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Sample report · synthetic patient data. Everything below was produced by the actual HealthDetective agents from a fictional, computer-generated medical record — no real patient is involved. Your own report is built the same way, from your records.

What a finished case looks like

One coherent story drawn from years of scattered records: a working hypothesis cascade with its supporting lab values and verified medical literature, and the questions worth asking at the next appointment. Select any node to read its full reasoning.

Educational synthesis of your records. Not a diagnosis, not medical advice — bring this to your physician and review together.
AI synthesislast analyzed sample case · gemini-2.5-pro
Things that may have set this off
Root cause
Related conditions
Knock-on effects
Symptoms you notice

Medical literature · 7 citations (AMA format)

  1. Hecht SS. Lung carcinogenesis by tobacco smoke. Int J Cancer. 2012;131(12):2724-2732. doi:10.1002/ijc.27816(opens in a new tab)
  2. Gridelli C, Rossi A, Carbone DP, et al. Non-small-cell lung cancer. Nat Rev Dis Primers. 2015;1:15009. doi:10.1038/nrdp.2015.9(opens in a new tab)
  3. Pelosof VC, Gerber DE. Paraneoplastic syndromes: an approach to diagnosis and treatment. Mayo Clin Proc. 2010;85(9):838-854. doi:10.4065/mcp.2010.0099(opens in a new tab)
  4. Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;12(5):489-495. doi:10.1016/S1470-2045(10)70218-7(opens in a new tab)
  5. Ellison DH, Berl T. The syndrome of inappropriate antidiuresis. N Engl J Med. 2007;356(20):2064-2072. doi:10.1056/NEJMcp066837(opens in a new tab)
  6. Stewart AF. Hypercalcemia associated with cancer. N Engl J Med. 2005;352(4):373-379. doi:10.1056/NEJMcp042806(opens in a new tab)
  7. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med. 2005;352(10):1011-1023. doi:10.1056/NEJMra041809(opens in a new tab)

Links open in a new tab. Every DOI above was independently resolved and matched against the publisher record before it was shown.

For physician review

safety & gaps
Safety flags
  • The combination of coughing up blood, losing weight without trying, and several specific abnormal lab results are serious warning signs that point towards a possible cancer and require prompt medical attention.
  • The high level of calcium in your blood can affect your heart and brain and needs to be addressed and managed by your doctor soon.
  • The low level of sodium in your blood can affect your brain, causing symptoms like confusion or extreme tiredness, and needs to be monitored and treated by your doctor.
Data gaps
  • Imaging scans (like a CT or PET scan) are needed to look for an abnormal growth, see how big it is, and check if it has spread to other parts of the body.
  • A small sample of tissue from any abnormal area would need to be taken and looked at under a microscope to get a definite diagnosis.
  • Specific blood tests could confirm if the high calcium level is being caused by the hormone-like substance PTHrP.
  • Comparing salt and water concentration in both blood and urine would confirm if the low sodium is due to SIADH.
  • Examining your sputum (phlegm) under a microscope could check for the presence of cancer cells.

Findings this hypothesis doesn't explain

1

Recorded rather than forced into the cascade. An honest residue is part of the rigor — bring these to your physician too.

  • Your history of high blood pressure and mild COPD are long-term conditions that are separate from this new set of problems, although the COPD may make your current breathing symptoms feel worse.
This is a hypothesis, not a diagnosis

Educational synthesis only. Generated content was produced by an AI model based on uploaded records. All findings must be reviewed with your physician. This does not constitute clinical endorsement.

Questions for the doctor

Drafted from the same case and grouped by topic, so a 15-minute appointment starts where it matters.

Understanding what's going on

4 questions
  1. What do you think is the most likely cause of my cough, weight loss, and all these strange blood test results?
  2. Could something in my lungs be making hormones that are messing up my body's salt and calcium levels?
  3. I'm worried about the word 'malignancy' in my lab report. What does that mean in my case?
  4. With my history of smoking and possible asbestos at work, what are the biggest concerns we should be looking into?

Tests

4 questions
  1. What are the next tests we need to do to get a clear answer?
  2. Will I need a scan of my chest, like a CT scan?
  3. The lab report mentioned checking my liver and bones. What kind of tests would we do for that?
  4. Is a biopsy, where you take a small piece of tissue, something we might need to do?

