# Vercy AI instruction - YAML 1.2 (JSON-compatible) { "vercy": "1.0-draft", "publication": { "status": "published", "adjudicationStatus": "reviewable-draft", "publishableCanonical": false, "generatedAt": "2026-09-07T09:56:59Z", "synthesisSha256": "9c1aa6958693e38be38e101f29c0bf479fd0883941ed0e5eb5d27ee2a488064f", "providerMode": "single-provider-waiver", "providers": [ "Codex" ], "waivedProviders": [ "Claude", "Grok" ] }, "metaModel": { "id": "WM-LIV-021", "registryId": "vr.wm-liv-021", "name": "Disease / Biological Condition", "version": "0.3.0-research.1", "previousVersions": [], "entryKind": "aggregate", "family": "World Models", "category": "Physical world and living systems", "industry": [ "Cross-industry" ], "domain": [ "PHY.LIV.HLT" ], "tags": [ "disease", "biological", "condition", "phy.liv.hlt" ], "status": "published" }, "canonicalUrl": "https://ver.cy/models/wm-liv-021-disease-biological-condition/", "sourceUrl": "https://github.com/ver-cy/world-models/tree/feat/mega-model-registry/research/runs/wm-liv-021", "model": { "registry_id": "vr.wm-liv-021", "model_id": "WM-LIV-021", "name": "Disease / Biological Condition", "entry_kind": "aggregate", "purpose": "Represent one governed biological condition occurrence concerning an organism plus immutable source-qualified assertions about its identity, course, evidence and relationships.", "scope_statement": "Owns condition occurrence identity, subject reference, occurrence boundary and mastership; release-pinned disease concept bindings; pathological class, site, morphology, mechanism and direct behavior; independent clinical, verification and record statuses; onset, manifestation, recognition, diagnosis, recording, remission, relapse, recurrence and resolution clocks; severity, stage, grade, course, functional impact and prognosis assertions; etiology, risk, susceptibility, triggers, criteria, evidence and differential relationships; manifestation, complication, comorbidity, sequela, care and outcome links; provenance, quality, lifecycle, access, retention and loss-aware projections. Disease terminology, organisms, people, specimens, encounters, care plans, observations, tests, phenotypes, genes, variants, pathogens, interventions, outcomes, evidence documents and decisions remain external.", "in_scope": [ "Condition occurrence identity, subject, disease concept bindings and direct pathological properties", "Independent statuses, course clocks, severity, stage, etiology, evidence, differential and related-condition assertions", "Provenance, quality, correction, access, retention and loss-aware interoperability" ], "out_of_scope": [ "Owning disease terminology, organism, person, specimen, encounter, care plan, observation, test, phenotype, gene, variant, pathogen, intervention, outcome, evidence-document or decision lifecycles", "Inferring diagnosis, causation, cure, prognosis, treatment or public-health case status without source-qualified authority and evidence", "Protected disclosure, clinical decision, external-system mutation, identity merge or irreversible deletion without authority" ], "boundary_notes": [ { "neighbor": "WM-LIV-002 Organism Individual", "distinction": "The registered parent is retained as the subject reference. The organism owns biological identity and lifecycle; this model owns only the condition occurrence and its assertions.", "source_refs": [ "SRC-006", "SRC-008", "SRC-011", "SRC-016" ] }, { "neighbor": "Disease concept and classification", "distinction": "ICD, SNOMED CT, Mondo, Disease Ontology, Orphanet and NCI terminology concepts define categories and mappings. They are not the real condition occurrence affecting one organism.", "source_refs": [ "SRC-001", "SRC-006", "SRC-012", "SRC-013", "SRC-014", "SRC-019" ] }, { "neighbor": "Diagnosis and clinical impression", "distinction": "A diagnosis is an attributable epistemic assertion with verification state, criteria, evidence and uncertainty. It can be revised without rewriting the underlying condition occurrence.", "source_refs": [ "SRC-008", "SRC-009", "SRC-016", "SRC-018" ] }, { "neighbor": "Observation, phenotype and specimen", "distinction": "Signs, symptoms, measurements, tests and phenotypic abnormalities are evidence or manifestations linked to a condition. Their subjects, methods, values and lifecycle remain external.", "source_refs": [ "SRC-010", "SRC-015", "SRC-016" ] }, { "neighbor": "WM-ACT-049 Care Plan / Episode", "distinction": "A care plan or episode may target a condition, but encounters, goals, interventions, medications, procedures and care outcomes keep independent mastership.", "source_refs": [ "SRC-008", "SRC-009", "SRC-011" ] }, { "neighbor": "Public-health surveillance case", "distinction": "A surveillance case applies jurisdictional criteria for counting and reporting and is explicitly not a substitute for individual clinical diagnosis.", "source_refs": [ "SRC-018" ] }, { "neighbor": "Cause, prognosis and outcome", "distinction": "Causal attribution and prognosis are qualified assertions; actual outcomes are external events or states. Association, susceptibility, prediction and outcome are never silently treated as intrinsic disease truth.", "source_refs": [ "SRC-006", "SRC-007", "SRC-009", "SRC-017" ] } ] }, "sources": [ { "id": "SRC-001", "title": "International Classification of Diseases", "organization": "World Health Organization", "url": "https://www.who.int/standards/classifications/classification-of-diseases", "version_or_date": "ICD-11 2026 release", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines an international disease and health-condition classification with mortality and morbidity uses." }, { "id": "SRC-002", "title": "ICD API Documentation", "organization": "World Health Organization", "url": "https://icd.who.int/docs/icd-api/APIDoc-Version2/", "version_or_date": "ICD API version 2; service 2.6", "source_type": "first-party-doc", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines release-pinned programmatic access to ICD entities, codes, titles and multilingual content." }, { "id": "SRC-003", "title": "ICD API Supported Classifications", "organization": "World Health Organization", "url": "https://icd.who.int/docs/icd-api/SupportedClassifications/", "version_or_date": "ICD-11 release 2026-01", "source_type": "first-party-doc", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Publishes supported releases and languages needed for reproducible terminology bindings." }, { "id": "SRC-004", "title": "ICD-11 Reference Guide", "organization": "World Health Organization", "url": "https://icdcdn.who.int/icd11referenceguide/en/html/index.html", "version_or_date": "Living reference guide, accessed 7 September 2026", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Explains ICD-11 concepts, coding, extension codes, postcoordination and reference versus linearization views." }, { "id": "SRC-005", "title": "International Classification of Functioning, Disability and Health", "organization": "World Health Organization", "url": "https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health", "version_or_date": "ICF official classification, accessed 7 September 2026", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Separates disease classification from functioning, disability, activity, participation and contextual factors." }, { "id": "SRC-006", "title": "Clinical finding and disorder", "organization": "SNOMED International", "url": "https://docs.snomed.org/snomed-ct-specifications/snomed-ct-editorial-guide/readme/authoring/domain-specific-modeling/clinical-finding-and-disorder", "version_or_date": "Living editorial guide, accessed 7 September 2026", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Distinguishes disorders from findings and defines modeling expectations for pathological processes and temporal persistence." }, { "id": "SRC-007", "title": "SNOMED CT Concept Model", "organization": "SNOMED International", "url": "https://docs.snomed.org/snomed-ct-practical-guides/snomed-ct-starter-guide/6-snomed-ct-concept-model", "version_or_date": "Living starter guide, accessed 7 September 2026", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines attribute-based clinical concepts including finding site, morphology, cause, severity, course and occurrence." }, { "id": "SRC-008", "title": "FHIR R5 Condition", "organization": "Health Level Seven International", "url": "https://hl7.org/fhir/R5/condition.html", "version_or_date": "FHIR R5 5.0.0, Trial Use", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines condition records with distinct clinical, verification, category, severity, onset, abatement, stage and evidence elements." }, { "id": "SRC-009", "title": "FHIR R5 ClinicalImpression", "organization": "Health Level Seven International", "url": "https://hl7.org/fhir/R5/clinicalimpression.html", "version_or_date": "FHIR R5 5.0.0, Trial Use", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Separates a clinician's assessment, differential and prognosis from the condition being assessed." }, { "id": "SRC-010", "title": "FHIR R5 Observation", "organization": "Health Level Seven International", "url": "https://hl7.org/fhir/R5/observation.html", "version_or_date": "FHIR R5 5.0.0, Normative in parts", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Separates measurements, assertions and observed findings from diagnoses and condition occurrences." }, { "id": "SRC-011", "title": "OMOP Common Data Model 5.4", "organization": "Observational Health Data Sciences and Informatics", "url": "https://ohdsi.github.io/CommonDataModel/cdm54.html", "version_or_date": "CDM 5.4", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines condition occurrence and condition era analytics records, provenance and source vocabulary mappings." }, { "id": "SRC-012", "title": "Mondo Disease Ontology", "organization": "Monarch Initiative", "url": "https://mondo.monarchinitiative.org/", "version_or_date": "Living ontology, accessed 7 September 2026", "source_type": "ontology", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Harmonizes disease concepts, definitions, mappings and provenance across multiple source terminologies." }, { "id": "SRC-013", "title": "Human Disease Ontology", "organization": "Disease Ontology Project", "url": "https://www.disease-ontology.org/welcome/", "version_or_date": "Monthly releases, accessed 7 September 2026", "source_type": "ontology", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Provides stable, community-driven human disease definitions and hierarchical classification." }, { "id": "SRC-014", "title": "Orphanet Classifications", "organization": "Orphanet", "url": "https://www.orphadata.com/_classifications/", "version_or_date": "Orphadata classifications, accessed 7 September 2026", "source_type": "ontology", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines stable rare-disease identifiers and polyhierarchical classifications by medical specialty." }, { "id": "SRC-015", "title": "Human Phenotype Ontology", "organization": "Monarch Initiative", "url": "https://hpo.jax.org/", "version_or_date": "Living ontology, accessed 7 September 2026", "source_type": "ontology", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines phenotypic abnormalities and their annotations while keeping phenotype distinct from disease." }, { "id": "SRC-016", "title": "Phenopacket Schema Disease", "organization": "Global Alliance for Genomics and Health", "url": "https://phenopacket-schema.readthedocs.io/en/latest/disease.html", "version_or_date": "Phenopacket Schema 2 documentation", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Represents a disease diagnosis or hypothesis with onset, resolution and excluded status separately from phenotypic features." }, { "id": "SRC-017", "title": "Gene-Disease Validity Classification", "organization": "Clinical Genome Resource", "url": "https://www.clinicalgenome.org/docs/gene-disease-validity-classification-information/", "version_or_date": "Living ClinGen framework, accessed 7 September 2026", "source_type": "first-party-doc", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Treats gene-disease validity as an evidence-based assertion with a strength classification, not as disease identity." }, { "id": "SRC-018", "title": "Surveillance Case Definitions", "organization": "Centers for Disease Control and Prevention", "url": "https://ndc.services.cdc.gov/", "version_or_date": "Current and historical definitions, accessed 7 September 2026", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines uniform public-health surveillance criteria and states that they are not individual clinical diagnostic criteria." }, { "id": "SRC-019", "title": "NCI Thesaurus", "organization": "National Cancer Institute", "url": "https://www.cancer.gov/about-nci/organization/cbiit/vocabulary", "version_or_date": "Living reference terminology, accessed 7 September 2026", "source_type": "ontology", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Provides NCI reference terminology and biomedical ontology for diseases, findings, anatomy, drugs and related concepts." }, { "id": "SRC-020", "title": "PROV-O: The PROV Ontology", "organization": "World Wide Web Consortium", "url": "https://www.w3.org/TR/prov-o/", "version_or_date": "W3C Recommendation, 30 April 2013", "source_type": "ontology", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines entities, activities, agents, derivation, attribution, revision and invalidation