From 8ab0e2826eab329d0a2c86347c3be4b2836582ff Mon Sep 17 00:00:00 2001
From: BigSimmo <87357024+BigSimmo@users.noreply.github.com>
Date: Tue, 14 Jul 2026 19:56:17 +0800
Subject: [PATCH 1/5] feat(formulation): add psychiatric formulation workspace

---
 docs/codebase-index.md                        |   44 +-
 docs/site-map.md                              |   45 +-
 playwright.config.ts                          |    4 +-
 scripts/generate-site-map.ts                  |   33 +-
 src/app/formulation/[slug]/page.tsx           |   15 +
 src/app/formulation/builder/page.tsx          |   19 +
 src/app/formulation/compare/page.tsx          |   14 +
 .../{specifiers => formulation}/layout.tsx    |    4 +-
 src/app/formulation/map/page.tsx              |   11 +
 src/app/formulation/page.tsx                  |   16 +
 src/app/page.tsx                              |   15 +-
 src/app/specifiers/[[...path]]/page.tsx       |   19 +
 src/app/specifiers/[slug]/page.tsx            |   16 -
 src/app/specifiers/builder/page.tsx           |   16 -
 src/app/specifiers/compare/page.tsx           |   14 -
 src/app/specifiers/map/page.tsx               |   11 -
 src/app/specifiers/page.tsx                   |   17 -
 .../clinical-dashboard/ClinicalSidebar.tsx    |    4 +-
 .../global-search-shell.tsx                   |    8 +-
 .../master-search-header.tsx                  |   22 +-
 .../clinical-dashboard/mode-action-popup.tsx  |   36 +-
 .../formulation/formulation-builder-page.tsx  |  707 ++++++++++
 .../formulation/formulation-compare-page.tsx  |  286 ++++
 .../formulation-home-page.tsx}                |  245 ++--
 .../formulation/formulation-map-page.tsx      |  188 +++
 .../formulation-mechanism-page.tsx            |  361 +++++
 .../formulation-ui.tsx}                       |   73 +-
 .../specifiers/specifier-builder-page.tsx     |  264 ----
 .../specifiers/specifier-compare-page.tsx     |  238 ----
 .../specifiers/specifier-map-page.tsx         |  169 ---
 .../specifiers/specifier-record-page.tsx      |  251 ----
 src/data/formulation-content.json             | 1188 +++++++++++++++++
 src/lib/app-mode-icons.ts                     |    4 +-
 src/lib/app-modes.ts                          |   40 +-
 src/lib/formulation.ts                        |  311 +++++
 src/lib/specifiers.ts                         |  711 ----------
 tests/app-modes.test.ts                       |   32 +-
 tests/formulation.test.ts                     |  100 ++
 tests/specifiers.test.ts                      |   91 --
 tests/ui-formulation.spec.ts                  |  154 +++
 tests/ui-smoke.spec.ts                        |   12 +-
 tests/ui-specifiers.spec.ts                   |  138 --
 42 files changed, 3707 insertions(+), 2239 deletions(-)
 create mode 100644 src/app/formulation/[slug]/page.tsx
 create mode 100644 src/app/formulation/builder/page.tsx
 create mode 100644 src/app/formulation/compare/page.tsx
 rename src/app/{specifiers => formulation}/layout.tsx (53%)
 create mode 100644 src/app/formulation/map/page.tsx
 create mode 100644 src/app/formulation/page.tsx
 create mode 100644 src/app/specifiers/[[...path]]/page.tsx
 delete mode 100644 src/app/specifiers/[slug]/page.tsx
 delete mode 100644 src/app/specifiers/builder/page.tsx
 delete mode 100644 src/app/specifiers/compare/page.tsx
 delete mode 100644 src/app/specifiers/map/page.tsx
 delete mode 100644 src/app/specifiers/page.tsx
 create mode 100644 src/components/formulation/formulation-builder-page.tsx
 create mode 100644 src/components/formulation/formulation-compare-page.tsx
 rename src/components/{specifiers/specifiers-home-page.tsx => formulation/formulation-home-page.tsx} (56%)
 create mode 100644 src/components/formulation/formulation-map-page.tsx
 create mode 100644 src/components/formulation/formulation-mechanism-page.tsx
 rename src/components/{specifiers/specifier-ui.tsx => formulation/formulation-ui.tsx} (56%)
 delete mode 100644 src/components/specifiers/specifier-builder-page.tsx
 delete mode 100644 src/components/specifiers/specifier-compare-page.tsx
 delete mode 100644 src/components/specifiers/specifier-map-page.tsx
 delete mode 100644 src/components/specifiers/specifier-record-page.tsx
 create mode 100644 src/data/formulation-content.json
 create mode 100644 src/lib/formulation.ts
 delete mode 100644 src/lib/specifiers.ts
 create mode 100644 tests/formulation.test.ts
 delete mode 100644 tests/specifiers.test.ts
 create mode 100644 tests/ui-formulation.spec.ts
 delete mode 100644 tests/ui-specifiers.spec.ts

