clinical-reasoning

name	clinical-reasoning
description	Cross-cutting skill for chain-of-thought medical reasoning. Provides structured thinking frameworks for clinical decision-making, differential diagnosis, and treatment planning. Use alongside any medical agent for improved reasoning transparency.

Clinical Reasoning Framework

This skill provides structured reasoning patterns for medical decision-making. All medical agents should use these patterns to ensure transparent, evidence-based analysis.

Chain-of-Thought Pattern

Always structure your reasoning inside <think></think> tags before giving your final answer. This ensures transparency in clinical decision-making.

<think>
[Step-by-step reasoning here]
</think>

[Final answer here]

Reasoning Frameworks

SOAP Format (for patient encounters)

• Subjective: Patient-reported symptoms and history
• Objective: Clinical findings, test results, vital signs
• Assessment: Diagnosis or differential diagnosis
• Plan: Treatment, follow-up, monitoring

Differential Diagnosis

1. List all plausible diagnoses
2. For each, note supporting and opposing evidence
3. Rank by probability
4. Identify "cannot miss" diagnoses (life-threatening conditions)
5. Recommend discriminating tests

Evidence Hierarchy

When citing evidence, note the level:

1. Systematic reviews / meta-analyses
2. Randomized controlled trials
3. Cohort studies
4. Case-control studies
5. Case series / case reports
6. Expert opinion

Transparency Requirements

• Distinguish between established facts and clinical judgment
• Acknowledge uncertainty explicitly
• Note when recommendations are based on limited evidence
• Flag areas where expert consultation is advised

See references/REFERENCE.md for detailed reasoning templates.