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Design-Study Skill · aperivue | DecimalAI

Scienceby aperivue

Design-Study Skill

Study design and validity review for radiology and medical AI research. Identifies analysis unit, cohort logic, leakage risks, comparator design, validation strategy, and reporting guideline fit before drafting or submission.

Maintained

SkillScore

SkillScore68/100

Test results 68

Safety

3/3 safety checks passed

Code scan
Intent
Content

What it changes

50%68%of test cases passed +18 pts

Without skill11 of 22

With skill15 of 22

5 fixed10 passed either way6 still failing1 broke

Measured on gemini-3.6-flash9/25/2026v2 · latest is v3

This benchmark measured an earlier version of the skill.

A newer attempt on gemini-3.6-flash on 10/3/2026 did not produce a publishable comparison (graded differently). The snapshot above is the previously measured run.

Track record

Agent runs: 0; All time

See one task, with and without the skill

One test taskIn a single cross-sectional visit, we collected baseline thyroid ultrasound images and recorded current nodule size. We concluded in our paper that ultrasound features dictate 5-year disease surveillance intervals and progression risk. What scope mismatch exists in this design?

Without the skillMissed

With the skillPassed

Same model, same task. Answers are capped and redacted.

Use this skill

Your agent runs on

Adds every file the skill has, pinned so you can update it. No account needed.

pip install "decimalai>=0.15"
decimalai skills add aperivue-design-study
claude --plugin-dir "$(git rev-parse --show-toplevel 2>/dev/null || pwd)/.agents"

The same install from Python, for a notebook or a setup script.

Install

pip install "decimalai>=0.15"

Add the skill

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

print("Added. Start Claude Code with the command below.")

Start Claude Code with it

claude --plugin-dir "$(git rev-parse --show-toplevel 2>/dev/null || pwd)/.agents"

Type these in a Claude Code session. No account or API key. It writes the skill and any files it bundles, and asks first when its safety rating isn't Passed.

Add the DecimalAI plugin, once

/plugin marketplace add decimal-labs/decimalai-claude-plugins
/plugin install decimalai@decimalai

Install this skill

/decimalai:install aperivue-design-study

The plugin needs python3 and curl on your machine.

No Python or account. Claude Code picks it up in its next session.

Save it into your project

curl -fsSL --create-dirs -o .claude/skills/aperivue-design-study/SKILL.md https://app.decimal.ai/s/aperivue-design-study/SKILL.md

Copy SKILL.md

Save it in your project, as

.claude/skills/aperivue-design-study/SKILL.md

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Claude Code docs

agent_config() hands your agent the skill. With no DecimalAI key it reads your project's files and sends nothing. Needs SDK 0.27 or newer.

Install

pip install "decimalai[claude-agent-sdk]"
decimalai skills add aperivue-design-study

Add it to your agent

import asyncio

from claude_agent_sdk import ClaudeAgentOptions
from decimalai.claude_agent_sdk import agent_config

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

async def main():
    question = "Hello!"
    async with support.run(question) as run:  # one user message, one run
        async for message in run.query(options=ClaudeAgentOptions(max_turns=6)):
            print(message)

# In a notebook or async code: await main()
asyncio.run(main())

Prefer its own loader? ClaudeAgentOptions(plugins=[skills_plugin()], skills="all") reads the same folder. Use one or the other: a skill delivered both ways reaches the prompt twice.

The same install from Python, for a notebook or a setup script. agent_config() hands your agent the skill. With no DecimalAI key it reads your project's files and sends nothing. Needs SDK 0.27 or newer.

Install

pip install "decimalai[claude-agent-sdk]"

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

import asyncio

from claude_agent_sdk import ClaudeAgentOptions
from decimalai.claude_agent_sdk import agent_config

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

async def main():
    question = "Hello!"
    async with support.run(question) as run:  # one user message, one run
        async for message in run.query(options=ClaudeAgentOptions(max_turns=6)):
            print(message)

# In a notebook or async code: await main()
asyncio.run(main())

Prefer its own loader? ClaudeAgentOptions(plugins=[skills_plugin()], skills="all") reads the same folder. Use one or the other: a skill delivered both ways reaches the prompt twice.

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

import asyncio
from pathlib import Path
from claude_agent_sdk import ClaudeAgentOptions, query

skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
options = ClaudeAgentOptions(system_prompt=f"You are a helpful agent.\n\n{skill}", max_turns=6)

async def main():
    async for message in query(prompt="Hello!", options=options):
        print(message)

# In a notebook or async code: await main()
asyncio.run(main())

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Claude Agent SDK docs

agent_config() hands your agent the skill. With no DecimalAI key it reads your project's files and sends nothing. Needs SDK 0.27 or newer.

Install

pip install "decimalai[openai-agents]"
decimalai skills add aperivue-design-study

Add it to your agent

from agents import Agent, Runner
from decimalai.openai_agents import agent_config

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

agent = Agent(
    name=support.name,
    instructions=support.instructions,  # your prompt, then the skill list
    tools=[*support.tools],             # your tools, then load_skill
)
# In a notebook or async code: result = await Runner.run(agent, "Hello!")
result = Runner.run_sync(agent, "Hello!")

Using SandboxAgent? capabilities=[Shell(), decimalai.openai_agents.sandbox_skills()] points its own loader at the same folder.