Daily life & Next steps

3 questions
  1. Is there anything I can do right now to help with the fatigue and shortness of breath?
  2. What symptoms should I watch for that would mean I need to call you or go to the hospital right away?
  3. Who will be managing my care? Will I be seeing specialists, like the lung doctor who ordered my tests?

Also consider asking

opportunistic
—“If you were me, what would you do first?”
—“What would make you change your mind about this diagnosis?”
—“What's the least-invasive next step we can agree on?”
—“Who on your team should I also be talking to?”

The records brief

The same library, organised rather than interpreted: what the records hold, which values fall outside the range each laboratory printed, and what every named clinician actually wrote. Built to be printed and handed across a desk.

Records brief · SBAR

Records Brief

HealthDetective.aiAssembled by the patient
24 Aug 2026
Record span
2020–2023
Documents
12
Institutions
9
Countries
Germany · United States · United Kingdom · Belgium · France · Sweden
Languages
English (10) · French (2)

This brief was assembled from the patient’s own records. The software makes no clinical assessment. Every clinical statement below is a quotation or close paraphrase attributed to the clinician who wrote it, with document and date; the reference in the margin resolves to the document index at the foot. Values are shown with the reference range printed by the issuing laboratory, verbatim. Nothing here is ordered by importance.

Situation

Library facts

This brief covers 12 documents held in the patient’s library, dated 2020 to 2023, issued by 9 institutions in 6 countries.

The library contains 8 laboratory reports and 4 clinic letters, naming 11 clinicians across 7 specialties. 2 documents are not in English; source text is shown in its original language.

It holds 24 recorded values. 13 fall outside the range printed on their own report, 3 fall inside it, and 8 were reported without any reference range. 6 clinical statements appear across the letters and reports.

It was assembled by the patient on 24 Aug 2026 for this appointment.

Background

The record itself: what the library holds, and which values fall outside the range printed by the laboratory that issued them.
Chronology
12 documents, 2020–2023

The library, by year

2019
No document in the library
2020
2021
2022
2023
2024
No document in the library
2025
No document in the library
Infectious diseasesImmunologyPaediatric neurologyGastroenterologyMetabolic medicineGeneticsGeneral paediatrics
Grouping
clinical category, then analyte, then date

Values outside the issuing laboratory’s range — 13

Grouped by clinical category, then by analyte, then by date. Out-of-range is a mechanical comparison with the range printed on the same report — no other filter is applied.

Inflammatory markers

6 values · 3 analytes
IL-6, serumpg/mL
8.1 (2020) · 14 (2021) · 11.4 (2022)2 laboratories
IL-6, serum, measurements outside the range printed on their own report, in date order
ValueDateRange as printedComparisonSource
8.13 Nov 2020<7.0above range
1412 Mar 2021<5Sierra Immunology Reference Laboratoryabove range
11.42 Jul 2022<5Sierra Immunology Reference Laboratoryabove range

Measurements in this block come from 2 laboratories, which printed different ranges. Each value is shown against the range printed on its own report.

IL-8, serumpg/mL
106 (2021) · 11 (2023)Sierra Immunology Reference Laboratory
IL-8, serum, measurements outside the range printed on their own report, in date order
ValueDateRange as printedComparisonSource
10612 Mar 2021<15above range

11 (2023) was inside the range printed on that report and is listed in the full value index.

hs-CRPmg/L
28 (2021) · 6.4 (2022) · 0.8 (2023)Sierra Immunology Reference Laboratory
hs-CRP, measurements outside the range printed on their own report, in date order
ValueDateRange as printedComparisonSource
2812 Mar 2021<1.0above range
6.42 Jul 2022<1.0above range

0.8 (2023) was inside the range printed on that report and is listed in the full value index.

Immune

4 values · 2 analytes
CD57 absolute countcells/µL
5 (2021) · 12 (2023)Sierra Immunology Reference Laboratory
CD57 absolute count, measurements outside the range printed on their own report, in date order
ValueDateRange as printedComparisonSource
512 Mar 2021>60below range
1221 Aug 2023>60below range
Soluble CD14ng/mL
4884 (2021) · 3503 (2022)Sierra Immunology Reference Laboratory
Soluble CD14, measurements outside the range printed on their own report, in date order
ValueDateRange as printedComparisonSource
488412 Mar 2021<2800above range
35032 Jul 2022<2800above range

