{ "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-12T08:21:20Z", "providers": [ "Codex" ], "breadth": "recalled by Codex without web access - no source was read", "missingProviders": [], "pass": 2, "cost": { "grok": { "seconds": 24.0, "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: 01a094b3-d074-7680-a193-23aa7e68a4fb\n--------\nuser\nDescribe what is already known about one registered thing. Answer as JSON only, no prose around it.\n\nThing: camptodactyly\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 r", "usd": 0.0, "recall": true }, "codex": { "seconds": 73.5, "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: 01a094b3-d067-7161-81ed-6cfab2ba344e\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: camptodactyly\nRegistry id: vr.tr.camptodactyly\nPlane / domain: XCT / XCT.STA\nRegistry definition: (none recorded)\nNames folded into this entry: (none" } }, "enrichment": { "pass": 3, "engine": "claude", "producedAt": "2026-10-06T12:00:00Z", "ingestedAt": "2026-10-06T08:43:50+00:00", "fields": [ "agent_conduct", "ethics", "failure_modes_and_hazards", "owners", "visual_identification" ] }, "gate": { "passed": true, "version": "1.0", "at": "2026-10-07T10:10:32+00:00", "evidence": [ "completeness 1.00", "sense: Wikidata description", "2 live sources", "review by codex: pass" ] } }, "metaModel": { "id": "THING-Q614013", "registryId": "vr.tr.camptodactyly", "name": "camptodactyly", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "XCT.STA" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q614013/", "model": { "registry_id": "vr.tr.camptodactyly", "name": "camptodactyly", "purpose": "Enable an agent to recognise camptodactyly, record finger-specific severity and progression, and support clinician-led decisions about observation, therapy and specialist assessment.", "definition": "Camptodactyly is a usually painless, nontraumatic flexion contracture of a finger's proximal interphalangeal joint, most often affecting the little finger, that may occur in isolation or as part of a syndrome.", "scope_statement": "This model owns the camptodactyly phenotype associated with vr.tr.camptodactyly: persistent finger flexion, typically at the proximal interphalangeal joint, its correctability, functional effects and course; it distinguishes the local condition from any underlying syndrome.", "in_scope": [ "Affected fingers, hands and joint-level flexion pattern", "Active extension deficit and passive correctability", "Age at recognition, growth-related changes and longitudinal progression", "Hand function, symptoms and patient priorities", "Evidence for isolated, familial or syndromic presentation", "Clinician-directed management and measured outcomes" ], "out_of_scope": [ "Complete models of syndromes that include camptodactyly", "Clinodactyly and other primarily sideways finger deviations", "Acquired contractures attributable to trauma, burns or inflammatory disease", "Trigger digit and other distinct tendon disorders", "Detailed surgical techniques and orthosis manufacturing specifications" ], "distinguishing_features": [ "Establish whether the principal deformity is flexion at the proximal interphalangeal joint rather than sideways deviation characteristic of clinodactyly.", "Measure active and passive extension separately: passive correction can remain possible, so rigidity is not a required recognition criterion.", "Investigate injury, scarring, inflammation or another acquired explanation before classifying a bent finger as camptodactyly.", "Record the affected joints and any catching or locking to distinguish persistent PIP flexion from a trigger digit presentation.", "Treat little-finger involvement as supportive rather than mandatory; other fingers and both hands may be affected." ], "characteristics": [ { "name": "Affected digit and joint distribution", "kind": "category", "unit_or_values": "Left/right hand; digit; PIP and any additional involved joints", "why_it_matters": "Prevents different fingers and different deformities from being collapsed into one severity label." }, { "name": "Active PIP extension deficit", "kind": "measurement", "unit_or_values": "Degrees short of full extension, with examination position recorded", "why_it_matters": "Quantifies the person's ability to straighten the finger." }, { "name": "Passive PIP extension deficit", "kind": "measurement", "unit_or_values": "Degrees short of full extension under examiner-assisted movement", "why_it_matters": "Separates passively correctable posture from a fixed component." }, { "name": "Available finger flexion", "kind": "measurement", "unit_or_values": "Joint-specific degrees and ability to complete a functional fist", "why_it_matters": "Detects loss of useful flexion when assessing extension-focused treatment." }, { "name": "Onset and recognition", "kind": "category", "unit_or_values": "Present at birth; infancy; adolescence; other; unknown, with age first observed", "why_it_matters": "Distinguishes documented onset from delayed recognition." }, { "name": "Contracture trajectory", "kind": "state", "unit_or_values": "Stable; worsening; improving; recurrent; insufficient comparable observations", "why_it_matters": "Supports