NextConsensus
Discuss a Program

Pipeline

From raw revision history to a source-linked trajectory.

NextConsensus estimates the current state and future transitions of consequential claims across institutions. Four stages, each one auditable: extract the trajectory, classify what kind of change it was, decide how it should be reviewed, and deliver it with the evidence attached. Forecasting is a research program built on top of it. The full method is on its own page.

The pipeline

Extract, classify, prioritize, deliver

The classify step carries the weight. Without it, a burst of editorial housekeeping looks identical to a claim genuinely gaining ground, and a system that cannot tell those apart will confidently rank the wrong things. Where actors disagree, the record shows the disagreement before it summarises it.

1

Extract

Refract reconstructs claim trajectories from public revision history. Every wording change, citation, certainty shift, and propagation event is dated and verifiable.

2

Classify

Each change is labelled for what it actually was. A new trial citation attaching to a benefit claim is evidence movement. That same wording turning up in a guideline entry is authority language spreading. A reformatted table or a renumbered reference is neither. Without the distinction, housekeeping reads as momentum.

3

Prioritize

Direction and strength of movement are the features under test: gaining stronger support, becoming harder to dismiss, spreading across influential sources, losing qualifiers, appearing in regulator or guideline language. They are the features for ranking review attention.

4

Deliver

The current program returns the trajectory with its source trail, ready for review. A useful lead-time result remains part of the research program.

Interactive Dissection

Breaking a broad question into units the record can settle

“Will payers cover our drug?” is where most teams start. The pipeline breaks a question like that into four conditions before it looks at any evidence: a named authority, a defined action, a target population and a cutoff date. We call a question in that form resolvable: the named body either takes the action by the date or it does not. Try one.

Proposition Dissection Sandbox

Deterministic Claim Decomposition

Transforming ambiguous commercial and evidentiary questions into resolvable, time-bounded propositions with named authorities and explicit verification criteria.

Unstructured Question Non-Resolvable

“Will payers lift restrictions on GLP-1s for diabetic kidney disease?”

✕ No named authority ✕ No defined action ✕ No temporal deadline ✕ No resolution source
Nothing in this form can be checked against a dated public action.
Structured Resolvable Unit Target Rung 7 · Payer / Coverage
Will CMS & Major Part D Formularies issue an updated national coverage memo removing mandatory metformin pre-step requirement for patients with documented Type 2 Diabetes and CKD (eGFR 25–60) on or before 2027-06-30?
Resolution Rule Publication of final coverage determination or Part D formulary guidance removing step therapy restriction on CMS coverage database.
Upstream States Rungs 1–4 observed: FLOW trial readout (R1) · ADA/KDIGO consensus upgrade (R5) · Label expansion (R6).
Reliance Scope High: Class-wide Medicare Part D formulary restriction across beneficiaries with baseline albuminuria.
Ledger Hash
Deterministic SHA-256 fingerprint
Unstructured Question Non-Resolvable

“When will bispecifics move to second-line DLBCL standard of care?”

✕ No named authority ✕ No defined action ✕ No temporal deadline ✕ No resolution source
Nothing in this form can be checked against a dated public action.
Structured Resolvable Unit Target Rung 5 · Guideline Action
Will NCCN Guidelines Panel upgrade Bispecific Antibody Therapy to Category 1 Preferred Recommendation for relapsed/refractory DLBCL after 1 prior line in transplant-ineligible adult patient population on or before 2026-11-30?
Resolution Rule Publication of updated NCCN B-Cell Lymphomas Guidelines (Version 2026.N) with Category 1 designation in the second-line pathway.
Upstream States Rungs 1–4 observed: Pivotal Phase III PFS superiority (R1) · ASH consensus (R3) · Real-world safety registry (R4).
Reliance Scope Critical: Determines clinical placement ahead of CAR-T cellular therapy referral pathways.
Ledger Hash
Deterministic SHA-256 fingerprint
Unstructured Question Non-Resolvable

“Will European health authorities approve and reimburse complement therapies for GA?”

✕ No named authority ✕ No defined action ✕ No temporal deadline ✕ No resolution source
Nothing in this form can be checked against a dated public action.
Structured Resolvable Unit Target Rung 6 · Regulatory Action
Will European Medicines Agency (CHMP) adopt a positive scientific opinion recommending marketing authorization for intravitreal complement C3/C5 inhibitor for geographic atrophy secondary to age-related macular degeneration on or before 2027-03-31?
Resolution Rule Official CHMP meeting highlights publishing a positive opinion for the named marketing authorization application on the EMA portal.
Upstream States Rungs 1–4 observed: 24-month lesion rate slowing (R1) · FDA approval granted (R6 US) · EURETINA panel debate (R3).
Reliance Scope Global: Gates EU-wide commercial launch and subsequent national HTA pricing submissions (G-BA, HAS, NICE).
Ledger Hash
Deterministic SHA-256 fingerprint

Where it sits

The twelve-rung ladder

A claim climbs from first publication through replication and expert consensus to the moment an institution acts in public. Rungs 1–4 are the claim moving through the literature: that is what a claim history records. Rungs 5–7 are a guideline body, a regulator or a payer acting: that is what a forecast is registered against. Each rung on the ladder below names what is observable at that step.

The 12-rung ladder Rung 5 / 12 · Guideline action
1 2 3 4 5 6 7 8 9 10 11 12
resolvable Rung 5: Guideline action
Full 12-Rung Guide →

Formal recommendation change by a recognized guideline body: grade shift, new/retracted endorsement, population expansion/restriction.

Role: Primary forecast target: public, dated, adjudicable

The ladder guide gives each rung its signals and its role; the method gives the rules a forecast is registered and scored under.

Provenance

Every event is traceable to a public revision

Every event in a claim history has a dated public source and a reproducible hash, so a trajectory can be recomputed from the public record and checked.

Claim identity

The system maintains the same claim across paraphrase, wording changes, broadening, narrowing, qualification, relocation, removal, reintroduction, and citation replacement.

Distinguishing change types

A public source may change because of new evidence, delayed editor attention, imported regulator language, citation cleanup, editorial judgment, or routine maintenance. The system labels each — it does not automatically claim "evidence strengthened."

Reproducibility

Every trajectory is byte-for-byte reproducible from the public record. Registration hashes let anyone verify that the trajectory has not been altered.

A7F3
B8E4
Two revisions of the same claim, two registration hashes. The tile is drawn from the digest alone, so an altered record cannot produce a matching one — you can compare them by eye before checking the full hash. Illustrative.

Research program

What the research program is testing

The forecasting layer is a hypothesis under prospective test. None of the four questions below is settled yet. An earlier proof cycle appeared to show a relationship between public revision activity and later authority actions; the result was invalid, because the positive cases had full revision histories and the negatives did not. With the negatives correctly ingested, no signal remained in general activity. If there is one, it is more likely in specific claims and specific patterns of movement. That is the next experiment.

Prospective calibration

Scores appear only after a registered forecast resolves. The protocol is tracked in the Verification Ledger.

Baseline outperformance

Whether trajectory features improve on base-rate forecasts.

Decision-useful lead time

Whether the system surfaces movement earlier than the workflows teams already run.

Generalization across markets

Whether results from one therapeutic area, authority, or event class transfer to another.