diff --git a/docs/codebase-index.md b/docs/codebase-index.md
index 3f4a4dcc8..26088386c 100644
--- a/docs/codebase-index.md
+++ b/docs/codebase-index.md
@@ -44,23 +44,23 @@ Structured map for AI agents and onboarding. For live routes, see `docs/site-map
 - **App shell:** `src/components/clinical-dashboard/global-search-shell.tsx` — canonical route-aware shell and lazy dashboard dispatch. The mockup-named module is a compatibility re-export used only below `/mockups`.
 - **Home:** `src/app/page.tsx` — dashboard rendered by shell
 - **Dashboard:** `src/components/ClinicalDashboard.tsx` + `src/components/clinical-dashboard/`
-- **Modes (9):** `src/lib/app-modes.ts` — answer, documents, services, forms, favourites, differentials, specifiers, prescribing, tools
+- **Modes (9):** `src/lib/app-modes.ts` — answer, documents, services, forms, favourites, differentials, formulation, prescribing, tools
 
 ### Product pages (`src/app/`)
 
-| Route                                                               | File                                   |
-| ------------------------------------------------------------------- | -------------------------------------- |
-| `/`                                                                 | `src/app/page.tsx`                     |
-| `/applications`                                                     | `src/app/applications/page.tsx`        |
-| `/differentials`, `/diagnoses`, `/presentations`                    | `src/app/differentials/`               |
-| `/documents/search`, `/source`, `/evidence`, `/[id]`                | `src/app/documents/`                   |
-| `/favourites`                                                       | `src/app/favourites/page.tsx`          |
-| `/forms`, `/forms/[slug]`                                           | `src/app/forms/`                       |
-| `/medications`, `/medications/[slug]`                               | `src/app/medications/`                 |
-| `/services`, `/services/[slug]`                                     | `src/app/services/`                    |
-| `/specifiers`, `/specifiers/[slug]`, `/builder`, `/compare`, `/map` | `src/app/specifiers/`                  |
-| `/mockups/*`                                                        | `src/app/mockups/` (404 in production) |
-| `/auth/callback`                                                    | `src/app/auth/callback/route.ts`       |
+| Route                                                                 | File                                   |
+| --------------------------------------------------------------------- | -------------------------------------- |
+| `/`                                                                   | `src/app/page.tsx`                     |
+| `/applications`                                                       | `src/app/applications/page.tsx`        |
+| `/differentials`, `/diagnoses`, `/presentations`                      | `src/app/differentials/`               |
+| `/documents/search`, `/source`, `/evidence`, `/[id]`                  | `src/app/documents/`                   |
+| `/favourites`                                                         | `src/app/favourites/page.tsx`          |
+| `/forms`, `/forms/[slug]`                                             | `src/app/forms/`                       |
+| `/medications`, `/medications/[slug]`                                 | `src/app/medications/`                 |
+| `/services`, `/services/[slug]`                                       | `src/app/services/`                    |
+| `/formulation`, `/formulation/[slug]`, `/builder`, `/compare`, `/map` | `src/app/formulation/`                 |
+| `/mockups/*`                                                          | `src/app/mockups/` (404 in production) |
+| `/auth/callback`                                                      | `src/app/auth/callback/route.ts`       |
 
 ### API routes (`src/app/api/`)
 
@@ -123,11 +123,11 @@ Structured map for AI agents and onboarding. For live routes, see `docs/site-map
 
 ### Clinical product data
 
-| Module                                                               | Role                                  |
-| -------------------------------------------------------------------- | ------------------------------------- |
-| `differentials.ts`, `forms.ts`, `services.ts`, `registry-records.ts` | Registry-backed content               |
-| `specifiers.ts`                                                      | Local psychiatric specifier catalogue |
-| `clinical-safety.ts`, `demo-data.ts`, `ui-copy.ts`                   | Safety copy and demo mode             |
+| Module                                                               | Role                                                    |
+| -------------------------------------------------------------------- | ------------------------------------------------------- |
+| `differentials.ts`, `forms.ts`, `services.ts`, `registry-records.ts` | Registry-backed content                                 |
+| `formulation.ts`                                                     | Local formulation mechanism library and builder helpers |
+| `clinical-safety.ts`, `demo-data.ts`, `ui-copy.ts`                   | Safety copy and demo mode                               |
 
 ### Infra helpers
 
@@ -252,16 +252,16 @@ Golden retrieval fixture: `scripts/fixtures/rag-retrieval-golden.json`
 - 9 app modes with unified search shell
 - Documents mode: upload/manage private guidelines, search, cited answers
 - Answer mode: grounded Q&A with PDF-linked citations
-- Registry modes: services, forms, medications, differentials; Specifiers is a local structured decision-support catalogue
+- Registry modes: services, forms, medications, differentials; Formulation is a local mechanism and structured-draft workspace
 - Demo mode: synthetic data when Supabase unavailable (`demo-data.ts`, `isDemoMode()` in `env.ts`)
 
 ### Global search composer placement rules
 
 One shared composer (`master-search-header.tsx`) serves every mode. Placement:
 
