Synthetic data only. Never enter patient information; nothing is sent or stored. For clinicians. Not FDA cleared.For licensed clinicians. Educational demonstration on synthetic data. Never enter real patient identifiers or protected health information: everything runs in your browser and nothing is sent or stored. Clinical decision support only; not FDA cleared; physician review is required.
CPE-002 · synthetic case CPE002-FX-017
HbA1c Potentially Unreliable
HbA1c 6.0% in a patient with a known hemoglobin variant.
Purpose: HbA1c is not used when interference is documented.
Inputs the engine received
Patient
- Age
- 45 years
Context
- Sex for threshold application
- female
- Active medication list available
- Yes
- A1c interference present
- Yes
- A1c interference reason
- hemoglobinopathy
Laboratory
- Hemoglobin a1c
- 6 %
What the engine reports
A documented condition can distort HbA1c. It is not used as the sole basis for glycemic classification.
Detected clinical pattern
Glycemic Category Not Assessable
No interpretable glycemic test was entered, so a glycemic category cannot be assigned.
- Glycemic: Glycemic Category Not Assessable
- Validity: Interpretation limited
- Metabolic syndrome: Metabolic syndrome: incomplete assessment
- IR-associated pattern: IR-associated pattern: not assessable
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Interpret with the listed validity modifiers in mind.a1c reliability limitation present
Missing information
- An interpretable glycemic test (confirmed-fasting glucose, HbA1c without interference, or a protocol-confirmed 2-h OGTT).
- Metabolic syndrome components not entered: Elevated waist circumference; Triglycerides ≥150 mg/dL (or treated); Low HDL-C (men <40, women <50 mg/dL); BP ≥130/85 mmHg (or treated); Fasting glucose ≥100 mg/dL (or treated).
- Fasting insulin (supporting pattern only; fasting and same-collection glucose required).
Evidence and rule trace · 7 rules
A1C-REL-001HbA1c Reliability Limitation
Inputs: a1c interference documented · hemoglobinopathy
A1C_RELIABILITY_LIMITATION_PRESENT
MISS-002Metabolic Syndrome Incomplete Data
Inputs: 0 of 5 components met · missing: Elevated waist circumference; Triglycerides ≥150 mg/dL (or treated); Low HDL-C (men <40, women <50 mg/dL); BP ≥130/85 mmHg (or treated); Fasting glucose ≥100 mg/dL (or treated)
METABOLIC_SYNDROME_ASSESSMENT_INCOMPLETE
MISS-001Insulin Pattern Missing Data
Inputs: fasting insulin not provided
IR_PATTERN_NOT_FULLY_ASSESSABLE_WITH_CURRENT_DATA
IRP-002Hyperinsulinemic Supporting Patternsandbox · off
Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.
IRP-003Elevated HOMA-IR Supporting Findingsandbox · off
Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.
IRP-004Convergent IR-Associated Patternsandbox · off
Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.
TREND-MET-001Composite Metabolic Deterioration Warningsandbox · off
Sandbox rule — disabled by default. Needs an assay-specific threshold profile and external endocrinology validation.
A1C_AS_SOLE_BASIS_FOR_CLASSIFICATIONa1c as sole basis for classificationsuppressed
Suppressed by a validity or safety rule.
Evidence
- EV-NGSP-A1C · National Glycohemoglobin Standardization Program. Factors that Interfere with HbA1c Test Results.
Physician adjudication required. Clinical decision support only. This output identifies guideline-based glycemic and metabolic findings and risk context. It does not diagnose insulin resistance, select treatment or recommend medication. Physician adjudication is required.
Change the values
The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.
Glycemic testsDrag the sliders to cross a threshold
- <100
- 100–125 prediabetes
- ≥126 diabetes range
- <5.7
- 5.7–6.4 prediabetes
- ≥6.5 diabetes range
75-g protocol
Lipids, body and blood pressure
- <150
- 150–499
- ≥500 priority
- ≥1000 urgent
Metabolic syndrome components0 of 5
- ○ Waist not entered
- ○ Triglycerides not entered
- ○ Low HDL-C not entered
- ○ Blood pressure not entered
- ○ Fasting glucose not entered
● met · ◌ not met · ○ not entered. Three or more meet the criteria; that does not confirm insulin resistance.
Patient and scope
Symptoms and safety
Risk context
Liver context
Medications
Outside the standard adult runtime
Fasting insulin (supporting only)Calculation and sandbox
Shown with HOMA-IR when fasting and same-collection are confirmed. It does not classify anything.
Research sandbox (unvalidated)
In production the insulin and HOMA-IR rules are off: no validated threshold profile exists. Here you can supply your own threshold to see how the sandbox rules would behave. The output is labeled a sandbox candidate and is never a diagnosis.
More metabolic cases
CPE002-FX-001
Healthy Metabolic Baseline
A 35-year-old with normal glucose, lipids, waist and blood pressure.
CPE002-FX-002
Prediabetes by HbA1c
HbA1c of 6.0% and nothing else.
CPE002-FX-003
Prediabetes by FPG
Confirmed-fasting glucose of 108 mg/dL.
CPE002-FX-004
OGTT-Only Prediabetes
Only a 75-g OGTT: 2-hour glucose 165 mg/dL.
CPE002-FX-005
Diabetes-Range Finding
HbA1c 6.8% and fasting glucose 134 mg/dL.
CPE002-FX-006
Metabolic Syndrome with Normal Glucose
Normal glucose, but waist 108 cm, TG 190, HDL 36 and BP 138/88.
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