clinical-case-report

Clinical Case Report Skill

Generate a structured medical case presentation for clinical rounds, conferences, or documentation. The output follows standard medical formatting conventions used in hospital settings worldwide.

What you will produce

A single-page HTML case report (index.html). Content varies by format (see references/case-formats.md — selected in Step 0):

SOAP / Conference format:

• Patient identification — age, sex, chief complaint
• History of Present Illness (HPI) — chronological narrative with pertinent positives and negatives
• Past Medical History, Medications, Allergies
• Review of Systems
• Physical Examination — systematic findings by system
• Vital Signs — formatted table with reference ranges and flags
• Investigations — laboratory results and imaging findings
• Assessment — primary diagnosis and differential (3–5 items) with clinical reasoning for each
• Management Plan — evidence-based, organised by problem

Brief Rounds format (daily review, ward round, handover, ICU, post-call):

• ID line — age, sex, day of admission, primary problem
• Interval events / current status — what has changed since last review
• Active problems — numbered list
• Plan-by-problem — concise actions for each active problem
• Full HPI and systematic physical examination are not included

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Step-by-step workflow

Step 0 — Load reference files

Before starting, read both reference files:

1. references/case-formats.md — use this to choose the correct output format (SOAP, Conference, or Brief Rounds) based on the user's context
2. references/checklist.md — keep P0 gates in mind throughout; you must pass all P0 items before emitting the final artifact

Step 1 — Parse the brief

Read the user's prompt and extract:

• Patient age and sex
• Chief complaint or presenting problem
• Any vitals, labs, or imaging the user has provided
• Clinical context: ED, ward rounds, conference case, outpatient, etc.
• Specialty context: cardiology, emergency, internal medicine, etc.