「clinical」の検索結果

NLP on clinical text — de-identification, concept extraction, phenotyping from notes, and LLM safety guardrails.

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Clinical prediction models and risk scores — development, validation, calibration, and bedside use.

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Designing clinical trials — phases, randomization, endpoints, sample size, and CONSORT-compliant reporting.

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Use this skill when configuring Health Cloud referral management: setting up ClinicalServiceRequest-based referrals, provider search, referral status workflows, and network management. NOT for referrals in Financial Services Cloud — use admin/fsc-referral-management. NOT for care team workflow and transition-of-care design — use admin/care-coordination-requirements.

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Configure patient or member records in Salesforce Health Cloud: Person Account enablement, patient record types, care team role configuration, patient card customization, clinical data display. Trigger keywords: patient setup, Health Cloud person account, patient card component, care team roles, clinical data display. NOT for Person Accounts outside Health Cloud - use data/person-accounts. NOT for enrolling a patient into a care program - use admin/care-program-management.

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Clinical Decision Support System (CDSS) development patterns. Drug interaction checking, dose validation, clinical scoring (NEWS2, qSOFA), alert severity classification, and integration into EMR workflows.

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EMR/EHR development patterns for healthcare applications. Clinical safety, encounter workflows, prescription generation, clinical decision support integration, and accessibility-first UI for medical data entry.

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Structures biological experiments so inference is valid by construction, covering Fisher's principles (randomization, replication, local control), the experimental-vs-observational unit distinction and pseudoreplication (Hurlbert 1984; Lazic 2018), randomization mechanics (complete, restricted, stratified, rerandomization, run-order), blocking layouts (randomized complete block, Latin square, incomplete block), factorial designs and interactions, and the split-plot/nested error strata hidden inside multi-batch genomics. Use when deciding the experimental unit and what counts as a replicate, planning randomization and run order, choosing a blocked/factorial/split-plot/nested layout, avoiding pseudoreplication in cell-culture or animal studies, or specifying the random-effects structure of the analysis model. For assigning samples to sequencing batches/lanes/plates and batch-effect correction see experimental-design/batch-design; for regulated clinical-trial randomization see clinical-biostatistics.

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Calculates statistical power for high-dimensional genomics experiments (bulk RNA-seq, scRNA-seq, ATAC-seq, ChIP-seq, methylation, proteomics) under negative-binomial count models using RNASeqPower, PROPER, and simulation via powsimR, distinguishing per-gene from marginal (transcriptome-wide) power, the role of mean expression and dispersion, and the sequencing-depth-versus-replicate tradeoff. Covers simulation as the honest default for overdispersed counts, FDR-aware average power versus single-test power, observed/post-hoc power as an anti-pattern, and the winner's-curse / Type-S / Type-M consequences of underpowering. Use when planning replicate number for a sequencing experiment, deciding whether to add depth or samples, choosing closed-form versus simulation power, estimating power from pilot dispersions, or justifying replication in a grant. For clinical-trial power see clinical-biostatistics/power-and-sample-size; for the inverse sample-size question see experimental-design/sample-size.

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Estimates the minimum biological replicates (or cells/events) for a target power at a target FDR in genomics experiments using ssizeRNA, PROPER, powsimR for scRNA-seq, and pilot-data dispersion estimation from DESeq2/edgeR. Covers the biological-versus-technical replication distinction (technical replicates do not add degrees of freedom for biological inference), replicate-number-versus-sequencing-depth budgeting, scRNA-seq sample-versus-cell allocation under a pseudobulk model, and the critique that "n=3" is a publication convention rather than a power calculation. Use when budgeting a sequencing experiment, writing the sample-size justification in a grant, estimating replicates from pilot data, allocating a fixed budget between samples and depth, or planning scRNA-seq cohort size. For clinical-trial sample size see clinical-biostatistics/power-and-sample-size; for the power-given-n direction see experimental-design/power-analysis.

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Prioritizes rare-disease variants from trio/quad WES/WGS with de novo (DeNovoGear, Triodenovo), compound-heterozygous phasing (WhatsHap), mosaic VAF tiering, phenotype-driven ranking (Exomiser, Phen2Gene, AMELIE), ClinGen gene-disease validity gating, and ACMG SF v3.2 secondary findings reporting. Use when running diagnostic exome / genome pipelines, identifying candidate Mendelian disease genes, screening for incidental findings, or auditing VUS reclassification cycles. The ACMG/AMP classification framework (PVS1 decision tree, Pejaver PP3/BP4 calibration, Tavtigian point system) is in clinical-databases/acmg-classification.

