{ "vercy": "1.0-draft", "publication": { "status": "research-draft", "adjudicationStatus": "unreviewed", "publishableCanonical": false, "generatedAt": "2026-09-07T15:10:47Z", "providers": [ "Codex", "Grok" ], "missingProviders": [], "pass": 2, "cost": { "grok": { "usd": 0.00728586, "turns": 1, "seconds": 115.7, "error": null }, "codex": { "seconds": 86.7, "error": "Reading additional input from stdin...\nOpenAI Codex v0.153.3\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: 01a07c68-1c4b-7100-95f2-be3442cf9813\n--------\nuser\nYou are drafting a Vercy meta-model for one registered thing. Answer as JSON only, no prose around it.\n\nThing: prostate\nRegistry id: vr.tr.prostate\nPlane / domain: PHY / PHY.LIV\nRegistry definition: (none recorded)\nNames folded into this entry: (none)\n\nA Vercy" } }, "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", "visual_identification" ] }, "revisions": [ { "at": "2026-10-07T11:42:17+00:00", "engine": "codex", "fields": [ "definition", "distinguishing_features", "visual_identification" ], "answering_review": "9584e865cd76f7e01fe232b5316d0a3e4b93143315959422e7e836a1005d9c9d" } ], "gate": { "passed": true, "version": "1.0", "at": "2026-10-07T12:16:35+00:00", "evidence": [ "completeness 1.00", "sense: Wikidata description", "3 live sources", "review by codex: pass" ] } }, "metaModel": { "id": "THING-Q9625", "registryId": "vr.tr.prostate", "name": "prostate", "version": "0.1.0-research.1", "entryKind": "thing", "family": "Thing Registry", "domain": [ "PHY.LIV" ], "status": "research-draft" }, "canonicalUrl": "https://ver.cy/models/thing/q9625/", "model": { "registry_id": "vr.tr.prostate", "name": "prostate", "purpose": "Enable an AI agent to recognise a prostate, record evidence about its anatomy and condition, and identify appropriate assessment or management options without treating uncertain findings as diagnoses.", "definition": "The prostate is an accessory gland of the male reproductive system in most mammals that contributes secretions to semen, with anatomy and secretion characteristics varying across species. In humans, it is normally an unpaired gland immediately inferior to the urinary bladder and surrounding the prostatic urethra, with branched tubuloalveolar glands and fibromuscular stroma that produce zinc-rich, normally slightly acidic fluid forming a substantial fraction of the ejaculate. Human prostatic zonal architecture is relevant to the distribution of conditions such as benign prostatic hyperplasia, prostatitis and prostatic adenocarcinoma.", "scope_statement": "This model owns the identity, anatomical organisation, secretory function, observed condition and intervention history of an individual prostate, primarily in humans, including its relationships to adjacent structures and organism-level clinical evidence.", "in_scope": [ "Identification of the prostate and its anatomical boundaries, including altered or residual anatomy", "Gland size, shape, tissue organisation and spatially localised findings", "Prostatic secretory function and relationships to ejaculation and urinary outflow", "Evidence concerning enlargement, inflammation, infection and neoplasia", "Prostate-directed assessments, interventions and resulting changes" ], "out_of_scope": [ "Whole-person diagnosis, preferences, consent and overall treatment eligibility", "Bladder, urethral, ureteric, testicular and seminal-vesicle models beyond their relationships to the prostate", "Complete models of urinary disorders, sexual function or fertility", "Independent models of prostate cancer, metastatic disease and systemic infection", "Laboratory assays, imaging devices, medicines and surgical procedures as independently managed things" ], "distinguishing_features": [ "In typical human anatomy, it lies inferior to the bladder and surrounds the proximal urethra; the bladder is a urine reservoir rather than glandular tissue surrounding that urethral segment.", "In humans, it is a single organ with zonal glandular organisation and an anterior fibromuscular region; the seminal vesicles are paired structures posterior to the bladder.", "In humans, its glandular ducts communicate with the prostatic urethra; the bulbourethral glands lie inferior to the prostate and drain into a different urethral segment.", "A biopsy or resected fragment represents prostate tissue only when specimen provenance and pathological interpretation support that identity; it is not automatically the whole organ." ], "characteristics": [ { "name": "Anatomical presence", "kind": "state", "unit_or_values": "Present; partially resected; residual tissue identified; removed by documented procedure; indeterminate", "why_it_matters": "Determines whether observations concern an intact gland, treated gland or residual