  "vercy": "1.0-draft",
  "publication": {
    "status": "research-draft",
    "adjudicationStatus": "unreviewed",
    "publishableCanonical": false,
    "generatedAt": "2026-09-12T09:38:39Z",
    "providers": [
      "Codex"
    ],
    "breadth": "recalled by Codex without web access - no source was read",
    "missingProviders": [],
    "pass": 2,
    "cost": {
      "grok": {
        "seconds": 22.8,
        "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: 01a094fa-768d-78f2-b1f1-55d5dd7da88b\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: fallopian tube cancer\nSense to describe: (none recorded)\nDomain code: PHY.LIV\nAlso known as: (none)\n\n\nContext for this batch of 1001 things:\n# Batch 043",
        "usd": 0.0,
        "recall": true
      },
      "codex": {
        "seconds": 82.2,
        "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: 01a094fa-767d-7cd0-b00a-5287f7e57325\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: fallopian tube cancer\nRegistry id: vr.tr.fallopian-tube-cancer\nPlane / domain: PHY / PHY.LIV\nRegistry definition: (none recorded)\nNames folded into t"
      }
    },
    "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",
        "standards_and_regulation"
      ]
    },
    "gate": {
      "passed": true,
      "version": "1.0",
      "at": "2026-10-07T10:10:31+00:00",
      "evidence": [
        "completeness 1.00",
        "sense: Wikidata description",
        "2 live sources",
        "review by codex: pass"
      ]
    }
  },
  "metaModel": {
    "id": "THING-Q4818922",
    "registryId": "vr.tr.fallopian-tube-cancer",
    "name": "fallopian tube cancer",
    "version": "0.1.0-research.1",
    "entryKind": "thing",
    "family": "Thing Registry",
    "domain": [
      "PHY.LIV"
    ],
    "status": "research-draft"
  },
  "canonicalUrl": "https://ver.cy/models/thing/q4818922/",
  "model": {
    "registry_id": "vr.tr.fallopian-tube-cancer",
    "name": "fallopian tube cancer",
    "purpose": "Enable an agent to recognise a documented fallopian tube malignancy, assess its extent and course, and identify evidence needed for specialist care decisions.",
    "definition": "Fallopian tube cancer is a malignant neoplasm arising in the uterine tube, most commonly an epithelial carcinoma, with high-grade serous carcinoma closely related biologically and clinically to ovarian and primary peritoneal high-grade serous carcinoma.",
    "scope_statement": "This model owns the disease-specific identity, primary-site attribution, pathology, extent, molecular context and longitudinal state of fallopian tube cancer under vr.tr.fallopian-tube-cancer in PHY / PHY.LIV, distinguishing the disease category from an individual patient's cancer episode.",
    "in_scope": [
      "Primary malignant neoplasms attributed to the fallopian tube, with histological type explicitly recorded",
      "Evidence supporting or disputing tubal origin within a tubo-ovarian or peritoneal presentation",
      "Invasive disease and its relationship to associated serous tubal intraepithelial carcinoma",
      "Anatomical spread, staging evidence and residual disease",
      "Disease-relevant molecular findings, treatment history, response and recurrence"
    ],
    "out_of_scope": [
      "Primary ovarian and primary peritoneal cancers except as differential diagnoses or linked shared-care models",
      "Cancers originating elsewhere that secondarily involve the fallopian tube",
      "Isolated serous tubal intraepithelial carcinoma without established invasive cancer, except as a boundary or precursor relationship",
      "Benign tubal lesions, salpingitis, hydrosalpinx and ectopic pregnancy",
      "General hereditary cancer syndromes, screening programmes and preventive surgery protocols",
      "Detailed drug, surgical procedure and whole-person health models"
    ],
    "distinguishing_features": [
      "Require documented primary-site attribution: involvement of a fallopian tube alone does not establish that the cancer originated there.",
      "Separate invasive malignancy from an isolated intraepithelial lesion; record associated STIC without treating its presence alone as proof of invasion.",
      "Resolve disagreements between an ovarian clinical label and a tubal pathological assignment using the underlying pathology evidence and applicable attribution rules. [NCI SEER primary-site inquiry](https://seer.cancer.gov/seer-inquiry/inquiry-detail/20210025/)",
      "Record histological type independently of location; the registry label must not automatically become high-grade serous carcinoma.",
      "Distinguish a primary tubal cancer with ovarian or peritoneal spread from neighbouring primary-site categories, while retaining their relationship to shared epithelial cancer care pathways. [NCI treatment overview](https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq)"
    ],
    "characteristics": [
      {
        "name": "Diagnostic status",
        "kind": "state",
        "unit_or_values": "suspected; pathologically confirmed; disputed; excluded",
        "why_it_matters": "Prevents an adnexal mass or provisional diagnosis from becoming an established tubal cancer."
