meta:
  id: consumer-health-intelligence
  title: "Consumer Health Intelligence"
  subtitle: "The Living Truth Layer"
  version: "1.0.0"

actors: {}

slides:
  # ============================================
  # TITLE
  # ============================================
  - type: title
    id: title

  # ============================================
  # HOOK
  # ============================================
  - type: hook
    id: hook
    line: "Your sources contradict each other."
    subline: "And you have no way to weigh them."

  # ============================================
  # THE DRIFT - Seven sources, one hour
  # ============================================
  - type: code
    id: drift-doctor
    title: "Source 1: Your doctor"
    code: |
      "Well-tolerated. Nausea is common but transient."

      // Confidence: high (MD, treating physician)
      // Basis: prescribing guidelines, clinical experience
      // What's missing: doesn't see Reddit, doesn't see FAERS

  - type: code
    id: drift-fda
    title: "Source 2: The FDA label"
    code: |
      WARNING: Thyroid C-cell tumors (boxed warning)

      Adverse reactions:
        - Nausea (44%)
        - Diarrhea (30%)
        - Vomiting (24%)

      // No mention of gastroparesis (yet).
      // Label last updated: 2021.

  - type: code
    id: drift-reddit
    title: "Source 3: Reddit (1.2M members)"
    code: |
      r/Ozempic - sorted by top, past month:

      "Ozempic face is real. I look 10 years older."    [2.1k upvotes]
      "Month 3: can't eat, stomach won't empty"         [1.8k upvotes]
      "Hair is falling out in clumps"                    [1.4k upvotes]
      "Lost 40 lbs, feel amazing, life changed"          [947 upvotes]

      // 4 posts. 4 different realities.

  - type: code
    id: drift-tiktok
    title: "Source 4: TikTok (4M views)"
    code: |
      @healthinfluencer:
      "Ozempic gave me stomach paralysis.
       I was in the ER for 3 days."

      4.2M views | 340K likes | 12K comments

      // One person's experience.
      // Presented as universal truth.
      // Engagement = visibility, not validity.

  - type: code
    id: drift-nejm
    title: "Source 5: NEJM meta-analysis"
    code: |
      // Pooled analysis, n = 14,847
      // Design: randomized controlled trials

      Result: "No statistically significant increase
               in gastroparesis incidence vs placebo"

      // p = 0.23, CI crosses 1.0
      // The gold standard says: no signal.

  - type: code
    id: drift-faers
    title: "Source 6: FDA Adverse Event Reports"
    code: |
      FAERS query: semaglutide + gastroparesis

      Total reports:    8,547
      Serious:          3,201
      Hospitalizations: 1,894
      Trend:            increasing (2022-2024)

      // Self-reported + unverified.
      // But 8,547 reports is a signal.

  - type: hook
    id: drift-question
    line: "Seven sources. Seven answers."
    subline: "You make your decision based on whichever one you saw last."

  # ============================================
  # THE SPIRAL
  # ============================================
  - type: code
    id: spiral
    title: "The same problem, everywhere"
    code: |
      // Gastroparesis:
      Doctor:   "Rare"
      FDA:      (not on label)
      Reddit:   "It happened to me" (x 4,200)
      TikTok:   "It's an epidemic"  (12M views)
      NEJM:     "No significant signal"
      FAERS:    8,547 reports

      // Hair loss:
      Clinical trials:   not studied
      Reddit:            1,847 posts
      Clinical evidence: zero

      // Muscle loss:
      Phase III:  "~40% of weight lost is lean mass"
      Reddit:     "My legs are wasting away"
      Trainers:   "Just lift weights"

  - type: hook
    id: spiral-insight
    line: "This is the vaccine problem."
    subline: "Not misinformation. The absence of a system that can hold all claims and show you the shape of the evidence."

  # ============================================
  # THE CATASTROPHE
  # ============================================
  - type: code
    id: catastrophe
    title: "The Catastrophe"
    code: |
      // June 2023: She starts Semaglutide.
      // Her research: doctor + Google + a few Reddit posts.
      // Gastroparesis wasn't on the FDA label.
      //
      // January 2024: FDA updates the label.
      // Intestinal obstruction warning added.
      //
      // Reddit had flagged this a year earlier.
      // FAERS reports were accumulating for two years.
      //
      // Nobody told her. Google doesn't send updates.
      // Her doctor's office doesn't track label changes.
      // The truth changed. Her information didn't.

  - type: code
    id: catastrophe-pattern
    title: "The pattern repeats"
    code: |
      // COVID vaccines, 2021:
      // April: "No myocarditis signal"
      // June:  VAERS reports accumulating
      // July:  CDC acknowledges elevated risk in young males
      //
      // Millions of decisions made between April and July
      // based on information that was about to change.
      //
      // Not because anyone lied.
      // Because no system could show:
      //   "Here is what we know, at each level,
      //    and here is what changed since you last looked."

  # ============================================
  # THE FIX
  # ============================================
  - type: hook
    id: fix-intro
    line: "What if every source had a weight?"
    subline: "And the disagreement was the answer."

  - type: code
    id: fix-tiers
    title: "Source-class hierarchy"
    code: |
      // Not all sources are equal. Make it structural.