decisions based on change rather than a single examination." }, { "name": "Functional interference", "kind": "state", "unit_or_values": "Task-specific difficulty, assistance, avoidance and patient-reported burden", "why_it_matters": "Links the deformity to meaningful hand use." }, { "name": "Associated condition", "kind": "relation", "unit_or_values": "No association identified; suspected syndrome; confirmed syndrome, with evidence", "why_it_matters": "Connects the phenotype to broader assessment without equating it with a syndrome." }, { "name": "Management exposure", "kind": "relation", "unit_or_values": "Observation; prescribed stretching; splinting; hand therapy; surgery, with dates", "why_it_matters": "Makes outcome interpretation dependent on what was actually undertaken." } ], "affordances": [ "Create a finger-by-finger record of posture, movement and diagnostic confidence.", "Compare serial extension and flexion measurements under documented examination conditions.", "Identify unresolved differential diagnoses or associated findings requiring clinician review.", "Track prescribed therapy, tolerability and barriers to completion.", "Prepare a specialist review summary linking progression, task limitations and treatment response.", "Evaluate outcomes against patient priorities while recording residual deformity or lost motion." ], "agent_conduct": { "may": [ "Explain the condition from medical references.", "Help a person find hand specialists or support." ], "must_not": [ "Diagnose the condition from photos in place of a clinician.", "Speculate that a named person has a syndrome because of a bent finger.", "Share hand images or medical records without consent." ], "requires_human": [ "Any decision about splinting or surgery." ] }, "ethics": { "considerations": [ "Visible differences can draw unwanted attention, especially for children." ], "affected_parties": [ "People with the condition", "Children and their parents" ] }, "owners": { "steward": "Nobody owns the condition; each patient's records are kept by their healthcare provider.", "master_systems": [] }, "visual_identification": [ "A finger, most often the little finger, bent at its middle joint that cannot fully straighten." ], "failure_modes_and_hazards": [ "Severe cases can limit grip and hand function." ], "what_it_is_for": [ "Camptodactyly is encountered in assessments of finger posture, hand function and congenital limb differences.", "Clinical documentation distinguishes isolated involvement from cases associated with broader syndromes and records changes during growth." ], "standards_and_regulation": [ "The World Health Organization International Classification of Diseases, Tenth Revision, includes congenital camptodactyly under Q68.1, congenital deformity of hand." ] }, "sources": [ { "id": "wikidata", "title": "Wikidata item Q614013: camptodactyly", "url": "https://www.wikidata.org/wiki/Q614013", "url_status": "live", "what_it_supports": "identity and sense of the item", "checked_by": "wikidata-api" }, { "id": "wikipedia-en", "title": "Wikipedia: Camptodactyly", "url": "https://en.wikipedia.org/wiki/Camptodactyly", "url_status": "live", "what_it_supports": "general description of the item", "checked_by": "wikidata-api sitelink" } ], "structure": { "bundles": [ { "id": "phenotype-and-boundaries", "name": "Phenotype and diagnostic boundaries", "description": "Establish which finger posture is being modelled and why it is considered camptodactyly.", "rationale": "A bent finger alone does not establish this condition or distinguish its mimics.", "layers": [ { "id": "joint-pattern", "name": "Joint pattern", "description": "Localise the deformity and distinguish active limitation from fixed restriction.", "findings": [ { "id": "pip-flexion-phenotype", "name": "PIP flexion phenotype", "description": "Camptodactyly typically involves incomplete PIP extension; some affected joints remain passively correctable. [Boston Children's Hospital](https://www.childrenshospital.org/sites/default/files/2022-04/camptodactyly-factsheet.pdf)", "questions": [ { "text": "Which fingers and joints show persistent flexion, and on which hand?", "kind": "measurement", "id": "pip-flexion-phenotype-q01" }, { "text": "Can each affected PIP joint straighten actively, passively, both or neither?", "kind": "measurement", "id": "pip-flexion-phenotype-q02" } ] } ] }, { "id": "alternative-explanations", "name": "Alternative explanations", "description": "Check whether a different deformity or acquired process better explains the finding.", "findings": [ { "id": "diagnostic-attribution", "name": "Diagnostic attribution", "description": "Keep the observed posture separate from the clinician's diagnostic interpretation.", "questions": [ { "text": "Is the principal abnormality PIP flexion, sideways angulation, or a different joint pattern?", "kind": "boundary", "id": "diagnostic-attribution-q01" }, { "text": "What history or examination evidence supports an alternative involving injury, scarring, inflammation or triggering?", "kind": "boundary", "id": "diagnostic-attribution-q02" }, { "text": "Who established the diagnosis, when, and what uncertainty