      },
      {
        "name": "Primary-site attribution",
        "kind": "category",
        "unit_or_values": "fallopian tube; ovary; peritoneum; other primary; indeterminate, with attribution authority and date",
        "why_it_matters": "Determines whether the episode belongs to this model and preserves uncertainty when origin cannot be resolved."
      },
      {
        "name": "Tubal location",
        "kind": "category",
        "unit_or_values": "right; left; bilateral; unknown, plus documented tubal segment",
        "why_it_matters": "Connects the diagnosis to the examined anatomy and distinguishes tumour involvement from assigned origin."
      },
      {
        "name": "Histological classification",
        "kind": "category",
        "unit_or_values": "reported histotype and applicable grade, with classification version; unknown",
        "why_it_matters": "Prevents assumptions that all tubal malignancies share the same biology or management."
      },
      {
        "name": "Invasion and associated STIC",
        "kind": "state",
        "unit_or_values": "invasion: present, absent or indeterminate; STIC: present, not identified, indeterminate or not assessed",
        "why_it_matters": "Separates invasive cancer from a related intraepithelial lesion and distinguishes negative findings from missing examination."
      },
      {
        "name": "Stage at diagnosis",
        "kind": "category",
        "unit_or_values": "documented FIGO stage and/or TNM classification, system version, assessment date and evidence basis",
        "why_it_matters": "Makes anatomical extent interpretable without confusing original stage with later progression."
      },
      {
        "name": "Sites of spread",
        "kind": "relation",
        "unit_or_values": "linked anatomical sites, each with suspected or confirmed involvement and supporting evidence",
        "why_it_matters": "Represents ovarian, peritoneal, nodal and distant involvement without changing the assigned primary site."
      },
      {
        "name": "Postoperative residual disease",
        "kind": "measurement",
        "unit_or_values": "largest documented residual lesion in mm; no macroscopic residual disease; unknown",
        "why_it_matters": "Records the surgical disease state separately from initial tumour size and stage."
      },
      {
        "name": "Molecular and hereditary findings",
        "kind": "relation",
        "unit_or_values": "linked germline or tumour reports, including BRCA1/2 and HRD where assessed, with assay, interpretation and date",
        "why_it_matters": "Supports review of disease-relevant options while preserving the distinction between inherited and tumour-only findings."
      },
      {
        "name": "Current disease state",
        "kind": "state",
        "unit_or_values": "newly diagnosed; persistent; responding; stable; progressing; recurrent; no evidence of disease; indeterminate",
        "why_it_matters": "Anchors the episode to dated evidence rather than treating the initial diagnosis as its permanent state."
      }
    ],
    "affordances": [
      "Assemble pathology, imaging and operative evidence for review of tubal primary-site attribution.",
      "Identify missing examination or conflicting reports that require specialist pathology review.",
      "Summarise documented spread and stage while exposing unsupported staging assumptions.",
      "Link molecular results and treatment history to a current, histotype-appropriate specialist guideline review.",
      "Track residual disease, response and recurrence without silently rewriting the original diagnosis.",
      "Prepare a disease-specific handoff that includes unresolved origin, pathology and treatment-relevance questions."
    ],
    "agent_conduct": {
      "may": [
        "Explain fallopian tube cancer in general terms from reputable medical sources.",
        "Direct a person with concerning symptoms or a family history to a qualified clinician."
      ],
      "must_not": [
        "Diagnose or stage the disease for a specific person.",
        "Recommend or advise against specific treatments, surgery or genetic testing for a person.",
        "Disclose a person's diagnosis or genetic risk to anyone without consent.",
        "Promote unproven cures or discourage evidence-based treatment."
      ],
      "requires_human": [
        "Any treatment, surgery or preventive decision for a patient."