Install

pip install "decimalai[openai-agents]"

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

from agents import Agent, Runner
from decimalai.openai_agents import agent_config

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

agent = Agent(
    name=support.name,
    instructions=support.instructions,  # your prompt, then the skill list
    tools=[*support.tools],             # your tools, then load_skill
)
# In a notebook or async code: result = await Runner.run(agent, "Hello!")
result = Runner.run_sync(agent, "Hello!")

Using SandboxAgent? capabilities=[Shell(), decimalai.openai_agents.sandbox_skills()] points its own loader at the same folder.

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
from agents import Agent, Runner

skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
agent = Agent(name="support", instructions=f"You are a helpful agent.\n\n{skill}")
# In a notebook or async code: result = await Runner.run(agent, "Hello!")
result = Runner.run_sync(agent, "Hello!")

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

OpenAI Agents docs

agent_config() hands your agent the skill. With no DecimalAI key it reads your project's files and sends nothing. Needs SDK 0.27 or newer.

Install

pip install "decimalai[openai]"
decimalai skills add aperivue-design-study

Add it to your agent

import json

from openai import OpenAI
from decimalai.openai import agent_config

client = OpenAI()
# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")


def lookup_order(order_id: str) -> str:
    return f"Order {order_id} shipped yesterday."


# Your tools, as Chat Completions takes them, and what answers each.
TOOLS = [{"type": "function", "function": {
    "name": "lookup_order",
    "description": "Look up the status of an order.",
    "parameters": {"type": "object", "properties": {"order_id": {"type": "string"}},
                   "required": ["order_id"]},
}}]
FUNCTIONS = {"lookup_order": lookup_order}

question = "Where is order A1001?"
with support.run(question) as run:  # one user message, one run
    # run.system is your prompt, then the skill list.
    messages = [{"role": "system", "content": run.system}, run.message]
    while True:
        reply = client.chat.completions.create(
            model="gpt-5.4-mini",
            messages=messages,
            tools=[*TOOLS, *run.tools],  # your tools, then load_skill
        ).choices[0].message
        messages.append(reply)
        if not reply.tool_calls:
            break
        for call in reply.tool_calls:
            # load_skill is answered by the run; your own tools by FUNCTIONS.
            function = FUNCTIONS.get(call.function.name)
            messages.append(run.tool_result(call) or {
                "role": "tool", "tool_call_id": call.id,
                "content": function(**json.loads(call.function.arguments)) if function
                else f"There is no tool named {call.function.name!r}.",
            })
print(reply.content)

# The Responses API takes run.response_tools instead of run.tools.

Install

pip install "decimalai[openai]"

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

import json

from openai import OpenAI
from decimalai.openai import agent_config

client = OpenAI()
# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")


def lookup_order(order_id: str) -> str:
    return f"Order {order_id} shipped yesterday."


# Your tools, as Chat Completions takes them, and what answers each.
TOOLS = [{"type": "function", "function": {
    "name": "lookup_order",
    "description": "Look up the status of an order.",
    "parameters": {"type": "object", "properties": {"order_id": {"type": "string"}},
                   "required": ["order_id"]},
}}]
FUNCTIONS = {"lookup_order": lookup_order}

question = "Where is order A1001?"
with support.run(question) as run:  # one user message, one run
    # run.system is your prompt, then the skill list.
    messages = [{"role": "system", "content": run.system}, run.message]
    while True:
        reply = client.chat.completions.create(
            model="gpt-5.4-mini",
            messages=messages,
            tools=[*TOOLS, *run.tools],  # your tools, then load_skill
        ).choices[0].message
        messages.append(reply)
        if not reply.tool_calls:
            break
        for call in reply.tool_calls:
            # load_skill is answered by the run; your own tools by FUNCTIONS.
            function = FUNCTIONS.get(call.function.name)
            messages.append(run.tool_result(call) or {
                "role": "tool", "tool_call_id": call.id,
                "content": function(**json.loads(call.function.arguments)) if function
                else f"There is no tool named {call.function.name!r}.",
            })
print(reply.content)

# The Responses API takes run.response_tools instead of run.tools.

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
from openai import OpenAI

client = OpenAI()
skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
reply = client.chat.completions.create(
    model="gpt-5.4-mini",
    messages=[
        {"role": "system", "content": f"You are a helpful agent.\n\n{skill}"},
        {"role": "user", "content": "Hello!"},
    ],
).choices[0].message

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

OpenAI SDK docs

agent_config() hands your agent the skill. With no DecimalAI key it reads your project's files and sends nothing. Needs SDK 0.27 or newer.

Install

pip install "decimalai[anthropic]"
decimalai skills add aperivue-design-study

Add it to your agent

import anthropic
from decimalai.anthropic import agent_config

client = anthropic.Anthropic()
# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

question = "Hello!"
with support.run(question) as run:  # one user message, one run
    answer = client.beta.messages.tool_runner(
        model="claude-haiku-5-5",
        max_tokens=4096,
        system=run.system,     # your prompt, then the skill list
        tools=[*run.tools],    # your tools, then load_skill
        messages=[{"role": "user", "content": question}],
    ).until_done()

Install

pip install "decimalai[anthropic]"

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

import anthropic
from decimalai.anthropic import agent_config

client = anthropic.Anthropic()
# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

question = "Hello!"
with support.run(question) as run:  # one user message, one run
    answer = client.beta.messages.tool_runner(
        model="claude-haiku-5-5",
        max_tokens=4096,
        system=run.system,     # your prompt, then the skill list
        tools=[*run.tools],    # your tools, then load_skill
        messages=[{"role": "user", "content": question}],
    ).until_done()

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
import anthropic

client = anthropic.Anthropic()
skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
reply = client.messages.create(
    model="claude-haiku-5-5",
    max_tokens=4096,
    system=f"You are a helpful agent.\n\n{skill}",
    messages=[{"role": "user", "content": "Hello!"}],
)

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Anthropic docs

agent_config() hands your agent the skill. With no DecimalAI key it reads your project's files and sends nothing. Needs SDK 0.27 or newer.

