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This skill guides clinicians to inform and counsel individuals seeking gender-affirming medical treatment about fertility preservation options before initiating puberty suppression in adolescents or before starting hormonal therapy in adolescents and adults. It is triggered when a patient is eligible for pubertal suppression or sex hormone treatment and is about to begin such therapy.

日本語の概要は準備中です。原文の説明を表示しています。

This skill suggests using real-time continuous glucose monitoring (CGM) rather than no CGM for outpatients with type 2 diabetes (T2D) who take insulin and/or sulfonylureas and are at high risk for hypoglycemia. It is triggered by clinician questions such as "Should I use CGM for this T2D patient on insulin or sulfonylureas with high hypoglycemia risk?" or "Is CGM indicated for this patient?"

日本語の概要は準備中です。原文の説明を表示しています。

Determines if patient meets criteria for genital gender-affirming surgery affecting fertility. Triggers include patient on hormones, considering surgery.

日本語の概要は準備中です。原文の説明を表示しています。

Provides monitoring schedule for transgender females on estrogen therapy, including clinical evaluation, hormone levels, prolactin, electrolytes, BMD, and cancer screening. Triggered when a transgender female is receiving estrogen therapy for gender affirmation.

日本語の概要は準備中です。原文の説明を表示しています。

Suggests initiating inpatient CGM for select diabetic patients at high risk for hypoglycemia based on Table 3 criteria. Triggers include "Should I initiate CGM for this hospitalized diabetic patient at high risk for hypoglycemia?" or "Is inpatient CGM warranted for this patient?"

日本語の概要は準備中です。原文の説明を表示しています。

Determines if adolescent meets criteria for GnRH agonist treatment to suppress pubertal development. Triggers include adolescent requesting to suppress puberty, adolescent with gender dysphoria seeking pubertal blockade, or clinician noting Tanner G2/B2 with request for hormone suppression.

日本語の概要は準備中です。原文の説明を表示しています。

Recommends real-time CGM with confirmatory bedside POC-BG monitoring for insulin dosing adjustments rather than POC-BG testing alone in adults with insulin-treated diabetes at high risk of hypoglycemia. Consider this approach for patients aged ≥65 years, BMI ≤27 kg/m², total daily insulin dose ≥0.6 units/kg, CKD stage ≥3, or recent hypoglycemia.

日本語の概要は準備中です。原文の説明を表示しています。

Recommends using continuous glucose monitoring instead of fingerstick self-monitoring for type 1 diabetes patients on multiple daily injections to reduce hypoglycemia risk. Use when a clinician evaluates glucose monitoring options for T1D on MDIs or manages hypoglycemia-prone T1D patients.

日本語の概要は準備中です。原文の説明を表示しています。

Assesses whether the patient has emergency supplies such as glucagon, ketone strips, and backup insulin readily available. Triggered when clinicians verify the patient carries a glucagon kit or ensure backup insulin and supplies are accessible.

日本語の概要は準備中です。原文の説明を表示しています。

Recommends continuous subcutaneous insulin infusion (CSII) over multiple daily injections (MDI) for adults with type 1 diabetes who have achieved their A1C goal but experience severe hypoglycemia or high glucose variability, provided the patient and caregivers are willing and able to use the device. Consider CSII when clinicians hear 'A1C is at goal but patient has severe lows or glucose swings' or think 'pump for hypoglycemia-prone controlled T1DM'.

日本語の概要は準備中です。原文の説明を表示しています。

This skill directs lifelong treatment of cardiovascular risk factors, osteoporosis, and psychiatric symptoms in all patients with Cushing's syndrome until biochemical resolution of hypercortisolism. Use when managing any CS patient for long‑term comorbidity control; triggers include persistent hypertension, dyslipidemia, low bone density, depression, anxiety, or cognitive changes in the setting of known or suspected CS.

日本語の概要は準備中です。原文の説明を表示しています。

This skill recommends discontinuing glucocorticoid when the response to HPA axis recovery tests (morning cortisol, ACTH stimulation, or insulin-induced hypoglycemia) is normal, indicating adequate adrenal function recovery. Use in postoperative Cushing’s syndrome patients with at least one intact adrenal gland when test results are available.