Gastrointestinal

2 values · 2 analytes
Transferrine (selles)
Laboratoire Bio-Analytique
Transferrine (selles), measurements outside the range printed on their own report, in date order
ValueDateRange as printedComparisonSource
positive20 May 2021négatifoutside range
IgA sécrétoiresng/g selles
Laboratoire Bio-Analytique
IgA sécrétoires, measurements outside the range printed on their own report, in date order
ValueDateRange as printedComparisonSource
2020 May 2021200–3000below range

Neurological

1 value · 1 analyte
Acide kynuréniqueratio to median
Laboratoire Barbier
Acide kynurénique, measurements outside the range printed on their own report, in date order
ValueDateRange as printedComparisonSource
8.8711 Feb 20220,85–1,24above range

Reported without a reference range — 8

The issuing laboratory printed no reference range for these 8 values, so they cannot be placed inside or outside a range.

Values reported without a reference range, in date order
AnalyteValueDateRange as printedIssuing laboratorySource
Borrelia miyamotoidetected3 Nov 2020none statedNordwest Diagnostik GmbH
MCP-1pg/mL19112 Mar 2021none statedSierra Immunology Reference Laboratory
Zonulinepositif20 May 2021none statedLaboratoire Bio-Analytique
Acide quinoliniqueratio to median2.2711 Feb 2022none statedLaboratoire Barbier
Ochratoxine Ang/g créatinine22.311 Feb 2022none statedLaboratoire Barbier
RC-I activity% of normal mean1714 Sep 2022none statedReligen Inc.
RC-I / CS ratioratio1.214 Sep 2022none statedReligen Inc.
TREX1 c.341G>A (p.Arg114His)heterozygous16 Sep 2022none statedRegional Genetics Service

Notes on the library

  • IL-6, serum is given two different reference ranges by two laboratories: “<7.0” (Nordwest Diagnostik GmbH, Nov 2020) and “<5” (Sierra Immunology Reference Laboratory, Mar 2021 and Jul 2022). Values below are shown against the range printed on their own report.
  • Eight of the 24 values in the library were reported without any reference range by the issuing laboratory. They cannot be placed inside or outside a range and are listed separately.
  • Three values that were inside the range printed on their own report are listed in the full value index rather than in the tables above.
  • The paediatric neurology letter of 18 Mar 2021 cites a brain MRI dated 2 Mar 2021. That imaging report does not appear in the library.
  • The urinary organic acids report refers to “Annexe 2 — chromatogramme”. Annexe 2 does not appear in the library.
  • The general paediatrics letter of 12 Nov 2023 cites an interferon signature assay. No interferon signature result appears in the library.
  • No document is dated between 3 Nov 2020 and 12 Mar 2021, or in 2024 and 2025.

Grouping · clinical category, then analyte, then date

Assessments on record

Every assessment a named clinician recorded in the library, in the order it was written. Nothing here is ranked, weighed or resolved, and no statement is joined to any other.
Attribution
every statement below is quoted verbatim from the document named on its card
6 assessments recorded in 5 documents by 5 named sources, 2021–2023. 1 of the 6 record something a clinician excluded.
2021
Dr M. AlvarezPaediatric neurology
Clinic letterMarch 2021[3]
The temporal association with a preceding viral illness raises the possibility of a post-infectious mechanism, though I cannot exclude a primary neurodevelopmental cause.”
Reasoning as written in this document
  1. Preceding viral illness
  2. Post-infectious mechanism
  3. Regression
  4. the document stops here
Meadowbank Children's Hospital
Dr M. AlvarezPaediatric neurology
Clinic letterMarch 2021[3]
A clinician considered this and excluded it
MRI is normal and examination is non-focal; I do not think a structural CNS lesion is likely.”
Meadowbank Children's Hospital
2022
Dr S. RenardClinical immunology
Clinic letterJanuary 2022[5]
Elevated sCD14 in this context most likely reflects monocyte activation in response to LPS of intestinal origin.”
Reasoning as written in this document
  1. Intestinal permeability
  2. LPS translocation
  3. Monocyte activation
  4. the document stops here
Royal Free Hospital
Dr P. OkaforMetabolic medicine
Clinic letterJune 2022[7]
The kynurenine to tryptophan pattern is consistent with a shunt toward the kynurenine pathway; I would want to see this repeated before drawing conclusions.”
Reasoning as written in this document
  1. Inflammatory state
  2. Kynurenine pathway shunt
  3. the document stops here
From the record
  • No repeat result appears in the library.
Akademiska sjukhuset
Regional Genetics ServiceClinical genetics laboratory
Laboratory reportSeptember 2022[10]
TREX1 c.341G>A (p.Arg114His), heterozygous. Classified as a variant of uncertain significance. Biallelic variants are associated with Aicardi-Goutières syndrome; the significance of a single heterozygous variant is not established.”
From the record
  • Also named in “Clinic letter — general paediatrics”, November 2023. Neither document references the other.
Regional Genetics Service
2023
Dr J. WhitfieldGeneral paediatrics
Clinic letterNovember 2023[12]
The pathogenic TREX1 variant likely contributes to an interferon-driven inflammatory picture.”
Reasoning as written in this document
  1. TREX1 variant
  2. Interferon activation
  3. Chronic inflammation
  4. the document stops here
From the record
  • Also named in “Genetics report — interferonopathy panel”, September 2022. Neither document references the other.
Meadowbank Children's Hospital

