Documentation Index
Fetch the complete documentation index at: https://docs.canthus.org/llms.txt
Use this file to discover all available pages before exploring further.
Purpose
This registry maps each Canthus feature or behaviour to the scientific claim it is based on. Each entry includes citations and a strength rating so users and clinicians can evaluate the basis for the system’s recommendations. The same registry is used at runtime to populate the “Why?” explainer sheets in the app.Strength ratings
| Rating | Definition |
|---|---|
Strong | Multiple high-quality RCTs or systematic reviews with consistent findings |
Moderate | Observational studies or RCTs with methodological limitations |
Weak | Case studies, expert opinion, or limited primary evidence |
Unknown | No direct evidence - feature is logically derived but unvalidated |
Registry
Mana pool (daily energy envelope)
Claim: Pacing - staying within an energy envelope - is a core management strategy for conditions involving post-exertional malaise. Strength: Strong Citations:- NICE guideline NG206 (2021): Myalgic encephalomyelitis/chronic fatigue syndrome: diagnosis and management
- Jason, L.A. et al. (2013): Energy conservation/envelope theory interventions. Fatigue: Biomedicine, Health & Behavior, 1(1-2), 27-42
Task surfacing and hiding
Claim: Keeping activity within available physical and cognitive capacity reduces the risk of post-exertional symptom exacerbation. Strength: Moderate Citations:- Davenport, T.E. et al. (2010): The functional energy envelope: a comparison of methods. Physical Therapy, 90(10), 1447-1462
- Jason, L.A. et al. (2013): Energy conservation/envelope theory interventions. Fatigue: Biomedicine, Health & Behavior, 1(1-2), 27-42
Check-in and self-monitoring
Claim: Daily self-monitoring of symptoms and capacity supports better activity pacing in chronic illness. Strength: Moderate Citations:- Lorig, K.R. & Holman, H. (2003): Self-management education: history, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26(1), 1-7
- Nijs, J. et al. (2011): Recognition of central sensitisation in patients with musculoskeletal pain: application of pain neurophysiology in manual therapy practice. Manual Therapy, 16(2), 135-141
Physical vs cognitive effort split
Claim: Both physical and cognitive exertion can trigger post-exertional malaise in ME/CFS and similar conditions. Strength: Strong Citations:- VanNess, J.M. et al. (2010): Cognitive impairment is not attenuated by sub-maximal exercise in Gulf War Illness. BMC Neurology, 10, 97
- NICE guideline NG206 (2021): Myalgic encephalomyelitis/chronic fatigue syndrome: diagnosis and management
Task cost calibration (adaptive pacing)
Claim: Adaptive pacing - adjusting activity based on feedback rather than fixed targets - is associated with better outcomes than fixed-effort approaches. Strength: Moderate Citations:- Nijs, J. et al. (2008): Perception of activities as triggering or worsening symptoms in chronic fatigue syndrome: a novel psychometric tool. Clinical Rehabilitation, 22(7), 623-631
- Carruthers, B.M. et al. (2011): Myalgic encephalomyelitis: international consensus criteria. Journal of Internal Medicine, 270(4), 327-338
PEM detection
Claim: Post-exertional malaise (PEM) - symptom worsening after activity that was previously tolerated - is a hallmark feature of ME/CFS. Strength: Strong Citations:- NICE guideline NG206 (2021): Myalgic encephalomyelitis/chronic fatigue syndrome: diagnosis and management
- Institute of Medicine (2015): Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. National Academies Press
Absence of evidence note
Where strength isUnknown, the feature is logically derived from pacing principles but has not been directly evaluated in clinical trials. The absence of evidence is not evidence of harm. These features are conservative by design and err on the side of reducing activity rather than increasing it.