CardioTriage MCP — Phenotype-aware Cardiovascular Triage

Prompt Opinion MCP superpower for phenotype-aware emergency cardiovascular triage with FHIR R5 context, missing-data checks, structured bilingual handoff, and Chagas-compatible cardiomyopathy differential surfacing backed by ECGFounder bridge phenotype detection.

NOT FOR CLINICAL USE. Hackathon demonstration only. Synthetic FHIR metadata plus public de-identified ECG samples. Foundation model outputs are uncalibrated demo scores -- they SURFACE differentials for clinical workup, never DIAGNOSE conditions.

We do not propose AI-ECG as a replacement for serology.

We propose it as a low-cost triage layer.

Quick Links

• Live MCP endpoint: https://claudiomedina17--mcp.modal.run/mcp
• Live health endpoint: https://claudiomedina17--mcp.modal.run/health
• Marketplace listing evidence: docs/MARKETPLACE_VERIFICATION.md
• Demo video: TBD - Phase 2
• Devpost submission: TBD - Phase 2
• Repository: TBD public repo URL (local prototype workspace)
• Data provenance: docs/DATA_PROVENANCE.md
• BYO Agent system prompt: docs/BYO_AGENT_SYSTEM_PROMPT.md

Elevator Pitch

CardioTriage gives any Prompt Opinion agent a governed phenotype-aware cardiovascular triage toolkit instead of a free-text-only workflow.

It exposes six MCP tools that discover cases, retrieve FHIR R5 bundles, check critical missing data, run ECGFounder-backed phenotype inference, summarize risk signals, and render an SBAR handoff note.

The ECG tool uses ECGFounder (PKUDigitalHealth, MIT; NEJM AI 2025) embeddings and signal features to return transparent uncalibrated demo scores.

The demo is anchored on chest-pain triage, STEMI pattern recognition, and a Latam Chagas-compatible cardiomyopathy workup scenario.

The MCP server is the primary submission; the Prompt Opinion BYO Agent is the demo wrapper that proves the tools are invokable inside the platform.

Architecture Summary

CardioTriage uses a five-layer architecture:

1. Domain logic: synthetic FHIR R5 case bundles, HEART-style risk signals, missing-data review, and deterministic SBAR handoff scaffolding.
2. AI-ECG layer: ECG signal preprocessing plus ECGFounder 1024-d embeddings, centroid cosine similarity, and neurokit2-derived signal features.
3. MCP server: FastMCP tools exposed over Streamable HTTP for Prompt Opinion.
4. BYO Agent wrapper: a Prompt Opinion demo agent orchestrates the six tools with concise clinical rationale before each call.
5. Submission polish: provenance docs, Marketplace evidence, cache skeletons, disclaimers, and a reproducible local test suite.

Six MCP Tools

#	Tool	Purpose
1	list_synthetic_cases	Discover the available demo case IDs A, B, and C.
2	get_fhir_case_bundle	Return the FHIR R5-style bundle for the selected case.
3	analyze_missing_critical_data	Flag missing or pending triage data such as troponin, echo, Chagas serology, or contraindications.
4	summarize_cardiovascular_risk_signals	Summarize deterministic cardiovascular risk signals for STEMI, HF/Chagas, or low-risk patterns.
5	generate_structured_handoff_note	Generate an SBAR-style handoff note in en, es, or pt.
6	interpret_12_lead_ecg	AI-ECG inference (lite + live), uncalibrated demo scores. Bridge phenotype detection backed by ECGFounder; surfaces Chagas-compatible cardiomyopathy pattern when context warrants serology workup. NOT a diagnostic tool.

Tool #6 scores are evidence signals for the hackathon demo. They surface phenotype-aware differentials for workup; they are not calibrated clinical probabilities.

Local Development

uv sync
uv run pytest tests/ -q
uv run python -m server.main

The default transport is stdio. For local Streamable HTTP:

$env:CARDIOTRIAGE_MCP_TRANSPORT = "streamable-http"
$env:CARDIOTRIAGE_MCP_HOST = "127.0.0.1"
$env:CARDIOTRIAGE_MCP_PORT = "8000"
$env:CARDIOTRIAGE_MCP_PATH = "/mcp"
uv run python -m server.main

Health smoke:

curl.exe http://127.0.0.1:8000/health

Marketplace Publish Steps

Phase 0 Gate 0 found that CardioTriage is usable in Prompt Opinion as a WORKSPACE-ONLY listing. Public Marketplace publishing may require subscription publishing enablement.

1. Open Prompt Opinion.
2. Go to Configuration -> MCP Servers -> Add.
3. Friendly name: CardioTriage MCP Server.
4. Endpoint: https://claudiomedina17--mcp.modal.run/mcp.
5. Transport: Streamable HTTP.
6. Authentication: No authentication / open.
7. Save and verify that the server appears in the workspace MCP server list.
8. Confirm /health, initialize, and tools/list expose six tools.
9. Use screenshots from the workspace Manage view as Marketplace evidence if public listing remains unavailable.

See docs/MARKETPLACE_VERIFICATION.md.

BYO Agent Demo

Open or create the Prompt Opinion BYO Agent named CardioTriage Demo.

1. Tools tab: attach CardioTriage MCP Server.
2. System Prompt tab: paste docs/BYO_AGENT_SYSTEM_PROMPT.md.
3. Save.
4. Run: Triage Case B end-to-end. Use Spanish for the handoff.
5. Expected trace: all six tools in order, including interpret_12_lead_ecg, with chagas_suspect_demo_score around 0.925 and calibration_status="uncalibrated_demo".

Offline deterministic cache skeletons live in cardiotriage_core/demo_cache/run_case_{a,b,c}.json; rationale and final PO handoff text remain TODO_LIVE_CAPTURE until Claudio captures real UI runs.

License

MIT. See LICENSE.

Acknowledgements

• ECGFounder by PKUDigitalHealth (MIT license), used for ECG foundation-model embeddings.
• CODE-15 / Ribeiro et al., Zenodo 4916206, CC-BY 4.0, for public de-identified ECG demo samples.
• SaMi-Trop / PhysioNet Challenge 2025 for the Chagas-cohort public de-identified ECG demo sample.
• Bern et al., CDC 2007, for Chagas disease clinical grounding.
• Nunes et al., JACC 2013, for Chagas cardiomyopathy clinical grounding.
• Anthropic Claude Haiku for the planned Prompt Opinion BYO Agent narrative layer; this repository does not run live LLM API calls during deterministic cache generation.

Disclaimer

NOT FOR CLINICAL USE. This software is a hackathon demonstration. Demo data only: synthetic FHIR metadata plus public de-identified ECG samples. Scores are uncalibrated demo scores, not clinical probabilities. A licensed clinician must validate all findings and actions.