{"slug":"nexu-io-clinical-case-report","name":"clinical-case-report","description":"Structured medical case presentation for clinical rounds, conferences,\nand documentation. Generates SOAP-format or narrative case reports\nwith physiologically accurate vitals, labs, and evidence-based plans.\nUse when the brief mentions \"case report\", \"case presentation\", \"SOAP note\",\n\"clinical case\", \"ward rounds\", \"case summary\", or \"patient presentation\".","long_description":"---\nname: clinical-case-report\ndescription: |\n  Structured medical case presentation for clinical rounds, conferences,\n  and documentation. Generates SOAP-format or narrative case reports\n  with physiologically accurate vitals, labs, and evidence-based plans.\n  Use when the brief mentions \"case report\", \"case presentation\", \"SOAP note\",\n  \"clinical case\", \"ward rounds\", \"case summary\", or \"patient presentation\".\ntriggers:\n  - \"case report\"\n  - \"case presentation\"\n  - \"soap note\"\n  - \"clinical case\"\n  - \"ward rounds\"\n  - \"patient presentation\"\n  - \"case summary\"\n  - \"medical case\"\nod:\n  mode: prototype\n  platform: desktop\n  scenario: healthcare\n  preview:\n    type: html\n    entry: index.html\n  fidelity: high-fidelity\n  example_prompt: \"58-year-old male with 2 hours of substernal chest pain radiating to the left arm, diaphoresis, and ST elevation in leads II, III, aVF. Generate a full emergency cardiology case presentation.\"\n---\n\n# Clinical Case Report Skill\n\nGenerate a structured medical case presentation for clinical rounds,\nconferences, or documentation. The output follows standard medical\nformatting conventions used in hospital settings worldwide.\n\n## What you will produce\n\nA single-page HTML case report (`index.html`). Content varies by format\n(see `references/case-formats.md` — selected in Step 0):\n\n**SOAP / Conference format:**\n- **Patient identification** — age, sex, chief complaint\n- **History of Present Illness (HPI)** — chronological narrative with\n  pertinent positives and negatives\n- **Past Medical History, Medications, Allergies**\n- **Review of Systems**\n- **Physical Examination** — systematic findings by system\n- **Vital Signs** — formatted table with reference ranges and flags\n- **Investigations** — laboratory results and imaging findings\n- **Assessment** — primary diagnosis and differential (3–5 items)\n  with clinical reasoning for each\n- **Management Plan** — evidence-based, organised by problem\n\n**Brief Rounds format** (daily review, ward round, handover, ICU, post-call):\n- **ID line** — age, sex, day of admission, primary problem\n- **Interval events / current status** — what has changed since last review\n- **Active problems** — numbered list\n- **Plan-by-problem** — concise actions for each active problem\n- Full HPI and systematic physical examination are **not** included\n\n---\n\n## Step-by-step workflow\n\n### Step 0 — Load reference files\n\nBefore starting, read both reference files:\n\n1. `references/case-formats.md` — use this to choose the correct output\n   format (SOAP, Conference, or Brief Rounds) based on the user's context\n2. `references/checklist.md` — keep P0 gates in mind throughout; you\n   must pass all P0 items before emitting the final artifact\n\n### Step 1 — Parse the brief\n\nRead the user's prompt and extract:\n\n- Patient age and sex\n- Chief complaint or presenting problem\n- Any vitals, labs, or imaging the user has provided\n- Clinical context: ED, ward rounds, conference case, outpatient, etc.\n- Specialty context: cardiology, emergency, internal medicine, etc.\n\nIf the chief complaint or presenting problem is missing:\n- **SOAP / Conference**: ask one clarifying question before proceeding. Do not proceed without it.\n- **Brief Rounds**: if the admission problem or ID line is already available (e.g. \"day-3 ICU review for septic shock\"), proceed directly — a separate chief complaint is not required.\n\n### Step 2 — Build the clinical narrative\n\n**For SOAP / Conference outputs:** write the HPI as a continuous prose\nnarrative in standard clinical style:\n\n> \"This is a [age]-year-old [sex] with a history of [relevant PMH] who\n> presents with [chief complaint]. Symptoms began [timeline] and are\n> characterised by [quality, severity, radiation]. Associated symptoms\n> include [list]. Pertinent negatives include [list].\"\n\nThe HPI must be chronological. Include timeline markers\n(\"2 hours prior to presentation\", \"onset yesterday morning\").\n\n**For Brief Rounds outputs** (daily review, ward round, handover, ICU,\npost-call): skip the full HPI and examination. Instead produce:\n\n- **ID line**: \"[Age][sex], Day [N] of admission, [primary problem]\"\n- **Interval events / current status**: what has changed since last review\n- **Active problems**: numbered list\n- **Plan-by-problem**: concise action for each active problem\n\n### Step 3 — Generate physiologically consistent clinical data\n\nIf the user has not provided specific values, generate values that are\ninternally consistent with the diagnosis:\n\n**Consistency checks (typical patterns):**\n\n- A patient in shock **typically** has: HR >100, SBP <90, raised lactate,\n  impaired capillary refill — but medications (beta-blockers), age, or\n  shock type (neurogenic, spinal) can alter this pattern\n- Pneumonia **typically** presents with raised WBC, raised CRP,\n  temperature >38°C — but