Clinical interpretation
What ESP360° adds to the clinical picture
Not another glucose dashboard. A structured record of the decision state surrounding an action.
What clinicians already see
CGM values, trajectories, insulin doses, time in range, variability and treatment outcomes remain essential. ESP360° does not compete with any of it.
What may be missing
The reason a correction was delayed. Whether a lower dose reflected fear after a recent hypoglycemic event. Whether fatigue, cognitive load, social pressure or uncertainty shaped the action. And what the person expected to happen, before the outcome was known.
A worked example
Over roughly two hours on one afternoon in the study window, glucose moved 8.7 → 9.2 → 11.0 → 9.9 → 10.9 mmol/L. No threshold was crossed. No alarm fired. On review, the trace is unremarkable — mild post-prandial drift, the kind of stretch that would not attract a second look in a clinic visit.
The decision record across the same three annotated events shows confidence falling 7 → 3 → 1 while stress holds at 5. The first record describes slow absorption and watchful waiting. The second describes a plateau that will not break and three competing explanations held at once — insulin failure, wrong ratio, or the body simply being difficult. By the third, the person has stopped reasoning about the physiology and is describing the act of dosing as a gamble.
What this is not
It is not a diagnosis, a risk score, or a psychological assessment. Nothing in the architecture generates a treatment recommendation, and the human decision right is preserved at every point by design. A clinician reading a decision record is reading what the patient documented at the time, not a model's interpretation of it.
Questions clinicians raise
Is this feasible outside a research setting?
Not yet at this density. The study record was produced by a single expert annotator with unusual training and motivation. Establishing what a realistic clinical subset looks like is open work, and is named as such on the Evidence page.
How would it change a consultation?
The intended use is retrospective review — being able to ask why a particular week looked the way it did and get a documented answer rather than a reconstructed one. It is not designed for real-time use.
What about recall bias?
Capture is synchronised to the moment of dosing, before the outcome is known. That is the specific bias the method is built to avoid; whether it succeeds is a question for inter-rater work that has not yet been done.