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Example forecast specification.

See the structure of a transition forecast: a defined proposition, frozen evidence cutoff, declared baseline plan, and objective resolution rule.

Evidence summary

At-a-glance assessment

The upstream signal state and bottleneck before the coverage forecast.

Rung 1 — Evidence emergence

High — pivotal trial published

Rung 2 — Replication

Moderate — one confirmatory study

Rung 3 — Expert recognition

Moderate — growing consensus

Rung 4 — RWE confirmation

Low — registry data accumulating

Primary bottleneck

Rung 4→5 translation — insufficient real-world confirmation to trigger guideline procedural signal

Forecast specification

The fields that define this proposition

The registered fields below make the proposition resolvable and scoreable.

Forecast Specification Specification
Target rung
7 — Payer/coverage action
Proposition
Will CMS issue a national coverage determination expanding access to amyloid-directed therapy for biomarker-confirmed early Alzheimer's disease by Q1 2027?
Authority
CMS (Centers for Medicare & Medicaid Services)
Event class
Coverage expansion
Deadline
Q1 2027
Evidence cutoff
January 2026
Method version
v0.1.0
Forecast threshold
70%
Primary comparator rung
Rung 3 — Expert recognition & KOL convergence
Comparator timestamp rule
First date when ≥3 independent KOL sources express directional consensus in peer-reviewed commentary or major conference proceedings
Operational constraint
Precision at 70% threshold ≥ predefined minimum
Countervailing factors
Implementation complexity, budget impact, or stakeholder resistance
Registration hash
nc-39c02226c4ad How to verify
Baseline plan
Base-rate

Computed from the declared historical cohort

Heuristic

Frozen rules scored on the same cohort

Expert

Structured elicitation under the same resolution rule

LLM

Controlled prompt baseline with version recorded

Resolution rule

CMS publishes a final national coverage determination that expands access beyond the current restricted coverage.

Upstream states at freeze

Rung 1–4 states locked at evidence cutoff

Rungs 1–4 record the public evidence state at cutoff. Later evidence belongs to a new registration.

Rung 1 Evidence emergence High — pivotal trial published upstream
Rung 2 Replication & strengthening Moderate — one confirmatory study upstream
Rung 3 Expert recognition & KOL convergence Moderate — growing consensus in review articles upstream
Rung 4 Real-world confirmation Low — registry data accumulating upstream
Rung 5 Guideline action Not yet initiated resolvable
Rung 6 Regulatory action Label approved (restricted) resolvable
Rung 7 Payer/coverage action Forecast target resolvable

Bottleneck diagnosis

Where the transition chain is limiting

The bottleneck identifies the rung currently limiting downstream movement.

Primary bottleneck

Rung 4→5 translation: Insufficient real-world confirmation to trigger guideline procedural signal, which historically precedes coverage expansion.

Mechanism Hypothesis

The transition is likely to stall at rung 4 → 5 because real-world evidence confirmation has not yet reached the threshold that historically precedes guideline procedural signals. Until RWE signals strengthen, the momentum for authority action remains low.

Every registered forecast

What comes with the specification

Scoring only means something if the forecast is sealed off from hindsight and from your internal context. Four things hold that line, and they apply to every forecast we register.

Independent resolution: Outcomes are adjudicated using pre-registered source documents.
Calibration controls: Accuracy is evaluated against naive base-rates and heuristic baselines.
Temporal freeze: All evidence is locked at the cutoff date to eliminate hindsight bias.
Your data stays yours: forecasts are built entirely from the public record. We never take your proprietary claims, so there is nothing of yours to leak.

What it's for

Built to arrive before a date you already have.

A brief like this is registered against a decision date you bring — a coverage review, a launch gate, a diligence window. The probability and its frozen evidence state go on the record ahead of that date, giving your team a dated basis to prepare documentation, coordinate evidence, and set review priorities while the authority's process is still open.

Whether earlier notice changes the decision is itself tested — that is what an Enterprise Application program measures.