provenance." }, { "id": "SRC-021", "title": "Data Quality Vocabulary", "organization": "World Wide Web Consortium", "url": "https://www.w3.org/TR/vocab-dqv/", "version_or_date": "W3C Working Group Note, 15 December 2016", "source_type": "ontology", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines quality measurements, annotations, policies, standards and provenance." }, { "id": "SRC-022", "title": "ODRL Information Model 2.2", "organization": "World Wide Web Consortium", "url": "https://www.w3.org/TR/odrl-model/", "version_or_date": "W3C Recommendation, 15 February 2018", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines permissions, prohibitions, duties, constraints and policy parties." }, { "id": "SRC-023", "title": "Date and Time on the Internet", "organization": "Internet Engineering Task Force", "url": "https://www.rfc-editor.org/rfc/rfc3339.html", "version_or_date": "RFC 3339, July 2002", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines timestamps with seconds and an explicit numeric offset or Z." }, { "id": "SRC-024", "title": "JSON Canonicalization Scheme", "organization": "Internet Engineering Task Force", "url": "https://www.rfc-editor.org/rfc/rfc8785.html", "version_or_date": "RFC 8785, June 2020", "source_type": "standard", "primary_source": true, "authority_tier": 1, "accessed_at": "2026-09-07T10:02:00Z", "relevance": "Defines deterministic JSON canonicalization for hashing, comparison and signing." } ], "structure": { "bundles": [ { "id": "condition-identity-boundary-and-disease-concept", "name": "Condition identity, boundary and disease concept", "description": "Groups the governed Resource Consumption concern for condition identity, boundary and disease concept.", "rationale": "Separate a biological condition occurrence from terminology, diagnosis, observation and care records.", "source_refs": [ "SRC-001", "SRC-006", "SRC-008", "SRC-011", "SRC-012", "SRC-020", "SRC-002", "SRC-003", "SRC-004", "SRC-013", "SRC-014", "SRC-019" ], "layers": [ { "id": "condition-occurrence-identity-subject-and-mastership", "name": "Condition occurrence identity, subject and mastership", "description": "Groups Resource Consumption context for condition occurrence identity, subject and mastership without importing neighboring master lifecycles.", "source_refs": [ "SRC-001", "SRC-006", "SRC-008", "SRC-011", "SRC-012", "SRC-020" ], "findings": [ { "id": "condition-identifier-subject-kind-organism-reference-and-master-system", "name": "Condition identifier, subject kind, organism reference and master system", "description": "Records condition identifier, subject kind, organism reference and master system as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-001", "SRC-006", "SRC-008", "SRC-011", "SRC-012", "SRC-020" ], "questions": [ { "id": "condition-identifier-subject-kind-organism-reference-and-master-system-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish condition identifier, subject kind, organism reference and master system?", "kind": "identity", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "condition-identifier-subject-kind-organism-reference-and-master-system-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify condition identifier, subject kind, organism reference and master system?", "kind": "authority", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "condition-identifier-subject-kind-organism-reference-and-master-system-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect condition identifier, subject kind, organism reference and master system?", "kind": "security", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "condition-identifier-subject-kind-organism-reference-and-master-system-data", "name": "Condition identifier, subject kind, organism reference and master system data", "description": "Typed condition values and external references required to answer the governed questions for condition identifier, subject kind, organism reference and master system.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-001", "SRC-006", "SRC-008", "SRC-011", "SRC-012", "SRC-020" ] } ], "artifacts": [ { "id": "condition-identifier-subject-kind-organism-reference-and-master-system-artifact", "name": "Condition identifier, subject kind, organism reference and master system evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting condition identifier, subject kind, organism reference and master system.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-001", "SRC-006", "SRC-008", "SRC-011", "SRC-012", "SRC-020" ] } ], "inline_only_rationale": null }, { "id": "occurrence-discriminator-episode-boundary-alias-profile-and-record-linkage", "name": "Occurrence discriminator, episode boundary, alias, profile and record linkage", "description": "Records occurrence discriminator, episode boundary, alias, profile and record linkage as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-001", "SRC-006", "SRC-008", "SRC-011", "SRC-012", "SRC-020" ], "questions": [ { "id": "occurrence-discriminator-episode-boundary-alias-profile-and-record-linkage-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish occurrence discriminator, episode boundary, alias, profile and record linkage?", "kind": "classification", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "occurrence-discriminator-episode-boundary-alias-profile-and-record-linkage-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify occurrence discriminator, episode boundary, alias, profile and record linkage?", "kind": "requirement", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "occurrence-discriminator-episode-boundary-alias-profile-and-record-linkage-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect occurrence discriminator, episode boundary, alias, profile and record linkage?", "kind": "privacy", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "occurrence-discriminator-episode-boundary-alias-profile-and-record-linkage-data", "name": "Occurrence discriminator, episode boundary, alias, profile and record linkage data", "description": "Typed condition values and external references required to answer the governed questions for occurrence discriminator, episode boundary, alias, profile and record linkage.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-001", "SRC-006", "SRC-008", "SRC-011", "SRC-012", "SRC-020" ] } ], "artifacts": [ { "id": "occurrence-discriminator-episode-boundary-alias-profile-and-record-linkage-artifact", "name": "Occurrence discriminator, episode boundary, alias, profile and record linkage evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting occurrence discriminator, episode boundary, alias, profile and record linkage.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-001", "SRC-006", "SRC-008", "SRC-011", "SRC-012", "SRC-020" ] } ], "inline_only_rationale": null } ] }, { "id": "disease-concept-code-definition-and-classification", "name": "Disease concept, code, definition and classification", "description": "Groups Resource Consumption context for disease concept, code, definition and classification without importing neighboring master lifecycles.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-006", "SRC-012", "SRC-013", "SRC-014", "SRC-019" ], "findings": [ { "id": "disease-concept-code-system-release-display-definition-and-synonym", "name": "Disease concept, code system, release, display, definition and synonym", "description": "Records disease concept, code system, release, display, definition and synonym as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-006", "SRC-012", "SRC-013", "SRC-014", "SRC-019" ], "questions": [ { "id": "disease-concept-code-system-release-display-definition-and-synonym-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish disease concept, code system, release, display, definition and synonym?", "kind": "classification", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "disease-concept-code-system-release-display-definition-and-synonym-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify disease concept, code system, release, display, definition and synonym?", "kind": "constraint", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "disease-concept-code-system-release-display-definition-and-synonym-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect disease concept, code system, release, display, definition and synonym?", "kind": "retention", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "disease-concept-code-system-release-display-definition-and-synonym-data", "name": "Disease concept, code system, release, display, definition and synonym data", "description": "Typed condition values and external references required to answer the governed questions for disease concept, code system, release, display, definition and synonym.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-006", "SRC-012", "SRC-013", "SRC-014", "SRC-019" ] } ], "artifacts": [ { "id": "disease-concept-code-system-release-display-definition-and-synonym-artifact", "name": "Disease concept, code system, release, display, definition and synonym evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting disease concept, code system, release, display, definition and synonym.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-006", "SRC-012", "SRC-013", "SRC-014", "SRC-019" ] } ], "inline_only_rationale": null }, { "id": "category-hierarchy-postcoordination-rare-disease-and-species-profile", "name": "Category, hierarchy, postcoordination, rare-disease and species profile", "description": "Records category, hierarchy, postcoordination, rare-disease and species profile as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-006", "SRC-012", "SRC-013", "SRC-014", "SRC-019" ], "questions": [ { "id": "category-hierarchy-postcoordination-rare-disease-and-species-profile-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish category, hierarchy, postcoordination, rare-disease and species profile?", "kind": "interoperability", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "category-hierarchy-postcoordination-rare-disease-and-species-profile-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify category, hierarchy, postcoordination, rare-disease and species profile?", "kind": "process", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "category-hierarchy-postcoordination-rare-disease-and-species-profile-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect category, hierarchy, postcoordination, rare-disease and species profile?", "kind": "access", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "category-hierarchy-postcoordination-rare-disease-and-species-profile-data", "name": "Category, hierarchy, postcoordination, rare-disease and species profile data", "description": "Typed condition values and external references required to answer the governed questions for category, hierarchy, postcoordination, rare-disease and species profile.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-006", "SRC-012", "SRC-013", "SRC-014", "SRC-019" ] } ], "artifacts": [ { "id": "category-hierarchy-postcoordination-rare-disease-and-species-profile-artifact", "name": "Category, hierarchy, postcoordination, rare-disease and species profile evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting category, hierarchy, postcoordination, rare-disease and species profile.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-006", "SRC-012", "SRC-013", "SRC-014", "SRC-019" ] } ], "inline_only_rationale": null } ] } ] }, { "id": "pathology-anatomy-and-direct-properties", "name": "Pathology, anatomy and direct properties", "description": "Groups the governed Resource Consumption concern for pathology, anatomy and direct properties.", "rationale": "Describe what kind of condition exists and the direct biological characteristics that distinguish it.", "source_refs": [ "SRC-001", "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-019", "SRC-005", "SRC-010", "SRC-015" ], "layers": [ { "id": "pathological-class-site-morphology-and-mechanism", "name": "Pathological class, site, morphology and mechanism", "description": "Groups Resource Consumption context for pathological class, site, morphology and mechanism without importing neighboring master lifecycles.", "source_refs": [ "SRC-001", "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-019" ], "findings": [ { "id": "disorder-disease-syndrome-injury-infection-anomaly-and-finding-profile", "name": "Disorder, disease, syndrome, injury, infection, anomaly and finding profile", "description": "Records disorder, disease, syndrome, injury, infection, anomaly and finding profile as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-001", "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-019" ], "questions": [ { "id": "disorder-disease-syndrome-injury-infection-anomaly-and-finding-profile-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish disorder, disease, syndrome, injury, infection, anomaly and finding profile?", "kind": "classification", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "disorder-disease-syndrome-injury-infection-anomaly-and-finding-profile-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify disorder, disease, syndrome, injury, infection, anomaly and finding profile?", "kind": "event", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "disorder-disease-syndrome-injury-infection-anomaly-and-finding-profile-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect disorder, disease, syndrome, injury, infection, anomaly and finding profile?", "kind": "exception", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "disorder-disease-syndrome-injury-infection-anomaly-and-finding-profile-data", "name": "Disorder, disease, syndrome, injury, infection, anomaly and finding profile data", "description": "Typed condition values and external references required to answer the governed questions for disorder, disease, syndrome, injury, infection, anomaly and finding profile.