Rule Set v3.1
Rule set 3.1.0 defines what SurgiCheck can flag, which pathway each flag follows and which source it rests on. This page describes its structure. The full rule catalogue with trigger logic is provided in the Clinical Rule Set Reference Document (v3.1), available on request.
Rules by family and pathway
| Family | DEFER | REVIEW | VERIFY | INFO | Total |
|---|---|---|---|---|---|
| Medications | 1 | 2 | 4 | 1 | 8 |
| Wound healing and surgical history | 0 | 6 | 1 | 1 | 8 |
| Haematology | 1 | 2 | 2 | 1 | 6 |
| Metabolic (BMI, diabetes, acute instability) | 1 | 3 | 1 | 0 | 5 |
| Gates and absolute stops | 4 | 0 | 0 | 0 | 4 |
| Cardiovascular | 0 | 2 | 1 | 0 | 3 |
| Psychiatric | 0 | 2 | 0 | 0 | 2 |
| Respiratory | 0 | 1 | 1 | 0 | 2 |
| Thromboembolism | 0 | 2 | 0 | 0 | 2 |
| Allergy | 0 | 0 | 1 | 0 | 1 |
| Anaesthetic history | 0 | 0 | 1 | 0 | 1 |
| Endocrine | 0 | 1 | 0 | 0 | 1 |
| HIV | 0 | 0 | 1 | 0 | 1 |
| Hepatitis | 0 | 0 | 1 | 0 | 1 |
| Oncology | 1 | 0 | 0 | 0 | 1 |
| Supplements | 0 | 0 | 1 | 0 | 1 |
| All families | 8 | 21 | 15 | 3 | 47 |
Every rule is linked to at least one cited source. Of the 8 DEFER rules, 4 are hard stops with no override and 4 allow a dual-authorised override.
How the decision gate works
A clean "proceed" can be recorded only when there is no open hard stop, no open VERIFY item, no unacknowledged REVIEW item and no overridable DEFER awaiting override. An override must carry a distinct second authoriser, a mandatory rationale of at least 20 characters and the frozen system recommendation from the evaluation snapshot, so later rule changes cannot rewrite history. The pathway definitions are on the risk governance page.
Sources
The 36 references are guidelines and consensus documents from professional bodies, such as ASA, RCOG, CHEST, ADA, ACC/AHA, ISAPS, BAPRAS and BSH, and documented local protocols where no guideline exists. Rules are written so that a recommendation is not stronger than its source: for example, no universal waiting periods and no automatic medication-stopping rules are applied where guidance does not support them.
What changed in v3.1
- Pathway model (INFO, VERIFY, REVIEW, DEFER) consolidated as the rule set output.
- Two new rules: unverified patient-reported active smoking, and BMI 35 to 39 with high-volume contouring.
- Five new clinician-verification fields: facility and rescue capability, active infection, consent capacity, acute metabolic instability and anaemia severity.
- GLP-1 tiering retained: GLP-1 use alone is not an automatic contraindication; the clinician's assessment (Standard, Review or Defer) sets the pathway. See the worked example.
- Each clinician decision is stored as an immutable revision with the engine and rule-set version and the flags shown at the time.
Reclassifications relative to the v2.x model were reviewed and approved by the clinical lead on 30 October 2026.
Request the reference document