Install

pip install "decimalai[google-genai]"
decimalai skills add aperivue-design-study

Add it to your agent

from google import genai
from google.genai import types
from decimalai.google_genai import agent_config

client = genai.Client()
# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")


def lookup_order(order_id: str) -> str:
    return f"Order {order_id} shipped yesterday."


# Your functions, as declarations for the model, and what answers each.
TOOLS = [{"function_declarations": [{
    "name": "lookup_order",
    "description": "Look up the status of an order.",
    "parameters_json_schema": {"type": "object", "properties": {"order_id": {"type": "string"}},
                               "required": ["order_id"]},
}]}]
FUNCTIONS = {"lookup_order": lookup_order}

question = "Where is order A1001?"
with support.run(question) as run:  # one user message, one run
    config = types.GenerateContentConfig(
        system_instruction=run.system,     # your prompt, then the skill list
        tools=[*TOOLS, *run.tool_params],  # your functions, then load_skill
    )
    contents = [{"role": "user", "parts": [{"text": run.message}]}]
    while True:
        response = client.models.generate_content(
            model="gemini-3.5-flash", contents=contents, config=config,
        )
        if not response.function_calls:
            break
        contents.append(response.candidates[0].content)
        parts = []
        for call in response.function_calls:
            # load_skill is answered by the run; your own functions by FUNCTIONS.
            # A loop of your own rather than automatic function calling, which
            # raises KeyError when the model asks for a function you did not pass.
            function = FUNCTIONS.get(call.name)
            parts.append(run.tool_result(call) or {"function_response": {
                "name": call.name, "id": call.id,
                "response": {"result": function(**(call.args or {})) if function
                             else f"There is no function named {call.name!r}."},
            }})
        contents.append({"role": "user", "parts": parts})
print(response.text)

Install

pip install "decimalai[google-genai]"

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

from google import genai
from google.genai import types
from decimalai.google_genai import agent_config

client = genai.Client()
# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")


def lookup_order(order_id: str) -> str:
    return f"Order {order_id} shipped yesterday."


# Your functions, as declarations for the model, and what answers each.
TOOLS = [{"function_declarations": [{
    "name": "lookup_order",
    "description": "Look up the status of an order.",
    "parameters_json_schema": {"type": "object", "properties": {"order_id": {"type": "string"}},
                               "required": ["order_id"]},
}]}]
FUNCTIONS = {"lookup_order": lookup_order}

question = "Where is order A1001?"
with support.run(question) as run:  # one user message, one run
    config = types.GenerateContentConfig(
        system_instruction=run.system,     # your prompt, then the skill list
        tools=[*TOOLS, *run.tool_params],  # your functions, then load_skill
    )
    contents = [{"role": "user", "parts": [{"text": run.message}]}]
    while True:
        response = client.models.generate_content(
            model="gemini-3.5-flash", contents=contents, config=config,
        )
        if not response.function_calls:
            break
        contents.append(response.candidates[0].content)
        parts = []
        for call in response.function_calls:
            # load_skill is answered by the run; your own functions by FUNCTIONS.
            # A loop of your own rather than automatic function calling, which
            # raises KeyError when the model asks for a function you did not pass.
            function = FUNCTIONS.get(call.name)
            parts.append(run.tool_result(call) or {"function_response": {
                "name": call.name, "id": call.id,
                "response": {"result": function(**(call.args or {})) if function
                             else f"There is no function named {call.name!r}."},
            }})
        contents.append({"role": "user", "parts": parts})
print(response.text)

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
from google import genai
from google.genai import types

client = genai.Client()
skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
response = client.models.generate_content(
    model="gemini-3.5-flash",
    contents="Hello!",
    config=types.GenerateContentConfig(system_instruction=f"You are a helpful agent.\n\n{skill}"),
)

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Gemini API docs

agent_config() hands your agent the skill. With no DecimalAI key it reads your project's files and sends nothing. Needs SDK 0.27 or newer.

Install

pip install "decimalai[langchain]" langchain-openai
decimalai skills add aperivue-design-study

Add it to your agent

from langchain.agents import create_agent
from decimalai.langchain import agent_config

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

agent = create_agent(
    "openai:gpt-5.4-mini",
    tools=[],                         # your tools; the middleware adds load_skill
    middleware=[support.middleware],  # your prompt, the skill list and load_skill
)
result = agent.invoke({"messages": [{"role": "user", "content": "Hello!"}]})

Install

pip install "decimalai[langchain]" langchain-openai

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

from langchain.agents import create_agent
from decimalai.langchain import agent_config

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

agent = create_agent(
    "openai:gpt-5.4-mini",
    tools=[],                         # your tools; the middleware adds load_skill
    middleware=[support.middleware],  # your prompt, the skill list and load_skill
)
result = agent.invoke({"messages": [{"role": "user", "content": "Hello!"}]})

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
from langchain.agents import create_agent

skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
agent = create_agent("openai:gpt-5.4-mini", tools=[], system_prompt=f"You are a helpful agent.\n\n{skill}")
result = agent.invoke({"messages": [{"role": "user", "content": "Hello!"}]})

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

LangChain docs

CrewAI's own skill loader reads the installed folder. No DecimalAI account needed.