-- **Mode homes** (`/services`, `/forms`, `/favourites`, `/differentials`, `/specifiers`, `/applications`, and dashboard homes): inline in the hero via the `mode-home-composer-slot` portal, on phone and tablet+ alike.
+- **Mode homes** (`/services`, `/forms`, `/favourites`, `/differentials`, `/formulation`, `/applications`, and dashboard homes): inline in the hero via the `mode-home-composer-slot` portal, on phone and tablet+ alike.
 - **Result and detail views**: fixed bottom dock on phone (compact variant on submitted searches), sticky top from `sm` up.
-- **Results routing**: standalone routes own their submitted searches via `?q=…&run=1` (`/services` → `ServicesNavigatorPage`, `/forms` → `FormsSearchResultsPage`, `/differentials` → `DifferentialsHome` results view, `/specifiers` → local structured results, `/favourites` filters the command library in place). Answer, Documents, and Prescribing submitted searches render inside `ClinicalDashboard` — intentional, since they need retrieval/answer state. `/?mode=favourites` redirects to `/favourites`; `/?mode=differentials` redirects to `/differentials`.
+- **Results routing**: standalone routes own their submitted searches via `?q=…&run=1` (`/services` → `ServicesNavigatorPage`, `/forms` → `FormsSearchResultsPage`, `/differentials` → `DifferentialsHome` results view, `/formulation` → local mechanism results, `/favourites` filters the command library in place). Answer, Documents, and Prescribing submitted searches render inside `ClinicalDashboard` — intentional, since they need retrieval/answer state. `/?mode=favourites` redirects to `/favourites`; `/?mode=differentials` redirects to `/differentials`; `/?mode=formulation` redirects to `/formulation`.
 - **Intentionally composer-free routes**: `/differentials/presentations/*` (comparison workflow owns its chrome), `/documents/[id]` viewer (has its own in-document ask composer), `/documents/source/*` (document flow owns mobile chrome). Do not re-flag these in search-consistency audits.
 - **Local filter fields** (sidebar "Search chats", document drawer "Find a document"/"Find a source PDF") are scoped filters, not global search; they share the `fieldControlWithIcon`/`fieldIcon` primitives.
 
diff --git a/docs/site-map.md b/docs/site-map.md
index 90a90483f..affd3a90e 100644
--- a/docs/site-map.md
+++ b/docs/site-map.md
@@ -15,14 +15,15 @@ This file is generated by `npm run sitemap:update`. Run `npm run sitemap:check`
 - `/documents/source/evidence` - Compatibility redirect sharing the canonical live document viewer handoff. Source: `src/app/documents/source/evidence/page.tsx`.
 - `/favourites` - Saved clinical items and sets. Source: `src/app/favourites/page.tsx`.
 - `/forms` - Forms home and search surface. Source: `src/app/forms/page.tsx`.
+- `/formulation` - Clinical formulation home and local mechanism search surface. Source: `src/app/formulation/page.tsx`.
+- `/formulation/builder` - Structured clinical formulation builder. Source: `src/app/formulation/builder/page.tsx`.
+- `/formulation/compare` - Side-by-side mechanism comparison. Source: `src/app/formulation/compare/page.tsx`.
+- `/formulation/map` - Formulation mechanism domain map. Source: `src/app/formulation/map/page.tsx`.
 - `/medications` - Medication index redirect. Source: `src/app/medications/page.tsx`.
 - `/privacy` - Privacy and data-processing governance draft. Source: `src/app/privacy/page.tsx`.
 - `/reference/colour-coding` - Route discovered from app directory Source: `src/app/reference/colour-coding/page.tsx`.
 - `/services` - Services home and search surface. Source: `src/app/services/page.tsx`.
-- `/specifiers` - Psychiatric specifier home and local search surface. Source: `src/app/specifiers/page.tsx`.
-- `/specifiers/builder` - Structured diagnostic wording builder. Source: `src/app/specifiers/builder/page.tsx`.
-- `/specifiers/compare` - Side-by-side psychiatric specifier comparison. Source: `src/app/specifiers/compare/page.tsx`.
-- `/specifiers/map` - Psychiatric specifier family map. Source: `src/app/specifiers/map/page.tsx`.
+- `/specifiers/[[...path]]` - Compatibility redirect to the corrected Formulation workspace. Source: `src/app/specifiers/[[...path]]/page.tsx`.
 - `/tools` - Route discovered from app directory Source: `src/app/tools/page.tsx`.
 
 ## Mode/query routes
@@ -33,7 +34,7 @@ This file is generated by `npm run sitemap:update`. Run `npm run sitemap:check`
 - `/forms` - Forms mode. Search kind: `forms`. Query example: `/forms?q=transport+forms&focus=1&run=1`.
 - `/favourites` - Favourites mode. Search kind: `favourites`. Query example: `/favourites?q=clozapine+set&focus=1&run=1`.
 - `/differentials` - Differentials mode. Search kind: `differentials`. Query example: `/differentials?q=acute+confusion&focus=1&run=1`.
-- `/specifiers` - Specifiers mode. Search kind: `specifiers`. Query example: `/specifiers?q=depressed+but+racing+thoughts&focus=1&run=1`.
+- `/formulation` - Formulation mode. Search kind: `formulation`. Query example: `/formulation?q=I+keep+going+over+it&focus=1&run=1`.
 - `/?mode=prescribing` - Medication mode. Search kind: `documents`. Query example: `/?mode=prescribing&q=acamprosate+renal+dose&focus=1&run=1`.
 - `/?mode=tools` - Tools mode. Search kind: `tools`. Query example: `/?mode=tools&q=medications&focus=1&run=1`.
 