      ]
    },
    "ethics": {
      "considerations": [
        "A cancer diagnosis touches fertility, family and life itself; honesty and compassion matter.",
        "Inherited risk affects relatives, who have their own right to know or not to know."
      ],
      "affected_parties": [
        "Patients",
        "Their families and relatives with inherited risk",
        "Carers"
      ]
    },
    "owners": {
      "steward": "Nobody owns the disease; patients and their clinicians answer for care.",
      "master_systems": [
        "Cancer registries"
      ]
    },
    "failure_modes_and_hazards": [
      "Often found late because early symptoms are vague.",
      "Can spread within the abdomen in the same way as ovarian cancer."
    ],
    "standards_and_regulation": [
      "International Classification of Diseases (ICD-11), World Health Organization.",
      "FIGO staging of ovarian, fallopian tube and peritoneal cancer, International Federation of Gynecology and Obstetrics."
    ],
    "what_it_is_for": [
      "Fallopian tube cancer is encountered in gynecologic oncology, pathology and clinical records concerning malignancies arising in the uterine tube.",
      "Its identification supports specialist assessment of the primary site, disease extent and relationship to ovarian or primary peritoneal malignancy."
    ],
    "visual_identification": [
      "A tumor involving the tubal lining or distending the tube may be visible in a surgical specimen, but gross appearance alone cannot establish its origin.",
      "Microscopy may show malignant epithelial growth involving the tubal mucosa, with specialist interpretation needed to distinguish primary tubal cancer from secondary involvement."
    ]
  },
  "sources": [
    {
      "id": "wikidata",
      "title": "Wikidata item Q4818922: fallopian tube cancer",
      "url": "https://www.wikidata.org/wiki/Q4818922",
      "url_status": "live",
      "what_it_supports": "identity and sense of the item",
      "checked_by": "wikidata-api"
    },
    {
      "id": "wikipedia-en",
      "title": "Wikipedia: Fallopian tube cancer",
      "url": "https://en.wikipedia.org/wiki/Fallopian_tube_cancer",
      "url_status": "live",
      "what_it_supports": "general description of the item",
      "checked_by": "wikidata-api sitelink"
    }
  ],
  "structure": {
    "bundles": [
      {
        "id": "tubal-primary-identity",
        "name": "Tubal primary identity",
        "description": "Establish whether the disease episode is an invasive primary fallopian tube malignancy.",
        "rationale": "Tubo-ovarian and peritoneal presentations can obscure the distinction between site of origin and sites involved.",
        "layers": [
          {
            "id": "origin-attribution",
            "name": "Origin attribution",
            "description": "Preserve the assigned primary site and the evidence used to choose it.",
            "findings": [
              {
                "id": "supported-tubal-origin",
                "name": "Supported tubal origin",
                "description": "Record the pathologist's assignment, relevant tubal findings and competing site labels without resolving conflicts by tumour size alone.",
                "questions": [
                  {
                    "text": "What pathology findings and attribution rules support a fallopian tube primary rather than ovarian, peritoneal or metastatic disease?",
                    "kind": "boundary",
                    "id": "supported-tubal-origin-q01"
                  },
                  {
                    "text": "Which report, author and date establish the assignment, and do other reports disagree?",
                    "kind": "provenance",
                    "id": "supported-tubal-origin-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "invasive-disease-boundary",
            "name": "Invasive disease boundary",
            "description": "Distinguish invasive cancer from intraepithelial and nonmalignant tubal abnormalities.",
            "findings": [
              {
                "id": "invasion-and-stic-relationship",
                "name": "Invasion and STIC relationship",
                "description": "Record invasion and STIC separately. STIC is discussed as a putative precursor of high-grade serous carcinoma, so its relationship to an invasive episode must be explicit. [NCI screening evidence](https://www.cancer.gov/types/ovarian/hp/ovarian-screening-pdq)",
                "questions": [
                  {
                    "text": "Is invasive malignancy demonstrated, or is the documented lesion limited to STIC or another abnormality?",
                    "kind": "boundary",
                    "id": "invasion-and-stic-relationship-q01"
                  },
                  {
                    "text": "If STIC and invasive disease coexist, what evidence connects them and what remains uncertain?",
                    "kind": "provenance",
                    "id": "invasion-and-stic-relationship-q02"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "tubal-pathology-evidence",
        "name": "Tubal pathology evidence",
        "description": "Characterise the malignancy and the adequacy of the tissue evidence.",
        "rationale": "A tubal label cannot substitute for histotype, and incomplete sampling can limit origin assessment.",
        "layers": [
          {
            "id": "histological-identity",
            "name": "Histological identity",
            "description": "Capture the reported tumour type and the reasoning supporting classification.",
            "findings": [
              {
                "id": "histotype-and-grade",
                "name": "Histotype and grade",
