Test Ordering Optimization Layer
Not clinical advice. Protocol-dependent. Must be configured and validated per deployment.
The Challenge
Even with good triage, ordering behavior remains inconsistent. Clinicians often order broad panels because it is faster than reasoning through minimal pathways under time pressure.
What It Reduces
Broad Panels
Reduces "shotgun" panel ordering patterns
Duplicate Tests
Eliminates redundant tests across visits
Protocol Drift
Maintains consistent ordering standards
Input Sources
Engine Outputs
Risk bands and recommendations from SVC-01 to SVC-09
Clinic Protocols
Local protocol rules (configurable)
Constraints
Patient constraints (cost sensitivity, access)
How It Works
This layer does not detect disease. It converts risk bands into a minimal test plan that is:
Output Schema
- • Minimal next test category
- • Rationale notes (short, structured)
- • Confidence and abstain notes
- • "Stop conditions" (when to escalate)
- • Not clinical advice
- • Protocol-dependent
- • Must be configured per deployment
- • Clinician override always available
Abstain Conditions
No protocol configuration present
Conflicting engine outputs
Missing constraint inputs
Model Sources
| Domain | Task | Model / Source | Link |
|---|---|---|---|
| Decision logic | Ranking | scikit-learn | Source → |
| Tabular ranking | Baseline | LightGBM | Source → |
| Constraint logic | Optimization (optional) | OR-Tools | Source → |
Deployment Configuration
Runs CPU-only. Sits above all other wings. Exports a printable "minimal plan" for clinician sign-off.
Important Limitations
- ✗Not clinical advice
- ✗Protocol-dependent
- ✗Must be configured and validated per deployment
- ✗Requires local protocol configuration
Example Outputs
"Minimal plan: monitor + targeted check. Broad panel not recommended unless new red flags appear."
"Protocol missing. Abstain. Recommend clinician decision."
Clinical Workflow Integration
How This Service Fits the Engine
The Test Ordering Optimization Layer operates as a meta-service that sits above all other wings (SVC-01 to SVC-09). It converts risk bands and recommendations from individual services into a minimal, protocol-aligned test pathway with auditable rationale, reducing broad panel ordering while maintaining clinician control.
Meta-service for test ordering optimization
MINIMAL PANEL