@@ -47,7 +48,7 @@ This file is generated by `npm run sitemap:update`. Run `npm run sitemap:check`
 | Forms         | `/forms`             | `/forms?q=transport+forms&focus=1&run=1`                              | `/forms/[slug]` form record pages.                                                                                         |
 | Favourites    | `/favourites`        | `/favourites?q=clozapine+set&focus=1&run=1`                           | Saved set and saved item detail render inside the favourites page surface.                                                 |
 | Differentials | `/differentials`     | `/differentials?q=acute+confusion&focus=1&run=1`                      | `/differentials/diagnoses`, `/differentials/diagnoses/[slug]`, and `/differentials/presentations`.                         |
-| Specifiers    | `/specifiers`        | `/specifiers?q=depressed+but+racing+thoughts&focus=1&run=1`           | `/specifiers/[slug]`, `/specifiers/builder`, `/specifiers/compare`, and `/specifiers/map`.                                 |
+| Formulation   | `/formulation`       | `/formulation?q=I+keep+going+over+it&focus=1&run=1`                   | `/formulation/[slug]`, `/formulation/builder`, `/formulation/compare`, and `/formulation/map`.                             |
 | Medication    | `/?mode=prescribing` | `/?mode=prescribing&q=acamprosate+renal+dose&focus=1&run=1`           | `/medications/[slug]`; `/medications` redirects to medication mode.                                                        |
 | Tools         | `/?mode=tools`       | `/?mode=tools&q=medications&focus=1&run=1`                            | Tool launcher and detail panels inside dashboard tools mode (`/?mode=tools`).                                              |
 
@@ -505,21 +506,21 @@ This file is generated by `npm run sitemap:update`. Run `npm run sitemap:check`
 - `very-late-onset-schizophrenia-like-psychosis-delusional-disorder`
 - `wernicke-encephalopathy`
 
-### Psychiatric specifier slugs
-
-- `/specifiers/[slug]` - Dynamic route family.
-- `in-full-remission`
-- `in-partial-remission`
-- `mild-severity`
-- `with-anxious-distress`
-- `with-atypical-features`
-- `with-catatonia`
-- `with-melancholic-features`
-- `with-mixed-features`
-- `with-peripartum-onset`
-- `with-psychotic-features`
-- `with-rapid-cycling`
-- `with-seasonal-pattern`
+### Formulation mechanism slugs
+
+- `/formulation/[slug]` - Dynamic route family.
+- `attachment-avoidance`
+- `avoidance`
+- `dissociation`
+- `emotional-dysregulation`
+- `negative-core-beliefs`
+- `perfectionism`
+- `projection`
+- `reassurance-seeking`
+- `rumination`
+- `shame`
+- `splitting`
+- `worry`
 
 ### Medication slugs
 
@@ -631,7 +632,7 @@ This file is generated by `npm run sitemap:update`. Run `npm run sitemap:check`
 | Forms                          | `src/app/forms, src/lib/forms.ts, src/app/api/registry/records`                               |
 | Favourites                     | `src/app/favourites, src/components/clinical-dashboard/favourites-command-library-page.tsx`   |
 | Differentials                  | `src/app/differentials, src/lib/differentials.ts`                                             |
-| Specifiers                     | `src/app/specifiers, src/components/specifiers, src/lib/specifiers.ts`                        |
+| Formulation                    | `src/app/formulation, src/components/formulation, src/lib/formulation.ts`                     |
 | Medications                    | `src/app/medications, src/components/clinical-dashboard/medication-prescribing-workspace.tsx` |
 | Documents                      | `src/app/documents, src/lib/document-flow-routes.ts`                                          |
 | Tools                          | `src/components/applications-launcher-page.tsx`                                               |
diff --git a/playwright.config.ts b/playwright.config.ts
index aa0cdd32f..ddcce3876 100644
--- a/playwright.config.ts
+++ b/playwright.config.ts
@@ -11,14 +11,14 @@ const chromiumExecutablePath = process.env.PLAYWRIGHT_CHROMIUM_EXECUTABLE_PATH;
 // mockup can never mask a production-journey regression (PT-05). The two
 // Tag-level filters keep production and prototype journeys disjoint even when
 // they share a spec file; firefox/webkit retain the legacy full testMatch.
-const productionSpecPattern = /.*ui-(smoke|stress|accessibility|tools|overlap|universal-search|specifiers)\.spec\.ts/;
+const productionSpecPattern = /.*ui-(smoke|stress|accessibility|tools|overlap|universal-search|formulation)\.spec\.ts/;
 const mockupSpecPattern = /.*ui-(tools|tools-collapse|tools-task-directory)\.spec\.ts/;
 const mockupTag = /@mockup/;
 