tissue." }, { "name": "Host organism and developmental context", "kind": "relation", "unit_or_values": "Link to organism, species, age or developmental stage, and relevant hormonal context", "why_it_matters": "Anatomical expectations and interpretation depend on species, development and hormonal exposure." }, { "name": "Gland dimensions and volume", "kind": "measurement", "unit_or_values": "Dimensions in mm; volume in mL, with acquisition method, estimation method and date", "why_it_matters": "Supports assessment of enlargement, longitudinal change and procedure planning without equating size with obstruction." }, { "name": "Anatomical zone and location", "kind": "category", "unit_or_values": "Peripheral zone; transition zone; central zone; anterior fibromuscular stroma; unspecified, with side and apex-to-base position", "why_it_matters": "Localises observations within prostate-specific anatomy and supports comparison across examinations." }, { "name": "Relationship to urinary outflow", "kind": "state", "unit_or_values": "No demonstrated compromise; suspected contribution; supported contribution; indeterminate", "why_it_matters": "Separates gland enlargement from evidence that the prostate contributes to urinary obstruction." }, { "name": "Focal finding extent", "kind": "measurement", "unit_or_values": "Dimensions in mm and documented location, method and date", "why_it_matters": "Allows a lesion or other focal abnormality to be matched across imaging, sampling and follow-up." }, { "name": "Tissue interpretation", "kind": "category", "unit_or_values": "Reported benign, inflammatory, atypical, malignant or nondiagnostic interpretation, with specimen and report links", "why_it_matters": "Preserves what sampled tissue establishes and the limits of extrapolating it to the entire gland." }, { "name": "Associated serum PSA", "kind": "relation", "unit_or_values": "Link to serum prostate-specific antigen result in ng/mL, assay, date and relevant clinical context", "why_it_matters": "Supports interpretation of prostate-related evidence while preserving that PSA is a blood measurement and does not independently establish cancer." }, { "name": "Local tissue extension", "kind": "state", "unit_or_values": "Confined appearance; suspected extension; confirmed extension; indeterminate, with affected structure and evidence", "why_it_matters": "Distinguishes an observation within the prostate from involvement of adjacent tissues." }, { "name": "Treatment-altered anatomy", "kind": "state", "unit_or_values": "Untreated; medically modified; resected; ablated; irradiated; combined; unknown, with intervention dates", "why_it_matters": "Changes the expected appearance, function and interpretation of subsequent observations." } ], "affordances": [ "Locate and delineate the gland and prostate-specific regions using documented anatomical or imaging evidence.", "Measure gland size and compare localised findings across examinations while retaining method differences.", "Associate symptoms, PSA results, imaging and tissue findings to assess possible prostate involvement without asserting unsupported causation.", "Identify whether further prostate-directed examination, imaging or sampling warrants clinical consideration.", "Represent prostate-directed treatment targets and anatomical constraints for review by qualified clinicians.", "Track gland response, residual tissue and local complications after intervention." ], "agent_conduct": { "may": [ "Explain the anatomy and function of the prostate in general terms from medical sources.", "Point a person reporting urinary symptoms toward a qualified clinician." ], "must_not": [ "Diagnose prostate disease or interpret a person's test results as if it were their doctor.", "Recommend for or against screening or treatment for a specific person.", "Disclose a person's prostate health records without consent.", "Promote unproven remedies as treatments for prostate conditions." ], "requires_human": [ "Any decision on biopsy, surgery or other treatment of the prostate." ] }, "ethics": { "considerations": [ "Prostate conditions are common and often embarrassing to discuss; dignity and privacy matter.", "Screening decisions involve real trade-offs between early detection and overtreatment." ], "affected_parties": [ "Patients with prostate conditions", "Their partners and families", "Transgender women and others who have a prostate" ] }, "owners": { "steward": "Nobody owns the organ in general; each person's own body and their clinician answer for care.", "master_systems": [] }, "visual_identification": [ "In typical adult human anatomy, the prostate is a walnut-sized gland sitting just below the bladder and surrounding the start of the urethra.", "In human imaging, it appears as a rounded