                "description": "Retain morphology, applicable grade, ancillary tests and diagnostic qualifications as reported.",
                "questions": [
                  {
                    "text": "What histotype and applicable grade were assigned, using which classification?",
                    "kind": "definition",
                    "id": "histotype-and-grade-q01"
                  },
                  {
                    "text": "What morphology or ancillary testing supports that diagnosis and excludes a different primary malignancy?",
                    "kind": "provenance",
                    "id": "histotype-and-grade-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "specimen-coverage",
            "name": "Specimen coverage",
            "description": "Record which tubal and neighbouring tissues were available and examined.",
            "findings": [
              {
                "id": "fimbrial-and-bilateral-assessment",
                "name": "Fimbrial and bilateral assessment",
                "description": "Preserve sampling details for both tubes, their fimbriae and associated specimens, including limitations caused by fragmentation or prior treatment.",
                "questions": [
                  {
                    "text": "Were both tubes and fimbrial ends examined, and was a documented SEE-FIM or other sampling protocol used?",
                    "kind": "provenance",
                    "id": "fimbrial-and-bilateral-assessment-q01"
                  },
                  {
                    "text": "Does missing tissue or limited sampling prevent a reliable statement about tubal origin or absence of STIC?",
                    "kind": "boundary",
                    "id": "fimbrial-and-bilateral-assessment-q02"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "anatomical-extent-and-residual-disease",
        "name": "Anatomical extent and residual disease",
        "description": "Represent spread from the attributed tubal primary and disease remaining after surgery.",
        "rationale": "Stage, distribution and postoperative residual disease answer different questions and must remain distinguishable.",
        "layers": [
          {
            "id": "spread-and-stage",
            "name": "Spread and stage",
            "description": "Link anatomical observations to a dated staging assessment.",
            "findings": [
              {
                "id": "evidence-backed-stage",
                "name": "Evidence-backed stage",
                "description": "Capture tubal confinement, surface involvement, rupture or spill, washings, pelvic or extrapelvic spread, nodes and distant sites as documented.",
                "questions": [
                  {
                    "text": "Which operative, imaging, cytology and pathology findings establish the recorded distribution of disease?",
                    "kind": "provenance",
                    "id": "evidence-backed-stage-q01"
                  },
                  {
                    "text": "What FIGO or TNM stage was assigned, under which version, and which staging elements remain unassessed?",
                    "kind": "measurement",
                    "id": "evidence-backed-stage-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "postoperative-burden",
            "name": "Postoperative burden",
            "description": "Describe the result of each disease-directed operation.",
            "findings": [
              {
                "id": "residual-tumour-distribution",
                "name": "Residual tumour distribution",
                "description": "Keep the surgeon's residual-disease assessment distinct from pathology margins and pretreatment disease burden.",
                "questions": [
                  {
                    "text": "After which operation was residual disease assessed, and what sites and maximum dimensions were documented?",
                    "kind": "measurement",
                    "id": "residual-tumour-distribution-q01"
                  },
                  {
                    "text": "Does the report establish no macroscopic residual disease, or is the residual state unknown?",
                    "kind": "boundary",
                    "id": "residual-tumour-distribution-q02"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "molecular-and-hereditary-context",
        "name": "Molecular and hereditary context",
        "description": "Connect the tubal malignancy to interpretable tumour and germline findings.",
        "rationale": "An agent must distinguish hereditary implications from tumour characteristics and avoid treating an unperformed test as a negative result.",
        "layers": [
          {
            "id": "tumour-biomarkers",
            "name": "Tumour biomarkers",
            "description": "Preserve assay-specific results relevant to the documented histotype.",
            "findings": [
              {
                "id": "interpretable-molecular-results",
                "name": "Interpretable molecular results",
                "description": "Record tested specimen, assay, result, interpretation and limitations for BRCA1/2, HRD or other clinically requested markers.",
                "questions": [
                  {
                    "text": "Which tumour biomarkers were tested, on what specimen, with what assay and reported interpretation?",
                    "kind": "provenance",
                    "id": "interpretable-molecular-results-q01"
                  },
                  {
                    "text": "Which current guideline or treatment indication makes each result relevant to this histotype and disease state?",
                    "kind": "action",
