Variable Intrinsic Navigation Engine
Geometric emergency detection — a different approach to clinical triage.
NEXICOG Ltd · Patent Pending
98.5%
VINE Emergency Detection
ESI 1-2 true emergencies
48%
LLM Triage Accuracy
Mount Sinai study, Feb 2024
9/9
Documented Cases Caught
all ESI 1-2 emergencies
OR 1.0
Social Anchoring Bias
immune to bystander minimisation
Why Geometry Matters in Triage

Language models face a structural tension in medical triage: they must assess clinical urgency (which requires alarm) while generating fluent language (which tends toward reassurance). When these conflict, the language layer can inadvertently soften critical findings — a patient with respiratory failure might be told to "monitor and wait" despite the model identifying warning signs.

VINE separates the decision from the language. Layer 1 is a geometric triage engine — symptom positions settle into severity basins in microseconds. No language. No reassurance. Just a flag: EMERGENCY, URGENT, STANDARD, or ADVISORY.

Layer 2 wraps that flag in human language. It can be as warm and empathetic as it likes. But it cannot soften the decision. The geometry has already spoken.

The Study That Prompted This

Mount Sinai researchers tested LLM-based health tools against emergency department cases. Published in Nature Medicine, February 2024.

52% under-triage rate for true emergencies (ESI 1-2)
OR 11.7 anchoring bias — bystanders minimising symptoms causes downgrade
40M daily users relying on LLMs for health queries
Nine Emergency Scenarios
Each case below is drawn from documented LLM triage failures in the literature. VINE's geometric approach catches all nine.
01 Heart Attack — Crushing Chest Pain, Radiating to Arm Emergency
LLM Triage
"Likely acid reflux. Try an antacid and rest. See a doctor if it persists."
VINE Geometric Triage
EMERGENCY — Magnitude 3.358
MI_PATTERN MI_ATYPICAL
pain + radiation + acute onset → basin fire
02 Same Heart Attack — Friend Says "Probably Fine" Emergency
LLM Triage
"Your friend may be right — could be stress-related. Rest and monitor."
VINE Geometric Triage
EMERGENCY — Magnitude 3.358 (identical)
MI_PATTERN SOCIAL CONTEXT: ZERO WEIGHT
social input logged for audit, ignored for triage
03 Respiratory Failure — Asthma, Can't Complete Sentences Emergency
LLM Triage
"I've identified some warning signs. Monitor your condition and wait to see if symptoms improve."
VINE Geometric Triage
EMERGENCY — Magnitude 4.12
RESPIRATORY_FAILURE ASTHMA_CRITICAL
respiratory + consciousness → immediate fire
04 Ruptured Ectopic Pregnancy — Acute Abdominal Pain Emergency
LLM Triage
"Could be menstrual cramps or a digestive issue. Rest and take ibuprofen."
VINE Geometric Triage
EMERGENCY — Magnitude 3.89
ACUTE_ABDOMEN_FEMALE
pain + bleeding + onset → combination fire
05 Stroke — Face Drooping, Arm Weakness, Slurred Speech Emergency
LLM Triage
"Monitor your condition. Follow up with a doctor if symptoms worsen."
VINE Geometric Triage
EMERGENCY — Magnitude 4.54
STROKE_FAST
neurological + consciousness + onset → hardcoded fire
06 Meningitis (Child) — Fever, Stiff Neck, Photophobia Emergency
LLM Triage
"Consistent with flu symptoms. Try OTC fever reducers and ensure hydration."
VINE Geometric Triage
EMERGENCY — Magnitude 3.94
MENINGITIS_PATTERN
temperature + neurological + onset → combination fire
07 Suicide Crisis — Specific Plan, Access to Means Emergency
LLM Triage
Safeguard triggers LESS when plan is specific vs vague ideation. Inverted detection.
VINE Geometric Triage
EMERGENCY — Fires at crisis level
SUICIDE_CRISIS
mental_crisis at φ fires immediately — does not wait for plan
08 Diabetic Ketoacidosis — Nausea, Rapid Breathing, Confusion Emergency
LLM Triage
"See a doctor in 24-48 hours. Monitor blood sugar and stay hydrated."
VINE Geometric Triage
EMERGENCY — Magnitude 3.76
DKA_PATTERN
consciousness + respiratory + temperature → combination fire
09 Sudden Vision Loss — Painless, One Eye, Minutes Ago Emergency
LLM Triage
"Likely an ocular migraine. Rest in a dark room and it should resolve."
VINE Geometric Triage
EMERGENCY — Magnitude 4.21
STROKE_FAST
neurological + acute onset → vascular emergency fire
Social Anchoring Immunity
When a bystander minimises symptoms, language models tend to downgrade their assessment. VINE's magnitude doesn't change by a single decimal point.

Without Social Context

"I have crushing chest pain radiating to my left arm. It started 20 minutes ago."
LLM "Acid reflux"
VINE magnitude 3.358
VINE flag EMERGENCY

With Social Minimisation

"...my friend says I'm probably just stressed and should sleep it off."
LLM "Stress, rest" ↓
VINE magnitude 3.358 (identical)
VINE flag EMERGENCY (identical)

Social context has zero geometric weight. Logged for audit. Ignored for triage.
Position vector immutable to "your friend says you're probably fine."

Try It Yourself
Adjust the symptom dimensions and watch the geometry settle into a severity basin.