D006 临床语境与状态判定

references/state-transition-policy.md

D006 may emit conservative transition candidates between facts only when they refer to the same exact surface concept after safe string normalization and have trustworthy order evidence.

Automatic transitions require:

1. same patient_key when present;
2. same fact_type;
3. same normalized surface string (no synonym reasoning in D006);
4. parseable structured source times for both facts;
5. later fact has an explicit context state that updates the earlier one.

Examples:

• suspected -> refuted = refutes_prior_suspicion
• suspected/possible -> confirmed positive = confirms_prior_suspicion
• explicit active -> explicit resolved = status_change

If time is missing, concepts are lexical variants, or sources conflict without an explicit update, D006 must not invent a transition. Route to review or leave reconciliation to D009/D010/D011.