remains?", "kind": "provenance", "id": "diagnostic-attribution-q03" } ] } ] } ] }, { "id": "presentation-and-associations", "name": "Presentation and associations", "description": "Record developmental timing and evidence for a broader phenotype.", "rationale": "Similar finger contractures can occur in isolated and syndromic presentations with different assessment needs.", "layers": [ { "id": "developmental-history", "name": "Developmental history", "description": "Separate onset, recognition and subsequent growth-related change.", "findings": [ { "id": "onset-evidence", "name": "Onset evidence", "description": "Use dated observations rather than inferring congenital onset from the diagnostic label.", "questions": [ { "text": "When was the bend first observed, and is there evidence of an earlier normal or abnormal posture?", "kind": "provenance", "id": "onset-evidence-q01" }, { "text": "Did the finger posture change during a documented period of rapid growth?", "kind": "measurement", "id": "onset-evidence-q02" } ] } ] }, { "id": "familial-and-systemic-context", "name": "Familial and systemic context", "description": "Link relevant family history and additional findings without assigning an unsupported cause.", "findings": [ { "id": "isolated-or-associated", "name": "Isolated or associated presentation", "description": "Family history or a wider syndrome may accompany camptodactyly; either association needs its own evidence. [Boston Children's Hospital](https://www.childrenshospital.org/sites/default/files/2022-04/camptodactyly-factsheet.pdf)", "questions": [ { "text": "Which relatives have a comparable finger phenotype, and was it examined or only reported?", "kind": "provenance", "id": "isolated-or-associated-q01" }, { "text": "What additional contractures or extra-hand findings support assessment for an associated syndrome?", "kind": "boundary", "id": "isolated-or-associated-q02" }, { "text": "Is a syndrome confirmed, suspected or unassessed, and which separate model should own it?", "kind": "boundary", "id": "isolated-or-associated-q03" } ] } ] } ] }, { "id": "severity-and-course", "name": "Severity and course", "description": "Connect comparable joint measurements with actual consequences for hand use.", "rationale": "Contracture angle, passive stiffness and functional burden describe different aspects of severity.", "layers": [ { "id": "motion-and-change", "name": "Motion and change", "description": "Measure extension and retained flexion for each affected digit over time.", "findings": [ { "id": "comparable-motion-record", "name": "Comparable motion record", "description": "Document measurement conditions so apparent progression can be distinguished from examination variation.", "questions": [ { "text": "What are the active and passive PIP extension deficits and available flexion, in degrees?", "kind": "measurement", "id": "comparable-motion-record-q01" }, { "text": "Were wrist position, adjacent-joint position and measurement method comparable with the previous assessment?", "kind": "measurement", "id": "comparable-motion-record-q02" }, { "text": "What observed change supports stable, worsening, improving or recurrent status?", "kind": "measurement", "id": "comparable-motion-record-q03" } ] } ] }, { "id": "functional-and-symptom-burden", "name": "Functional and symptom burden", "description": "Capture task limitations, appearance concerns and symptoms that need separate explanation.", "findings": [ { "id": "patient-important-effects", "name": "Patient-important effects", "description": "Camptodactyly may have little pain or functional effect; record individual burden rather than assuming disability from appearance. [Children's Hospital of Philadelphia](https://www.chop.edu/conditions-diseases/camptodactyly)", "questions": [ { "text": "Which tasks are affected, such as gripping, releasing objects, writing or putting on gloves?", "kind": "measurement", "id": "patient-important-effects-q01" }, { "text": "What matters most to the person: function, appearance, comfort or preventing further change?", "kind": "action", "id": "patient-important-effects-q02" }, { "text": "Are pain, swelling, warmth or sensory symptoms present, and do they require investigation beyond the contracture?", "kind": "boundary", "id": "patient-important-effects-q03" } ] } ] } ] }, { "id": "management-and-outcomes", "name": "Management and outcomes", "description": "Support review of clinician-directed care and its effects on useful finger movement.", "rationale": "Treatment decisions require the course, correctability and person's priorities, while outcomes must capture more than straightening.", "layers": [ { "id": "care-selection-and-delivery", "name": "Care selection and delivery", "description": "Record the reason for observation, therapy or specialist intervention and what care was delivered.", "findings": [ { "id": "individualised-care-plan", "name": "Individualised care plan", "description": "Care can include stretching, splinting or surgery, with selection informed by severity and function. [Children's Hospital of Philadelphia](https://www.chop.edu/conditions-diseases/camptodactyly)", "questions": [ { "text": "What