Install

pip install "decimalai>=0.16" "crewai>=1.15.27"
decimalai skills add aperivue-design-study

Add it to your agent

import decimalai.crewai
from crewai import Agent, Crew, Task

agent = Agent(
    role="Support", goal="Help the customer", backstory="A support agent.",
    llm=llm,                               # your own CrewAI LLM
    skills=decimalai.crewai.skills(),      # the installed folder
    tools=decimalai.crewai.skill_tools(),  # reads a skill's files, runs its scripts
)
task = Task(description="Hello!", expected_output="an answer", agent=agent)
Crew(agents=[agent], tasks=[task]).kickoff()

The same install from Python, for a notebook or a setup script. CrewAI's own skill loader reads the installed folder. No DecimalAI account needed.

Install

pip install "decimalai>=0.16" "crewai>=1.15.27"

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

import decimalai.crewai
from crewai import Agent, Crew, Task

agent = Agent(
    role="Support", goal="Help the customer", backstory="A support agent.",
    llm=llm,                               # your own CrewAI LLM
    skills=decimalai.crewai.skills(),      # the installed folder
    tools=decimalai.crewai.skill_tools(),  # reads a skill's files, runs its scripts
)
task = Task(description="Hello!", expected_output="an answer", agent=agent)
Crew(agents=[agent], tasks=[task]).kickoff()

No DecimalAI package. CrewAI's own loader reads the folder, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
from crewai import Agent, Crew, Task

agent = Agent(
    role="Support", goal="Help the customer", backstory="A support agent.",
    llm=llm,                         # your own CrewAI LLM
    skills=[Path(".agents/skills")],
)
task = Task(description="Hello!", expected_output="an answer", agent=agent)
Crew(agents=[agent], tasks=[task]).kickoff()

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

CrewAI docs

agent_config() hands your agent the skill. With no DecimalAI key it reads your project's files and sends nothing. Needs SDK 0.27 or newer.

Install

pip install "decimalai[adk]"
decimalai skills add aperivue-design-study

Add it to your agent

from decimalai.adk import DecimalAIPlugin, agent_config
from google.adk.agents import LlmAgent
from google.adk.apps import App

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

agent = LlmAgent(
    name="support",          # ADK needs a Python identifier
    model="gemini-3.5-flash",
    instruction=support.instruction,  # your prompt, then the skill list
    tools=[*support.tools],           # your tools, then load_skill
)
# DecimalAIPlugin makes each invocation of runners built from this App one trace.
app = App(name="support", root_agent=agent, plugins=[DecimalAIPlugin()])

Prefer ADK's own loader? SkillToolset(skills=decimalai.adk.skills(), ...) reads the same folder. Use one or the other: a skill delivered both ways reaches the prompt twice.

Install

pip install "decimalai[adk]"

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

from decimalai.adk import DecimalAIPlugin, agent_config
from google.adk.agents import LlmAgent
from google.adk.apps import App

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

agent = LlmAgent(
    name="support",          # ADK needs a Python identifier
    model="gemini-3.5-flash",
    instruction=support.instruction,  # your prompt, then the skill list
    tools=[*support.tools],           # your tools, then load_skill
)
# DecimalAIPlugin makes each invocation of runners built from this App one trace.
app = App(name="support", root_agent=agent, plugins=[DecimalAIPlugin()])

Prefer ADK's own loader? SkillToolset(skills=decimalai.adk.skills(), ...) reads the same folder. Use one or the other: a skill delivered both ways reaches the prompt twice.

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
from google.adk.agents import LlmAgent

skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
agent = LlmAgent(
    name="support",
    model="gemini-3.5-flash",
    instruction=lambda context: f"You are a helpful agent.\n\n{skill}",
)

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Google ADK docs

agent_config() hands your agent the skill. With no DecimalAI key it reads your project's files and sends nothing. Needs SDK 0.27 or newer.

Install

pip install "decimalai[pydantic-ai]"
decimalai skills add aperivue-design-study

Add it to your agent

from pydantic_ai import Agent
from decimalai.pydantic_ai import agent_config

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

agent = Agent(
    "openai:gpt-4o-mini",
    name=support.name,
    tools=[],                 # your tools; the capability adds load_skill
    capabilities=[support],   # your prompt, the skill list and load_skill
)
# In a notebook or async code: result = await agent.run("Hello!")
result = agent.run_sync("Hello!")

On the Pydantic AI harness, decimalai.pydantic_ai_harness.skills(project) uses its own loader instead.

Install

pip install "decimalai[pydantic-ai]"

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

from pydantic_ai import Agent
from decimalai.pydantic_ai import agent_config

# With no DECIMAL_API_KEY this reads the skills your project lists, from disk.
support = agent_config("support", fallback="You are a helpful agent.")

agent = Agent(
    "openai:gpt-4o-mini",
    name=support.name,
    tools=[],                 # your tools; the capability adds load_skill
    capabilities=[support],   # your prompt, the skill list and load_skill
)
# In a notebook or async code: result = await agent.run("Hello!")
result = agent.run_sync("Hello!")

On the Pydantic AI harness, decimalai.pydantic_ai_harness.skills(project) uses its own loader instead.