 export default defineConfig({
   testDir: "./tests",
   testMatch:
-    /.*ui-(smoke|stress|accessibility|tools|tools-collapse|tools-task-directory|overlap|universal-search|specifiers)\.spec\.ts/,
+    /.*ui-(smoke|stress|accessibility|tools|tools-collapse|tools-task-directory|overlap|universal-search|formulation)\.spec\.ts/,
   timeout: 60_000,
   retries: process.env.CI ? 1 : 0,
   expect: {
diff --git a/scripts/generate-site-map.ts b/scripts/generate-site-map.ts
index ce1d12d7d..cacbd8b2b 100644
--- a/scripts/generate-site-map.ts
+++ b/scripts/generate-site-map.ts
@@ -6,9 +6,9 @@ import { format } from "prettier";
 import { appModeDefinitions, appModeHomeHref, type AppModeId } from "@/lib/app-modes";
 import { documentsSearchHref, DOCUMENTS_MODE_HOME_ROUTE } from "@/lib/document-flow-routes";
 import { differentialRecords } from "@/lib/differentials";
+import { formulationMechanisms } from "@/lib/formulation";
 import { formRecords } from "@/lib/forms";
 import { serviceRecords } from "@/lib/services";
-import { specifierRecords } from "@/lib/specifiers";
 
 const appDir = path.join(process.cwd(), "src", "app");
 const siteMapPath = path.join(process.cwd(), "docs", "site-map.md");
@@ -52,11 +52,12 @@ const routeDescriptions: Record<string, string> = {
   "/privacy": "Privacy and data-processing governance draft.",
   "/services": "Services home and search surface.",
   "/services/[slug]": "Registry-backed service detail.",
-  "/specifiers": "Psychiatric specifier home and local search surface.",
-  "/specifiers/[slug]": "Psychiatric specifier decision-support guide.",
-  "/specifiers/builder": "Structured diagnostic wording builder.",
-  "/specifiers/compare": "Side-by-side psychiatric specifier comparison.",
-  "/specifiers/map": "Psychiatric specifier family map.",
+  "/formulation": "Clinical formulation home and local mechanism search surface.",
+  "/formulation/[slug]": "Formulation mechanism decision-support guide.",
+  "/formulation/builder": "Structured clinical formulation builder.",
+  "/formulation/compare": "Side-by-side mechanism comparison.",
+  "/formulation/map": "Formulation mechanism domain map.",
+  "/specifiers/[[...path]]": "Compatibility redirect to the corrected Formulation workspace.",
 };
 
