Research program

The index is a running research program: declared monitors feed intake, intake is logged in an append-only ledger, and open questions track what the evidence has not settled.

Open questions

What the index is watching. Each names the strata it seeks evidence from.

  • What is the molecular basis of hEDS, and how genetically heterogeneous is it?

    watching

    KLK15 is the first associated gene but explains only a fraction of families; HEDGE (n=1,000) publications are expected to clarify. hEDS remains a clinical diagnosis.

    seeks: clinical, gray literature, registry · opened 2026-09-16 · reviewed 2026-09-16

  • Should the hEDS/HSD boundary be maintained, and how would a molecular marker change it?

    open

    HSD was defined as a residual category in 2017; patients excluded by strict hEDS criteria may share the same biology. The criteria review study is active.

    seeks: clinical, registry, community · opened 2026-09-16 · reviewed 2026-09-16

  • What is the true prevalence of hEDS/HSD, and how much does underdiagnosis distort it?

    open

    Textbook figures (1 in 5,000) conflict with diagnosed-prevalence data (about 1 in 500 in Wales) and community estimates are higher still. Ascertainment bias runs in both directions.

    seeks: clinical, registry, community · opened 2026-09-16 · reviewed 2026-09-16

  • Is the hEDS-POTS-MCAS clustering a shared mechanism or a referral artifact?

    watching

    The triad is community-observed and registry-supported, but mechanism evidence is thin and diagnostic criteria for each leg differ in rigor.

    seeks: clinical, registry, community · opened 2026-09-16 · reviewed 2026-09-16

  • Which exercise and physiotherapy modalities measurably help hEDS/HSD, and at what dose?

    open

    PT is the mainstay recommendation but trials are small and heterogeneous; community practice runs ahead of the trial record.

    seeks: clinical, community · opened 2026-09-16 · reviewed 2026-09-16

  • What mechanism explains reduced local-anesthetic effectiveness in EDS?

    watching

    The phenomenon is now trial-confirmed but the mechanism is unexplained; hypotheses range from tissue diffusion to sodium-channel and connective-tissue effects.

    seeks: clinical · opened 2026-09-16 · reviewed 2026-09-16

  • How should craniocervical instability and tethered-cord claims in hEDS be weighed?

    watching

    Strong community and some surgical-literature attention, limited controlled evidence, and meaningful surgical risk make this the sharpest contested area.

    seeks: clinical, community · opened 2026-09-16 · reviewed 2026-09-16

  • Which interventions actually shorten the EDS diagnostic odyssey?

    open

    Delays of 10-22 years are documented across cohorts; clinician-education programs exist (EDS ECHO) but effectiveness evidence is early.

    seeks: clinical, community, registry · opened 2026-09-16 · reviewed 2026-09-16

Collections

  • Cross-stratum convergences

    Records where independent strata agree — the pattern this index exists to surface.

    Local anesthetic resistance — the index's reference convergence · The diagnostic odyssey is measured in years, not visits · India Rubber Men and elastic performers in travelling shows

  • The hEDS genetics frontier

    The search for hEDS molecular markers, from unknown status to KLK15 and HEDGE.

    hEDS is the only subtype without a confirmed molecular basis · KLK15 is the first gene associated with hEDS · HEDGE — the 1,000-participant hEDS genetic evaluation · The 2017 hEDS criteria require hypermobility, systemic manifestations, and exclusion

  • The diagnostic odyssey

    Quantified delay, misdiagnosis, and dismissal across clinical and registry strata.

    The diagnostic odyssey is measured in years, not visits · hEDS patients average ten alternative diagnoses before confirmation · hEDS diagnosis remains clinical despite the KLK15 finding

Discovery monitors

Declared, bounded inputs on fixed cadences — what the program watches and why.

  • PubMed Ehlers-Danlos latest

    active

    New peer-reviewed EDS literature across all subtypes and comorbidity domains.

    literature-query · every 14d · strata: clinical · checked 2026-09-16

  • PubMed hypermobility spectrum latest

    active

    HSD literature that borders or feeds the hEDS corpus.

    literature-query · every 30d · strata: clinical · checked 2026-09-16

  • ClinicalTrials.gov EDS condition search

    active

    New and updated interventional and observational trials in EDS.

    trial-registry · every 30d · strata: registry · checked 2026-09-16

  • Ehlers-Danlos Society research news

    active

    Registry reports, HEDGE milestones, funded-study announcements, guideline updates.

    org-feed · every 14d · strata: community, registry · checked 2026-09-16

  • HEDGE study publication watch

    active

    First HEDGE publications were expected late 2025 into 2026; watch for genetic-marker findings.

    registry-watch · every 30d · strata: registry, clinical · checked 2026-09-16

  • Public community venue signal scan

    active

    Recurring practice and comorbidity signals reported by patients; never individual posters.

    venue-scan · every 60d · strata: community · checked 2026-09-16

  • Preprint servers EDS watch

    active

    Genetics and biomarker preprints ahead of peer review (e.g., KLK15 lineage).

    preprint-watch · every 30d · strata: gray literature · checked 2026-09-16

  • International Consortium and guideline watch

    active

    Criteria revision proposals, management guideline updates, pediatric framework follow-ups.

    guideline-watch · every 60d · strata: clinical, registry · checked 2026-09-16

  • Historical archive sweep

    active

    Pre-nosology case descriptions and documented folk management of joint laxity.

    venue-scan · every 180d · strata: historical

Run ledger

Append-only intake log. Corrections add new entries; history is never rewritten.

  • Initial corpus bootstrap across all five strata

    Seeded the classification, genetics, diagnostic-journey, management, community, historiography, and folk-practice categories with primary-linked records. Lidocaine resistance admitted as the reference convergent record; KLK15 admitted as emerging pending HEDGE replication.

    run-2026-09-16-bootstrap · 2026-09-16 · strata: clinical, community, historical, registry, gray literature · 8 monitors