Family Health

• Grandparents: health conditions, cause of death, age at death
• Aunts/Uncles: health conditions

For each condition, record:

• Who has it (relationship)
• What condition
• Age at diagnosis
• Severity (if provided)

Step 2: Calculate Genetic Risk Score

Based on OpenClaw family-health-analyzer algorithm:

Weighted Risk Formula

Genetic Risk Score = (F1 × 0.4) + (F2 × 0.3) + (F3 × 0.3)

Where:
- F1 = First-degree relatives with condition (weight 0.4)
- F2 = Early-onset cases (<50 years) × 0.3
- F3 = Family clustering score × 0.3

Family Clustering Score

Early-Onset Multiplier

Step 3: Risk Classification

By Score Range

By Condition Category

Cardiovascular

• High risk: 1 parent with MI/stroke <55 (male) or <65 (female)
• Moderate risk: 2+ relatives with hypertension before 50
• Elevated screening: lipid panel, BP monitoring from age 30

Diabetes

• High risk: 1 first-degree relative with T2DM
• Very high risk: 2+ first-degree relatives, or 1 with early onset (<50)
• Elevated screening: HbA1c from age 35, or 10 years before earliest family diagnosis

Cancer

• High risk: 2+ first-degree relatives with same cancer
• Very high risk: Any first-degree relative diagnosed <50
• BRCA/Lynch syndrome referral if indicated

Mental Health

• Family history of depression, anxiety, or substance use
• Triggers earlier PHQ-9/GAD-7 monitoring
• Increased suicide risk awareness

Thyroid/Nodules

• Family history of thyroid cancer or autoimmune thyroid disease
• Triggers more frequent thyroid monitoring
• Lower threshold for FNA biopsy consideration

Step 4: Personalized Screening Recommendations

Based on risk score, recommend:

Low Risk

• Standard age-based screening per USPSTF guidelines
• Maintain healthy lifestyle

Moderate Risk

• Start screening 5-10 years earlier than standard recommendation
• Increase frequency (e.g., annual instead of every 3 years)
• Consider additional biomarkers

High Risk

• Start screening at earliest recommended age or 10 years before earliest family diagnosis
• Discuss with doctor about genetic referral if applicable
• Consider comprehensive screening panel
• Lifestyle intervention with highest priority

Step 5: Cross-Dimensional Correlation

Family history should inform other skills:

Step 6: Create Family Health Record

Store in health/ directory:

health/
├── Family History.md
└── Family History.json

JSON Schema

{
  "family_history": {
    "first_degree": [
      {
        "relative": "father",
        "conditions": [
          {
            "name": "Type 2 Diabetes",
            "age_at_diagnosis": 55,
            "severity": "controlled",
            "notes": "On metformin"
          }
        ]
      }
    ],
    "second_degree": [
      {
        "relative": "maternal_grandmother",
        "conditions": [
          {
            "name": "Breast Cancer",
            "age_at_diagnosis": 62,
            "severity": "treated",
            "notes": "Early stage, no recurrence"
          }
        ]
      }
    ]
  },
  "risk_assessment": {
    "cardiovascular": {
      "score": 52,
      "level": "moderate",
      "factors": ["father MI at 58"]
    },
    "diabetes": {
      "score": 40,
      "level": "moderate",
      "factors": ["father T2DM at 55"]
    }
  },
  "screening_recommendations": [
    {
      "test": "HbA1c",
      "start_age": 35,
      "frequency": "annual",
      "reason": "Family history of T2DM"
    }
  ],
  "last_updated": "2026-03-21"
}

Output Format

# Family Health Assessment — [Date]

## Family History Summary

| Relative | Condition | Age at Dx | Notes |
|----------|-----------|-----------|-------|
| Father | Type 2 Diabetes | 55 | On metformin |
| Mother | Hypertension | 58 | Controlled |
| Mat. Grandmother | Breast Cancer | 62 | Treated |

## Genetic Risk Scores

| Condition | Score | Risk Level | Key Factors |
|-----------|-------|------------|-------------|
| Type 2 Diabetes | 52 | Moderate | Father T2DM at 55 |
| Cardiovascular | 45 | Moderate | Father MI at 58 |
| Breast Cancer | 32 | Low | 1 second-degree, age >50 |

## Screening Recommendations

**Diabetes Screening**
- Start: Age 35 (10 years before father's diagnosis)
- Frequency: Annual
- Test: HbA1c or fasting glucose

**Cardiovascular Screening**
- Start: Age 30 (earlier due to family history)
- Frequency: Annual lipid panel + BP check
- Consider: CAC scoring after 40

## Cross-Dimensional Correlations

🔗 Family history of T2DM + cardiovascular disease → increased monitoring priority
→ Recommend: nutrition-advisor (carb awareness), vital-monitor (BP + glucose tracking)

## Action Plan

- [ ] Complete detailed family health interview
- [ ] Schedule HbA1c test at next checkup
- [ ] Discuss lipid panel with doctor
- [ ] Add BP monitoring to weekly routine

Safety Boundaries

Can Do:

• Collect and document family health history
• Calculate statistical risk scores based on family patterns
• Recommend screening schedules based on risk level
• Provide lifestyle modification guidance
• Cross-correlate family history with current health data
• Educate about genetic risk factors

Cannot Do:

• Diagnose genetic or hereditary diseases
• Predict individual disease probability with certainty
• Recommend specific treatment plans
• Replace genetic counseling
• Interpret genetic test results (refer to genetic counselor)

Every output must include:

⚠️ This risk assessment is based on family health history patterns and is for informational purposes only. It does not constitute a medical diagnosis. Consult your healthcare provider for personalized screening plans and medical advice. Genetic counseling is recommended for high-risk families.

Reference Standards

• ACC/AHA: Cardiovascular risk screening with family history
• ADA: Diabetes risk screening based on family history
• USPSTF: Age-based screening modifications for high-risk individuals
• NCCN: Cancer family history assessment guidelines