findings and goals justify the clinician's current choice of observation, therapy or surgical assessment?", "kind": "action", "id": "individualised-care-plan-q01" }, { "text": "What stretching or splint programme was prescribed, and what was actually completed and tolerated?", "kind": "provenance", "id": "individualised-care-plan-q02" }, { "text": "What change should prompt an earlier review, and who is responsible for follow-up?", "kind": "action", "id": "individualised-care-plan-q03" } ] } ] }, { "id": "benefit-and-residual-limitation", "name": "Benefit and residual limitation", "description": "Evaluate extension gains alongside flexion, function and durability.", "findings": [ { "id": "balanced-treatment-outcome", "name": "Balanced treatment outcome", "description": "Residual curvature and stiffness can remain after surgery, so outcome assessment must include retained movement. [Boston Children's Hospital](https://www.childrenshospital.org/sites/default/files/2022-04/camptodactyly-factsheet.pdf)", "questions": [ { "text": "How did active extension, passive extension, flexion and priority tasks change from the pretreatment baseline?", "kind": "measurement", "id": "balanced-treatment-outcome-q01" }, { "text": "Is there residual or recurrent contracture, new stiffness, pain or difficulty using the finger?", "kind": "measurement", "id": "balanced-treatment-outcome-q02" }, { "text": "Does the observed benefit justify continuing or revising the plan at clinician review?", "kind": "action", "id": "balanced-treatment-outcome-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 recall-based information; no sources were consulted.", "The anatomical contributors vary between cases, so a single tendon or muscle abnormality should not be presented as the universal cause.", "Classification boundaries, prevalence estimates and treatment thresholds require source verification." ], "questions": [ { "id": "evidence-confidence-notes-q01", "text": "Which of these check these first hold for the sense of camptodactyly 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": [ "Infantile-onset camptodactyly", "Adolescent-onset camptodactyly", "Syndromic camptodactyly" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of camptodactyly 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": [ "Recognition and assessment of congenital or developmental finger deformity", "Assessment of hand function and suitability for observation, stretching, splinting or surgery", "Evaluation for an underlying syndrome when multiple contractures or other abnormalities coexist" ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of camptodactyly 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": "Proximal interphalangeal joint extension deficit", "typical_range": "Variable; active and passive extension deficits should be recorded separately", "unit": "degrees" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of camptodactyly 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": [ "Contracture may progress during growth.", "Severe deformity can interfere with grasp, hand opening and other daily activities.", "Longstanding contracture may develop secondary joint changes.", "Correction may recur, and surgery can cause stiffness or loss of flexion." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of camptodactyly 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": "Clinodactyly", "difference": "Clinodactyly is sideways curvature of a digit, whereas camptodactyly primarily involves a flexion contracture." }, { "name": "Dupuytren contracture", "difference": "Dupuytren contracture arises from palmar fascial disease, typically with nodules or cords; these are not defining features of camptodactyly." }, { "name": "Trigger finger", "difference": "Trigger finger involves impaired flexor tendon gliding with catching or locking; camptodactyly does not require these mechanical symptoms." }, { "name": "Boutonnière deformity", "difference": "Boutonnière deformity combines proximal interphalangeal flexion with distal interphalangeal hyperextension through an extensor mechanism disorder." }, { "name": "Arthrogryposis", "difference": "Arthrogryposis describes congenital contractures affecting multiple joints or body regions; camptodactyly describes a particular finger deformity that can occur within such a presentation." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of camptodactyly this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Which diagnostic criteria most reliably separate camptodactyly from other causes of persistent PIP flexion across age groups?", "Which examination positions and measurement methods provide reproducible active and passive extension measurements?", "How well do age, passive correctability and digit distribution predict progression during growth?", "Which associated findings justify genetic assessment, and what evidence supports that referral threshold?", "Which treatment indications and patient-reported outcome measures have sufficient evidence to compare observation, therapy and surgery over long-term follow-up?" ], "statistics": { "bundles": 5, "layers": 9, "findings": 14, "questions": 28 } }