Guided walkthrough
One case, start to finish
This case comes from the August 2026 Clinical Proof Review and was scored by the production engine. Nothing on this page is a mock-up and nothing is recomputed as you read it.
Hypertension. Age 73. Chronic Kidney Disease, Resistant Hypertension, Gout.
What the clinician entered
A workup is structured clinical data, not a chart note. These are the fields this patient produced. No name, no date of birth, no identifiers of any kind: the engine never needs them and never asks.
- Age
- 73
- Blood pressure
- 164/92 mmHg
- eGFR
- 49 mL/min/1.73m2
- Potassium
- 5.2 mEq/L
- Coverage
- Medicaid / Medicare
- Comorbidities
- Chronic Kidney Disease, Resistant Hypertension, Gout, COPD, Hypertension, Mild GI Issues
- Allergies
- ACE Inhibitors: Lisinopril (Zestril); CCBs (Dihydropyridine): Amlodipine (Norvasc), open to trial; Beta Blockers: Atenolol (Tenormin)
- Current therapy
- Losartan (Cozaar) 100 mg Daily; Chlorthalidone (Thalitone) 12.5 mg Daily; Diltiazem 24-Hr (Cardizem CD) 240 mg Daily
What the engine returned
The engine weighed 60 candidates for Hypertension and ruled out 35 of them outright, then ranked what was left by clinical fit. The same inputs return this same list every time.
Why it ranked that way
Every score is the sum of the rules that fired. These are the ones that acted on increase Chlorthalidone (Thalitone), with the source behind each. Rules that lowered the score are shown alongside the ones that raised it, because a list of only the favorable ones would not be a trace.
- Raised the scoreDose optimization of active therapy to reduce polypharmacyboost-Chlorthalidone-1
- Raised the scoreMost potent first-line agents for severe uncontrolled hypertensionboost-Chlorthalidone-2
- 2025 AHA/ACC/Multisociety Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults
- Lowered the scoreThiazides increase uric acid; may trigger gout flarespenalty-Chlorthalidone-3
- 2025 AHA/ACC/Multisociety Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults (p. e255)
Safety alerts raised on this workup
- Hyperkalemia: RAAS/MRA/K+ Sparing Diuretic and K+ > 5; avoid new starts/titrations
Synthetic patient data, no PHI. Built on clinician-reviewed rules and sources. Not a substitute for clinical judgment; not validated for patient care.
See the other eleven
The full review carries every case, every ranked option and every citation, including the ones this walkthrough left out.