Robert Calloway

62M · SH-10351OFF

Respiratory (COPD moderate) · Retired (lorry driver)

Next consult

Sat 18 Apr, 09:15

Gray zone· p 0.58Steady

Trajectory headline

Spirometry stable but two winter exacerbations inflate forward trajectory. Inhaler technique + vaccination compliance are the levers.

Model priority

Gray zone · pattern emerging

Biggest single change you could makeLifestyle programme → −23% (CRP)

Patient Context Card · AIME

Brief

Trajectory-grounded orientation for today's appointment.

Two winter exacerbations. Annual review is the prevention opportunity.

Trajectory narrative

Robert's FEV1 has been stable at ~55% predicted, but he has had two courses of oral steroids in the last 9 months. Horizon-1 weights exacerbation history heavily; forward trajectory is stable-but-elevated. Inhaler technique review and vaccination status are the interventions with the biggest leverage at his stage.

Active concerns

Two OCS courses in last 9m
Ex-smoker (35 pack-years)
BMI 24.1 (deliberately low — caution)
Has not engaged with pulmonary rehab

Suggested consultation focus

Inhaler technique review in clinic
Offer pulmonary rehab again — barriers?
Check pneumococcal + influenza vaccination status

Supporting record context

Current medications

Spiolto Respimat · Salbutamol PRN

Allergies

NKDA

Smoking

Ex-smoker — stopped 2019

For demonstration purposes. Not a diagnostic tool.

Horizon-1 · Syndrome activation

Latent clinical states

Output of the dynamic hypergraph. Direction = trajectory on that axis.

Respiratory (COPD)

0.62

Cardiometabolic (background)

0.32

For demonstration purposes. Not a diagnostic tool.