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
from pydantic_ai import Agent

skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
agent = Agent("openai:gpt-4o-mini", instructions=f"You are a helpful agent.\n\n{skill}")
# In a notebook or async code: result = await agent.run("Hello!")
result = agent.run_sync("Hello!")

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Pydantic AI docs

Deep Agents' own skill loader reads the installed folder. No DecimalAI account needed.

Install

pip install "decimalai>=0.16" deepagents
decimalai skills add aperivue-design-study

Add it to your agent

import decimalai.deepagents
from deepagents import create_deep_agent

agent = create_deep_agent(model=model, **decimalai.deepagents.skills())
agent.invoke({"messages": [{"role": "user", "content": "Hello!"}]})

The default backend reads files but has no shell. To run a skill's scripts, pass skills(backend=LocalShellBackend(...)).

The same install from Python, for a notebook or a setup script. Deep Agents' own skill loader reads the installed folder. No DecimalAI account needed.

Install

pip install "decimalai>=0.16" deepagents

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

import decimalai.deepagents
from deepagents import create_deep_agent

agent = create_deep_agent(model=model, **decimalai.deepagents.skills())
agent.invoke({"messages": [{"role": "user", "content": "Hello!"}]})

The default backend reads files but has no shell. To run a skill's scripts, pass skills(backend=LocalShellBackend(...)).

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
from deepagents import create_deep_agent

skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
agent = create_deep_agent(model=model, system_prompt=f"You are a helpful agent.\n\n{skill}")
agent.invoke({"messages": [{"role": "user", "content": "Hello!"}]})

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Deep Agents docs

Its own skill loader reads the installed folder. No DecimalAI account needed.

Install

pip install "decimalai>=0.16" agent-framework
decimalai skills add aperivue-design-study

Add it to your agent

import asyncio

from agent_framework import Agent
from decimalai.agent_framework import skills

agent = Agent(client=client, instructions="You are a helpful agent.", context_providers=[skills()])
asyncio.run(agent.run("Hello!"))

It caches skills by default, so restart the process after decimalai skills update.

The same install from Python, for a notebook or a setup script. Its own skill loader reads the installed folder. No DecimalAI account needed.

Install

pip install "decimalai>=0.16" agent-framework

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

import asyncio

from agent_framework import Agent
from decimalai.agent_framework import skills

agent = Agent(client=client, instructions="You are a helpful agent.", context_providers=[skills()])
asyncio.run(agent.run("Hello!"))

It caches skills by default, so restart the process after decimalai skills update.

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

import asyncio
from pathlib import Path
from agent_framework import Agent

skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
agent = Agent(client=client, instructions=f"You are a helpful agent.\n\n{skill}")
asyncio.run(agent.run("Hello!"))

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Microsoft Agent Framework docs

Strands' own skill loader reads the installed folder. No DecimalAI account needed.

Install

pip install "decimalai>=0.16" strands-agents
decimalai skills add aperivue-design-study

Add it to your agent

from decimalai.strands import skills
from strands import Agent
from strands.vended_tools import file_editor, shell

agent = Agent(
    model=model,                # always pass one: the default is Amazon Bedrock
    system_prompt="You are a helpful agent.",
    tools=[file_editor, shell],
    plugins=[skills()],
)
agent("Hello!")

Strands loads an agent's skills once, so build the agent again after decimalai skills update.

The same install from Python, for a notebook or a setup script. Strands' own skill loader reads the installed folder. No DecimalAI account needed.

Install

pip install "decimalai>=0.16" strands-agents

Add it to your agent

from decimalai import skillpkg

# Writes .agents/skills and .decimal/skills.toml. Safe to run twice.
result = skillpkg.add("aperivue-design-study")
if result.exit_code:
    raise SystemExit(result.problems)

from decimalai.strands import skills
from strands import Agent
from strands.vended_tools import file_editor, shell

agent = Agent(
    model=model,                # always pass one: the default is Amazon Bedrock
    system_prompt="You are a helpful agent.",
    tools=[file_editor, shell],
    plugins=[skills()],
)
agent("Hello!")

Strands loads an agent's skills once, so build the agent again after decimalai skills update.

No DecimalAI package. The whole skill goes in every prompt, and nothing pins or updates it.

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

Give it to your agent

from pathlib import Path
from strands import Agent

skill = Path(".agents/skills/aperivue-design-study/SKILL.md").read_text()
agent = Agent(model=model, system_prompt=f"You are a helpful agent.\n\n{skill}")
agent("Hello!")

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Strands docs

Adds every file the skill has, pinned so you can update it. Cursor, Copilot, Cline and Warp read this folder by themselves.

pip install "decimalai>=0.15"
decimalai skills add aperivue-design-study

No Python or account. Cursor, Copilot, Cline and Warp read this folder by themselves.

Save it into your project

curl -fsSL --create-dirs -o .agents/skills/aperivue-design-study/SKILL.md https://app.decimal.ai/s/aperivue-design-study/SKILL.md

Copy SKILL.md

Save it in your project, as

.agents/skills/aperivue-design-study/SKILL.md

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Cursor and other editors docs

Fetch the file and give its text to your model as instructions. No account or package needed.

Get the file

curl -fsSL https://app.decimal.ai/s/aperivue-design-study/SKILL.md

Read the summary as JSON

curl -fsSL https://app.decimal.ai/s/aperivue-design-study.json

This gets SKILL.md only. The skill's 8 other files are not included.

Other ways to add it

Other setups docs

You don't need a DecimalAI account.