 const apiDescriptions: Record<string, string> = {
@@ -96,7 +97,7 @@ const routeOwnershipRows = [
   ["Forms", "src/app/forms, src/lib/forms.ts, src/app/api/registry/records"],
   ["Favourites", "src/app/favourites, src/components/clinical-dashboard/favourites-command-library-page.tsx"],
   ["Differentials", "src/app/differentials, src/lib/differentials.ts"],
-  ["Specifiers", "src/app/specifiers, src/components/specifiers, src/lib/specifiers.ts"],
+  ["Formulation", "src/app/formulation, src/components/formulation, src/lib/formulation.ts"],
   ["Medications", "src/app/medications, src/components/clinical-dashboard/medication-prescribing-workspace.tsx"],
   ["Documents", "src/app/documents, src/lib/document-flow-routes.ts"],
   ["Tools", "src/components/applications-launcher-page.tsx"],
@@ -205,7 +206,7 @@ function renderModeRoutes() {
     forms: appModeHomeHref("forms", { query: "transport forms", focus: true, run: true }),
     favourites: appModeHomeHref("favourites", { query: "clozapine set", focus: true, run: true }),
     differentials: appModeHomeHref("differentials", { query: "acute confusion", focus: true, run: true }),
-    specifiers: appModeHomeHref("specifiers", { query: "depressed but racing thoughts", focus: true, run: true }),
+    formulation: appModeHomeHref("formulation", { query: "I keep going over it", focus: true, run: true }),
     prescribing: appModeHomeHref("prescribing", { query: "acamprosate renal dose", focus: true, run: true }),
     tools: appModeHomeHref("tools", { query: "medications", focus: true, run: true }),
   };
@@ -273,10 +274,10 @@ function renderModePageIndex() {
       detail: "`/differentials/diagnoses`, `/differentials/diagnoses/[slug]`, and `/differentials/presentations`.",
     },
     {
-      mode: "Specifiers",
-      home: appModeHomeHref("specifiers"),
-      search: appModeHomeHref("specifiers", { query: "depressed but racing thoughts", focus: true, run: true }),
-      detail: "`/specifiers/[slug]`, `/specifiers/builder`, `/specifiers/compare`, and `/specifiers/map`.",
+      mode: "Formulation",
+      home: appModeHomeHref("formulation"),
+      search: appModeHomeHref("formulation", { query: "I keep going over it", focus: true, run: true }),
+      detail: "`/formulation/[slug]`, `/formulation/builder`, `/formulation/compare`, and `/formulation/map`.",
     },
     {
       mode: "Medication",
@@ -326,7 +327,7 @@ function renderSiteMapRaw(data = collectSiteMapData()) {
         "/services/[slug]",
         "/forms/[slug]",
         "/differentials/diagnoses/[slug]",
-        "/specifiers/[slug]",
+        "/formulation/[slug]",
         "/medications/[slug]",
       ].includes(route.route),
   );
@@ -377,9 +378,9 @@ function renderSiteMapRaw(data = collectSiteMapData()) {
       ),
       "",
       ...renderSlugInventory(
-        "Psychiatric specifier slugs",
-        "/specifiers/[slug]",
-        specifierRecords.map((record) => record.slug),
+        "Formulation mechanism slugs",
+        "/formulation/[slug]",
+        formulationMechanisms.map((mechanism) => mechanism.id),
       ),
       "",
       ...renderSlugInventory("Medication slugs", "/medications/[slug]", medicationSlugs),
diff --git a/src/app/formulation/[slug]/page.tsx b/src/app/formulation/[slug]/page.tsx
new file mode 100644
index 000000000..5752eea9a
--- /dev/null
+++ b/src/app/formulation/[slug]/page.tsx
@@ -0,0 +1,15 @@
+import { notFound } from "next/navigation";
+
+import { FormulationMechanismPage } from "@/components/formulation/formulation-mechanism-page";
+import { findFormulationMechanism, formulationMechanisms } from "@/lib/formulation";
+
+export function generateStaticParams() {
+  return formulationMechanisms.map((mechanism) => ({ slug: mechanism.id }));
+}
+
+export default async function FormulationMechanismRoute({ params }: { params: Promise<{ slug: string }> }) {
+  const { slug } = await params;
+  const mechanism = findFormulationMechanism(slug);
+  if (!mechanism) notFound();
+  return <FormulationMechanismPage mechanism={mechanism} />;
+}
diff --git a/src/app/formulation/builder/page.tsx b/src/app/formulation/builder/page.tsx
new file mode 100644
index 000000000..1fc2e66ad
--- /dev/null
+++ b/src/app/formulation/builder/page.tsx
@@ -0,0 +1,19 @@
+import { FormulationBuilderPage } from "@/components/formulation/formulation-builder-page";
+
+type BuilderRouteProps = {
+  searchParams?: Promise<{
+    mechanism?: string | string[];
+    template?: string | string[];
+  }>;
+};
+
+export default async function FormulationBuilderRoute({ searchParams }: BuilderRouteProps) {
+  const params = searchParams ? await searchParams : {};
+  const initialMechanisms = Array.isArray(params.mechanism)
+    ? Array.from(new Set(params.mechanism))
+    : params.mechanism
+      ? [params.mechanism]
+      : [];
+  const initialTemplate = Array.isArray(params.template) ? params.template[0] : params.template;
+  return <FormulationBuilderPage initialMechanisms={initialMechanisms} initialTemplate={initialTemplate} />;
+}
diff --git a/src/app/formulation/compare/page.tsx b/src/app/formulation/compare/page.tsx
new file mode 100644
index 000000000..ac29c74f4
--- /dev/null
+++ b/src/app/formulation/compare/page.tsx
@@ -0,0 +1,14 @@
+import { FormulationComparePage } from "@/components/formulation/formulation-compare-page";
+
+type CompareRouteProps = {
+  searchParams?: Promise<{ a?: string | string[]; b?: string | string[] }>;
+};
+
+function firstParam(value: string | string[] | undefined) {
+  return Array.isArray(value) ? value[0] : value;
+}
+
+export default async function FormulationCompareRoute({ searchParams }: CompareRouteProps) {
+  const params = searchParams ? await searchParams : {};
+  return <FormulationComparePage initialLeft={firstParam(params.a)} initialRight={firstParam(params.b)} />;
+}
diff --git a/src/app/specifiers/layout.tsx b/src/app/formulation/layout.tsx
similarity index 53%
rename from src/app/specifiers/layout.tsx
rename to src/app/formulation/layout.tsx
index 744354acd..3c2c1a89f 100644
--- a/src/app/specifiers/layout.tsx
+++ b/src/app/formulation/layout.tsx
@@ -2,9 +2,9 @@ import type { ReactNode } from "react";
 
 import { GlobalSearchShell } from "@/components/clinical-dashboard/global-search-shell";
 