Recommendations on record

What clinicians wrote in the notes, and whether a corresponding result appears in the library.

Recommended by a clinician in the records — 6

Dr M. Kellner
Laboratory medicine
3 Nov 2020
Laboratory report
“Borrelia PCR recommended to confirm the immunoblot finding.”
not in libraryNo PCR result appears in the library.
Dr M. Alvarez
Paediatric neurology
18 Mar 2021
Clinic letter
“CSF study proposed, to include neopterin and oligoclonal bands.”
not in libraryNo CSF result appears in the library.
Dr S. Renard
Clinical immunology
14 Jan 2022
Clinic letter
“Repeat soluble CD14 and secretory IgA at six months.”
partly in librarySoluble CD14 repeated 2 Jul 2022. No secretory IgA result after 20 May 2021 appears in the library.
Dr P. Okafor
Metabolic medicine
20 Jun 2022
Clinic letter
“Paired plasma tryptophan and kynurenine requested.”
not in libraryNo result for either analyte appears in the library.
Dr J. Vance
Laboratory medicine
14 Sep 2022
Laboratory report
“Repeat respiratory chain assay at twelve months.”
not in libraryNo respiratory chain result after 14 Sep 2022 appears in the library.
Dr J. Whitfield
General paediatrics
12 Nov 2023
Clinic letter
“Parental testing for TREX1 c.341G>A proposed.”
not in libraryNo parental test result appears in the library.
Every margin reference on this page resolves here.
Index
Every document in the library, in date order
RefDateDocumentTypeInstitutionAuthoring clinicianLanguagePages
[1]3 Nov 2020Laboratory reportNordwest Diagnostik GmbH
Augsburg, Germany
Dr M. Kellner, laboratory medicineEnglish4
[2]12 Mar 2021Laboratory reportSierra Immunology Reference Laboratory
San Jose, CA, USA
Dr R. Okafor, clinical pathologyEnglish3
[3]18 Mar 2021Clinic letterMeadowbank Children's Hospital
Bristol, United Kingdom
Dr M. Alvarez, paediatric neurologyEnglish2
[4]20 May 2021Laboratory reportLaboratoire Bio-Analytique
Bruxelles, Belgique
Dr C. Delvaux, biologie cliniqueFrench5
[5]14 Jan 2022Clinic letterRoyal Free Hospital
London, United Kingdom
Dr S. Renard, clinical immunologyEnglish3
[6]11 Feb 2022Laboratory reportLaboratoire Barbier
Lyon, France
Dr F. Aubert, biochimieFrench6
[7]20 Jun 2022Clinic letterAkademiska sjukhuset
Uppsala, Sweden
Dr P. Okafor, metabolic medicineEnglish4
[8]2 Jul 2022Laboratory reportSierra Immunology Reference Laboratory
San Jose, CA, USA
Dr R. Okafor, clinical pathologyEnglish3
[9]14 Sep 2022Laboratory reportReligen Inc.
Plymouth Meeting, PA, USA
Dr J. Vance, laboratory medicineEnglish2
[10]16 Sep 2022Laboratory reportRegional Genetics Service
Manchester, United Kingdom
Regional Genetics Service (report unsigned by an individual clinician)English11
[11]21 Aug 2023Laboratory reportSierra Immunology Reference Laboratory
San Jose, CA, USA
Dr R. Okafor, clinical pathologyEnglish3
[12]12 Nov 2023Clinic letterMeadowbank Children's Hospital
Bristol, United Kingdom
Dr J. Whitfield, general paediatricsEnglish2

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