structure in front of the rectum." ], "failure_modes_and_hazards": [ "Benign enlargement can block urine flow and cause urinary retention.", "Prostate cancer can grow without early symptoms.", "Prostatitis causes pain and infection that can recur." ], "standards_and_regulation": [ "International Classification of Diseases (ICD-11), World Health Organization, which codes prostate diseases." ], "what_it_is_for": [ "The prostate contributes secretions to semen and is encountered in reproductive anatomy and veterinary or human clinical assessment.", "In humans it lies below the urinary bladder around the proximal urethra, making its condition relevant to both urinary and reproductive function.", "Its structure and distribution vary among mammalian species, so anatomical observations require species-specific interpretation." ] }, "sources": [ { "id": "mcneal-1981", "title": "The zonal anatomy of the prostate", "url": "https://pubmed.ncbi.nlm.nih.gov/6169032/", "what_it_supports": "McNeal zonal subdivision (peripheral, transition, central, anterior fibromuscular stroma) that pathology, radiology and urology still use.", "url_status": "live" }, { "id": "grays-anatomy", "title": "Gray's Anatomy: The Anatomical Basis of Clinical Practice", "url": "", "what_it_supports": "Gross relations (bladder neck, urethra, seminal vesicles, rectum), classical lobes, and glandular/stromal histology." }, { "id": "who-blue-book-5", "title": "WHO Classification of Tumours: Urinary and Male Genital Tumours, 5th edition", "url": "", "what_it_supports": "Tumour types arising in the gland, ISUP/WHO grade groups, and the organ as an ICD-O topography (C61)." }, { "id": "fipat-ta", "title": "Terminologia Anatomica", "url": "", "what_it_supports": "Official anatomical name Prostata and the TA code used in anatomical nomenclature." }, { "id": "campbell-walsh-wein", "title": "Campbell-Walsh-Wein Urology", "url": "", "what_it_supports": "Clinical encounter (DRE, PSA, TURP/HoLEP, radical prostatectomy), BPH physiology, and treatment-related harms." }, { "id": "pirads-acr", "title": "PI-RADS: Prostate Imaging-Reporting and Data System (v2.1)", "url": "", "what_it_supports": "How the living gland is zoned and scored on multiparametric MRI in current practice." }, { "id": "wikidata", "title": "Wikidata item Q9625: prostate", "url": "https://www.wikidata.org/wiki/Q9625", "url_status": "live", "what_it_supports": "identity and sense of the item", "checked_by": "wikidata-api" }, { "id": "wikipedia-en", "title": "Wikipedia: Prostate", "url": "https://en.wikipedia.org/wiki/Prostate", "url_status": "live", "what_it_supports": "general description of the item", "checked_by": "wikidata-api sitelink" } ], "structure": { "bundles": [ { "id": "prostate-identity-and-anatomy", "name": "Prostate identity and anatomy", "description": "Establishes which prostate or prostate-derived tissue is being described and how its internal regions and neighbours are situated.", "rationale": "A whole gland, a residual gland and a labelled tissue fragment support different conclusions and possible actions.", "layers": [ { "id": "organ-identity-and-presence", "name": "Organ identity and presence", "description": "Connects the anatomical entity to its host and establishes whether an intact or altered prostate is present.", "findings": [ { "id": "identified-prostate-entity", "name": "Identified prostate entity", "description": "Records the basis for identifying the entity as a prostate, residual prostate tissue or a specimen derived from it.", "questions": [ { "text": "Does this record describe an intact prostate, a treated or residual gland, or a prostate-derived specimen?", "kind": "definition", "id": "identified-prostate-entity-q01" }, { "text": "Which imaging, operative or pathology record establishes its identity and connection to the host organism?", "kind": "provenance", "id": "identified-prostate-entity-q02" } ] } ] }, { "id": "zones-and-adjacent-structures", "name": "Zones and adjacent structures", "description": "Locates prostate tissue and findings relative to internal zones, the urethra, bladder neck and surrounding tissues.", "findings": [ { "id": "prostate-spatial-map", "name": "Prostate spatial map", "description": "Preserves the anatomical landmarks needed to locate observations and interpret local boundaries.", "questions": [ { "text": "Which zone or region, side and apex-to-base level contains each recorded finding?", "kind": "boundary", "id": "prostate-spatial-map-q01" }, { "text": "How are the urethra, bladder neck, seminal vesicles and outer gland boundary situated, and which boundaries are obscured or altered?", "kind": "boundary", "id": "prostate-spatial-map-q02" } ] } ] } ] }, { "id": "prostate-function-and-local-effects", "name": "Prostate