Overview¶

AI-CDSS runs a closed adaptive loop: the clinic measures patient status, the CDSS selects protocols, monitors how the patient responds, and adjusts the plan, then protocol-effectiveness feedback returns to the clinic.

Closed-loop CDSS protocol cycle

The four numbered stages:

1 · Clinic — patient status¶

Clinical assessment defines the patient's deficit profile: MoCA (cognitive) and ARAT / Fugl-Meyer (upper-extremity motor) subscales. These become the patient deficit vector that drives PPF.

Clinic step: patient assessment regions and clinical scales

2 · Intervention — protocol matching¶

The patient's subscales are matched against the 27 RGS protocols; the top candidates are ranked, and the top-12 form the prescription. This is the scoring pipeline + recommender.

Intervention step: protocol matching

3 · Monitor — supervisor view¶

Each protocol is tracked over time: difficulty modulation (DM) by week and adherence by weekday. A fitted slope per protocol gives ΔDM and Δadherence, which feed the score.

Monitor step: supervisor heatmaps of DM and adherence

4 · Adjust — MVT swap¶

Protocols are ranked by score; those below the cohort-wide MVT threshold are swapped out and replaced by similar substitutes (therapeutic interchange), producing the adjusted prescription.

Adjust step: MVT-based swap via therapeutic interchange