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Practice trajectory
-26%
JD
Dr John Dolittle
Ashford Vale Medical Group
Patients/Robert Calloway · SH-10351
← Practice Horizon

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.