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Annotate copy number variant segments with overlapping genes, dosage-sensitivity scores, cancer driver databases, population frequencies, and clinical-variant content. Covers bedtools/pybedtools interval intersection, AnnotSV comprehensive annotation and ranking, ClinGen haploinsufficiency/triplosensitivity scoring, gnomAD-SV/DGV frequency filtering, COSMIC Cancer Gene Census, and ClinVar overlap. Use when interpreting which genes a CNV affects, distinguishing the driver gene of a focal event from passengers, filtering against population CNVs, separating whole-gene from partial-gene overlap, or preparing CNVs for clinical classification.

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Performs subgroup and heterogeneous treatment effect (HTE) analyses for clinical trials. Covers Mantel-Haenszel pooling, Breslow-Day, interaction tests in regression, RERI for additive interaction, modern data-adaptive HTE methods (STEPP, SIDES, causal forests, X/R-learners), Bayesian shrinkage (Dixon-Simon, MAP, EXNEX), graphical multiplicity (Bretz-Maurer), and credibility frameworks (Sun BMJ, EMA 2019). Use when analyzing treatment effects across patient subgroups for regulatory submissions or precision-medicine claims.

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Prepares statistical reports for clinical trials following CONSORT 2025, SPIRIT 2025, ICH E9(R1) estimands, and FDA 2023 covariate adjustment guidance. Covers Table 1 generation, analysis populations (ITT/FAS/PP/Safety), the 5 ICH E9(R1) intercurrent-event strategies, MMRM under MAR (mmrm), reference-based MI (rbmi J2R/CR/CIR), Permutt tipping-point sensitivity, and Rubin's-rules vs frequentist variance debate. Use when preparing regulatory submissions, defining estimands, or implementing missing-data sensitivity analyses.

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Queries ClinVar for variant pathogenicity classifications, ClinGen VCEP curations, and somatic-vs-germline interpretations via REST API, weekly VCF, or bulk XML. Use when determining clinical significance, triangulating conflicting interpretations, or aggregating evidence against the ACMG/AMP framework with ClinGen SVI specifications.

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Implements missing-data sensitivity analyses for confirmatory clinical trials including MMRM under MAR (with Kenward-Roger correction), reference-based multiple imputation (J2R, CR, CIR, LMCF per Carpenter-Roger 2013), Permutt delta-adjustment / tipping-point analysis, pattern-mixture identifying restrictions (CCMV, NCMV, ACMV), and the Cro vs Bartlett variance debate. Use when handling missing primary or secondary endpoint data in regulatory submissions following NRC 2010 and ICH E9(R1).

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Designs Bayesian clinical trials including Phase I dose-finding (BOIN, CRM, EWOC, mTPI-2), meta-analytic-predictive (MAP) priors with robust mixtures for external data borrowing, EXNEX for basket trials, hierarchical models for safety AE (Berry-Berry), Bayesian platform trials (I-SPY 2, GBM AGILE, REMAP-CAP), and posterior probability stopping rules. Covers FDA Bayesian Devices Guidance (2010), FDA Bayesian Methodology in Drugs Draft (January 2026), BOIN Fit-for-Purpose qualification (December 2021), and Project Optimus dose-optimisation. Use when designing dose-finding studies, platform trials, or sensitivity analyses with informative priors.

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Designs adaptive clinical trials including group-sequential (O'Brien-Fleming, Pocock, Lan-DeMets spending), sample-size re-estimation (blinded Friede-Kieser, unblinded Cui-Hung-Wang, Mehta-Pocock promising zone), seamless Phase 2/3 with treatment-arm selection, population enrichment, and response-adaptive randomisation. Covers FDA 2019 Final Adaptive Designs Guidance, FDA 2022 Master Protocols, and ICH E20 Step 2b/3 draft (June 2025, NOT final). Use when planning interim analyses, sample-size re-estimation, or master/platform-trial designs.

