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-001 · synthetic case FX-013
Severe decompensation risk alert
A 78-year-old, confused and cold, with TSH 38.5 and sodium 128.
Purpose: Escalate severe clinical pattern without routine outpatient framing.
Inputs the engine received
Patient
- Age and sex
- 78, female
Context
- Elderly or frail
- Yes
Symptoms
- Fatigue
- Present
- Cognitive slowing
- Present
Signs
- Altered mental status
- Present
- Bradycardia
- Present
- Hypothermia
- Present
Laboratory
- TSH
- 38.5 mIU/L (ref 0.4–4.5)
- FT4
- 0.4 ng/dL (ref 0.8–1.8)
- SODIUM
- 128 mEq/L (ref 135–145)
What the engine reports
Severe hypothyroid decompensation risk features are present. Routine outpatient interpretation may be inappropriate. Urgent clinical assessment is required based on patient condition.
Detected clinical pattern
Biochemical Pattern Compatible with Overt Primary Hypothyroidism
Elevated TSH with FT4 below the laboratory reference range supports this pattern.
Why this pattern was identified
- Elevated TSH with low FT4. TSH 38.5 mIU/L (ref 0.4–4.5) and FT4 0.4 ng/dL (ref 0.8–1.8).
- Elderly/frail or cardiovascular context. Documented context that the treating physician weighs before any thyroid hormone decision.
- Decompensation red flags. Altered mental status; Hypothermia
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Urgent physician assessment or emergency escalation based on clinical severity; do not manage through the routine outpatient rule pathway.
- 2Confirm clinical context, etiology modifiers and medication/exposure history.
- 3Assess Anti-TPO if autoimmune etiology is clinically relevant and not previously known.
- 4Consider lipid panel, CBC and CK if clinically indicated.
- 5Physician to determine levothyroxine initiation and dose using age and cardiovascular context.
Evidence and rule trace · 2 rules
PR-HT-01Overt Primary Hypothyroidism Biochemical Pattern
Inputs: TSH 38.5 mIU/L (ref 0.4–4.5) · FT4 0.4 ng/dL (ref 0.8–1.8)
TSH above and FT4 below the laboratory reference range.
PR-HT-07Severe Decompensated Hypothyroidism / Myxedema Coma Risk Alert
Inputs: Overt primary hypothyroidism pattern · Altered mental status · Hypothermia
Urgent clinical assessment; do not manage through the routine outpatient rule pathway.
Evidence
- EV-AACE-ATA-2012 · Garber JR et al. Clinical Practice Guidelines for Hypothyroidism in Adults. Endocr Pract. 2012;18(6):988-1028.
- EV-ATA-HYPO-2014 · Jonklaas J et al. Guidelines for the Treatment of Hypothyroidism. Thyroid. 2014;24(12):1670-1751.
Physician adjudication required. For clinician review only. This output identifies clinical patterns and safety considerations from the documented inputs. It does not establish an autonomous diagnosis or treatment plan. Physician confirmation is required.
Change the values
The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.
Thyroid-function testsMove the sliders or type values
- below range
- within range
- above range
- below range
- within range
- above range
Zones are drawn from your reference intervals. The engine, not the map, decides the pattern.
Laboratory values and reference rangesUse your lab's own interval
µIU/mL and mIU/L are numerically identical.
Interpreted against the reporting assay's upper limit.
Only used in the thyrotoxicosis pathway.
Patient context
Medications and exposures
Symptoms and physical findingsSupportive only: never classify on their own
Symptoms
Signs and decompensation red flags
More thyroid cases
FX-001
Overt primary hypothyroidism with autoimmune support
A 54-year-old with fatigue, cold intolerance and a TSH of 18.4.
FX-002
Antibody positive with euthyroid function
Strongly positive antibodies, but TSH and FT4 are both normal.
FX-003
Mild subclinical pattern with positive Anti-TPO
Mildly high TSH, normal FT4, positive Anti-TPO.
FX-004
TSH at or above 10 with normal FT4
TSH of 12 with a normal FT4 in a woman of 57.
FX-005
Pregnancy context with mild TSH elevation and Anti-TPO positivity
Pregnant, TSH 3.1 against a pregnancy range, Anti-TPO positive.
FX-006
Preconception infertility context
Trying to conceive, TSH 4.8, Anti-TPO positive.
Try Biod in your practice
The Clinical Intelligence Layer — transforming fragmented clinical information into structured intelligence for clinician review and action.