                    "id": "interpretable-molecular-results-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "inherited-risk-linkage",
            "name": "Inherited risk linkage",
            "description": "Link cancer-associated inherited findings to a separate hereditary-risk assessment.",
            "findings": [
              {
                "id": "germline-status-and-referral",
                "name": "Germline status and referral",
                "description": "Separate confirmed germline findings, tumour-only findings, uncertain variants and absent testing.",
                "questions": [
                  {
                    "text": "Is a reported variant confirmed germline, tumour-only or of unresolved origin, and how was it classified?",
                    "kind": "boundary",
                    "id": "germline-status-and-referral-q01"
                  },
                  {
                    "text": "Has hereditary cancer assessment been documented, and what unresolved result needs genetics review?",
                    "kind": "action",
                    "id": "germline-status-and-referral-q02"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "care-course-and-recurrence",
        "name": "Care course and recurrence",
        "description": "Track disease-directed care and the evidence supporting subsequent disease states.",
        "rationale": "Care review depends on histotype, prior interventions and observed course rather than the tubal site label alone.",
        "layers": [
          {
            "id": "treatment-context",
            "name": "Treatment context",
            "description": "Summarise the specialist plan and completed interventions for this cancer episode.",
            "findings": [
              {
                "id": "documented-care-sequence",
                "name": "Documented care sequence",
                "description": "Link surgery, systemic treatment and maintenance where used to their dates, intent and specialist rationale.",
                "questions": [
                  {
                    "text": "What treatments were planned and delivered, in what sequence, and for which documented disease state?",
                    "kind": "provenance",
                    "id": "documented-care-sequence-q01"
                  },
                  {
                    "text": "What histotype, stage, molecular findings and patient constraints must the specialist review before the next treatment decision?",
                    "kind": "action",
                    "id": "documented-care-sequence-q02"
                  }
                ]
              }
            ]
          },
          {
            "id": "response-and-relapse-evidence",
            "name": "Response and relapse evidence",
            "description": "Maintain dated response assessments and distinguish suspected from established recurrence.",
            "findings": [
              {
                "id": "longitudinal-disease-assessment",
                "name": "Longitudinal disease assessment",
                "description": "Keep symptoms, imaging, pathology and tumour-marker trends separately attributable before recording an overall disease state.",
                "questions": [
                  {
                    "text": "What dated evidence and assessment criteria support response, persistence, progression or recurrence?",
                    "kind": "measurement",
                    "id": "longitudinal-disease-assessment-q01"
                  },
                  {
                    "text": "If CA-125 or another marker changes, what corroborating evidence and specialist interpretation support the recorded conclusion?",
                    "kind": "boundary",
                    "id": "longitudinal-disease-assessment-q02"
                  },
                  {
                    "text": "If platinum treatment was given, what were the last dose and subsequent progression dates, and how did the treating team interpret that interval?",
                    "kind": "measurement",
                    "id": "longitudinal-disease-assessment-q03"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "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": [
                  "This is recalled knowledge; no sources were consulted.",
                  "Verify current classification editions and primary-site assignment criteria before operational use.",
                  "Many pelvic high-grade serous carcinomas are understood to originate in the distal tube, but this does not make every ovarian or peritoneal cancer a fallopian tube cancer."
                ],
                "questions": [
                  {
                    "id": "evidence-confidence-notes-q01",
                    "text": "Which of these check these first hold for the sense of fallopian tube cancer 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": [
                  "High-grade serous carcinoma",
                  "Endometrioid carcinoma",
                  "Clear cell carcinoma",
                  "Carcinosarcoma"
                ],
                "questions": [
                  {
                    "id": "evidence-kinds-q01",
                    "text": "Which of these kinds and varieties hold for the sense of fallopian tube cancer 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": "C57.0",
                    "note": "Malignant neoplasm of fallopian tube; this is an anatomical-site category, not a histological subtype."
                  },
                  {
                    "scheme": "ICD-O",
                    "value_or_pattern": "C57.0",
                    "note": "Topography code for fallopian tube; separate morphology and behavior codes describe the tumor."