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Implements multiplicity control for confirmatory clinical trials using graphical procedures (Bretz-Maurer-Hommel), gatekeeping (parallel, serial, mixed), Hochberg/Hommel/Holm with PRDS, and the closed-testing principle (Marcus-Peritz-Gabriel; Goeman 2021 admissibility). Covers FDA Multiple Endpoints Final Guidance (October 2022), graphical procedures via R gMCP, primary + key-secondary + subgroup hierarchies, and FWER vs FDR distinction. Use when designing the multiplicity strategy for confirmatory trials with multiple primary or key secondary endpoints.

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This skill recommends educating patients and families about the clinical features of remission in Cushing's syndrome when a patient achieves biochemical remission after treatment. Use when a CS patient has postoperative normal cortisol levels, reports symptom improvement, and requires guidance on long-term expectations and monitoring for recurrence.

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The Endocrine Society guideline recommends against routine hormonal monitoring of glucocorticoid replacement in primary adrenal insufficiency and advises adjusting therapy solely based on clinical response. Use when evaluating glucocorticoid dose adequacy, such as when patients report fatigue, weight loss, hypotension, or signs of Cushingoid over-replacement.

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医学证据等级排序与编排层 skill。当用户请求"证据等级 / GRADE / 证据排序 / 医学证据评估 / evidence grading / quality of evidence / 系统评价排序 / 临床证据排序 / 证据金字塔"时触发。本 skill 不直接调用 NCBI/Europe PMC/ClinicalTrials API,而是编排 6 个底层原子 skill(pubmed-eutils / europepmc-search / clinical-trials-v2 / aact-bulk-trials / bioc-fulltext-fetch / pubtator-entity-search)的召回结果,按 ChatGPT 推荐的证据金字塔(指南 > Meta > RCT > Cohort > Case-Control > Case Report)做 GRADE 自动评级,自动剔除 editorial / letter / comment。优先使用 BioMCP MCP server 做 fan-out(genomoncology/biomcp),无 BioMCP 时走自建 slow-path 兜底。

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Europe PMC RESTful Web Service 多源文献聚合检索原子 skill。一次调用同时召回 PubMed + PMC + AGRICOLA + CABI + 预印本(bioRxiv / medRxiv / ChemRxiv 等)+ 灰色文献,自动按 PMID/PMCID/DOI 三级去重,返回完整元数据(含全文 OA 链接、citations metadata、grants 资助信息)。当任务出现 Europe PMC、多源文献聚合、广召回、RAG 检索、预印本搜索、bioRxiv、medRxiv、全文链接、DOI 检索、跨库去重、灰色文献、资助检索 等触发词时使用。**定位**:广召回 · 多源聚合 · RAG 友好(与 pubmed-eutils 互补——后者做精准官方源、Clinical Queries;本 skill 做"撒网"式广召回)。**不做**:NCBI E-utilities 直检(交给 pubmed-eutils)、临床试验(clinical-trials-v2)、全文 XML 抽取(bioc-fulltext-fetch)、实体识别(pubtator-entity-search)、证据分级(medical-evidence-grading)。

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Europe PMC RESTful Web Service 多源文献聚合检索原子 skill。**使用本 skill 进行医学文献广召回 / RAG 知识库构建 / 跨库聚合 / 预印本扫描 / 全文链接发现**。一次调用同时召回 PubMed (MED) + PMC + AGRICOLA + CABI + 预印本(bioRxiv / medRxiv / ChemRxiv / Research Square)+ NCBI Bookshelf + 专利,自动按 PMID/PMCID/DOI 三级去重,返回完整元数据(全文 OA 链接、citations、grants 资助信息)。**定位:广召回 · 多源 · RAG 友好**(与 pubmed-eutils 互补 — 后者做单源精准官方检索 + Clinical Queries;本 skill 做"撒网"式多源聚合)。触发词:Europe PMC / EuropePMC / 多源文献聚合 / 广召回 / RAG 召回 / RAG 知识库 / 预印本搜索 / preprint search / bioRxiv / medRxiv / ChemRxiv / DOI 检索 / DOI lookup / 全文链接 / full-text links / OA 全文 / PMCID / 灰色文献 / grey literature / 跨库去重 / 资助检索 / grant search / NIH funded / Wellcome funded / citations metadata。**不做**:NCBI E-utilities 直检(→ pubmed-eutils)、临床试验注册(→ clinical-trials-v2)、全文 XML 抽取(→ bioc-fulltext-fetch)、实体识别(→ pubtator-entity-search)、证据分级(→ medical-evidence-grading)、参考文献终态写入(→ evidence-appendix-sync)。

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