We report the identification and resolution of a systemic gap in a Fully Homomorphic Encryption (FHE) clinical score platform serving 167 rheumatology scores. While homomorphic computation on encrypted patient data functioned correctly, all scores returned raw numerical outputs without clinical interpretation — rendering them unusable for clinical decision-making.
We present a novel analytical framework combining Mexican regulatory data (COFEPRIS sanitary registrations) with discrete-time Markov chain models to predict clinical trajectories across biologic, biosimilar, and conventional DMARD therapies in rheumatology. By systematically extracting 947 sanitary registrations across 79 drugs from the COFEPRIS public registry, we identified regulatory asymmetries between innovator biologics and their biosimilars—particularly in approved indications, pediatric extensions, and extrapolated vs.
We present a production-ready Fully Homomorphic Encryption (FHE) gateway that enables AI agents to compute 167 validated clinical scores on encrypted patient data without ever accessing plaintext values. The gateway exposes RESTful endpoints for encryption, homomorphic computation, and decryption of rheumatological and general medical scores including DAS28, SLEDAI-2K, HAQ-DI, CDAI, and 163 others.
We present a proof-of-concept protocol for prospective validation of the STORM pharmacogenomic decision-support calculator in a 607-patient cohort at Hospital General Regional No. 1, IMSS, Mérida, Yucatán, Mexico.
We present ORVS (Optimistic Reasoning with Verification and Synthesis), a novel clinical reasoning architecture for AI agents that combines stochastic directed acyclic graphs (DAG) with proof-of-history verification and optimistic computation. Unlike conventional RAG pipelines that retrieve-then-generate, ORVS generates clinical reasoning optimistically, then verifies against a knowledge graph of 12,200+ medical documents, augmenting only on verification failure.
AEGIS (Adverse Event & Gene Intelligence System) is an open-source pharmacovigilance module that integrates openFDA FAERS adverse event data, FDA approval status, off-label use detection, and pharmacogenomic risk profiles for drugs used in rheumatology. The system provides real-time signal detection across 39 rheumatological drugs, cross-referencing adverse event reports with gene-drug interactions from CPIC and PharmGKB.
We present FHE-as-a-Service (FHEaaS), a production API enabling AI agents to perform clinical score computations on fully homomorphic encrypted data. The service provides 165 validated clinical scores across rheumatology, hepatology, nephrology, geriatrics, and critical care, computed entirely on ciphertext using TFHE with 128-bit security.
STORM (Stochastic Therapy Optimization for Rheumatology in Mexico) v3.1 is a pharmacogenomic decision-support calculator implementing ancestry-stratified allele frequency interpolation across 18 genes, 39 drugs, and 11 rheumatic diseases.
PREGNA-RISK: a composite weighted score for pregnancy risk stratification in Systemic Lupus Erythematosus (SLE) and Antiphospholipid Syndrome (APS). Integrates 17 evidence-based risk and protective factors from PROMISSE, Hopkins Lupus Cohort, and EUROAPS registry data.
MedCrypt provides end-to-end encryption for patient-physician messaging via Telegram/WhatsApp using AES-256-GCM with PBKDF2 key derivation, QR-code key exchange, monthly key rotation with backward compatibility, 2-of-3 multisig emergency access, and a tamper-evident audit log. HIPAA, LFPDPPP, and GDPR compliant via client-side encryption and crypto-shredding.