Use Clinical Reasoning Prover with your AI.

Validate clinical reasoning

This is NOT a diagnostic capability. it is a reasoning integrity check. You must: (1) detail PATIENT PRESENTATION. chief complaint with timeline, vital signs (BP, HR, RR, SpO2, Temp), HPI (onset, location, duration, character, aggravating/alleviating, radiation, timing, severity), relevant PMH, medications, allergies, social history. Structured, not narrative, (2) construct DIFFERENTIAL DIAGNOSIS. systematically. Use VINDICATE mnemonic (Vascular, Infectious, Neoplastic, Degenerative, Iatrogenic, Congenital, Autoimmune, Traumatic, Endocrine/metabolic) to ensure completeness. Rule out life-threatening "cannot miss" diagnoses FIRST. For chest pain: ACS, aortic dissection, PE, tension pneumothorax, esophageal rupture. before considering GERD, (3) cite EVIDENCE LEVEL. name the specific guideline (AHA 2023 STEMI Guidelines, ACC/AHA Chest Pain Evaluation, USPSTF Grade A Recommendation). Cite evidence class (I, IIa, IIb, III) and level (A, B-R, B-NR, C-LD, C-EO). "Standard of care" without a citation is not evidence-based, (4) analyze PHARMACOKINETICS. for every proposed medication: ADME (absorption route, distribution volume, metabolism pathway including CYP450 isoenzymes, elimination half-life and route). Adjust for renal function (CrCl/eGFR), hepatic function (Child-Pugh), age, weight. Check CYP450 inhibitor/inducer interactions with current medications, (5) assess TRIAGE SEVERITY. use validated, objective scales: ESI (1-5), GCS (3-15), qSOFA (0-3), HEART score, CHADS₂-VASc, Wells criteria. Justify the score with specific findings, (6) check CONTRAINDICATIONS. FDA black box warnings, absolute/relative contraindications, drug-drug interactions, allergies (including cross-reactivity classes), pregnancy category (Category X agents explicitly excluded), (7) propose TREATMENT PLAN. exact medication name (generic), dose, route, frequency, duration. Include monitoring parameters (labs, vitals, clinical signs) and follow-up timeline. "Give antibiotics" is rejected. "Ceftriaxone 1g IV q24h × 5 days, monitor Cr and WBC q48h" is required. If rejected, your clinical analysis has a structural deficiency. fix it before advising. Structured reflection capability for US clinical reasoning (AHA/ACC/FDA/USPSTF guidelines). Forces the agent to build rigorous, evidence-grounded differential diagnoses with pharmacokinetic analysis and actionable treatment plans before reaching any clinical conclusion. Catches Anchoring Bias (locking onto the first diagnosis without ruling out life-threatening differentials), Evidence Vacuum (citing "standard of care" without naming the AHA/ACC guideline or evidence level), Pharmacokinetic Blindness (prescribing without ADME analysis, CYP450 interactions, or renal/hepatic adjustments), Triage Confusion (no objective severity scoring. ESI, GCS, qSOFA. just "seems serious"), and Contraindication Omission (missing FDA black box warnings, cross-reactivities, pregnancy categories). Call once per clinical case analysis