function and local effects", "description": "Records evidence about prostatic secretion and the gland's contribution to urinary and ejaculatory function.", "rationale": "Prostate-related symptoms require attribution; neither organ size nor a symptom alone establishes functional impairment caused by the gland.", "layers": [ { "id": "secretory-and-ejaculatory-role", "name": "Secretory and ejaculatory role", "description": "Connects prostate tissue and ductal pathways to their contribution to ejaculate.", "findings": [ { "id": "prostatic-secretory-contribution", "name": "Prostatic secretory contribution", "description": "Records evidence or uncertainty concerning gland secretion and its delivery, including changes after treatment.", "questions": [ { "text": "What evidence addresses prostatic secretion or ductal patency, and is it direct or inferred from broader reproductive observations?", "kind": "provenance", "id": "prostatic-secretory-contribution-q01" }, { "text": "Which observed ejaculatory changes can reasonably be attributed to the prostate or its treatment, and which remain attributable to neighbouring systems?", "kind": "boundary", "id": "prostatic-secretory-contribution-q02" } ] } ] }, { "id": "urinary-outflow-interface", "name": "Urinary outflow interface", "description": "Describes how prostate anatomy may affect the prostatic urethra and bladder outlet.", "findings": [ { "id": "prostate-related-outflow-compromise", "name": "Prostate-related outflow compromise", "description": "Separates anatomical narrowing or protrusion from symptoms and functional evidence of obstruction.", "questions": [ { "text": "What anatomical evidence shows urethral compression, bladder-outlet distortion or intravesical prostatic protrusion?", "kind": "measurement", "id": "prostate-related-outflow-compromise-q01" }, { "text": "Which linked urinary assessments support a prostate contribution, and what competing bladder or urethral explanations remain?", "kind": "boundary", "id": "prostate-related-outflow-compromise-q02" } ] } ] } ] }, { "id": "prostate-morphology-and-tissue-condition", "name": "Prostate morphology and tissue condition", "description": "Describes gland enlargement, focal abnormalities and evidence of inflammatory or infectious processes.", "rationale": "Different prostate processes can produce overlapping appearances and symptoms but require different evidence and responses.", "layers": [ { "id": "size-and-growth-pattern", "name": "Size and growth pattern", "description": "Captures whole-gland size, regional enlargement and changes over time.", "findings": [ { "id": "measured-gland-enlargement", "name": "Measured gland enlargement", "description": "Records dimensions and regional growth without treating enlargement as proof of histological hyperplasia or obstruction.", "questions": [ { "text": "What are the gland dimensions and estimated volume, measured when and by which method?", "kind": "measurement", "id": "measured-gland-enlargement-q01" }, { "text": "Is enlargement diffuse or regionally concentrated, and is apparent interval growth distinguishable from measurement variation?", "kind": "measurement", "id": "measured-gland-enlargement-q02" } ] } ] }, { "id": "inflammation-infection-and-focal-change", "name": "Inflammation, infection and focal change", "description": "Localises tissue abnormalities and preserves the evidence supporting proposed causes.", "findings": [ { "id": "localised-nonneoplastic-or-unresolved-abnormality", "name": "Localised nonneoplastic or unresolved abnormality", "description": "Records suspected inflammation, infection, abscess, cysts, calculi or other focal changes without assigning an unsupported cause.", "questions": [ { "text": "Where is the abnormality, what is its extent, and what examination, imaging or tissue evidence characterises it?", "kind": "measurement", "id": "localised-nonneoplastic-or-unresolved-abnormality-q01" }, { "text": "What evidence supports inflammation or infection within the prostate, and does any organism identification come from a specimen that supports that attribution?", "kind": "provenance", "id": "localised-nonneoplastic-or-unresolved-abnormality-q02" }, { "text": "Does the documented finding warrant prompt clinical assessment, and what observed feature supports that urgency?", "kind": "action", "id": "localised-nonneoplastic-or-unresolved-abnormality-q03" } ] } ] } ] }, { "id": "prostate-neoplasia-evidence", "name": "Prostate neoplasia evidence", "description": "Connects prostate-localised suspicion, sampling and pathological interpretation while retaining uncertainty.", "rationale": "PSA, imaging suspicion and biopsy findings provide different kinds of evidence and must not be treated as interchangeable diagnoses.", "layers": [ { "id": "biomarker-and-imaging-suspicion", "name": "Biomarker and imaging suspicion", "description": "Links serum PSA and prostate imaging to the circumstances in which they were obtained.", "findings": [ { "id": "contextualised-cancer-suspicion", "name": "Contextualised cancer suspicion", "description": "Records evidence that raises or reduces concern while preserving alternative explanations and assessment limitations.", "questions": [ { "text": "Which PSA results and trends are available, and what medications, inflammation or recent procedures could affect their interpretation?", "kind": "provenance", "id": "contextualised-cancer-suspicion-q01" }, { "text": "Which prostate lesions were reported on imaging, with what location, dimensions and assessment category under the stated reporting system?", "kind": "measurement", "id": "contextualised-cancer-suspicion-q02" } ] } ] }, { "id": "sampling-and-local-extent", "name": "Sampling and local extent", "description": "Relates sampled tissue to prostate locations and distinguishes sampled findings from whole-gland conclusions.", "findings": [ { "id": "pathology-supported-prostate-involvement", "name": "Pathology-supported prostate involvement", "description": "Records pathological diagnosis, reported grade and involvement together with sampling coverage and evidence of local extension.", "questions": [ { "text": "Which targeted or systematic samples support the reported diagnosis, grade and extent of involvement?", "kind": "provenance", "id": "pathology-supported-prostate-involvement-q01" }, { "text": "Which regions remain unsampled or uncertain, and what evidence supports or excludes extension beyond the gland within the limits of the assessment?", "kind": "boundary", "id": "pathology-supported-prostate-involvement-q02" } ] } ] } ] }, { "id": "prostate-directed-action-and-follow-up", "name": "Prostate-directed action and follow-up", "description": "Connects proposed and completed interventions to their prostate targets, anatomical constraints and subsequent observations.", "rationale": "Assessment and treatment alter prostate anatomy and the meaning of later measurements, so action history is part of interpreting gland state.", "layers": [ { "id": "assessment-and-treatment-targets", "name": "Assessment and treatment targets", "description": "Identifies the prostate-specific question or tissue target that a proposed action would address.", "findings": [ { "id": "justified-prostate-directed-action", "name": "Justified prostate-directed action", "description": "Records the rationale and local constraints for clinician-reviewed examination, sampling, surveillance or treatment.", "questions": [ { "text": "What unresolved prostate finding or confirmed condition would the proposed assessment or intervention address?", "kind": "action", "id": "justified-prostate-directed-action-q01" }, { "text": "Which gland dimensions, lesion locations, prior treatments and relationships to the urethra, sphincter or neurovascular structures constrain the action?", "kind": "boundary", "id": "justified-prostate-directed-action-q02" } ] } ] }, { "id": "post-intervention-state", "name": "Post-intervention state", "description": "Tracks residual anatomy, treatment effects and evidence of persistence or recurrence.", "findings": [ { "id": "interpretable-prostate-follow-up", "name": "Interpretable prostate follow-up", "description": "Compares subsequent observations against a treatment-appropriate baseline and records local complications or unresolved findings.", "questions": [ { "text": "What tissue was removed or treated, when, and what prostate tissue is documented to remain?", "kind": "provenance", "id": "interpretable-prostate-follow-up-q01" }, { "text": "How have gland or lesion measurements and associated PSA changed relative to the intervention and its expected assessment timeline?", "kind": "measurement", "id": "interpretable-prostate-follow-up-q02" }, { "text": "Which findings warrant continued surveillance or reassessment for residual disease, recurrence or a local treatment complication?", "kind": "action", "id": "interpretable-prostate-follow-up-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-kinds", "name": "Kinds and varieties", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Peripheral zone (McNeal) - posterolateral glandular tissue, origin of most prostatic carcinomas", "Transition zone (McNeal) - periurethral glandular tissue, principal site of benign prostatic hyperplasia", "Central zone (McNeal) - tissue surrounding the ejaculatory ducts, embryologically Wolffian-related", "Anterior fibromuscular stroma - non-glandular anterior wall of the gland", "Median (middle) lobe - surgical/endoscopic usage for periurethral tissue that can ball-valve into the