🏥 Clinical AI & Computable Decision Logic

"Sepsis is a life-threatening condition caused by a dysregulated host response to infection.
Clinicians should recognize early signs: fever or hypothermia, tachycardia, tachypnea,
evidence of infection (positive culture, localizing signs). Immediate interventions include:
antibiotics (within 1 hour), IV fluids (30 mL/kg), vasopressors if hypotensive after fluids,
and investigation of infection source. Lactate >2 mmol/L indicates tissue hypoperfusion."
                

# RULE 1: Recognize Early Sepsis (≥2 of these + evidence of infection)
IF (
    (temp < 36 OR temp > 38.3) OR
    (heart_rate > 90) OR
    (respiratory_rate > 20)
) AND
(blood_culture_positive OR
 imaging_shows_infection OR
 localizing_signs_present)
THEN diagnosis = "SEPSIS"

# RULE 2: RED FLAG - Severe Sepsis
IF diagnosis = "SEPSIS" AND (
    (systolic_BP < 90) OR
    (lactate > 2) OR
    (urine_output < 0.5 mL/kg/hr) OR
    (altered_mental_status)
)
THEN severity = "SEVERE"
      recommendation = "🚨 ICU admission required"

# RULE 3: Immediate Interventions
IF diagnosis = "SEPSIS"
THEN
    action1: "Antibiotics WITHIN 1 HOUR"
    action2: "IV fluid bolus: 30 mL/kg"
    action3: "Obtain blood cultures before antibiotics"
    action4: "Investigate infection source (imaging, etc.)"
    action5: "IF severe: add vasopressor (target MAP ≥ 65)"

# RULE 4: Timing is Critical
IF diagnosis = "SEPSIS" AND time_since_onset > 3_hours AND
   no_antibiotics_yet
THEN escalate = TRUE
      notify_physician_urgently = TRUE
      confidence_in_decision = 0.5  # Delayed treatment reduces confidence
                

# STEP 1: Input (Natural Language)
patient_report = """
Child: 18 months old
Symptoms: Fever 101.5F for 2 days, mild cough, no difficulty breathing
Activity: Playful, alert
Prior: No serious illnesses, up-to-date vaccines
                

extracted_facts = {
    'age': '18 months',
    'symptom_fever': True,
    'fever_temp': 101.5,
    'symptom_cough': True,
    'symptom_dyspnea': False,
    'mental_status': 'alert',
    'activity': 'playful',
    'risk_factors': []
}
                

RED_FLAGS = {
    'respiratory_distress': False,
    'lethargy': False,
    'cyanosis': False,
    'severe_dehydration': False,
    'rash': False,
    'seizure': False
}

# ALL RED FLAGS NEGATIVE → No emergency escalation
confidence_in_low_severity = 0.95
                

# Apply clinical guidelines as rules
IF fever AND cough AND no_dyspnea AND alert AND playful
THEN diagnosis_likely = "viral_upper_respiratory"
     severity = "mild"

IF age < 3_years AND fever AND alert
THEN consider = "febrile_seizure_risk"
     recommendation = "educate_parent_on_fever_management"

IF no_red_flags AND mild_illness_presentation
THEN disposition = "home_care"
     safety_plan = "monitor_for_48_hours"
                

# Before outputting decision, verify:
verify_checklist = {
    'all_red_flags_checked': True,
    'age_appropriate_reasoning': True,
    'guideline_applied': True,
    'escalation_criteria_met': False,
    'confidence_high_enough': True  # 0.95 > threshold of 0.70
}

if all(verify_checklist.values()):
    decision_ready = True
else:
    escalate_to_physician = True
                

RECOMMENDATION FOR TONIGHT:
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
✓ Most likely: Viral fever with cough

TONIGHT'S PLAN:
1. Monitor fever (acetaminophen or ibuprofen for comfort)
2. Ensure adequate hydration
3. Watch for respiratory distress (rapid/labored breathing)
4. Keep environment cool (reduce fever risk)

🚨 GO TO ER IMMEDIATELY IF:
• Difficulty breathing
• Difficulty staying awake or unusual behavior
• Purple or blue spots on skin
• Difficulty swallowing or drooling

📋 CALL DOCTOR IF:
• Fever > 104F
• Fever lasts > 5 days
• Appears much worse
• You're very concerned

Confidence: HIGH (0.95)
This recommendation based on: mild symptoms + no red flags + alert behavior
Time-sensitive: No urgency based on current presentation
                

# CRITICAL RED FLAGS - if ANY are present, escalate immediately
CRITICAL_RED_FLAGS = [
    'difficulty_breathing',
    'severe_distress',
    'unresponsiveness_or_severe_lethargy',
    'signs_of_meningitis',  # stiff neck, rash, sensitivity to light
    'seizure',
    'cyanosis',
    'severe_dehydration',
    'altered_mental_status'
]

# IMPORTANT RED FLAGS - warrant urgent evaluation
IMPORTANT_RED_FLAGS = [
    'age < 3_months AND fever',  # Neonates have different threshold
    'fever > 40C (104F)',
    'fever > 7_days_duration',
    'cannot_tolerate_fluids',
    'appears_very_sick'
]

# Implementation:
def assess_fever(patient):
    # CHECK CRITICAL FIRST
    for flag in CRITICAL_RED_FLAGS:
        if patient[flag]:
            return {
                'action': '🚨 GO TO ER IMMEDIATELY',
                'reason': f'RED FLAG DETECTED: {flag}',
                'confidence': 1.0
            }

    # Then check important
    for flag in IMPORTANT_RED_FLAGS:
        if patient[flag]:
            return {
                'action': '📞 CALL DOCTOR NOW',
                'reason': f'IMPORTANT FLAG: {flag}',
                'confidence': 1.0
            }

    # Only after red flags checked, proceed with normal reasoning
    return routine_assessment(patient)