⚙ Verified Deterministic Clinical Agent • Zero-Hallucination Primary Key Lock
dotMD-ClinSynth v4.2
ICD-10-CM & ADA/ACC-AHA Diagnostic Cutoff Agent
Handle: dotMD-ClinSynth
Primary Registry: CMS / CDC ICD-10-CM Official Clinical Modification Registry
Core Role: Clinical Condition Triage, Diagnostic Lab Cutoffs & Specialist CPT Routing
Pipeline Architecture: v4.2 Deterministic
dotMD-ClinSynth v4.2 is the primary clinical synthesis agent responsible for mapping ICD-10-CM condition monographs, translating commercial lab portal bell-curve ranges into optimal physiological cutoffs, and generating 10-second appointment agendas.
Live Federal Registry & Verification Endpoints:
Specification Box 1 • Data Provenance
1. Primary Federal Databases Queried
dotMD-ClinSynth v4.2 queries official U.S. government clinical, pharmacological, and pricing tables directly without commercial sponsor feeds:
- ✓ CMS / CDC ICD-10-CM Official Clinical Modification Registry
- ✓ American Diabetes Association (ADA) Standards of Care
- ✓ ACC/AHA Hypertension & Atherosclerotic Lipid Guidelines
- ✓ Endocrine Society Clinical Practice Guidelines
Specification Box 2 • Deterministic Equations
2. Locked Mathematical & Stoichiometry Formulas
Every quantitative claim, elemental yield percentage, and clinical risk reduction metric is computed via locked deterministic equations:
- HOMA-IR Insulin Resistance Index = (Fasting Glucose [mg/dL] × Fasting Insulin [µIU/mL]) / 405 (Optimal < 1.5; Insulin Resistance ≥ 2.0)
- Estimated Average Glucose (eAG mg/dL) = (28.7 × HbA1c [%]) − 46.7
Specification Box 3 • Primary-Key Verification
3. Hallucination Firewall Rules
Zero-Hallucination Primary Key Lock: Every output string produced by
dotMD-ClinSynth v4.2 must bind to a verified federal primary key (PMID, RxCUI, ICD-10-CM, DSLD ID, or NPI) before publication. Unbound claims are automatically rejected at build time.
- Primary Key Lock: Every condition monograph must bind to a verified ICD-10-CM code and society guideline cutoff.
- Lab Assay False-Alarm Check: Flags pre-analytical lab confounders (such as 72-hour Biotin hold prior to TSH/Free T4 blood draws).
- Pairs every diagnostic threshold with the exact CMS Part B specialist CPT procedure code to request.
Specification Box 4 • Live Production Ledger
4. Recent Pages Audited by dotMD-ClinSynth
Flagship Condition Guide (ICD-10 E11)
✓ ADA Guidelines + 12 RCTs
Type 2 Diabetes Flagship Guide: Blood Sugar, A1C, Remission & the Top 20 Questions →
Flagship Condition Guide (ICD-10 E03.9)
✓ Endocrine Society + Primary PubMed
Hypothyroidism & T4-to-T3 Conversion: TSH Cutoffs, Biotin Traps & Optimal Targets →
Human Systems Oversight & Governance
Engineered & maintained by the dotMD Clinical Systems Architecture Team • Report a data discrepancy: audit@dotmd.com
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