Medicine measures diseases precisely and patients barely at all. The NSI changes that: a continuous, whole-patient measure of clinical status, seven dimensions fused into one number from 0 to 100, updated as life happens.
The number that decides who is treated, at what dose, who enters a trial and when treatment stops is still a six-point scale with no unit, assigned by eye in a fifteen-minute visit.
ECOG performance status — Zubrod et al., c.1960, formalised 1982.
Performance status is captured roughly once a month, so a decline that began weeks earlier becomes visible only when it surfaces as an emergency.
Alishahi Tabriz et al., JAMA Netw Open 2023 (2019 data).
Three things had to be true before a general measure of patient condition was possible. All three stopped being obstacles in the last few years.
Patients now own one. Heart rate, oxygen, activity and sleep, captured continuously.
FHIR changed what a third party can legitimately assemble about one patient.
Incomparable scales, frequencies and missing data. Now tractable.
The ingredients arrived. We built the instrument.
A geometric mean, not an average: one collapsing dimension pulls the whole score down, however healthy the other six look.
Where a patient sits matters — and so does how fast they move, and in which direction.
Doctors grade the whole patient with ECOG. We put the NSI head-to-head against it on a completed phase III cancer trial, scored on patients the model had never seen.
Take two patients and ask which one is sicker. A coin flip gets it right 50 times in 100. ECOG, the standard doctors use today, gets 58. The NSI gets 69: more than twice ECOG’s edge over chance.
Tested on patients the model had never seen, from a completed phase III trial in metastatic colorectal cancer. The advantage holds up statistically.
Scattered signals become one clear score. The score becomes awareness. Awareness becomes action — and every action sharpens the next read.
A device reads your body around the clock. It can't read your fear. Both go in — on their own lines, never held against you.
One patient, one Tuesday, one score. Three people need something different from it — pick one and see what they actually get.
Your kidney markers moved and inflammation is up. Not an emergency tonight — but worth a call tomorrow.
Illustrative data — one score, three views.
The NSI was designed as a general measure of the whole patient. Cancer is where it starts. The architecture is built for everything after.
Cancer-specific models for colorectal, breast, lung, prostate, pancreatic and neuroendocrine cancer are already in the engine, each reading its own tumour marker and treatment rhythm.
Our validation pipeline reads the industry-standard trial data format (CDISC SDTM). Any completed cancer trial can be re-scored with the NSI, turning decades of trial data into new evidence.
Clinical validation trials are in process with partner hospitals, taking the NSI from completed-trial data to live patients, with wearables provided to the people taking part.
A native iOS and Android app brings wearables and the patient’s own words into the score, so the measure keeps moving between visits instead of waiting for the next one.
Heart failure, COPD, transplant, dialysis, frailty and recovery after surgery all ask the same question: is this patient getting worse, and how fast? The seven dimensions answer it for any of them.
The next leap: telling a failing treatment from a declining patient, early enough to change the decision.
A vital sign for the whole patient: read continuously, understood by everyone in the room, and trusted by every clinician the way they trust a lab value.
A patient's insight, a surgeon's judgement, a mathematician's models, an engineer's systems, a commercial leader's access and a research team.
Almost 90 chemotherapy sessions taught me what no chart shows: how a patient is really doing between visits. My vision is to turn that experience into something practical, a measure that doctors, patients, caregivers and the whole industry can act on.
Cancer centres, clinicians, researchers, trial sponsors, investors and patients: if you want a better way to see how a patient is really doing, let's talk.
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