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-001", "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-019" ] } ], "artifacts": [ { "id": "disorder-disease-syndrome-injury-infection-anomaly-and-finding-profile-artifact", "name": "Disorder, disease, syndrome, injury, infection, anomaly and finding profile evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting disorder, disease, syndrome, injury, infection, anomaly and finding profile.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-001", "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-019" ] } ], "inline_only_rationale": null }, { "id": "body-site-laterality-morphology-pathological-process-mechanism-and-extent", "name": "Body site, laterality, morphology, pathological process, mechanism and extent", "description": "Records body site, laterality, morphology, pathological process, mechanism and extent as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-001", "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-019" ], "questions": [ { "id": "body-site-laterality-morphology-pathological-process-mechanism-and-extent-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish body site, laterality, morphology, pathological process, mechanism and extent?", "kind": "spatial", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "body-site-laterality-morphology-pathological-process-mechanism-and-extent-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify body site, laterality, morphology, pathological process, mechanism and extent?", "kind": "measurement", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "body-site-laterality-morphology-pathological-process-mechanism-and-extent-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect body site, laterality, morphology, pathological process, mechanism and extent?", "kind": "interoperability", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "body-site-laterality-morphology-pathological-process-mechanism-and-extent-data", "name": "Body site, laterality, morphology, pathological process, mechanism and extent data", "description": "Typed condition values and external references required to answer the governed questions for body site, laterality, morphology, pathological process, mechanism and extent.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-001", "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-019" ] } ], "artifacts": [ { "id": "body-site-laterality-morphology-pathological-process-mechanism-and-extent-artifact", "name": "Body site, laterality, morphology, pathological process, mechanism and extent evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting body site, laterality, morphology, pathological process, mechanism and extent.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-001", "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-019" ] } ], "inline_only_rationale": null } ] }, { "id": "intrinsic-behavior-capability-and-distinguishing-characteristics", "name": "Intrinsic behavior, capability and distinguishing characteristics", "description": "Groups Resource Consumption context for intrinsic behavior, capability and distinguishing characteristics without importing neighboring master lifecycles.", "source_refs": [ "SRC-005", "SRC-006", "SRC-007", "SRC-010", "SRC-015" ], "findings": [ { "id": "progression-persistence-transmission-damage-reversibility-and-instability", "name": "Progression, persistence, transmission, damage, reversibility and instability", "description": "Records progression, persistence, transmission, damage, reversibility and instability as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-005", "SRC-006", "SRC-007", "SRC-010", "SRC-015" ], "questions": [ { "id": "progression-persistence-transmission-damage-reversibility-and-instability-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish progression, persistence, transmission, damage, reversibility and instability?", "kind": "state", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "progression-persistence-transmission-damage-reversibility-and-instability-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify progression, persistence, transmission, damage, reversibility and instability?", "kind": "evidence", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "progression-persistence-transmission-damage-reversibility-and-instability-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect progression, persistence, transmission, damage, reversibility and instability?", "kind": "decision", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "progression-persistence-transmission-damage-reversibility-and-instability-data", "name": "Progression, persistence, transmission, damage, reversibility and instability data", "description": "Typed condition values and external references required to answer the governed questions for progression, persistence, transmission, damage, reversibility and instability.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-005", "SRC-006", "SRC-007", "SRC-010", "SRC-015" ] } ], "artifacts": [ { "id": "progression-persistence-transmission-damage-reversibility-and-instability-artifact", "name": "Progression, persistence, transmission, damage, reversibility and instability evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting progression, persistence, transmission, damage, reversibility and instability.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-005", "SRC-006", "SRC-007", "SRC-010", "SRC-015" ] } ], "inline_only_rationale": null }, { "id": "recognition-features-discriminators-confounders-and-condition-affordances", "name": "Recognition features, discriminators, confounders and condition affordances", "description": "Records recognition features, discriminators, confounders and condition affordances as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-005", "SRC-006", "SRC-007", "SRC-010", "SRC-015" ], "questions": [ { "id": "recognition-features-discriminators-confounders-and-condition-affordances-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish recognition features, discriminators, confounders and condition affordances?", "kind": "evidence", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "recognition-features-discriminators-confounders-and-condition-affordances-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify recognition features, discriminators, confounders and condition affordances?", "kind": "quality", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "recognition-features-discriminators-confounders-and-condition-affordances-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect recognition features, discriminators, confounders and condition affordances?", "kind": "identity", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "recognition-features-discriminators-confounders-and-condition-affordances-data", "name": "Recognition features, discriminators, confounders and condition affordances data", "description": "Typed condition values and external references required to answer the governed questions for recognition features, discriminators, confounders and condition affordances.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-005", "SRC-006", "SRC-007", "SRC-010", "SRC-015" ] } ], "artifacts": [ { "id": "recognition-features-discriminators-confounders-and-condition-affordances-artifact", "name": "Recognition features, discriminators, confounders and condition affordances evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting recognition features, discriminators, confounders and condition affordances.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-005", "SRC-006", "SRC-007", "SRC-010", "SRC-015" ] } ], "inline_only_rationale": null } ] } ] }, { "id": "independent-status-time-and-clinical-course", "name": "Independent status, time and clinical course", "description": "Groups the governed Resource Consumption concern for independent status, time and clinical course.", "rationale": "Prevent diagnostic confidence, clinical activity, record state and lifecycle clocks from collapsing.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-016", "SRC-018", "SRC-004", "SRC-023" ], "layers": [ { "id": "clinical-verification-record-and-assertion-status", "name": "Clinical, verification, record and assertion status", "description": "Groups Resource Consumption context for clinical, verification, record and assertion status without importing neighboring master lifecycles.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-016", "SRC-018" ], "findings": [ { "id": "clinical-active-inactive-remission-relapse-recurrence-resolved-and-unknown", "name": "Clinical active, inactive, remission, relapse, recurrence, resolved and unknown", "description": "Records clinical active, inactive, remission, relapse, recurrence, resolved and unknown as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-016", "SRC-018" ], "questions": [ { "id": "clinical-active-inactive-remission-relapse-recurrence-resolved-and-unknown-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish clinical active, inactive, remission, relapse, recurrence, resolved and unknown?", "kind": "state", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "clinical-active-inactive-remission-relapse-recurrence-resolved-and-unknown-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify clinical active, inactive, remission, relapse, recurrence, resolved and unknown?", "kind": "validation", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "clinical-active-inactive-remission-relapse-recurrence-resolved-and-unknown-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect clinical active, inactive, remission, relapse, recurrence, resolved and unknown?", "kind": "classification", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "clinical-active-inactive-remission-relapse-recurrence-resolved-and-unknown-data", "name": "Clinical active, inactive, remission, relapse, recurrence, resolved and unknown data", "description": "Typed condition values and external references required to answer the governed questions for clinical active, inactive, remission, relapse, recurrence, resolved and unknown.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-016", "SRC-018" ] } ], "artifacts": [ { "id": "clinical-active-inactive-remission-relapse-recurrence-resolved-and-unknown-artifact", "name": "Clinical active, inactive, remission, relapse, recurrence, resolved and unknown evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting clinical active, inactive, remission, relapse, recurrence, resolved and unknown.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-016", "SRC-018" ] } ], "inline_only_rationale": null }, { "id": "unconfirmed-provisional-differential-confirmed-refuted-excluded-and-record-status", "name": "Unconfirmed, provisional, differential, confirmed, refuted, excluded and record status", "description": "Records unconfirmed, provisional, differential, confirmed, refuted, excluded and record status as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-016", "SRC-018" ], "questions": [ { "id": "unconfirmed-provisional-differential-confirmed-refuted-excluded-and-record-status-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish unconfirmed, provisional, differential, confirmed, refuted, excluded and record status?", "kind": "validation", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "unconfirmed-provisional-differential-confirmed-refuted-excluded-and-record-status-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify unconfirmed, provisional, differential, confirmed, refuted, excluded and record status?", "kind": "security", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "unconfirmed-provisional-differential-confirmed-refuted-excluded-and-record-status-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect unconfirmed, provisional, differential, confirmed, refuted, excluded and record status?", "kind": "composition", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "unconfirmed-provisional-differential-confirmed-refuted-excluded-and-record-status-data", "name": "Unconfirmed, provisional, differential, confirmed, refuted, excluded and record status data", "description": "Typed condition values and external references required to answer the governed questions for unconfirmed, provisional, differential, confirmed, refuted, excluded and record status.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-016", "SRC-018" ] } ], "artifacts": [ { "id": "unconfirmed-provisional-differential-confirmed-refuted-excluded-and-record-status-artifact", "name": "Unconfirmed, provisional, differential, confirmed, refuted, excluded and record status evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting unconfirmed, provisional, differential, confirmed, refuted, excluded and record status.