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Practice trajectory
-26%
JD
Dr John Dolittle
Ashford Vale Medical Group
Patients/Carlos Hirano · SH-10402
← Practice Horizon

Carlos Hirano

55M · SH-10402APP
MASLD (moderate fibrosis risk) · Civil engineer
Next consult
No scheduled consult
Gray zone· p 0.66Trending worse
Trajectory headline
FIB-4 in the intermediate band with active metabolic drift. GLP-1 eligibility + hepatology referral should be discussed.
Model priority
Gray zone · pattern emerging
Biggest single change you could makeLifestyle programme → −88% (BMI)
Patient Context Card · AIME

Brief

Trajectory-grounded orientation for today's appointment.

FIB-4 intermediate + metabolic drift. Referral decision is today's task.

Trajectory narrative

Carlos's liver blood tests have been drifting for 18 months. A recent FIB-4 sits at 2.1 — intermediate fibrosis risk. Coupled with his worsening metabolic profile, the forward trajectory is toward clinically significant MASLD. The question is whether to refer to hepatology now or attempt structured primary-care management first with GLP-1 eligibility assessment.

Active concerns
  • FIB-4 2.1 (intermediate)
  • ALT 72 · GGT 98
  • Triglycerides 2.9 mmol/L
  • No formal elastography yet
Suggested consultation focus
  • Discuss hepatology referral vs primary-care acceleration
  • Elastography request
  • GLP-1 eligibility assessment
Supporting record context
Current medications
Metformin 1g BD (prediabetes)
Allergies
NKDA
For demonstration purposes. Not a diagnostic tool.
Horizon-1 · Syndrome activation

Latent clinical states

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

Hepatic steatotic (moderate)
0.68
Metabolic (T2DM at risk)
0.60
For demonstration purposes. Not a diagnostic tool.