afebrile pneumonia exists, especially in\n  the elderly or immunocompromised\n- A STEMI **typically** shows ST elevation in contiguous leads and raised\n  high-sensitivity troponin — but early presentations may have initially\n  normal troponin; CK-MB is not universally required\n- Sepsis **typically** shows raised or low WBC, raised lactate >2,\n  temperature abnormality — but compensated early sepsis may present\n  with normal vitals\n- Lab units must match convention: creatinine in µmol/L or mg/dL\n  (state which), glucose in mmol/L, haemoglobin in g/dL\n\n**Critical rule — preserve user-provided data:**\n- Never overwrite a value the user has explicitly stated\n- If a user-provided value is atypical for the diagnosis, keep it and\n  note the atypical presentation in the assessment rather than\n  forcing canonical numbers\n- Never generate a value that contradicts the stated diagnosis\n\n### Step 4 — Write the assessment\n\nThe assessment section must contain:\n\n1. **Primary diagnosis** stated clearly on the first line\n2. **Clinical reasoning** — one sentence explaining why this is the\n   most likely diagnosis\n3. **Differential diagnosis** — exactly 3 to 5 items, each with one\n   sentence of supporting or refuting evidence\n4. **Risk stratification** — include a validated clinical score where\n   applicable (TIMI for ACS, GRACE for ACS, Killip class + Shock Index\n   for STEMI/cardiogenic shock, CURB-65 for pneumonia, qSOFA for sepsis,\n   Wells for PE, etc.). Killip class and Shock Index together are\n   accepted as sufficient risk stratification for STEMI/cardiogenic shock cases.\n\n### Step 5 — Write the management plan\n\nThe plan must be:\n\n- **Specific**: write drug names, doses, routes, and frequencies.\n  Do not write \"start antibiotics\" — write\n  \"Piperacillin-Tazobactam 4.5g IV q8h for 5 days\"\n- **Organised by problem** using numbered headers\n- **Evidence-based**: management must reflect current standard of care\n  for the diagnosis\n- **Complete**: include investigations to order, monitoring parameters,\n  consults to request, and disposition\n\nIf you are uncertain about a specific dose, write\n\"[drug name] — dose per local formulary/protocol\" rather than\ninventing a dose.\n\n### Important — Prescribing Safety\n\nGenerated plans must:\n- Be marked as educational/simulated, not a substitute for clinician judgment\n- Use \"per local formulary/protocol\" language when required patient variables\n  (weight, renal function, allergies) are missing from the brief\n- List key contraindications and unknowns before medication recommendations\n  when relevant patient data has not been provided\n- Never claim a plan is \"definitive\" or \"standard of care\" without full\n  patient context (allergy status, renal/hepatic function, pregnancy\n  status, weight, anticoagulation/bleeding risk)\n- Include a disclaimer footer in the HTML output stating the case is for\n  educational and documentation purposes only\n\n### Step 6 — Write `index.html`\n\nRequirements for the HTML output:\n\n- Professional medical document typography\n  (Georgia or system serif font preferred)\n- White background, dark text — suitable for printing\n- Vital signs and lab results in HTML `<table>` elements\n- Critical findings (ST elevation, raised troponin, low BP, etc.)\n  highlighted in a visually distinct callout box with red left border\n- @media print CSS rules so the document prints cleanly on A4/Letter\n- Tag every major section with `data-od-id` for comment-mode targeting:\n\n```html\n<section data-od-id=\"hpi\">...</section>\n<section data-od-id=\"vitals\">...</section>\n<section data-od-id=\"pmh\">...</section>\n<section data-od-id=\"examination\">...</section>\n<section data-od-id=\"investigations\">...</section>\n<section data-od-id=\"assessment\">...</section>\n<section data-od-id=\"plan\">...</section>\n```\n\n### Step 7 — Self-check against `references/checklist.md`\n\nBefore emitting `<artifact>`, run every P0 item in `references/checklist.md`.\nAll P0 items must pass. Fix any failures before emitting.","tagline":"Structured medical case presentation for clinical rounds, conferences,\nand documentation. Generates SOAP-format or narrative case reports\nwith physiologically accurate vitals, labs, and evidence-based plans.\nUse when the brief mentions \"case report\", \"case presentation\", \"SOAP no","category":"design-creative","commerce":{"type":"unknown","billing":"unknown","amount":null,"currency":null,"sourceUrl":null,"checkedAt":null,"runtime":"unknown","purchaseUrl":null,"checkout":"external","purchaseRequiresUserConsent":true},"tags":["agent-skill"],"author":"nexu-io","verified":false,"attribution":{"status":"registry_indexed","statusLabel":"Registry indexed","shortLabel":"REGISTRY INDEXED","sourceLabel":"recursive skill source sync","sourceDetail":"nexu-io/open-design","creatorName":"nexu-io","creatorUrl":"https://github.com/nexu-io","sourceUrl":"https://github.com/nexu-io/open-design/tree/main/design-templates/clinical-case-report","indexedBy":"OpenAgentSkill community index","claimUrl":"https://www.openagentskill.com/skills/nexu-io-clinical-case-report#claim-this-skill","claimCta":"Claim this skill","trustNote":"This listing was indexed from public sources and is not marked official until a maintainer claim is approved.","publicNote":"Attribution links to the public repository or creator profile. 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