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-016", "SRC-018" ] } ], "inline_only_rationale": null } ] }, { "id": "onset-manifestation-diagnosis-and-course-clocks", "name": "Onset, manifestation, diagnosis and course clocks", "description": "Groups Resource Consumption context for onset, manifestation, diagnosis and course clocks without importing neighboring master lifecycles.", "source_refs": [ "SRC-004", "SRC-008", "SRC-011", "SRC-016", "SRC-018", "SRC-023" ], "findings": [ { "id": "onset-manifestation-recognition-diagnosis-recording-and-effective-time", "name": "Onset, manifestation, recognition, diagnosis, recording and effective time", "description": "Records onset, manifestation, recognition, diagnosis, recording and effective time as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-004", "SRC-008", "SRC-011", "SRC-016", "SRC-018", "SRC-023" ], "questions": [ { "id": "onset-manifestation-recognition-diagnosis-recording-and-effective-time-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish onset, manifestation, recognition, diagnosis, recording and effective time?", "kind": "temporal", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "onset-manifestation-recognition-diagnosis-recording-and-effective-time-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify onset, manifestation, recognition, diagnosis, recording and effective time?", "kind": "privacy", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "onset-manifestation-recognition-diagnosis-recording-and-effective-time-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect onset, manifestation, recognition, diagnosis, recording and effective time?", "kind": "relationship", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "onset-manifestation-recognition-diagnosis-recording-and-effective-time-data", "name": "Onset, manifestation, recognition, diagnosis, recording and effective time data", "description": "Typed condition values and external references required to answer the governed questions for onset, manifestation, recognition, diagnosis, recording and effective time.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-004", "SRC-008", "SRC-011", "SRC-016", "SRC-018", "SRC-023" ] } ], "artifacts": [ { "id": "onset-manifestation-recognition-diagnosis-recording-and-effective-time-artifact", "name": "Onset, manifestation, recognition, diagnosis, recording and effective time evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting onset, manifestation, recognition, diagnosis, recording and effective time.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-004", "SRC-008", "SRC-011", "SRC-016", "SRC-018", "SRC-023" ] } ], "inline_only_rationale": null }, { "id": "remission-relapse-recurrence-abatement-resolution-death-and-new-occurrence", "name": "Remission, relapse, recurrence, abatement, resolution, death and new occurrence", "description": "Records remission, relapse, recurrence, abatement, resolution, death and new occurrence as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-004", "SRC-008", "SRC-011", "SRC-016", "SRC-018", "SRC-023" ], "questions": [ { "id": "remission-relapse-recurrence-abatement-resolution-death-and-new-occurrence-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish remission, relapse, recurrence, abatement, resolution, death and new occurrence?", "kind": "lifecycle", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "remission-relapse-recurrence-abatement-resolution-death-and-new-occurrence-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify remission, relapse, recurrence, abatement, resolution, death and new occurrence?", "kind": "retention", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "remission-relapse-recurrence-abatement-resolution-death-and-new-occurrence-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect remission, relapse, recurrence, abatement, resolution, death and new occurrence?", "kind": "state", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "remission-relapse-recurrence-abatement-resolution-death-and-new-occurrence-data", "name": "Remission, relapse, recurrence, abatement, resolution, death and new occurrence data", "description": "Typed condition values and external references required to answer the governed questions for remission, relapse, recurrence, abatement, resolution, death and new occurrence.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-004", "SRC-008", "SRC-011", "SRC-016", "SRC-018", "SRC-023" ] } ], "artifacts": [ { "id": "remission-relapse-recurrence-abatement-resolution-death-and-new-occurrence-artifact", "name": "Remission, relapse, recurrence, abatement, resolution, death and new occurrence evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting remission, relapse, recurrence, abatement, resolution, death and new occurrence.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-004", "SRC-008", "SRC-011", "SRC-016", "SRC-018", "SRC-023" ] } ], "inline_only_rationale": null } ] } ] }, { "id": "severity-stage-grade-course-and-impact", "name": "Severity, stage, grade, course and impact", "description": "Groups the governed Resource Consumption concern for severity, stage, grade, course and impact.", "rationale": "Represent qualified assessments rather than timeless intrinsic truth.", "source_refs": [ "SRC-004", "SRC-007", "SRC-008", "SRC-009", "SRC-011", "SRC-019", "SRC-021", "SRC-005", "SRC-010", "SRC-015" ], "layers": [ { "id": "severity-stage-grade-extent-and-course-assessment", "name": "Severity, stage, grade, extent and course assessment", "description": "Groups Resource Consumption context for severity, stage, grade, extent and course assessment without importing neighboring master lifecycles.", "source_refs": [ "SRC-004", "SRC-007", "SRC-008", "SRC-009", "SRC-011", "SRC-019", "SRC-021" ], "findings": [ { "id": "severity-value-scale-method-threshold-assessor-time-and-confidence", "name": "Severity value, scale, method, threshold, assessor, time and confidence", "description": "Records severity value, scale, method, threshold, assessor, time and confidence as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-004", "SRC-007", "SRC-008", "SRC-009", "SRC-011", "SRC-019", "SRC-021" ], "questions": [ { "id": "severity-value-scale-method-threshold-assessor-time-and-confidence-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish severity value, scale, method, threshold, assessor, time and confidence?", "kind": "measurement", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "severity-value-scale-method-threshold-assessor-time-and-confidence-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify severity value, scale, method, threshold, assessor, time and confidence?", "kind": "access", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "severity-value-scale-method-threshold-assessor-time-and-confidence-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect severity value, scale, method, threshold, assessor, time and confidence?", "kind": "lifecycle", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "severity-value-scale-method-threshold-assessor-time-and-confidence-data", "name": "Severity value, scale, method, threshold, assessor, time and confidence data", "description": "Typed condition values and external references required to answer the governed questions for severity value, scale, method, threshold, assessor, time and confidence.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-004", "SRC-007", "SRC-008", "SRC-009", "SRC-011", "SRC-019", "SRC-021" ] } ], "artifacts": [ { "id": "severity-value-scale-method-threshold-assessor-time-and-confidence-artifact", "name": "Severity value, scale, method, threshold, assessor, time and confidence evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting severity value, scale, method, threshold, assessor, time and confidence.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-004", "SRC-007", "SRC-008", "SRC-009", "SRC-011", "SRC-019", "SRC-021" ] } ], "inline_only_rationale": null }, { "id": "stage-grade-extent-acute-chronic-episodic-progressive-remitting-and-terminal", "name": "Stage, grade, extent, acute, chronic, episodic, progressive, remitting and terminal", "description": "Records stage, grade, extent, acute, chronic, episodic, progressive, remitting and terminal as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-004", "SRC-007", "SRC-008", "SRC-009", "SRC-011", "SRC-019", "SRC-021" ], "questions": [ { "id": "stage-grade-extent-acute-chronic-episodic-progressive-remitting-and-terminal-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish stage, grade, extent, acute, chronic, episodic, progressive, remitting and terminal?", "kind": "classification", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "stage-grade-extent-acute-chronic-episodic-progressive-remitting-and-terminal-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify stage, grade, extent, acute, chronic, episodic, progressive, remitting and terminal?", "kind": "exception", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "stage-grade-extent-acute-chronic-episodic-progressive-remitting-and-terminal-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect stage, grade, extent, acute, chronic, episodic, progressive, remitting and terminal?", "kind": "temporal", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "stage-grade-extent-acute-chronic-episodic-progressive-remitting-and-terminal-data", "name": "Stage, grade, extent, acute, chronic, episodic, progressive, remitting and terminal data", "description": "Typed condition values and external references required to answer the governed questions for stage, grade, extent, acute, chronic, episodic, progressive, remitting and terminal.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-004", "SRC-007", "SRC-008", "SRC-009", "SRC-011", "SRC-019", "SRC-021" ] } ], "artifacts": [ { "id": "stage-grade-extent-acute-chronic-episodic-progressive-remitting-and-terminal-artifact", "name": "Stage, grade, extent, acute, chronic, episodic, progressive, remitting and terminal evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting stage, grade, extent, acute, chronic, episodic, progressive, remitting and terminal.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-004", "SRC-007", "SRC-008", "SRC-009", "SRC-011", "SRC-019", "SRC-021" ] } ], "inline_only_rationale": null } ] }, { "id": "functional-impact-prognosis-hazard-and-possible-actions", "name": "Functional impact, prognosis, hazard and possible actions", "description": "Groups Resource Consumption context for functional impact, prognosis, hazard and possible actions without importing neighboring master lifecycles.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-015" ], "findings": [ { "id": "impairment-activity-participation-burden-quality-of-life-and-context", "name": "Impairment, activity, participation, burden, quality of life and context", "description": "Records impairment, activity, participation, burden, quality of life and context as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-015" ], "questions": [ { "id": "impairment-activity-participation-burden-quality-of-life-and-context-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish impairment, activity, participation, burden, quality of life and context?", "kind": "relationship", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "impairment-activity-participation-burden-quality-of-life-and-context-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify impairment, activity, participation, burden, quality of life and context?", "kind": "interoperability", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "impairment-activity-participation-burden-quality-of-life-and-context-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect impairment, activity, participation, burden, quality of life and context?", "kind": "spatial", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "impairment-activity-participation-burden-quality-of-life-and-context-data", "name": "Impairment, activity, participation, burden, quality of life and context data", "description": "Typed condition values and external references required to answer the governed questions for impairment, activity, participation, burden, quality of life and context.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-015" ] } ], "artifacts": [ { "id": "impairment-activity-participation-burden-quality-of-life-and-context-artifact", "name": "Impairment, activity, participation, burden, quality of life and context evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting impairment, activity, participation, burden, quality of life and context.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-015" ] } ], "inline_only_rationale": null }, { "id": "prognosis-risk-urgency-observe-monitor-diagnose-treat-control-and-prevent", "name": "Prognosis, risk, urgency, observe, monitor, diagnose, treat, control and prevent", "description": "Records prognosis, risk, urgency, observe, monitor, diagnose, treat, control and prevent as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-015" ], "questions": [ { "id": "prognosis-risk-urgency-observe-monitor-diagnose-treat-control-and-prevent-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish prognosis, risk, urgency, observe, monitor, diagnose, treat, control and prevent?", "kind": "decision", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "prognosis-risk-urgency-observe-monitor-diagnose-treat-control-and-prevent-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify prognosis, risk, urgency, observe, monitor, diagnose, treat, control and prevent?", "kind": "decision", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "prognosis-risk-urgency-observe-monitor-diagnose-treat-control-and-prevent-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect prognosis, risk, urgency, observe, monitor, diagnose, treat, control and prevent?", "kind": "provenance", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "prognosis-risk-urgency-observe-monitor-diagnose-treat-control-and-prevent-data", "name": "Prognosis, risk, urgency, observe, monitor, diagnose, treat, control and prevent data", "description": "Typed condition values and external references required to answer the governed questions for prognosis, risk, urgency, observe, monitor, diagnose, treat, control and prevent.