正文
获取原文件references/context-semantics.md
D006 separates five axes that must not be collapsed into one label.
Polarity
positive: the concept is asserted or considered, not explicitly absent.negative: the concept is explicitly denied/absent/refuted in this mention.unknown: source context does not safely resolve polarity.
Certainty
confirmed: the source explicitly asserts the mention, including a confirmed negative assertion such as “否认胸痛”.probable: strong but not definitive belief.possible: possibility / cannot-exclude language.suspected: consideration / rule-out / suspected diagnosis.refuted: the diagnostic hypothesis is explicitly rejected or unsupported.unknown: insufficient evidence.
polarity=negative, certainty=confirmed is valid for a clearly denied symptom.
polarity=negative, certainty=refuted is valid for a rejected diagnostic hypothesis.
Temporality
historical describes the mention context, not disease resolution. “既往高血压10年” is historical context but must not become clinical_status=resolved unless explicit resolution evidence exists.
Experiencer
Family-history concepts must not become patient problems. A family experiencer survives downstream for lineage and exclusion logic.
Clinical status
Set only from explicit state language or reliable structured status. Do not infer resolved merely from historical wording.
Medication boundary
D006 may resolve generic assertion/temporality around a medication mention, but final medication actions (start/hold/stop/resume/increase/decrease) belong to D008. D006 must not finalize medication action semantics.