日本語の概要は準備中です。原文の説明を表示しています。

This skill recommends follow-up morning cortisol and/or ACTH stimulation tests or insulin-induced hypoglycemia to assess HPA axis recovery in postoperative Cushing's syndrome patients with at least one intact adrenal gland. Triggers include postoperative remission (morning cortisol <5 µg/dL or UFC <28–56 nmol/d) and the need to evaluate HPA recovery before glucocorticoid discontinuation.

日本語の概要は準備中です。原文の説明を表示しています。

This skill suggests administering a glucocorticoid antagonist (e.g., mifepristone) in patients with Cushing's disease who have diabetes or glucose intolerance and are not surgical candidates or have persistent disease after transsphenoidal surgery. Consider when encountering persistent hypercortisolism after TSS, contraindications to surgery, or comorbid diabetes/glucose intolerance requiring medical control.

日本語の概要は準備中です。原文の説明を表示しています。

This skill recommends obtaining serum free T4 and prolactin levels within 1–2 weeks after transsphenoidal surgery (TSS) for Cushing's syndrome to screen for overt hypopituitarism. Use in postoperative Cushing's syndrome patients during the early recovery window when evaluating for new pituitary hormone deficiencies.

日本語の概要は準備中です。原文の説明を表示しています。

This skill recommends against initiating treatments aimed at normalizing cortisol or its action when only borderline biochemical abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis are present without specific signs of Cushing's syndrome. Use when encountering borderline urinary free cortisol, late-night salivary cortisol, or dexamethasone suppression test results without classic Cushingoid features; triggers include borderline UFC (1-2× ULN), equivocal late-night salivary cortisol, or nondiagnostic low-dose DST.

日本語の概要は準備中です。原文の説明を表示しています。

This skill recommends using biochemical tests to screen for hypercortisolism to detect recurrence in patients with ACTH-dependent Cushing's syndrome after surgical remission. It is triggered during postoperative follow-up when the HPA axis has recovered, annually, or sooner if clinical signs of hypercortisolism (e.g., weight gain, hypertension, glucose intolerance) or abnormal late-night salivary cortisol/UFC appear.

日本語の概要は準備中です。原文の説明を表示しています。

This skill advises regular visual examination of the mouth to monitor for osteonecrosis of the jaw and other dental issues in patients receiving antiresorptive agents. Trigger phrases include initiating bisphosphonate or denosumab therapy and requesting preventive dental care guidance.

日本語の概要は準備中です。原文の説明を表示しています。

Interprets the aldosterone-to-renin ratio using active renin concentration (ARC) to screen for primary aldosteronism. Triggered when a clinician has PAC and ARC results and asks 'How do I interpret this ARR using active renin concentration?'

日本語の概要は準備中です。原文の説明を表示しています。

Determines successful catheterization in adrenal venous sampling by applying selectivity index cut‑offs with and without ACTH stimulation. Triggered during AVS when measuring cortisol levels and asking “Is the catheter properly positioned?” or when reviewing results for technical adequacy.

日本語の概要は準備中です。原文の説明を表示しています。

Identifies young patients with classic primary aldosteronism features who may proceed directly to unilateral adrenalectomy without adrenal venous sampling based on high probability of unilateral disease. Triggered when a clinician sees a patient <35 years with hypokalemia, unilateral adrenal tumor on CT, and high plasma aldosterone concentration and asks whether AVS can be bypassed.

日本語の概要は準備中です。原文の説明を表示しています。

Determines whether to recommend unilateral laparoscopic adrenalectomy or medical therapy with a mineralocorticoid receptor antagonist for patients with confirmed unilateral PA (aldosterone-producing adenoma or unilateral adrenal hyperplasia). Triggered when discussing treatment options after confirming unilateral PA in a hypertensive patient with hypokalemia or resistant hypertension.

日本語の概要は準備中です。原文の説明を表示しています。

Selects the aldosterone-to-renin ratio (ARR) method over hypokalemia for screening hypertensive patients for primary aldosteronism. Use when a clinician asks what test to use for screening hypertensive patients with resistant hypertension or unexplained hypokalemia for PA.

日本語の概要は準備中です。原文の説明を表示しています。

Recommends correcting serum potassium to the laboratory reference range and repeating aldosterone-to-renin ratio (ARR) screening when the initial screen is negative in a hypertensive patient with hypokalemia. Use when a clinician encounters a negative PA screen in a hypertensive patient with hypokalemia and wonders whether to repeat testing after potassium repletion.

日本語の概要は準備中です。原文の説明を表示しています。