-export default function SpecifiersLayout({ children }: { children: ReactNode }) {
+export default function FormulationLayout({ children }: { children: ReactNode }) {
   return (
-    <GlobalSearchShell initialMode="specifiers" desktopSearchPlacement="hero">
+    <GlobalSearchShell initialMode="formulation" desktopSearchPlacement="hero">
       {children}
     </GlobalSearchShell>
   );
diff --git a/src/app/formulation/map/page.tsx b/src/app/formulation/map/page.tsx
new file mode 100644
index 000000000..46b24f6d7
--- /dev/null
+++ b/src/app/formulation/map/page.tsx
@@ -0,0 +1,11 @@
+import { FormulationMapPage } from "@/components/formulation/formulation-map-page";
+
+type MapRouteProps = {
+  searchParams?: Promise<{ mechanism?: string | string[] }>;
+};
+
+export default async function FormulationMapRoute({ searchParams }: MapRouteProps) {
+  const params = searchParams ? await searchParams : {};
+  const initialId = Array.isArray(params.mechanism) ? params.mechanism[0] : params.mechanism;
+  return <FormulationMapPage initialId={initialId} />;
+}
diff --git a/src/app/formulation/page.tsx b/src/app/formulation/page.tsx
new file mode 100644
index 000000000..a4a58ecc4
--- /dev/null
+++ b/src/app/formulation/page.tsx
@@ -0,0 +1,16 @@
+import { FormulationHomePage } from "@/components/formulation/formulation-home-page";
+
+type FormulationRouteProps = {
+  searchParams?: Promise<{ q?: string | string[]; run?: string | string[] }>;
+};
+
+function firstParam(value: string | string[] | undefined) {
+  return Array.isArray(value) ? value[0] : value;
+}
+
+export default async function FormulationRoute({ searchParams }: FormulationRouteProps) {
+  const params = searchParams ? await searchParams : {};
+  const query = firstParam(params.q)?.trim() ?? "";
+  const hasSubmittedSearch = firstParam(params.run) === "1" && query.length > 0;
+  return <FormulationHomePage query={query} autoRunSearch={hasSubmittedSearch} />;
+}
diff --git a/src/app/page.tsx b/src/app/page.tsx
index cf08ba561..b7d72a499 100644
--- a/src/app/page.tsx
+++ b/src/app/page.tsx
@@ -19,6 +19,7 @@ function firstSearchParam(value: string | string[] | undefined) {
 export default async function Home({ searchParams }: HomeProps) {
   const params = searchParams ? await searchParams : {};
   const requestedMode = firstSearchParam(params.mode);
+  const legacySpecifierMode = requestedMode === "specifiers";
   const initialSearchMode: AppModeId =
     isAppModeId(requestedMode) && isAppModeVisible(requestedMode) ? requestedMode : "answer";
 
@@ -44,14 +45,14 @@ export default async function Home({ searchParams }: HomeProps) {
     redirect(suffix ? `/differentials?${suffix}` : "/differentials");
   }
 
-  if (initialSearchMode === "specifiers") {
-    const specifierParams = new URLSearchParams();
+  if (initialSearchMode === "formulation" || legacySpecifierMode) {
+    const formulationParams = new URLSearchParams();
     const query = firstSearchParam(params.q)?.trim();
-    if (query) specifierParams.set("q", query);
-    if (firstSearchParam(params.focus) === "1") specifierParams.set("focus", "1");
-    if (firstSearchParam(params.run) === "1") specifierParams.set("run", "1");
-    const suffix = specifierParams.toString();
-    redirect(suffix ? `/specifiers?${suffix}` : "/specifiers");
+    if (query) formulationParams.set("q", query);
+    if (firstSearchParam(params.focus) === "1") formulationParams.set("focus", "1");
+    if (firstSearchParam(params.run) === "1") formulationParams.set("run", "1");
+    const suffix = formulationParams.toString();
+    redirect(suffix ? `/formulation?${suffix}` : "/formulation");
   }
 