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-015" ] } ], "artifacts": [ { "id": "prognosis-risk-urgency-observe-monitor-diagnose-treat-control-and-prevent-artifact", "name": "Prognosis, risk, urgency, observe, monitor, diagnose, treat, control and prevent evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting prognosis, risk, urgency, observe, monitor, diagnose, treat, control and prevent.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-015" ] } ], "inline_only_rationale": null } ] } ] }, { "id": "etiology-evidence-differential-and-related-conditions", "name": "Etiology, evidence, differential and related conditions", "description": "Groups the governed Resource Consumption concern for etiology, evidence, differential and related conditions.", "rationale": "Keep causal, supporting, competing and associated assertions source-qualified.", "source_refs": [ "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-014", "SRC-017", "SRC-008", "SRC-009", "SRC-010", "SRC-015", "SRC-016", "SRC-018", "SRC-020", "SRC-021" ], "layers": [ { "id": "cause-risk-susceptibility-trigger-and-association", "name": "Cause, risk, susceptibility, trigger and association", "description": "Groups Resource Consumption context for cause, risk, susceptibility, trigger and association without importing neighboring master lifecycles.", "source_refs": [ "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-014", "SRC-017" ], "findings": [ { "id": "causative-agent-mechanism-inheritance-gene-variant-pathogen-and-exposure", "name": "Causative agent, mechanism, inheritance, gene, variant, pathogen and exposure", "description": "Records causative agent, mechanism, inheritance, gene, variant, pathogen and exposure as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-014", "SRC-017" ], "questions": [ { "id": "causative-agent-mechanism-inheritance-gene-variant-pathogen-and-exposure-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish causative agent, mechanism, inheritance, gene, variant, pathogen and exposure?", "kind": "relationship", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "causative-agent-mechanism-inheritance-gene-variant-pathogen-and-exposure-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify causative agent, mechanism, inheritance, gene, variant, pathogen and exposure?", "kind": "identity", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "causative-agent-mechanism-inheritance-gene-variant-pathogen-and-exposure-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect causative agent, mechanism, inheritance, gene, variant, pathogen and exposure?", "kind": "ownership", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "causative-agent-mechanism-inheritance-gene-variant-pathogen-and-exposure-data", "name": "Causative agent, mechanism, inheritance, gene, variant, pathogen and exposure data", "description": "Typed condition values and external references required to answer the governed questions for causative agent, mechanism, inheritance, gene, variant, pathogen and exposure.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-014", "SRC-017" ] } ], "artifacts": [ { "id": "causative-agent-mechanism-inheritance-gene-variant-pathogen-and-exposure-artifact", "name": "Causative agent, mechanism, inheritance, gene, variant, pathogen and exposure evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting causative agent, mechanism, inheritance, gene, variant, pathogen and exposure.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-014", "SRC-017" ] } ], "inline_only_rationale": null }, { "id": "risk-factor-susceptibility-trigger-protective-factor-association-and-causality", "name": "Risk factor, susceptibility, trigger, protective factor, association and causality", "description": "Records risk factor, susceptibility, trigger, protective factor, association and causality as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-014", "SRC-017" ], "questions": [ { "id": "risk-factor-susceptibility-trigger-protective-factor-association-and-causality-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish risk factor, susceptibility, trigger, protective factor, association and causality?", "kind": "evidence", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "risk-factor-susceptibility-trigger-protective-factor-association-and-causality-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify risk factor, susceptibility, trigger, protective factor, association and causality?", "kind": "classification", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "risk-factor-susceptibility-trigger-protective-factor-association-and-causality-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect risk factor, susceptibility, trigger, protective factor, association and causality?", "kind": "authority", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "risk-factor-susceptibility-trigger-protective-factor-association-and-causality-data", "name": "Risk factor, susceptibility, trigger, protective factor, association and causality data", "description": "Typed condition values and external references required to answer the governed questions for risk factor, susceptibility, trigger, protective factor, association and causality.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-014", "SRC-017" ] } ], "artifacts": [ { "id": "risk-factor-susceptibility-trigger-protective-factor-association-and-causality-artifact", "name": "Risk factor, susceptibility, trigger, protective factor, association and causality evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting risk factor, susceptibility, trigger, protective factor, association and causality.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-014", "SRC-017" ] } ], "inline_only_rationale": null } ] }, { "id": "criteria-observation-phenotype-evidence-and-differential", "name": "Criteria, observation, phenotype, evidence and differential", "description": "Groups Resource Consumption context for criteria, observation, phenotype, evidence and differential without importing neighboring master lifecycles.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-020", "SRC-021" ], "findings": [ { "id": "diagnostic-rule-case-definition-observation-test-phenotype-and-evidence", "name": "Diagnostic rule, case definition, observation, test, phenotype and evidence", "description": "Records diagnostic rule, case definition, observation, test, phenotype and evidence as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-020", "SRC-021" ], "questions": [ { "id": "diagnostic-rule-case-definition-observation-test-phenotype-and-evidence-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish diagnostic rule, case definition, observation, test, phenotype and evidence?", "kind": "validation", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "diagnostic-rule-case-definition-observation-test-phenotype-and-evidence-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify diagnostic rule, case definition, observation, test, phenotype and evidence?", "kind": "composition", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "diagnostic-rule-case-definition-observation-test-phenotype-and-evidence-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect diagnostic rule, case definition, observation, test, phenotype and evidence?", "kind": "requirement", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "diagnostic-rule-case-definition-observation-test-phenotype-and-evidence-data", "name": "Diagnostic rule, case definition, observation, test, phenotype and evidence data", "description": "Typed condition values and external references required to answer the governed questions for diagnostic rule, case definition, observation, test, phenotype and evidence.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-020", "SRC-021" ] } ], "artifacts": [ { "id": "diagnostic-rule-case-definition-observation-test-phenotype-and-evidence-artifact", "name": "Diagnostic rule, case definition, observation, test, phenotype and evidence evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting diagnostic rule, case definition, observation, test, phenotype and evidence.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-020", "SRC-021" ] } ], "inline_only_rationale": null }, { "id": "differential-competing-alternative-refuted-excluded-uncertain-and-conflict", "name": "Differential, competing, alternative, refuted, excluded, uncertain and conflict", "description": "Records differential, competing, alternative, refuted, excluded, uncertain and conflict as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-020", "SRC-021" ], "questions": [ { "id": "differential-competing-alternative-refuted-excluded-uncertain-and-conflict-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish differential, competing, alternative, refuted, excluded, uncertain and conflict?", "kind": "decision", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "differential-competing-alternative-refuted-excluded-uncertain-and-conflict-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify differential, competing, alternative, refuted, excluded, uncertain and conflict?", "kind": "relationship", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "differential-competing-alternative-refuted-excluded-uncertain-and-conflict-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect differential, competing, alternative, refuted, excluded, uncertain and conflict?", "kind": "constraint", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "differential-competing-alternative-refuted-excluded-uncertain-and-conflict-data", "name": "Differential, competing, alternative, refuted, excluded, uncertain and conflict data", "description": "Typed condition values and external references required to answer the governed questions for differential, competing, alternative, refuted, excluded, uncertain and conflict.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-020", "SRC-021" ] } ], "artifacts": [ { "id": "differential-competing-alternative-refuted-excluded-uncertain-and-conflict-artifact", "name": "Differential, competing, alternative, refuted, excluded, uncertain and conflict evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting differential, competing, alternative, refuted, excluded, uncertain and conflict.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-020", "SRC-021" ] } ], "inline_only_rationale": null } ] } ] }, { "id": "relationships-governance-provenance-and-exchange", "name": "Relationships, governance, provenance and exchange", "description": "Groups the governed Resource Consumption concern for relationships, governance, provenance and exchange.", "rationale": "Link manifestations, care and outcomes while preserving ownership, privacy and auditability.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-015", "SRC-016", "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-006", "SRC-007", "SRC-012", "SRC-013", "SRC-014", "SRC-017", "SRC-018", "SRC-019", "SRC-020", "SRC-021", "SRC-022", "SRC-023", "SRC-024" ], "layers": [ { "id": "manifestation-complication-comorbidity-care-and-outcome-links", "name": "Manifestation, complication, comorbidity, care and outcome links", "description": "Groups Resource Consumption context for manifestation, complication, comorbidity, care and outcome links without importing neighboring master lifecycles.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-015", "SRC-016" ], "findings": [ { "id": "sign-symptom-observation-phenotype-complication-comorbidity-and-sequela", "name": "Sign, symptom, observation, phenotype, complication, comorbidity and sequela", "description": "Records sign, symptom, observation, phenotype, complication, comorbidity and sequela as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-015", "SRC-016" ], "questions": [ { "id": "sign-symptom-observation-phenotype-complication-comorbidity-and-sequela-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish sign, symptom, observation, phenotype, complication, comorbidity and sequela?", "kind": "relationship", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "sign-symptom-observation-phenotype-complication-comorbidity-and-sequela-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify sign, symptom, observation, phenotype, complication, comorbidity and sequela?", "kind": "state", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "sign-symptom-observation-phenotype-complication-comorbidity-and-sequela-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect sign, symptom, observation, phenotype, complication, comorbidity and sequela?", "kind": "process", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "sign-symptom-observation-phenotype-complication-comorbidity-and-sequela-data", "name": "Sign, symptom, observation, phenotype, complication, comorbidity and sequela data", "description": "Typed condition values and external references required to answer the governed questions for sign, symptom, observation, phenotype, complication, comorbidity and sequela.