bladder", "Canine prostate - compact, encapsulated gland of high veterinary importance (hyperplasia and carcinoma)", "Rodent prostate - discrete ventral, dorsal, lateral and anterior (coagulating) lobes used as a laboratory model", "Skene paraurethral glands (female prostate homologue) - PSA-immunoreactive paraurethral glands; terminology remains contested" ], "questions": [ { "id": "evidence-kinds-q01", "text": "Which of these kinds and varieties hold for the sense of prostate this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-identifiers", "name": "Identifiers and schemes", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "scheme": "Wikidata", "value_or_pattern": "Q9625", "note": "Item for the anatomical organ (prostate gland)." }, { "scheme": "UBERON", "value_or_pattern": "UBERON:0002367", "note": "prostate gland" }, { "scheme": "FMA", "value_or_pattern": "9600", "note": "Foundational Model of Anatomy identifier for prostate." }, { "scheme": "MeSH", "value_or_pattern": "D011467", "note": "Prostate" }, { "scheme": "SNOMED CT", "value_or_pattern": "41216001", "note": "Structure of prostate" }, { "scheme": "Terminologia Anatomica", "value_or_pattern": "A09.4.03.001", "note": "Prostata" }, { "scheme": "ICD-O topography", "value_or_pattern": "C61 / C61.9", "note": "Cancer-registry site code for prostate; not a code for the healthy organ as such." }, { "scheme": "NCI Thesaurus", "value_or_pattern": "C12410", "note": "Prostate" } ], "questions": [ { "id": "evidence-identifiers-q01", "text": "Which of these identifiers and schemes hold for the sense of prostate this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-standards-and-regulation", "name": "Standards and regulation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Terminologia Anatomica 2 - Federative International Programme for Anatomical Terminology (FIPAT / IFAA)", "WHO Classification of Tumours: Urinary and Male Genital Tumours, 5th edition - IARC / WHO", "ISUP Grade Groups and Gleason grading - International Society of Urological Pathology, adopted by WHO", "TNM Classification of Malignant Tumours - UICC and AJCC", "PI-RADS (Prostate Imaging-Reporting and Data System) - American College of Radiology, ESUR and AdMeTech Foundation", "CAP Cancer Protocol for the prostate gland - College of American Pathologists", "EAU Guidelines on Prostate Cancer and on Non-neurogenic Male LUTS - European Association of Urology", "AUA/SUO guidelines on early detection of prostate cancer and on BPH/LUTS - American Urological Association" ], "questions": [ { "id": "evidence-standards-and-regulation-q01", "text": "Which of these standards and regulation hold for the sense of prostate this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-real-world-use", "name": "Real-world use", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Palpated on digital rectal examination as a firm, walnut-sized structure anterior to the rectum.", "Imaged in life with transrectal ultrasound and multiparametric MRI, and scored with PI-RADS for suspected cancer.", "Source of serum PSA used in opportunistic or organised early-detection programmes.", "Systematically and MRI-targeted needle-biopsied; chips resected at TURP or enucleated at HoLEP for bladder-outlet obstruction.", "Removed en bloc at radical prostatectomy; whole-mount histology maps tumour to McNeal zones.", "Contributes a substantial fraction of ejaculate volume and the characteristic odour of semen (spermine, zinc, citrate).", "In veterinary practice, especially the dog, examined and treated for hyperplasia, cysts, abscess and carcinoma." ], "questions": [ { "id": "evidence-real-world-use-q01", "text": "Which of these real-world use hold for the sense of prostate this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-measurements", "name": "Typical measurements", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "quantity": "Gland volume (young adult human)", "typical_range": "15-30", "unit": "mL" }, { "quantity": "Gland volume with benign prostatic hyperplasia", "typical_range": "40-80 (can exceed 100)", "unit": "mL" }, { "quantity": "Gland mass (young adult human)", "typical_range": "about 15-25", "unit": "g" }, { "quantity": "Serum total PSA (younger men without known cancer; assay-dependent)", "typical_range": "typically below 2-4", "unit": "µg/L (ng/mL)" }, { "quantity": "PSA density (PSA divided by gland volume)", "typical_range": "decision thresholds often near 0.10-0.15", "unit": "ng/mL per cm³" }, { "quantity": "WHO/ISUP Grade Group of adenocarcinoma", "typical_range": "1-5", "unit": "dimensionless grade" } ], "questions": [ { "id": "evidence-measurements-q01", "text": "Which of these typical measurements hold for the sense of prostate