Clinical Knowledge Framework — CKF State Simulator
Prototype v0.4 · CKF state creation, visible reasoning commentary, MetaCKF transition review, and problem-led cognitive plugins
Demonstrator only. Synthetic data. This prototype does not provide clinical advice and does not attempt to infer a diagnosis from free text.
1 Evidence
2 Representation
3 Judgement
4 Commit CKF
5 MetaCKF: Past→Present
6 MetaCKF: Present→Future
7 Cognitive support
Gate 1 — Current evidence
Only current factual evidence is shown before the clinician constructs a representation.
Current observations and trajectory
Gate 2 — Clinical representation
Gate 3 — Clinical judgement
Gate 4 — Commit CKF state
This freezes the clinician's initial current judgement before MetaCKF information is revealed. Later changes create a new version rather than overwrite the original.
Describe the clinical difficulty in your own words. The Clinical Concern Router uses that concern together with the current CKF state to suggest a small number of reasoning questions. The clinician chooses which to explore.
Is it time to reconsider the current approach?
Stopping Rule. Examines whether non-response, accumulating discordance, trajectory change or unresolved uncertainty makes continued reliance on the present approach difficult to justify.
Does the current explanation still fit?
Counterfactual Reasoning. Tests the current representation against disconfirming evidence and plausible alternatives.
What has changed enough to matter?
BCCP. Examines whether new evidence has materially altered the knowledge state, uncertainty or likely management consequence.
How has the clinical representation changed over time?
Representation Trajectory. Looks for persistence, updating or reframing across successive CKF states.
Could work context be affecting this judgement?
Burnout/Brownout context. Treats workload, time pressure and cognitive depletion as contextual modifiers, not diagnoses or explanations of error.
CKF states and audit trail
No CKF state committed yet. The first committed state will become the independent current judgement against which MetaCKF operates.