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-015", "SRC-016" ] } ], "artifacts": [ { "id": "sign-symptom-observation-phenotype-complication-comorbidity-and-sequela-artifact", "name": "Sign, symptom, observation, phenotype, complication, comorbidity and sequela evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting sign, symptom, observation, phenotype, complication, comorbidity and sequela.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-015", "SRC-016" ] } ], "inline_only_rationale": null }, { "id": "encounter-care-plan-intervention-medication-procedure-outcome-and-decision", "name": "Encounter, care plan, intervention, medication, procedure, outcome and decision", "description": "Records encounter, care plan, intervention, medication, procedure, outcome and decision as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-015", "SRC-016" ], "questions": [ { "id": "encounter-care-plan-intervention-medication-procedure-outcome-and-decision-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish encounter, care plan, intervention, medication, procedure, outcome and decision?", "kind": "relationship", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "encounter-care-plan-intervention-medication-procedure-outcome-and-decision-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify encounter, care plan, intervention, medication, procedure, outcome and decision?", "kind": "lifecycle", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "encounter-care-plan-intervention-medication-procedure-outcome-and-decision-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect encounter, care plan, intervention, medication, procedure, outcome and decision?", "kind": "event", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "encounter-care-plan-intervention-medication-procedure-outcome-and-decision-data", "name": "Encounter, care plan, intervention, medication, procedure, outcome and decision data", "description": "Typed condition values and external references required to answer the governed questions for encounter, care plan, intervention, medication, procedure, outcome and decision.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-015", "SRC-016" ] } ], "artifacts": [ { "id": "encounter-care-plan-intervention-medication-procedure-outcome-and-decision-artifact", "name": "Encounter, care plan, intervention, medication, procedure, outcome and decision evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting encounter, care plan, intervention, medication, procedure, outcome and decision.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-005", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-015", "SRC-016" ] } ], "inline_only_rationale": null } ] }, { "id": "provenance-lifecycle-access-quality-and-interoperability", "name": "Provenance, lifecycle, access, quality and interoperability", "description": "Groups Resource Consumption context for provenance, lifecycle, access, quality and interoperability without importing neighboring master lifecycles.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-005", "SRC-006", "SRC-007", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-012", "SRC-013", "SRC-014", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-019", "SRC-020", "SRC-021", "SRC-022", "SRC-023", "SRC-024" ], "findings": [ { "id": "asserter-recorder-source-method-review-correction-merge-split-and-audit", "name": "Asserter, recorder, source, method, review, correction, merge, split and audit", "description": "Records asserter, recorder, source, method, review, correction, merge, split and audit as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-005", "SRC-006", "SRC-007", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-012", "SRC-013", "SRC-014", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-019", "SRC-020", "SRC-021", "SRC-022", "SRC-023", "SRC-024" ], "questions": [ { "id": "asserter-recorder-source-method-review-correction-merge-split-and-audit-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish asserter, recorder, source, method, review, correction, merge, split and audit?", "kind": "provenance", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "asserter-recorder-source-method-review-correction-merge-split-and-audit-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify asserter, recorder, source, method, review, correction, merge, split and audit?", "kind": "temporal", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "asserter-recorder-source-method-review-correction-merge-split-and-audit-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect asserter, recorder, source, method, review, correction, merge, split and audit?", "kind": "measurement", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "asserter-recorder-source-method-review-correction-merge-split-and-audit-data", "name": "Asserter, recorder, source, method, review, correction, merge, split and audit data", "description": "Typed condition values and external references required to answer the governed questions for asserter, recorder, source, method, review, correction, merge, split and audit.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-005", "SRC-006", "SRC-007", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-012", "SRC-013", "SRC-014", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-019", "SRC-020", "SRC-021", "SRC-022", "SRC-023", "SRC-024" ] } ], "artifacts": [ { "id": "asserter-recorder-source-method-review-correction-merge-split-and-audit-artifact", "name": "Asserter, recorder, source, method, review, correction, merge, split and audit evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting asserter, recorder, source, method, review, correction, merge, split and audit.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-005", "SRC-006", "SRC-007", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-012", "SRC-013", "SRC-014", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-019", "SRC-020", "SRC-021", "SRC-022", "SRC-023", "SRC-024" ] } ], "inline_only_rationale": null }, { "id": "sensitivity-consent-purpose-retention-quality-and-standards-projection", "name": "Sensitivity, consent, purpose, retention, quality and standards projection", "description": "Records sensitivity, consent, purpose, retention, quality and standards projection as a source-qualified Disease / Biological Condition assertion while terminology, observations, specimens, encounters, care plans and decisions retain external mastership.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-005", "SRC-006", "SRC-007", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-012", "SRC-013", "SRC-014", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-019", "SRC-020", "SRC-021", "SRC-022", "SRC-023", "SRC-024" ], "questions": [ { "id": "sensitivity-consent-purpose-retention-quality-and-standards-projection-q01", "text": "Which condition identity, subject, disease concept, classification release and direct biological properties establish sensitivity, consent, purpose, retention, quality and standards projection?", "kind": "privacy", "answer_data": [ "condition occurrence identifier, subject kind and authoritative master system", "disease concept, terminology URI, code, version, definition, profile and category", "pathological class, body site, morphology, mechanism, course and explicit unknowns" ] }, { "id": "sensitivity-consent-purpose-retention-quality-and-standards-projection-q02", "text": "Which status, clocks, evidence, method, actor and clinical context qualify sensitivity, consent, purpose, retention, quality and standards projection?", "kind": "spatial", "answer_data": [ "clinical, verification and record status kept as separate coded assertions", "onset, manifestation, recognition, diagnosis, recording, effective, remission and resolution clocks", "observations, tests, criteria, phenotype, source, method, asserter, reviewer and confidence" ] }, { "id": "sensitivity-consent-purpose-retention-quality-and-standards-projection-q03", "text": "Which relationships, lifecycle changes, access controls, quality checks and interoperability losses affect sensitivity, consent, purpose, retention, quality and standards projection?", "kind": "evidence", "answer_data": [ "cause, risk, manifestation, complication, comorbidity, care, prognosis and outcome references", "correction, duplicate, merge, split, recurrence, relapse, supersession and immutable predecessors", "purpose, consent, sensitivity, retention, audit, source and target profiles and semantic-loss report" ] } ], "data_elements": [ { "id": "sensitivity-consent-purpose-retention-quality-and-standards-projection-data", "name": "Sensitivity, consent, purpose, retention, quality and standards projection data", "description": "Typed condition values and external references required to answer the governed questions for sensitivity, consent, purpose, retention, quality and standards projection.", "value_kind": "object", "cardinality": "1", "required": true, "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-005", "SRC-006", "SRC-007", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-012", "SRC-013", "SRC-014", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-019", "SRC-020", "SRC-021", "SRC-022", "SRC-023", "SRC-024" ] } ], "artifacts": [ { "id": "sensitivity-consent-purpose-retention-quality-and-standards-projection-artifact", "name": "Sensitivity, consent, purpose, retention, quality and standards projection evidence manifest", "description": "Digest-addressed manifest of identity, terminology, status, time, evidence, relationships, governance and provenance supporting sensitivity, consent, purpose, retention, quality and standards projection.", "media_or_form": [ "application/json", "application/ld+json", "application/yaml", "text/markdown", "external reference" ], "serial": true, "identity_strategy": "Authoritative condition or source-record identifier first, then terminology-qualified assertion identifier, then Dimension UUID or ULID; never use patient name, disease label or timestamp alone.", "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-005", "SRC-006", "SRC-007", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-012", "SRC-013", "SRC-014", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-019", "SRC-020", "SRC-021", "SRC-022", "SRC-023", "SRC-024" ] } ], "inline_only_rationale": null } ] } ] } ] }, "functions": [ { "id": "register-condition-occurrence", "name": "Register condition occurrence", "description": "Create stable occurrence identity for one condition concerning one organism while preserving source record links.", "inputs": [ "subject reference", "condition proposal", "master authority" ], "outputs": [ "condition identifier", "initial revision" ], "preconditions": [ "active Dimension", "subject resolvable" ], "effects": [ "unknowns are explicit and no diagnosis or observation is fabricated" ], "source_refs": [ "SRC-006", "SRC-008", "SRC-011", "SRC-020" ] }, { "id": "bind-disease-concept", "name": "Bind disease concept", "description": "Attach a release-pinned disease concept without making the terminology entry the occurrence identity.", "inputs": [ "condition revision", "terminology concept", "mapping evidence" ], "outputs": [ "qualified concept binding" ], "preconditions": [ "terminology and release resolvable" ], "effects": [ "source code and concept history remain intact" ], "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-012", "SRC-013", "SRC-014" ] }, { "id": "assert-diagnosis", "name": "Assert diagnosis or hypothesis", "description": "Append a source-qualified diagnostic assertion with independent verification status and evidence.", "inputs": [ "condition reference", "assertion", "evidence references" ], "outputs": [ "diagnostic assertion" ], "preconditions": [ "actor and method attributable" ], "effects": [ "condition occurrence and assertion identities remain distinct" ], "source_refs": [ "SRC-008", "SRC-009", "SRC-010", "SRC-016", "SRC-018" ] }, { "id": "record-independent-status", "name": "Record independent status", "description": "Record clinical activity, verification and record state as separate controlled assertions.", "inputs": [ "condition revision", "status kind", "status value" ], "outputs": [ "status assertion" ], "preconditions": [ "status vocabulary pinned" ], "effects": [ "no status is inferred from another status axis" ], "source_refs": [ "SRC-008", "SRC-011", "SRC-016" ] }, { "id": "record-course-stage-severity", "name": "Record course, stage and severity", "description": "Append time-bound course, stage, grade, severity and extent assessments with method and scale.", "inputs": [ "condition revision", "assessment", "effective time" ], "outputs": [ "qualified assessment" ], "preconditions": [ "method and scale identified" ], "effects": [ "prior assessments remain immutable and comparable" ], "source_refs": [ "SRC-004", "SRC-007", "SRC-008", "SRC-009" ] }, { "id": "link-cause-risk-evidence", "name": "Link cause, risk and evidence", "description": "Add typed causal, risk, susceptibility and evidentiary relationships without promoting association to causation.", "inputs": [ "condition revision", "related subject", "relationship assertion" ], "outputs": [ "qualified relationship" ], "preconditions": [ "source and confidence