this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-failure-modes-and-hazards", "name": "Failure modes and hazards", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Benign prostatic hyperplasia of the transition zone causing lower urinary tract symptoms, acute retention, bladder stones, infection or hydronephrosis.", "Prostatic adenocarcinoma (and less often other histologies), most often arising in the peripheral zone.", "Acute bacterial prostatitis, chronic bacterial prostatitis, and chronic pelvic pain syndrome (NIH categories).", "Ejaculatory-duct obstruction, haematospermia, or contribution to male-factor infertility.", "Post-biopsy or post-resection haemorrhage, urinary sepsis, and (after bladder-neck surgery) retrograde ejaculation.", "Treatment harms of cancer therapy: urinary incontinence, erectile dysfunction, urethral stricture, radiation cystitis or proctitis." ], "questions": [ { "id": "evidence-failure-modes-and-hazards-q01", "text": "Which of these failure modes and hazards hold for the sense of prostate this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-regional-variation", "name": "Regional variation", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ "Age-standardised incidence and mortality of prostate cancer are highest in men of West African ancestry and in high-detection high-income settings, and historically lower in East Asia; both biology and screening intensity contribute.", "Screening practice ranges from opportunistic PSA testing (much of the United States) to more guideline-restricted or organised approaches in parts of Europe; many low-resource settings have little organised early detection.", "Radiology and pathology worldwide use McNeal zones; some surgical and older anatomical teaching still names anterior, posterior, lateral and median lobes.", "Common-language names differ (English prostate, Latin/medical prostata, German Vorsteherdrüse, Chinese 前列腺) without a change in the referent.", "Canine prostatic disease is a large part of the clinical picture in companion-animal practice; livestock species differ in gland compactness and clinical importance." ], "questions": [ { "id": "evidence-regional-variation-q01", "text": "Which of these regional variation hold for the sense of prostate this model covers, and on what evidence?", "kind": "provenance" } ] }, { "id": "evidence-neighbours", "name": "Neighbouring kinds and how to tell them apart", "description": "Reported by the breadth pass; each item needs checking against its source before it becomes normative.", "evidence": [ { "name": "Seminal vesicles", "difference": "Paired, superolateral, do not encircle the urethra; fructose-rich secretion; on MRI they are elongated T2-hyperintense sacs rather than a urethral-surrounding gland." }, { "name": "Bulbourethral (Cowper) glands", "difference": "Lie in the deep perineal pouch and drain to the bulbous urethra, well distal to the prostate." }, { "name": "Urinary bladder neck and trigone", "difference": "Immediately superior, lined by urothelium, lack prostatic acini and PSA-secreting epithelium; cystoscopy and sagittal imaging separate them." }, { "name": "Rectal wall or rectal mass", "difference": "Posterior to Denonvilliers fascia; mucosal on endoscopy and not a source of circulating PSA." }, { "name": "Skene paraurethral glands", "difference": "Female homologue: paraurethral, much smaller, do not form a compact organ around a prostatic urethra; sex and gross anatomy separate them." }, { "name": "External urethral (rhabdo)sphincter", "difference": "Striated muscle immediately distal to the apex; injury, not glandular disease, is what produces stress incontinence after apical dissection." } ], "questions": [ { "id": "evidence-neighbours-q01", "text": "Which of these neighbouring kinds and how to tell them apart hold for the sense of prostate this model covers, and on what evidence?", "kind": "provenance" } ] } ] } ] } ] }, "openQuestions": [ "Does the registry intend this entry to cover human prostates only, or must species-specific anatomy and terminology be represented?", "Which existing Vercy models own prostate cancer, prostatitis, benign prostatic hyperplasia and prostate-derived specimens, and how should this organ model link to them?", "Which authoritative anatomical and clinical sources should establish the model's terminology and evidence requirements?", "Which versions of imaging, pathology and clinical assessment systems should be referenced, and how should version changes affect comparison over time?", "How should identity and longitudinal continuity be represented after partial resection, focal ablation or radical prostatectomy, particularly when only a surgical bed or uncertain residual tissue remains?" ], "statistics": { "bundles": 6, "layers": 11, "findings": 18, "questions": 30 } }