clinical-reasoning: Instructions file for Codex

AGENTS.md

clinical-reasoning AGENTS.md is an instructions file for Codex, OpenCode from cqframework/clinical-reasoning. It costs 1,077 tokens per session, scanned A, original, Apache-2.0.

A project guide for JVM-based clinical software that evaluates medical measures and applies care plans using FHIR and CQL. FHIR is a standard for exchanging healthcare data, and CQL is a language for expressing clinical rules.

In plain words
What is it for?
Building the project, compiling Java, running all, module, integration, or individual tests, checking formatting, and applying clinical reasoning operations.
Why use it?
It provides the commands and conventions needed to build, test, format, and inspect this multi-module healthcare project safely.

Instructions file for CodexOpenCode

Written for Codex and OpenCode: the file is AGENTS.md. Also seen: mentions AGENTS.md; $skill-name invocation.

This is cqframework/clinical-reasoning's own configuration. It tells Codex and OpenCode how to work on clinical-reasoning itself, so it is not a mod to install elsewhere. Copy it as a starting point and replace the rules that are about this project. Everything clinical-reasoning configures →

Needs its repository: it reads a path above its own folder, which exists only inside the repository. The line is # cql.engine.path=../clinical_quality_language.

Reuse

Borrowing it

Nothing to install: this file belongs to cqframework/clinical-reasoning. Take a copy, put it at the same path in your own repository, and replace the rules that are about this project with yours.

Copy the file
curl -O https://raw.githubusercontent.com/cqframework/clinical-reasoning/main/AGENTS.md
Clone the repo
git clone --depth 1 https://github.com/cqframework/clinical-reasoning

Made for: Codex, OpenCode.

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README.md
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Per session 1,077 This file is loaded in full into every session.
When invoked 1,077 The same file — it is already loaded in full.
Security scan A 0 findings. A grade says what 26 rules found in the file — not that it is safe.
Origin original No closer match found in the catalogue.
Token cost

What it costs to keep this loaded

Counted locally with the o200k_base tokenizer, which is exact for GPT models; Claude uses its own tokenizer and its counts differ. Treat this as one consistent yardstick across the catalogue rather than a bill. Prices are per million input tokens.

ModelPer sessionOnce invoked
Fable 5.1 $0.01077 $0.01077
Opus 5.5 $0.00431 $0.00431
Sonnet 5.5 $0.00215 $0.00215
Haiku 4.5 $0.00108 $0.00108

Measured 8d ago against content hash 50bc2ac1db5b, method: parsed. Prices are Anthropic first-party input rates as of 2026-10-07, from the pricing page.

Security

Grade A, and why

clinical-reasoning AGENTS.md scanned grade A with 0 findings against 26 rules in 11 categories — prompt injection, anti-refusal, data exfiltration, privilege escalation, supply chain, agent snooping, system-prompt leakage, SSRF and excessive agency — measured 8d ago.

A static scan of the body, not an audit. Every finding is printed with the line that produced it so you can judge whether it matters here. A mod is markdown that instructs an agent; that is exactly why what it instructs is worth reading.

Nothing flagged

None of the 26 patterns this scan looks for appear in this file: no shell pipes, no recursive deletes, no credential paths, no hidden text, no instruction-override or anti-refusal phrasing, no agent-config snooping. That is not a guarantee, it is the absence of the things that are checkable.

AGENTS.md · 143 lines

How it starts

The opening of the file, as written. The whole thing — 143 lines — stays where its author put it; the contents beside it link to each section on GitHub.

AGENTS.md

Project Overview

This is the CQF Clinical Reasoning on FHIR repository, which provides JVM-based, FHIR-enabled clinical reasoning components. The project implements FHIR Clinical Reasoning operations like Measure evaluation ($evaluate-measure), PlanDefinition application ($apply), and CQL evaluation capabilities.

See the ARCHITECTURE.md document for a detailed overview of the vision, architecture, design patterns, and coding standards used in this project.

Build and Test Commands

Building the Project

# Full build with tests
./gradlew build

# Build without tests
./gradlew assemble

# Compile only
./gradlew compileJava

# Parallel build (enabled by default via gradle.properties)
./gradlew build

Running Tests

# Run all tests
./gradlew test

# Run tests in a specific module
./gradlew :cqf-fhir-cr:test

# Run a single test class
./gradlew :MODULE:test --tests ClassName

# Run a single test method
./gradlew :MODULE:test --tests "ClassName.methodName"

# Run integration tests
./gradlew integrationTest

# Skip tests
./gradlew assemble

Code Formatting and Quality

# Check code formatting (runs in CI on PRs)
./gradlew spotlessCheck

# Apply code formatting fixes
./gradlew spotlessApply

# This project uses Palantir Java Format (configured in buildSrc convention plugins)
# Checkstyle runs automatically as part of the build

Linked Builds (Cross-Repo Development)

To build against a local checkout of a dependency (e.g., CQL Engine) instead of Maven Central:

# Copy the template and set paths to your local checkouts
cp local.properties.example local.properties

# Edit local.properties — uncomment and set the path:
# cql.engine.path=../clinical_quality_language

# Build as normal — the settings plugin detects local.properties and includes the linked build
./gradlew build

Available linked builds are listed in local.properties.example. The registry is defined in build-logic/src/main/kotlin/cqf/LinkedBuild.kt.

Read the full file on GitHub · 143 lines

Changes

What this file has done since we first saw it

Hashed on every crawl. A supply-chain change to an agent config is a question of when, not whether, so the history is kept rather than the latest state alone.

  1. 8d ago Changed · +14 lines · +153 tokens per session 50bc2ac1db5b
  2. 1mo ago Changed · -3 tokens per session ea4e5d379e0c
  3. 2mo ago First seen · 129 lines · 927 tokens per session scan A ef28b8f2e8a9

Subscribe to this mod's changes

clinical-reasoning AGENTS.md is an instructions file published in the GitHub repository cqframework/clinical-reasoning (51 stars, last pushed yesterday), licensed Apache-2.0. It adds 1,077 tokens to every session, about $0.0043 per session on Opus 5.5. A static security scan graded it A with 0 findings. No closer match exists in the catalogue, so it is treated as the original; first seen 2026-08-30.

Related

clinical-reasoning AGENTS.md compared with instructions from other repositories

clinical-reasoning AGENTS.md next to 6 instructions from other repositories
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clinical-reasoning AGENTS.mdcqframework/clinical-reasoningInstructions file51yesterdayApache-2.0A1,077Codex, OpenCode
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deepseek-harness AGENTS.mddeepseek-ai/deepseek-harnessInstructions file274k2d agoMITA4,313Codex, OpenCode