                  }
                ],
                "questions": [
                  {
                    "id": "evidence-identifiers-q01",
                    "text": "Which of these identifiers and schemes hold for the sense of fallopian tube cancer 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 Female Genital Tumours provides pathological terminology and diagnostic classification.",
                  "International Federation of Gynecology and Obstetrics (FIGO) provides a unified staging system for ovarian, fallopian tube and primary peritoneal cancer.",
                  "College of American Pathologists (CAP) provides cancer reporting protocols covering ovarian, fallopian tube and peritoneal tumors."
                ],
                "questions": [
                  {
                    "id": "evidence-standards-and-regulation-q01",
                    "text": "Which of these standards and regulation hold for the sense of fallopian tube cancer 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": [
                  "Pathological classification establishes tumor type and supports assignment of the primary site.",
                  "Cancer registries record fallopian tube malignancies by anatomical site and histology.",
                  "Clinical staging informs prognosis and treatment planning.",
                  "Genetic and tumor testing can identify hereditary susceptibility and clinically relevant molecular features."
                ],
                "questions": [
                  {
                    "id": "evidence-real-world-use-q01",
                    "text": "Which of these real-world use hold for the sense of fallopian tube cancer 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": "FIGO anatomical stage",
                    "typical_range": "I-IV, with substages",
                    "unit": "Ordinal category"
                  }
                ],
                "questions": [
                  {
                    "id": "evidence-measurements-q01",
                    "text": "Which of these typical measurements hold for the sense of fallopian tube cancer 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": [
                  "Early disease may cause no symptoms or nonspecific symptoms, delaying diagnosis.",
                  "Spread within the peritoneal cavity can cause ascites and bowel obstruction.",
                  "Recurrence and resistance to systemic therapy can occur.",
                  "Overlapping tubal, ovarian and peritoneal involvement can make primary-site assignment difficult.",
                  "Some cases are associated with inherited cancer susceptibility, particularly pathogenic BRCA1 or BRCA2 variants."
                ],
                "questions": [
                  {
                    "id": "evidence-failure-modes-and-hazards-q01",
                    "text": "Which of these failure modes and hazards hold for the sense of fallopian tube cancer 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": [
                  "Access to specialist pathology, molecular testing and gynecologic oncology varies between health systems.",
                  "Registry comparisons can be affected by differences in primary-site assignment and adoption of pathological classification practices."
                ],
                "questions": [
                  {
                    "id": "evidence-regional-variation-q01",
                    "text": "Which of these regional variation hold for the sense of fallopian tube cancer 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": "Ovarian cancer",
                    "difference": "Distinguished by assignment of the primary site using pathological criteria; ovarian involvement alone does not establish an ovarian origin."
                  },
                  {
                    "name": "Primary peritoneal carcinoma",
                    "difference": "Assigned a peritoneal primary site under pathological criteria rather than a tubal primary site, despite potentially similar serous histology."
                  },
                  {
                    "name": "Serous tubal intraepithelial carcinoma",
                    "difference": "A noninvasive epithelial lesion associated with high-grade serous carcinoma; invasion separates it from invasive tubal carcinoma."
                  },
                  {
                    "name": "Secondary malignancy involving the fallopian tube",
                    "difference": "Cancer originates elsewhere and spreads to the tube rather than arising there."
                  }
                ],
                "questions": [
                  {
                    "id": "evidence-neighbours-q01",
                    "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of fallopian tube cancer this model covers, and on what evidence?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          }
        ]
      }
    ]
  },
  "openQuestions": [
    "Does an existing Vercy world model already own fallopian tube cancer or the shared tubo-ovarian carcinoma concept, requiring this registry entry to link to it?",
    "Does the registry intend all primary tubal malignancies or specifically epithelial carcinoma, and how should rare non-epithelial histologies inherit shared content?",
    "Which pathology attribution standard and version should govern ambiguous tubo-ovarian cases, particularly after neoadjuvant treatment?",
    "Which neighbouring model should own isolated STIC and its follow-up while preserving its relationship to invasive tubal cancer?",
    "Which jurisdiction-specific guidelines, staging versions and biomarker indications should be adopted and periodically revalidated before operational use?"
  ],
  "statistics": {
    "bundles": 6,
    "layers": 11,
    "findings": 19,
    "questions": 30
  }
}