      Tier 0: Regulatory action       weight: 1.0   decay: never
      Tier 1: RCTs, meta-analyses     weight: 0.9   decay: 2 years
      Tier 2: Observational studies    weight: 0.7   decay: 1 year
      Tier 3: Pharmacovigilance        weight: 0.5   decay: 18 months
      Tier 4: Clinician case reports   weight: 0.4   decay: 6 months
      Tier 5: Patient community        weight: 0.2   decay: 3 months
      Tier 6: Media, influencers       weight: 0.1   decay: 30 days

      // A million TikTok posts cannot outvote one FDA action.
      // But they can signal that something is happening.

  - type: code
    id: fix-assert
    title: "Store claims with provenance"
    code: |
      // Clinical evidence enters with full metadata
      episteme.assert({
        subject: "semaglutide/adverse-effects/gastroparesis",
        predicate: "risk_level",
        value: "No statistically significant increase",
        source_class: "tier-1",
        source: {
          type: "meta-analysis",
          journal: "NEJM",
          sample_size: 14847
        },
        confidence: 0.92
      });

      // Patient report enters the same graph
      episteme.assert({
        subject: "semaglutide/adverse-effects/gastroparesis",
        predicate: "risk_level",
        value: "Experienced severe gastroparesis after 3 months",
        source_class: "tier-5",
        source: { platform: "reddit", upvotes: 847 },
        confidence: 0.3
      });

      // Both coexist. Neither overwrites. But they are not equal.

  - type: code
    id: fix-query
    title: "Query returns layers, not a single answer"
    code: |
      episteme.query({
        subject: "semaglutide/adverse-effects/gastroparesis",
        lens: "layered-consensus"
      });

      // Returns:
      {
        regulatory:        "Added to label Jan 2024",
        clinical_evidence: "No signal in Phase III (conflict: 0.34)",
        pharmacovigilance: "8,547 FAERS reports, trend: increasing",
        patient_community: "Widely reported, cluster size: 4,200",

        overall_conflict: 0.72,
        summary: "Trials show low incidence. Post-marketing and
                  patient reports show higher rates. FDA added
                  to label January 2024."
      }

      // Not "yes" or "no". The shape of the evidence.

  # ============================================
  # CLUSTER ESCALATION
  # ============================================
  - type: code
    id: escalation
    title: "Anecdotal signal detection"
    code: |
      // The Gardener monitors Tier 5 clusters.
      // When density crosses threshold:

      episteme.assert({
        subject: "semaglutide/adverse-effects/hair-loss",
        predicate: "escalation_signal",
        value: "Anecdotal cluster detected",
        source_class: "meta",
        meta: {
          tier_5_count: 1847,
          growth_rate: "312/month",
          tier_1_count: 0,           // no clinical evidence exists
          clinical_gap: true
        },
        lifecycle: "under-review"
      });

      // Does NOT claim hair loss is real.
      // Claims: "people are reporting this, and nobody has studied it."
      // The gap is the signal.

  # ============================================
  # GUIDANCE CHANGES
  # ============================================
  - type: code
    id: guidance-change
    title: "What changed since you last looked"
    code: |
      // FDA updates the label. Epoch shifts.
      episteme.epoch.supersede({
        old_epoch: "semaglutide-label-pre-2024",
        new_epoch: "semaglutide-label-2024-01",
        reason: "Intestinal obstruction warning added"
      });

      // Consumer returns 3 months later:
      episteme.query({
        subject: "semaglutide/adverse-effects",
        lens: "layered-consensus",
        since: "2023-10-01"           // their last visit
      });

      // Returns:
      {
        changes: [{
          date: "2024-01-12",
          type: "regulatory",
          change: "Intestinal obstruction added to warnings"
        }],
        prior_assertions_affected: 12
      }

      // Not just today's answer. What changed.

  # ============================================
  # TIME TRAVEL
  # ============================================
  - type: code
    id: time-travel
    title: "What was known when you decided?"
    code: |
      // "I started Semaglutide in June 2023.
      //  What were the known risks at that time?"

      episteme.query({
        subject: "semaglutide/adverse-effects",
        lens: "layered-consensus",
        as_of: "2023-06-15"
      });

      // Returns the June 2023 snapshot:
      {
        regulatory: "Boxed warning: thyroid. No GI obstruction.",
        clinical:   "Nausea common, no gastroparesis signal",
        patient:    "Growing reports (cluster size: 340)",
        escalation: "not yet triggered (threshold: 500)"
      }

      // Your decision was reasonable given available evidence.
      // The record proves it.

  # ============================================
  # DISAGREEMENT DASHBOARD
  # ============================================
  - type: code
    id: disagreement
    title: "The disagreement dashboard"
    code: |
      episteme.query({
        subject: "semaglutide",
        lens: "skeptic",
        scope: "adverse-effects"
      });

      // Returns:
      resolved: [
        { topic: "nausea", conflict: 0.08, "all tiers agree" }
      ]

      active_disagreement: [
        { topic: "gastroparesis", conflict: 0.72,
          clinical: "Low incidence",
          faers: "8,547 reports",
          patients: "Widely reported" }
      ]

      emerging_signal: [
        { topic: "hair loss",
          clinical_evidence: "none",
          patient_reports: 1847,
          status: "under-review" }
      ]

      // Settled. Contested. Emerging.
      // Honest answers, not false certainty.

  # ============================================
  # VISION
  # ============================================
  - type: vision
    id: vision
    title: "Episteme"
    points:
      - "Source-class hierarchy. Not all claims are equal."
      - "Anecdotal signals surfaced without false authority."
      - "Guidance changes propagated, not buried."
      - "Time travel to the evidence at any moment."
    tagline: "Git for Truth"