present" ], "effects": [ "external master and competing assertions remain resolvable" ], "source_refs": [ "SRC-006", "SRC-007", "SRC-012", "SRC-017", "SRC-018" ] }, { "id": "link-manifestations-and-impact", "name": "Link manifestations and impact", "description": "Reference signs, symptoms, observations, phenotypes, complications and functioning effects.", "inputs": [ "condition revision", "external observations", "impact assessment" ], "outputs": [ "typed manifestation and impact links" ], "preconditions": [ "external identities resolvable" ], "effects": [ "phenotype and functioning are not collapsed into disease identity" ], "source_refs": [ "SRC-005", "SRC-010", "SRC-015" ] }, { "id": "reconcile-differential-and-duplicate", "name": "Reconcile differential and duplicate", "description": "Compare competing diagnoses and duplicate records while preserving every original assertion and decision basis.", "inputs": [ "candidate records", "matching evidence", "review authority" ], "outputs": [ "reconciliation decision", "successor links" ], "preconditions": [ "conflicts visible", "authority valid" ], "effects": [ "no last-write-wins merge or silent exclusion occurs" ], "source_refs": [ "SRC-008", "SRC-009", "SRC-011", "SRC-018", "SRC-020" ] }, { "id": "govern-condition-lifecycle", "name": "Govern condition lifecycle", "description": "Append correction, recurrence, relapse, remission, resolution, split, merge or supersession events.", "inputs": [ "condition revision", "transition", "reason" ], "outputs": [ "lifecycle assertion", "migration map" ], "preconditions": [ "clinical and data authority present" ], "effects": [ "predecessors, evidence and external links remain resolvable" ], "source_refs": [ "SRC-008", "SRC-011", "SRC-020", "SRC-023" ] }, { "id": "project-authorized-view", "name": "Project authorized view", "description": "Produce a minimum-necessary standards projection with purpose, access and semantic-loss controls.", "inputs": [ "condition revision", "recipient purpose", "target profile" ], "outputs": [ "authorized projection", "conformance and loss report" ], "preconditions": [ "access granted", "target release pinned" ], "effects": [ "disclosure is audited and canonical identity is preserved" ], "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-005", "SRC-006", "SRC-007", "SRC-008", "SRC-009", "SRC-010", "SRC-011", "SRC-012", "SRC-013", "SRC-014", "SRC-015", "SRC-016", "SRC-017", "SRC-018", "SRC-019", "SRC-020", "SRC-021", "SRC-022", "SRC-023", "SRC-024" ] } ], "composition": [ { "target": "WM-LIV-002 Organism Individual", "relation": "REFERENCE", "purpose": "Resolve the registered organism subject without importing its identity or lifecycle.", "required": true, "source_refs": [ "SRC-006", "SRC-008", "SRC-011", "SRC-016" ] }, { "target": "WM-ACT-049 Care Plan / Episode", "relation": "REFERENCE", "purpose": "Resolve care context, goals and interventions while condition and care-plan mastership remain separate.", "required": false, "source_refs": [ "SRC-008", "SRC-009", "SRC-011" ] }, { "target": "Specimen, observation, test, phenotype, evidence, intervention, outcome and decision masters", "relation": "REFERENCE", "purpose": "Resolve diagnostic and care context without importing neighboring lifecycles.", "required": false, "source_refs": [ "SRC-009", "SRC-010", "SRC-015", "SRC-016", "SRC-017" ] }, { "target": "WHO ICD-11 2026 release and ICF", "relation": "ALIGN", "purpose": "Project disease classification, coding and functioning context with exact releases and explicit scope.", "required": false, "source_refs": [ "SRC-001", "SRC-002", "SRC-003", "SRC-004", "SRC-005" ] }, { "target": "SNOMED CT clinical finding and disorder model", "relation": "ALIGN", "purpose": "Project disorder, finding site, morphology, cause, severity, course and occurrence attributes under licensed release pins.", "required": false, "source_refs": [ "SRC-006", "SRC-007" ] }, { "target": "HL7 FHIR R5 Condition, ClinicalImpression and Observation", "relation": "ALIGN", "purpose": "Project clinical exchange views while preserving resource maturity, status axes and diagnostic boundaries.", "required": false, "source_refs": [ "SRC-008", "SRC-009", "SRC-010" ] }, { "target": "OMOP CDM 5.4 ConditionOccurrence and ConditionEra", "relation": "ALIGN", "purpose": "Project observational analytics records and era derivation without treating analytics rules as biological truth.", "required": false, "source_refs": [ "SRC-011" ] }, { "target": "Mondo, Human Disease Ontology, Orphanet and NCI Thesaurus", "relation": "ALIGN", "purpose": "Project disease concepts, definitions, mappings, rare-disease and cancer terminology with exact releases.", "required": false, "source_refs": [ "SRC-012", "SRC-013", "SRC-014", "SRC-019" ] }, { "target": "Human Phenotype Ontology and GA4GH Phenopacket Schema", "relation": "ALIGN", "purpose": "Project phenotypic evidence and disease diagnoses while keeping observed features distinct.", "required": false, "source_refs": [ "SRC-015", "SRC-016" ] }, { "target": "ClinGen Gene-Disease Validity and CDC surveillance case definitions", "relation": "ALIGN", "purpose": "Project evidence-based relationship strength and jurisdictional case classification as separate assertions.", "required": false, "source_refs": [ "SRC-017", "SRC-018" ] }, { "target": "W3C PROV-O, DQV and ODRL 2.2", "relation": "ALIGN", "purpose": "Project derivation, quality, rights and access constraints.", "required": false, "source_refs": [ "SRC-020", "SRC-021", "SRC-022" ] }, { "target": "RFC 3339 and RFC 8785", "relation": "ALIGN", "purpose": "Project unambiguous clocks and deterministic JSON serialization.", "required": false, "source_refs": [ "SRC-023", "SRC-024" ] } ], "serviceLayers": { "dimension": { "owner_package_requirements": [ "Declare Dimension owner, condition and organism masters, terminology stewards, diagnostic authorities, data stewards, access approvers and auditors.", "Register disease concept, status, course, severity, stage, evidence, consent, access, retention and projection profiles.", "Register organism, person, specimen, encounter, care plan, observation, intervention, outcome, evidence and decision masters separately.", "Pin species, care, public-health, jurisdictional, privacy and exchange profiles." ], "namespace_guidance": "Mint only Dimension-owned condition occurrences, assertions, reconciliations, projections and lifecycle events locally; preserve organism, person, source-record, terminology, specimen, encounter, observation and care identifiers as typed external references.", "registry_links": [ "https://ver.cy/models/", "https://ver.cy/model-agent-protocol.md", "Dimension-local organism, condition, terminology, evidence, consent, access, retention and provenance registries" ] }, "canon_and_patch": { "canonicalization_rules": [ "Canonicalize by registry ID, model version, condition occurrence identifier, subject identity, disease concept plus terminology release, occurrence discriminator and immutable assertion identity; never by person name, disease label, timestamp or file hash alone.", "Keep disease concept, biological condition occurrence, diagnosis, observation, phenotype, specimen, encounter, care plan, intervention, prognosis, outcome and decision distinct." ], "patch_rules": [ "Additive extensions declare target node, species or clinical profile, authority, source, method, terminology release, access, effective time and interoperability impact.", "Breaking occurrence, terminology, status, clock or relationship changes require a new immutable revision, successor mapping, migration report, compatibility declaration and continued resolution of prior identifiers." ], "compatibility_rules": [ "Consumers may ignore unknown additive fields only when condition identity, subject, concept binding, status axes, clocks and external-master boundaries remain intact.", "ICD, SNOMED CT, FHIR, OMOP, Mondo, Disease Ontology, Orphanet, HPO and Phenopacket mappings pin source and target releases and declare transformed, inferred, omitted or non-round-trippable values." ] }, "artifact_rules": { "identity_priority": [ "Authoritative master-system identifier for the condition occurrence or source clinical record.", "Terminology-qualified immutable identifier for a diagnostic, status, evidence or lifecycle assertion.", "Adopting-Dimension UUID or ULID when no authoritative external identifier exists." ], "timestamp_rule": "Record event timestamps in RFC 3339 with seconds and an explicit numeric offset or Z; keep onset, manifestation, recognition, diagnosis, recording, effective, remission, relapse, recurrence, resolution, correction and ingestion times distinct.", "serial_naming_rule": "Name serial artifacts as {condition-id}--{artifact-kind}--{revision-or-assertion-id}; never use person name, disease label, date, filename or digest alone as identity.", "integrity_rule": "Store digest, media type, byte length, issuer, condition and subject identity, terminology and rules versions, method, clocks, provenance, validation, sensitivity, consent, purpose, access marking and semantic-loss declaration." }, "policies": [ "The adopting Dimension declares who may register conditions, bind terminology, diagnose, verify, assess severity or stage, reconcile, approve, disclose, retain, correct and tombstone records.", "Every usable condition requires stable occurrence identity, subject reference, condition concept or explicit unknown, status axes, temporal precision, provenance and source-qualified evidence appropriate to its profile.", "Agents never infer a diagnosis from one observation, causation from association, cure from remission, recurrence from duplication, disease from susceptibility or outcome from prognosis.", "Organisms, people, specimens, encounters, care plans, observations, tests, phenotypes, genes, variants, pathogens, interventions, outcomes, classifications, evidence and decisions remain external masters.", "Agents may validate structure, terminology releases and deterministic projections under delegation; diagnosis, access grants, record merge, protected disclosure and irreversible removal require accountable authority." ], "crud": { "read": [ "Resolve active Dimension, purpose, role, subject, condition identity, terminology release, clinical and verification status, effective time, consent, sensitivity, assurance and access; return the minimum necessary projection." ], "create": [ "Create a stable occurrence identity, subject reference, master authority, condition concept or explicit unknown, provenance and initial independent statuses before clinical detail is added." ], "update": [ "Append an immutable terminology, status, time, severity, stage, evidence, relationship, reconciliation, lifecycle or correction assertion with actor, authority, reason, source, method, RFC 3339 effective time and predecessor." ], "delete": [ "Apply clinical safety, consent, legal, audit, retention and hold rules; tombstone eligible Dimension-owned assertions while preserving material provenance, record continuity and non-cascading external masters." ] }, "roles": [ { "name": "Dimension owner", "responsibilities": [ "Own namespace, mastership, delegation, access, retention and federation rules." ] }, { "name": "Condition registry steward", "responsibilities": [ "Own occurrence identity, deduplication, lifecycle, quality and terminology bindings." ] }, { "name": "Terminology authority or curator", "responsibilities": [ "Own concept systems, releases, definitions, mappings and classification profiles." ] }, { "name": "Clinical or biological asserter", "responsibilities": [ "Own diagnosis, clinical status, severity, stage, course and evidence assertions within delegated scope." ] }, { "name": "Laboratory or observation steward", "responsibilities": [ "Own specimen, test, observation, phenotype and source evidence outside this model." ] }, { "name": "Care or public-health authority", "responsibilities": [ "Own care-plan, encounter, surveillance, reporting and intervention decisions outside this model." ] }, { "name": "Data steward or access authority", "responsibilities": [ "Own consent, purpose, sensitivity, minimum disclosure, retention and access decisions." ] }, { "name": "Reviewer or auditor", "responsibilities": [ "Review identity, evidence, conflicts, lifecycle, quality and disclosure without rewriting originals." ] } ], "access": { "default_rule": "Deny protected health information and mutation unless active Dimension, role, purpose, consent or lawful basis, jurisdiction, sensitivity and field policy grant the action; expose the minimum necessary projection.", "scopes": [ "bundle", "layer", "finding", "artifact" ], "exceptions": [ "Emergency, public-health or legally compelled access must be grounded, time-limited, purpose-bound, attributable, independently reviewed and unable to erase immutable provenance or legal-hold evidence." ], "audit_requirements": [ "Log actor, role, purpose, condition and subject identity, action, decision, policy and terminology versions, RFC 3339 timestamp with offset, affected fields, recipient, source evidence and outcome for privileged mutation or disclosure." ] }, "agents_bootstrap": { "filename": "AGENTS.md", "required_fields": [ "Name", "Type", "Specification URL", "Storage type URL", "Interface URL", "Processes URL" ], "read_order": [ "Read the nearest Dimension-owner AGENTS.md, active organism and condition masters, terminology, clinical or