/clinical-decision-support

name: clinical-decision-support
description: "Generate professional clinical decision support (CDS) documents for pharmaceutical and clinical research settings, including patient cohort analyses (biomarker-stratified with outcomes) and treatment recommendation reports (evidence-based guidelines with decision algorithms). Supports GRADE evidence grading, statistical analysis (hazard ratios, survival curves, waterfall plots), biomarker integration, and regulatory compliance. Outputs publication-ready LaTeX/PDF format optimized for drug development, clinical research, and evidence synthesis."
allowed-tools: [Read, Write, Edit, Bash]

Clinical Decision Support Documents

Description

Generate professional clinical decision support (CDS) documents for pharmaceutical companies, clinical researchers, and medical decision-makers. This skill specializes in analytical, evidence-based documents that inform treatment strategies and drug development:

1. **Patient Cohort Analysis** - Biomarker-stratified group analyses with statistical outcome comparisons 2. **Treatment Recommendation Reports** - Evidence-based clinical guidelines with GRADE grading and decision algorithms

All documents are generated as publication-ready LaTeX/PDF files optimized for pharmaceutical research, regulatory submissions, and clinical guideline development.

**Note:** For individual patient treatment plans at the bedside, use the `treatment-plans` skill instead. This skill focuses on group-level analyses and evidence synthesis for pharmaceutical/research settings.

Capabilities

Document Types

**Patient Cohort Analysis**

• Biomarker-based patient stratification (molecular subtypes, gene expression, IHC)
• Molecular subtype classification (e.g., GBM mesenchymal-immune-active vs proneural, breast cancer subtypes)
• Outcome metrics with statistical analysis (OS, PFS, ORR, DOR, DCR)
• Statistical comparisons between subgroups (hazard ratios, p-values, 95% CI)
• Survival analysis with Kaplan-Meier curves and log-rank tests
• Efficacy tables and waterfall plots
• Comparative effectiveness analyses
• Pharmaceutical cohort reporting (trial subgroups, real-world evidence)

**Treatment Recommendation Reports**

• Evidence-based treatment guidelines for specific disease states
• Strength of recommendation grading (GRADE system: 1A, 1B, 2A, 2B, 2C)
• Quality of evidence assessment (high, moderate, low, very low)
• Treatment algorithm flowcharts with TikZ diagrams
• Line-of-therapy sequencing based on biomarkers
• Decision pathways with clinical and molecular criteria
• Pharmaceutical strategy documents
• Clinical guideline development for medical societies

Clinical Features

• **Biomarker Integration**: Genomic alterations (mutations, CNV, fusions), gene expression signatures, IHC markers, PD-L1 scoring
• **Statistical Analysis**: Hazard ratios, p-values, confidence intervals, survival curves, Cox regression, log-rank tests
• **Evidence Grading**: GRADE system (1A/1B/2A/2B/2C), Oxford CEBM levels, quality of evidence assessment
• **Clinical Terminology**: SNOMED-CT, LOINC, proper medical nomenclature, trial nomenclature
• **Regulatory Compliance**: HIPAA de-identification, confidentiality headers, ICH-GCP alignment
• **Professional Formatting**: Compact 0.5in margins, color-coded recommendations, publication-ready, suitable for regulatory submissions

Pharmaceutical and Research Use Cases

This skill is specifically designed for pharmaceutical and clinical research applications:

**Drug Development**

• **Phase 2/3 Trial Analyses**: Biomarker-stratified efficacy and safety analyses
• **Subgroup Analyses**: Forest plots showing treatment effects across patient subgroups
• **Companion Diagnostic Development**: Linking biomarkers to drug response
• **Regulatory Submissions**: IND/NDA documentation with evidence summaries

**Medical Affairs**

• **KOL Education Materials**: Evidence-based treatment algorithms for thought leaders
• **Medical Strategy Documents**: Competitive landscape and positioning strategies
• **Advisory Board Materials**: Cohort analyses and treatment recommendation frameworks
• **Publication Planning**: Manuscript-ready analyses for peer-reviewed journals

**Clinical Guidelines**

• **Guideline Development**: Evidence synthesis with GRADE methodology for specialty societies
• **Consensus Recommendations**: Multi-stakeholder treatment algorithm development
• **Practice Standards**: Biomarker-based treatment selection criteria
• **Quality Measures**: Evidence-based performance metrics

**Real-World Evidence**

• **RWE Cohort Studies**: Retrospective analyses of patient cohorts from EMR data
• **Comparative Effectiveness**: Head-to-head treatment comparisons in real-world settings
• **Outcomes Research**: Long-term survival and safety in clinical practice
• **Health Economics**: Cost-effectiveness analyses by biomarker subgroup

When to Use

Use this skill when you need to:

• **Analyze patient cohorts** stratified by biomarkers, molecular subtypes, or clinical characteristics
• **Generate treatment recommendation reports** with evidence grading for clinical guidelines or pharmaceutical strategies
• **Compare outcomes** between patient subgroups with statistical analysis (survival, response rates, hazard ratios)
• **Produce pharmaceutical research documents** for drug development, clinical trials, or regulatory submissions
• **Develop clinical practice guidelines** with GRADE evidence grading and decision algorithms
• **Document biomarker-guided therapy selection** at the population level (not individual patients)
• **Synthesize evidence** from multiple trials or real-world data sources
• **Create clinical decision algorithms** with flowcharts for treatment sequencing

**Do NOT use this skill for:**

• Individual patient treatment plans (use `treatment-plans` skill)
• Bedside clinical care documentation (use `treatment-plans` skill)
• Simple patient-specific treatment protocols (use `treatment-p