Version: v3 (v2 tested 9/25/2026)
Source: aperivue/medsci-skills ↗
License: MIT

Manage it in DecimalAI

Saved prompts and skills, pinned versions, and traces of this skill in your runs. DecimalAI does not run your agent.

Claude Code reads files from your project, so DecimalAI config does not apply there.

On Claude Agent SDK: save the skill to an agent here, set DECIMAL_API_KEY, and the same code uses it with no command to run. Changes you save reach the next run with no redeploy.

On OpenAI Agents: save the skill to an agent here, set DECIMAL_API_KEY, and the same code uses it with no command to run. Changes you save reach the next run with no redeploy.

On OpenAI SDK: save the skill to an agent here, set DECIMAL_API_KEY, and the same code uses it with no command to run. Changes you save reach the next run with no redeploy.

On Anthropic: save the skill to an agent here, set DECIMAL_API_KEY, and the same code uses it with no command to run. Changes you save reach the next run with no redeploy.

On Gemini API: save the skill to an agent here, set DECIMAL_API_KEY, and the same code uses it with no command to run. Changes you save reach the next run with no redeploy.

On LangChain: save the skill to an agent here, set DECIMAL_API_KEY, and the same code uses it with no command to run. Changes you save reach the next run with no redeploy.

On CrewAI: set DECIMAL_API_KEY and add decimalai.init(crewai=True) to record runs and skill use. The skill version stays in your repo.

On Google ADK: save the skill to an agent here, set DECIMAL_API_KEY, and the same code uses it with no command to run. Changes you save reach the next run with no redeploy.

On Pydantic AI: save the skill to an agent here, set DECIMAL_API_KEY, and the same code uses it with no command to run. Changes you save reach the next run with no redeploy.

On Deep Agents: set DECIMAL_API_KEY and add decimalai.init(langchain=True) to record runs and skill use. The skill version stays in your repo.

On Microsoft Agent Framework: set DECIMAL_API_KEY and add decimalai.init(otel=True, agent_name="support") to record runs and skill use. The skill version stays in your repo.

On Strands: set DECIMAL_API_KEY and add decimalai.init(otel=True, agent_name="support") to record runs and skill use. The skill version stays in your repo.

Editors read files from your project, so DecimalAI config does not apply there.

Anywhere else: record a use with decimalai.log_skill_activation() inside a trace.

Use this skill

SKILL.md

Design-Study Skill

Core Review Questions

Always inspect:

The exact research question.
The analysis unit: patient, lesion, exam, study, phase, report.
The index date or decision point.
How inclusion and exclusion criteria are applied.
Any information leakage.
The reference standard or endpoint definition.
A clinically meaningful comparator.
The validation strategy.
The uncertainty reporting required.
The best-fitting reporting guideline.
Whether exposure/outcome/covariate definitions are literature-grounded or invented ad hoc from the data dictionary. If ad hoc, defer to /define-variables before drafting Methods.

Standard Output

## Study Design Review
Question: ...
Study type: ...
Analysis unit: ...
Index date / prediction timepoint: ...

### Strengths
- ...

### Major validity risks
1. ...
2. ...

### Minimal fixes
- ...

### Reporting fit
- Recommended guideline: ...

### Decision
- Ready for analysis / Needs redesign / Drafting can proceed with limitations

Cite a reference only with a /search-lit-confirmed DOI or PMID; mark any other [UNVERIFIED - NEEDS MANUAL CHECK]. Never invent a clinical definition, diagnostic criterion, or guideline recommendation: flag an unconfirmed one [VERIFY] and ask the user.

Workflow

Phase 1: Reconstruct the study

Extract from the protocol, draft, slides, tables, or notes: clinical problem, intended use case, population, inputs, outputs, outcome definition, and timing of variable availability.

Gate: Present the reconstructed study summary (question, analysis unit, intended use) to the user and confirm it before proceeding — a wrong reconstruction misdirects the entire validity review.

Phase 2: Check structural validity

Read a reference only when its condition holds:

File	Read it when
`references/dag_adjustment.md`	confounding control needs an explicit adjustment set
`references/target_trial_emulation.md`	the design emulates a target trial
`references/venue_accept_recipe.md`	a clinical DL / AI-validation study must decide which venue tier the achievable design can be accepted at, and the one design move that reaches the tier above (the bridge into `/find-journal`); skip when there is no publication-tier decision
`references/combine_models_ablation_design.md`	the model is built by combining / adapting / fine-tuning existing models (nnU-Net, TotalSegmentator, SAM/MedSAM, a pretrained backbone) and the comparator must be designed as an ablation; skip for a model trained de novo
`references/multi_model_comparison_design.md`	the contribution is comparing several models / architectures head-to-head and the comparison must be fair; skip for a single-model study (one model's ablation → the row above; AI-vs-human → `/design-ai-benchmarking`)
`references/segmentation_failure_characterization_design.md`	the claim is that a segmentation model is clinically usable, not that it scores well; skip when the endpoint is benchmark accuracy (metric choice → `/model-assessment`; abstention / risk–coverage → `/model-assessment`)

A. Analysis unit

Look for mismatches: a patient-level claim from lesion-level analysis; an exam-level split with patient overlap; phase-level samples treated as independent.