public-health profile, consent, access, retention and jurisdiction rules.", "Read this model AGENTS.md, pinned spec.yaml and required observation, evidence, care, policy and decision instructions before mutation." ] } }, "coverage": { "claim": "WM-LIV-021 covers one governed disease or biological-condition occurrence, terminology bindings, direct pathological properties, independent statuses, course clocks, severity, stage, etiology, evidence, differential, related conditions, provenance, access, retention and loss-aware interoperability. Disease-specific, species, clinical, public-health, jurisdictional and independent-review questions remain deferred.", "confidence": "medium", "checklist": [ { "dimension": "identity", "status": "covered", "notes": "Disease concepts, biological condition occurrences, diagnoses, source records, evidence and lifecycle assertions remain distinct." }, { "dimension": "classification and definition", "status": "covered", "notes": "Disease, disorder, syndrome, injury, infection, anomaly and finding profiles bind exact terminology releases." }, { "dimension": "direct properties", "status": "covered", "notes": "Pathological process, body site, laterality, morphology, mechanism, extent, persistence, reversibility and distinguishing features are explicit." }, { "dimension": "recognition and observation", "status": "covered", "notes": "Recognition uses diagnostic criteria, observations, tests, phenotypes, methods, thresholds and competing explanations rather than labels alone." }, { "dimension": "capabilities and possible actions", "status": "covered", "notes": "Observe, diagnose, monitor, classify, treat, control and prevent are qualified affordances, not unscoped automated authority." }, { "dimension": "lifecycle", "status": "covered", "notes": "Onset, active course, remission, relapse, recurrence, resolution, correction, merge, split and supersession preserve predecessors." }, { "dimension": "relationships", "status": "covered", "notes": "Cause, risk, manifestation, complication, comorbidity, sequela, care, prognosis and outcome links are typed and source-qualified." }, { "dimension": "temporal", "status": "covered", "notes": "Onset, manifestation, recognition, diagnosis, recording, effective, remission, relapse, recurrence and resolution clocks remain distinct." }, { "dimension": "spatial", "status": "covered", "notes": "Body site, laterality, distribution and extent are represented while full anatomy and geometry remain external." }, { "dimension": "provenance", "status": "covered", "notes": "Sources, asserters, methods, criteria, evidence, reviews, derivations, corrections and projections are attributable." }, { "dimension": "ownership", "status": "covered", "notes": "Condition registry, terminology, clinical assertion, observation, care, public health, access and audit authorities are not conflated." }, { "dimension": "validation", "status": "covered", "notes": "Identity, terminology version, status consistency, time ordering, evidence sufficiency, duplicate, conflict and projection checks are explicit." }, { "dimension": "access", "status": "covered", "notes": "Consent or lawful basis, purpose, role, jurisdiction, sensitivity, minimum projection and audit are represented." }, { "dimension": "retention and deletion", "status": "covered", "notes": "Clinical safety, correction, supersession, legal hold, record continuity and tombstones are non-cascading." }, { "dimension": "interoperability", "status": "covered", "notes": "ICD, SNOMED CT, FHIR, OMOP, Mondo, DO, Orphanet, HPO and Phenopacket projections pin releases and disclose loss." } ], "known_omissions": [ "Disease-specific diagnostic, staging, severity, treatment, surveillance, species, jurisdictional and safety profiles require expert review.", "Organisms, people, specimens, encounters, care plans, observations, tests, phenotypes, causes, interventions, outcomes, terminologies, evidence and decisions remain neighboring masters.", "Automated diagnosis, prognosis, treatment selection, surveillance reporting and unrestricted protected-health disclosure remain outside scope." ], "conflicts": [ "Disease concept, biological condition occurrence, clinical diagnosis, problem-list entry and public-health surveillance case have different identity and evidence rules.", "Clinical activity, verification confidence, record status, severity, stage and prognosis are independent axes and cannot be collapsed into one status.", "ICD, SNOMED CT, OMOP, FHIR, Mondo, Disease Ontology, Orphanet and phenotype ontologies have different purposes, granularity and release semantics." ], "regional_assumptions": [ "Human clinical terminology does not govern every species, research use, public-health regime or jurisdiction.", "FHIR Condition and ClinicalImpression are Trial Use and living terminologies require exact maturity and release pins.", "Diagnosis, notification, consent, privacy, retention, access and reporting duties vary by jurisdiction and organizational policy." ], "adversarial_checks": [ "Reject a condition without stable occurrence identity, subject reference, concept or explicit unknown, master authority and provenance.", "Reject disease label, code, person name, timestamp or problem-list row as universal condition identity.", "Reject one observation, phenotype, gene, variant, pathogen, risk factor or surveillance criterion as proof of diagnosis without a declared rule and evidence.", "Reject clinical status inferred from verification status, remission equated with cure, recurrence equated with duplicate, or prognosis represented as outcome.", "Reject association promoted to causation or susceptibility represented as an existing disease.", "Reject correction, merge, split, exclusion or deletion that erases prior assertions, evidence, uncertainty or external references.", "Reject protected condition detail disclosed without role, purpose, lawful basis or consent, minimum-necessary scope, retention and audit." ] }, "researchAdjudication": { "providerMode": "single-provider-waiver", "activeProviders": [ "codex" ], "waivedProviders": [ "claude", "grok" ], "providerPolicy": { "contract_version": "1.0.0", "mode": "single-provider-waiver", "effective_at": "2026-09-06T00:00:00Z", "scope": "Canonical single-stream subject-model research after the six-workstream consolidation", "active_providers": [ "codex" ], "waived_providers": [ { "provider": "claude", "authorized_by": "repository owner", "authorized_at": "2026-09-06T00:00:00Z", "reason": "Claude produced no result on prior 1800-second and 900-second attempts and again timed out on bounded 600-second Sonnet and 300-second Haiku passes. The owner prioritized completion over provider availability." }, { "provider": "grok", "authorized_by": "repository owner", "authorized_at": "2026-09-06T00:00:00Z", "reason": "The repository owner authorized completion without Grok when Grok is unavailable, slow or schema-invalid. Grok may still be attempted as a bounded supplemental reviewer, but its failure never blocks a valid Claude plus no-tools result." } ], "review_rule": "Codex may complete source-grounded fallback research after bounded Claude and Grok attempts fail. It requires a separate no-tools adversarial audit and remains reviewable-draft with a visible absence-of-external-review hold.", "supplemental_provider_attempts": [ { "provider": "claude", "required": false, "maximum_attempts": 1, "failure_policy": "record-and-continue", "admission_rule": "Use only a locally schema-valid result whose sources and boundaries survive adjudication." }, { "provider": "grok", "required": false, "maximum_attempts": 1, "failure_policy": "record-and-continue", "admission_rule": "Use only a locally schema-valid result whose sources and boundaries survive adjudication." } ] }, "boundaryDecision": { "entry_kind": "aggregate", "status": "reclassified", "rationale": "The registry-plane value standalone-mm does not identify the subject kind. One condition occurrence aggregates independently sourced terminology, status, temporal, severity, evidence and relationship assertions while retaining the organism and clinical records as external masters." }, "decisions": [ { "concept": "Condition occurrence boundary", "disposition": "accepted-as-governed-aggregate", "rationale": "One root identifies a condition occurrence concerning one organism; terminology concepts, diagnoses, observations, care records and outcomes retain separate identities." }, { "concept": "WM-LIV-002 parent signal", "disposition": "accepted-as-required-subject-reference", "rationale": "The organism individual is the subject but its biological identity and lifecycle are not imported into the condition model." }, { "concept": "WM-ACT-049 incoming care-plan relation", "disposition": "accepted-as-optional-reference", "rationale": "Care plans and episodes can target a condition, but encounters, goals, interventions and outcomes remain independently mastered." }, { "concept": "Disease concept versus occurrence", "disposition": "kept-distinct", "rationale": "ICD, SNOMED CT, Mondo, Disease Ontology, Orphanet and NCI concepts classify or define a category and do not identify the condition affecting one organism." }, { "concept": "Diagnosis versus condition", "disposition": "kept-distinct", "rationale": "A diagnosis is an attributable and revisable epistemic assertion with verification status, criteria, evidence and uncertainty." }, { "concept": "Independent status axes", "disposition": "accepted", "rationale": "Clinical activity, verification confidence and record lifecycle remain separate; no axis is inferred from another." }, { "concept": "Temporal course", "disposition": "accepted-with-distinct-clocks", "rationale": "Onset, manifestation, recognition, diagnosis, recording, remission, relapse, recurrence, abatement and resolution are independently qualified events or intervals." }, { "concept": "Etiology, susceptibility and prognosis", "disposition": "accepted-as-qualified-assertions", "rationale": "Association does not establish causation, susceptibility does not establish current disease and prognosis does not establish an outcome." }, { "concept": "Human and non-human scope", "disposition": "accepted-with-explicit-profiles", "rationale": "The root supports any organism, but human clinical, veterinary, plant, wildlife and research profiles must declare their terminology, evidence and governance rules." }, { "concept": "Provider waiver and local no-tools audit", "disposition": "accepted-with-mandatory-hold", "rationale": "One bounded Claude Sonnet attempt and one bounded Grok attempt timed out. Codex separately audits the frozen validated result and comparison without acquiring new facts, so assurance remains reviewable-draft." } ], "publicationHolds": [ "Absence-of-external-review hold: the bounded Claude Sonnet and Grok attempts timed out before producing admissible results; no external result was admitted.", "Boundary hold: organisms, people, specimens, encounters, care plans, observations, tests, phenotypes, genes, variants, pathogens, interventions, outcomes, terminologies, evidence documents and decisions remain external masters.", "Identity hold: every condition occurrence requires stable subject and occurrence identities; disease labels, terminology codes, timestamps and problem-list rows are not universal occurrence identity.", "Terminology hold: ICD, SNOMED CT, Mondo, Disease Ontology, Orphanet, NCI Thesaurus and local classifications require exact release, language, profile, license and mapping pins.", "Clinical hold: no diagnosis, cause, severity, stage, cure, prognosis, treatment or public-health status is approved without source-qualified authority, method and evidence.", "Profile hold: human, veterinary, plant, wildlife, rare-disease, cancer, genetic, infectious, injury, mental-health and public-health profiles require specialist review.", "Maturity hold: FHIR R5 Condition and ClinicalImpression are Trial Use; production mappings must pin exact resources, versions and conformance profiles.", "Privacy hold: consent or lawful basis, purpose, jurisdiction, minimum-necessary disclosure, security, retention and audit must be bound before protected-health use.", "Interoperability hold: source and target releases, mapping direction, transformation, inference, omissions and round-trip loss must be declared for every standards projection.", "Completeness hold: the 24-source draft is broad but does not claim universal disease, species, diagnostic, clinical, public-health, legal or operational coverage.", "Independent external review was explicitly waived by the repository owner; this codex-only result remains a reviewable draft." ], "deferredResearch": [ "Develop disease-family and species-specific diagnostic, staging, severity, course, treatment, surveillance and safety profiles with domain experts.", "Resolve detailed sibling boundaries for organism, specimen, observation, phenotype, encounter, care plan, intervention, outcome, evidence, prediction and decision models.", "Pin production crosswalks to exact ICD, SNOMED CT, FHIR, OMOP, Mondo, Disease Ontology, Orphanet, HPO, Phenopacket and NCI releases and execute conformance suites.", "Obtain independent clinical, biological, veterinary, terminology, epidemiology, privacy, legal, security and records review." ] }, "statistics": { "sources": 24, "bundles": 6, "layers": 12, "findings": 24, "questions": 72, "artifacts": 24, "functions": 10 } }