Synthetic patient
The decision
Competing clinical choices
Observed clinical findings
Adjust what is actually observed. The model converts the pattern, uncertainty and trajectory into a latent boundary position; the clinician does not set a boundary score.
Boundary assessment
decision uncertainty
Current leaning
Decision confidence
Uncertainty range
Trajectory
Pair-wise clinical reasoning
| Heuristic question | Current answer from the evidence | Implication |
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What would clarify the decision?
| Rank | Next discriminator | Expected clarification value | Reason |
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1. Current knowledge state
Define the present scientific environment within which the clinical uncertainty model operates. These controls describe knowledge quality, not the patient's condition.
Scientific evidence
Clinical translation
Current epistemic state
Two-cone decision architecture
Knowledge cone
What is currently known, how securely it is known, and how applicable it is to this decision.
K₀plausible knowledge states
TRANSLATIONAssessing alignment
Evidence → guidance → practice
Clinical outcome cone
What may happen to this patient under the competing clinical choices.
X₀future states
2. Introduce new knowledge
The patient is frozen. Change only the knowledge base and observe whether uncertainty is resolved, reduced, created, transformed, or materially unchanged.
New evidence
Describe the evidence. The model infers what it does to the current uncertainty.
Knowledge transformation
Recalculated present decision space
Blue = decision boundary under K₀. Purple = decision boundary after incorporating the new knowledge K₁. Patient findings remain unchanged.
knowledge-dependent boundary
K₀ leaning
K₁ leaning
Boundary movement
Uncertainty transformation
Present Decision State
Evidence–guideline–practice dissonance
Dissonance is displayed separately from scientific uncertainty. Common practice does not become stronger evidence merely because it is common.
| Domain | Present state | Relation to evidence | Decision-space effect |
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