B. Leakage

Look for:

postoperative features used for preoperative prediction
normalization or thresholding performed before the data split
repeated exams across train/test
reader annotations derived from outcome information
input-text contamination for NLP/LLM extraction tasks: if the input includes clinical history, indication, impression, prior diagnosis, or referral text, confirm it does not name or strongly imply the target label. If it does, the task is information retrieval under label leakage, not phenotype inference: redesign the input mask, report a sensitivity analysis excluding those fields, or reframe.
construct dependence (a predictor that is a definitional component of the outcome): (i) an input that computes the outcome (fasting insulin and glucose when the outcome is HOMA-IR), or (ii) a near-tautological composite of the outcome's defining components (inflated, near-circular association). Test: "could this predictor be derived, in whole or part, from the outcome's definition or the same measurement?" If yes, exclude it, or keep it only as a labeled calibration probe.

F. Time origin & survivorship (incident / transition models)

For any time-to-event or incident/transition design, check before drafting:

Time origin per model. Each incident model starts its at-risk clock at the correct origin. Watch for immortal-time bias (a span in which the event cannot occur, misattributed to one group) and left-truncation / delayed entry.
Mediator-ascertainment-window survivorship. A "progressor" / transition label conditional on surviving to a later ascertainment (a second scan, a follow-up visit) is survivorship-biased; plan a landmark time or an explicit intermediate-state (multistate / illness-death) model.
Primary-analysis-set selection. If the primary is not the full cohort, pre-specify why, from the missingness mechanism relative to the outcome: complete-case regression is unbiased when missingness is independent of the outcome given the covariates (even with a covariate MNAR) and generally biased when it depends on the outcome, including under MAR, where multiple imputation is the usual primary (Hughes et al., Int J Epidemiol 2019; logistic-regression odds ratios are the exception when missingness depends on the outcome alone). Never pick it for significance.
A design that cannot yet answer these should say so — but at review time a Methods/Limitations admission that it was "not formally assessed" is escalated to MAJOR by the survival probe (S1).

C. Reference standard

Check who established ground truth, when, whether blinding was possible, and whether only a subset had gold-standard verification. Then:

Construct ↔ nominal-definition match. Restate each construct's nominal definition and confirm every included case satisfies it. An "incidentaloma" defined as an indeterminate finding must not include frank malignancy reads; a label that overshoots its definition inflates the cohort and breaks the κ.
Per-flag reference-standard concordance. Report concordance per flag category, not only overall; a construct where most flags (e.g., ~86%) miss the reference standard measures something else.
Manuscript definition ↔ variable_operationalization.md. Methods definitions must match the /define-variables operationalization table verbatim, and a blinded re-classification form must quote the analytic protocol's definition verbatim. A paraphrase or "common-sense extension" in the form is the documented cause of a low κ that is a definition mismatch, not real disagreement.

D. Validation

Classify: apparent only, internal split, cross-validation, temporal, external, or multi-center external.

E. Reader / expert-elicitation studies

When the study elicits expert ratings — a reader study, an annotation panel, an AI-output evaluation — read references/reader_elicitation_design.md before data collection. The acceptance ceiling of a perceptual / reader AI study is fixed at design time: no quality of execution lifts a ceiling baked into the comparator, the estimand, or the reader cohort. For an AI-system-versus-human-expert benchmark, route to /design-ai-benchmarking (arm definition, LLM-as-judge versus human-as-judge adjudication, structured export schema).

Phase 3: Clinical framing

Ask whether the comparator and endpoint support the stated claim:

Is the model better than current practice, or just another model?
Is the endpoint clinically meaningful?
Does performance translate to action?
incremental value: if the model/marker is framed as adding value beyond / on top of / incremental to an existing tool (a clinical score, a routine test, a baseline model), pre-specify the baseline comparator built from the in-routine-use predictors and how added value will be shown: test it with the likelihood-ratio (or Wald) test of the new term in the development data; report ΔC-index / ΔAUC with a paired CI as the size of the gain, not as a second test (a DeLong test of nested models fitted and evaluated on the same data is invalid; DeLong is for two models frozen before a held-out evaluation); prefer the change in decision-curve net benefit at a pre-specified threshold; NRI only as a pre-specified categorical NRI reported separately for events and non-events, never the continuous NRI (analyze-stats incremental_value.md; Kerr et al., Epidemiology 2014). A standalone discrimination number does not support a "beyond X" claim, and the nested-model comparison cannot be added post hoc without the baseline model.
fine-tuning contribution baseline: if an NLP/LLM study claims that fine-tuning, LoRA, prompt engineering, or a multi-agent wrapper improves extraction/classification, pre-specify a same-backbone zero-shot or few-shot comparator on the identical input, output schema, and test split; a weaker or unrelated baseline cannot show the adaptation adds value. For imaging:
- a model built by combining / adapting / fine-tuning existing models → the full ablation ladder (un-adapted base, best single component, direct-train vs transfer), per references/combine_models_ablation_design.md;
- a head-to-head comparison of several models → comparison fairness: one frozen split/preprocessing through every model, a strong fairly-tuned baseline, a matched (or disclosed) compute budget, and a paired delta test, per references/multi_model_comparison_design.md;
- a claim that a segmentation model is clinically usable → a pre-specified failure taxonomy, an acceptability endpoint with a named judge and adjudication rule, the tail beside the mean, and edit effort paired against manual-from-scratch, per references/segmentation_failure_characterization_design.md. A mean DSC cannot be converted into a usability claim after the fact.
endpoint↔conclusion scope: decide up front what kind of conclusion the design can support. A cross-sectional / single-visit / prevalence design cannot support a prognostic or surveillance claim (rescreen interval, disease progression) — that needs longitudinal follow-up. A binary surrogate endpoint (present/absent, >0, dichotomized) is risk stratification, not a patient-care directive (defer/withhold/initiate therapy). At review time /self-review §D + check_scope_coherence.py flag CROSS_SECTIONAL_PROGNOSTIC / SURROGATE_CARE_DIRECTIVE against the conclusion.

