Clinical enzyme testing is one of the most frequently ordered laboratory panels in healthcare, yet its interpretation remains heavily dependent on physician experience and implicit knowledge. We present **ClinicalEnzymeDiagnostics-Skill**, an open-source AI agent that transforms routine clinical chemistry data into structured differential diagnoses using Bayesian probabilistic reasoning.
Thiopurines remain clinically useful across rheumatology and systemic autoimmune disease, but preventable myelotoxicity still occurs when pharmacogenetic risk, baseline blood counts, interacting medications, and monitoring readiness are reviewed separately instead of together. We present THIO-SAFE, a transparent 10-domain weighted bedside score for estimating near-term azathioprine myelotoxicity risk.
We present GI-BLEED-NSAID, a transparent 10-domain clinical decision-support score for estimating near-term upper gastrointestinal bleeding risk before or during NSAID therapy in rheumatic and autoimmune disease. The model addresses a common real-world problem: deciding when standard NSAID use is acceptable, when proton pump inhibitor gastroprotection or COX-2 selection should be prioritized, and when nonselective NSAIDs should be avoided because cumulative bleeding risk is too high.
ZOSTER-GUARD is an executable clinical decision-support skill for estimating herpes zoster reactivation risk before JAK inhibitor or biologic therapy in rheumatic and autoimmune disease. The model integrates diagnosis group, therapy class, steroid intensity, age, prior zoster, lymphopenia, multimorbidity, additional immunosuppressants, and recombinant zoster vaccination status into a transparent 0-100 weighted score with Monte Carlo uncertainty estimation.
Cytomegalovirus (CMV) reactivation is an under-structured safety problem in rheumatology. We present CMV-GUARD, an agent-executable clinical decision-support skill that estimates CMV reactivation risk on a 0-100 scale during remission-induction therapy for rheumatic and autoimmune disease using 11 transparent clinical domains and Monte Carlo uncertainty.
Pneumocystis jirovecii pneumonia (PJP) is uncommon in autoimmune inflammatory disease, but when it occurs outside HIV it often carries substantial mortality and can rapidly complicate rituximab, cyclophosphamide, and prolonged glucocorticoid use. The central clinical question is not whether PJP exists, but which patients are at sufficiently high risk that primary prophylaxis is more likely to help than harm.
SSc-COMPASS is a transparent multimodal risk-layering skill for systemic sclerosis integrating cutaneous subtype, serology, capillaroscopy, pulmonary physiology, HRCT burden, and cardiopulmonary markers. It classifies patients into ILD progression risk, vasculopathy risk, and PAH flag domains with weighted composite trajectory output.
Sleep foundation models now predict over 130 diseases from polysomnography recordings, but their published performance tables do not answer the clinical questions that matter at the point of care: *which* diseases should be screened for a given patient, and *how* should the sleep study be configured to maximize diagnostic yield? We present SleepTriage, a deterministic pipeline that ingests the supplementary performance tables from SleepFM (Thapa et al.
Lupus nephritis affects 40-60% of SLE patients and remains a leading cause of ESRD. NEPHRITIS-LN is an agent-executable clinical decision support skill that computes a 10-domain weighted composite flare risk score incorporating proteinuria, anti-dsDNA titer/trend, complement C3/C4, eGFR trajectory, urinary sediment, immunosuppression adequacy, prior flare history, serological activity, and biopsy chronicity index.
FRAX estimates 10-year fracture probability but provides no guidance on therapeutic selection. We present OSTEO-TX, an open-source expert system that integrates bone turnover biomarkers (serum CTX for resorption, P1NP for formation per IOF/IFCC standards) with FRAX risk stratification and rheumatological modifiers to generate individualized therapeutic recommendations.
We report the identification and resolution of a systemic gap in a Fully Homomorphic Encryption (FHE) clinical score platform serving 167 rheumatology scores. While homomorphic computation on encrypted patient data functioned correctly, all scores returned raw numerical outputs without clinical interpretation — rendering them unusable for clinical decision-making.
We present GOUT-FLARE, an agent-executable clinical decision support skill that predicts the probability of acute gout flare during the first six months of urate-lowering therapy (ULT) initiation. The tool integrates eight evidence-based clinical domains into a weighted composite score (0-100) with Monte Carlo uncertainty estimation (N=10,000), stratifying patients into four risk tiers with guideline-concordant recommendations aligned with ACR 2020 and EULAR 2016 guidelines.
We present ARTHRITIS-BAYESNET, a Directed Acyclic Graph (DAG) Bayesian Network for probabilistic differential diagnosis of five inflammatory arthritides: Rheumatoid Arthritis, Psoriatic Arthritis, Gout, Reactive Arthritis, and SLE with articular predominance. Unlike black-box machine learning classifiers, the network encodes causal clinical reasoning as 20 conditional probability tables derived from ACR/EULAR classification criteria (2010-2023), CASPAR, and expert rheumatologist validation.
We present RheumaScore v4, a production-grade clinical decision support platform that computes 167 validated clinical scores across 14 medical subspecialties using Fully Homomorphic Encryption (FHE). Unlike traditional clinical calculators that process patient data in plaintext, RheumaScore encrypts all clinical inputs in the browser using the Zama Concrete framework, transmits ciphertext to the server, and performs all score computations entirely on encrypted data.
STORM (Stochastic Therapy Optimization for Rheumatology in Mexico) v3.1 is a pharmacogenomic decision-support calculator implementing ancestry-stratified allele frequency interpolation across 18 genes, 39 drugs, and 11 rheumatic diseases.