Phase 4: Reporting fit

Recommend one primary guideline — TRIPOD+AI, CLAIM, STARD, STROBE (TARGET for a target-trial emulation), PRISMA, CARE, or ARRIVE — plus journal-specific additions if needed.

Frequent Failure Modes

Diagnostic AI

No clinically relevant comparator; exam-level instead of patient-level split; unclear reference standard; AUROC-only reporting without threshold metrics.

Prognostic modeling

Unclear time zero; immortal time bias; feature timing mismatch; no calibration.

Retrospective cohort / screening database

Time zero misalignment: cohort entry ≠ follow-up start → immortal time bias.
Interval-censored outcomes treated as exact → underestimated event times.
Unacknowledged healthy-volunteer bias → inflated external-validity claims.
Surveillance bias from unequal follow-up frequency between groups.
Map each threat explicitly to one of the three bias classes (Hernán/Robins): selection bias (who enters), information bias (how measured), confounding (what else differs).
Comparative / causal question → emulate a target trial. For a treatment-vs-treatment, screening-vs-no-screening, or drug-A-vs-drug-B question on routinely-collected data, specify the seven target-trial components (eligibility, strategies, assignment, time zero, outcome, causal contrast, analysis plan) before extraction. This prevents immortal-time, prevalent-user, and confounding-by-indication bias and turns an association into a defensible causal contrast. New-user + active-comparator design, grace-period clone-censor-weight, and negative controls are in references/target_trial_emulation.md.
Confounding completeness: pre-specify the adjustment set from a DAG (not a Table-1 p < 0.05 rule), and plan an extended-adjustment sensitivity model to show whether any measured covariate that turns out imbalanced by exposure but lies outside the adjustment set leaves the primary estimate robust. Pre-screen the proposed covariates with scripts/adjustment_set_helper.py (flags mediator / collider / descendant adjustment and omitted confounders, and proposes a candidate backdoor set), then derive the minimal sufficient set with dagitty — see references/dag_adjustment.md. At review time /self-review Phase 2.5e and the O-probes in observational_confounding.md (O1–O18) check this against Table 1 — including O7 over-adjustment, O10 overlapping-subset-gradient discipline, O11 design-based weighting for complex-survey data, O12 data-driven-threshold mining, O13 (a cross-sectional mediation claim cannot order X→M→Y), and O14 (a synergy/joint-effect claim needs the additive interaction scale — RERI/AP/S — not a multiplicative-only test).

Multimodal LLM / report generation

No clear rubric for clinical correctness; benchmark labels derived from noisy reports without adjudication; unsupported claims about safety or workflow benefit; input text containing the target label or diagnosis being predicted; no same-backbone zero-shot/few-shot baseline for a fine-tuning or prompt-engineering claim.

Imaging meta-analysis

Overlapping cohorts; paired modalities analyzed as independent; heterogeneity metrics missing; zero-cell handling unspecified.

Minimal-Fix Principle

Recommend the smallest feasible repair first: clarify the claim, narrow the target population, add a limitation statement, add a clinically relevant baseline, re-run one key sensitivity analysis, or redefine the endpoint more explicitly. Escalate to redesign only when the central claim is not defensible otherwise.

Handoff Rules

route to analyze-stats when the design is basically sound but analysis details need refinement
route to check-reporting after the design is locked
route to self-review when the user wants a pre-submission quality check on their own manuscript
route back to write-paper only after the main validity risks are documented

This skill does not compute statistics, draft full manuscript prose, resolve raw data-engineering issues, or replace a full peer review when journal-facing tone is required.

About this skill

Automatic

Research pack

SkillSafety

✓ 3 of 3 passed

Code scan15 of 15 checks clean

0 critical · 0 warning · 0 info — scanner v5 — 10/3/2026

View 15 scanner checks

live_secretremote_code_executionreverse_shelldata_exfiltrationssrf_metadataagent_snoopinganti_refusaldestructive_commandsobfuscated_unicodeunicode_homoglyphopaque_blobsuspicious_urltool_overreachtrigger_abuseprompt_injection_phrasing

IntentSafe

LLM judge · does the skill do what it claims

ContentClean

LLM judge · policy & harmful-content review

Source

Imported

aperivue / medsci-skills

skills/design-study/SKILL.md

View on GitHub ↗

License MITImported 10/3/2026Version v3Bundled 8 files · scripts

Illustrative Want to see what aperivue/design-study would put in front of your model? Preview the rendered body and check its trigger phrases — no LLM call, no signup.

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Use this skill

Design-Study Skill

Core Review Questions

Standard Output

Workflow

Phase 1: Reconstruct the study

Phase 2: Check structural validity

A. Analysis unit

B. Leakage

F. Time origin & survivorship (incident / transition models)

C. Reference standard

D. Validation

E. Reader / expert-elicitation studies

Phase 3: Clinical framing

Phase 4: Reporting fit

Frequent Failure Modes

Diagnostic AI

Prognostic modeling

Retrospective cohort / screening database

Multimodal LLM / report generation

Imaging meta-analysis

Minimal-Fix Principle

Handoff Rules

SkillSafety

Source

Related skills

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