   return <HomePageClient initialMode={initialSearchMode} />;
diff --git a/src/app/specifiers/[[...path]]/page.tsx b/src/app/specifiers/[[...path]]/page.tsx
new file mode 100644
index 000000000..d5f23fe32
--- /dev/null
+++ b/src/app/specifiers/[[...path]]/page.tsx
@@ -0,0 +1,19 @@
+import { redirect } from "next/navigation";
+
+type LegacySpecifierRouteProps = {
+  params: Promise<{ path?: string[] }>;
+  searchParams?: Promise<Record<string, string | string[] | undefined>>;
+};
+
+export default async function LegacySpecifierRoute({ params, searchParams }: LegacySpecifierRouteProps) {
+  const { path = [] } = await params;
+  const values = searchParams ? await searchParams : {};
+  const nextParams = new URLSearchParams();
+  for (const [key, value] of Object.entries(values)) {
+    if (Array.isArray(value)) value.forEach((item) => nextParams.append(key === "specifier" ? "mechanism" : key, item));
+    else if (value) nextParams.set(key === "specifier" ? "mechanism" : key, value);
+  }
+  const pathname = ["/formulation", ...path].join("/");
+  const suffix = nextParams.toString();
+  redirect(suffix ? `${pathname}?${suffix}` : pathname);
+}
diff --git a/src/app/specifiers/[slug]/page.tsx b/src/app/specifiers/[slug]/page.tsx
deleted file mode 100644
index e8bb1a5d5..000000000
--- a/src/app/specifiers/[slug]/page.tsx
+++ /dev/null
@@ -1,16 +0,0 @@
-import { notFound } from "next/navigation";
-
-import { SpecifierRecordPage } from "@/components/specifiers/specifier-record-page";
-import { findSpecifier, specifierRecords } from "@/lib/specifiers";
-
-export function generateStaticParams() {
-  return specifierRecords.map((record) => ({ slug: record.slug }));
-}
-
-export default async function SpecifierDetailRoute({ params }: { params: Promise<{ slug: string }> }) {
-  const { slug } = await params;
-  const record = findSpecifier(slug);
-  if (!record) notFound();
-
-  return <SpecifierRecordPage record={record} />;
-}
diff --git a/src/app/specifiers/builder/page.tsx b/src/app/specifiers/builder/page.tsx
deleted file mode 100644
index 26e85256f..000000000
--- a/src/app/specifiers/builder/page.tsx
+++ /dev/null
@@ -1,16 +0,0 @@
-import { SpecifierBuilderPage } from "@/components/specifiers/specifier-builder-page";
-
-type BuilderRouteProps = {
-  searchParams?: Promise<{ specifier?: string | string[] }>;
-};
-
-export default async function SpecifierBuilderRoute({ searchParams }: BuilderRouteProps) {
-  const params = searchParams ? await searchParams : {};
-  const initialSpecifiers = Array.isArray(params.specifier)
-    ? Array.from(new Set(params.specifier))
-    : params.specifier
-      ? [params.specifier]
-      : [];
-
-  return <SpecifierBuilderPage initialSpecifiers={initialSpecifiers} />;
-}
diff --git a/src/app/specifiers/compare/page.tsx b/src/app/specifiers/compare/page.tsx
deleted file mode 100644
index 41fb3905f..000000000
--- a/src/app/specifiers/compare/page.tsx
+++ /dev/null
@@ -1,14 +0,0 @@
-import { SpecifierComparePage } from "@/components/specifiers/specifier-compare-page";
-
-type CompareRouteProps = {
-  searchParams?: Promise<{ a?: string | string[]; b?: string | string[] }>;
-};
-
-function first(value?: string | string[]) {
-  return Array.isArray(value) ? value[0] : value;
-}
-
-export default async function SpecifierCompareRoute({ searchParams }: CompareRouteProps) {
-  const params = searchParams ? await searchParams : {};
-  return <SpecifierComparePage initialLeft={first(params.a)} initialRight={first(params.b)} />;
-}
diff --git a/src/app/specifiers/map/page.tsx b/src/app/specifiers/map/page.tsx
deleted file mode 100644
index 0f77de187..000000000
--- a/src/app/specifiers/map/page.tsx
+++ /dev/null
@@ -1,11 +0,0 @@
-import { SpecifierMapPage } from "@/components/specifiers/specifier-map-page";
-
-type MapRouteProps = {
-  searchParams?: Promise<{ selected?: string | string[] }>;
-};
-
-export default async function SpecifierMapRoute({ searchParams }: MapRouteProps) {
-  const params = searchParams ? await searchParams : {};
-  const selected = Array.isArray(params.selected) ? params.selected[0] : params.selected;
-  return <SpecifierMapPage initialSlug={selected} />;
-}
diff --git a/src/app/specifiers/page.tsx b/src/app/specifiers/page.tsx
deleted file mode 100644
index b685ade9f..000000000
--- a/src/app/specifiers/page.tsx
+++ /dev/null
@@ -1,17 +0,0 @@
-import { SpecifiersHomePage } from "@/components/specifiers/specifiers-home-page";
-
-type SpecifiersRouteProps = {
-  searchParams?: Promise<{ query?: string | string[]; q?: string | string[]; run?: string | string[] }>;
-};
-
-function firstSearchParam(value?: string | string[]) {
-  return Array.isArray(value) ? value[0] : value;
-}
-
-export default async function SpecifiersRoute({ searchParams }: SpecifiersRouteProps) {
-  const params = searchParams ? await searchParams : {};
-  const query = (firstSearchParam(params.q) ?? firstSearchParam(params.query) ?? "").trim();
-  const hasSubmittedSearch = firstSearchParam(params.run) === "1" && query.length > 0;
-
-  return <SpecifiersHomePage query={query} autoRunSearch={hasSubmittedSearch} />;
-}
diff --git a/src/components/clinical-dashboard/ClinicalSidebar.tsx b/src/components/clinical-dashboard/ClinicalSidebar.tsx
index 2c6597049..492f496a1 100644
--- a/src/components/clinical-dashboard/ClinicalSidebar.tsx
+++ b/src/components/clinical-dashboard/ClinicalSidebar.tsx
@@ -11,6 +11,7 @@ import {
   MessageSquarePlus,
   MessageSquare,
   Moon,
+  Network,
   PanelLeftClose,
   PanelLeftOpen,
   Pill,
@@ -18,7 +19,6 @@ import {
   Settings as SettingsIcon,
   Sparkles,
   Sun,
-  Tags,
   Wrench,
 } from "lucide-react";
 import { appModeIcons } from "@/lib/app-mode-icons";
@@ -76,7 +76,7 @@ const sidebarToolItems = [
   { id: "forms", label: "Forms", icon: ClipboardPen, href: "/forms", badge: "Early access" },
   { id: "favourites", label: "Favourites", icon: Heart, href: "/favourites" },
   { id: "differentials", label: "Differentials", icon: BrainCircuit, href: "/differentials" },
-  { id: "specifiers", label: "Specifiers", icon: Tags, href: "/specifiers" },
+  { id: "formulation", label: "Formulation", icon: Network, href: "/formulation" },
   { id: "prescribing", label: "Medication", icon: Pill, href: "/?mode=prescribing" },
   { id: "tools", label: "Tools", icon: Wrench, href: "/?mode=tools" },
 ] as const;
diff --git a/src/components/clinical-dashboard/global-search-shell.tsx b/src/components/clinical-dashboard/global-search-shell.tsx
index ee61e795a..3bc291bfd 100644
--- a/src/components/clinical-dashboard/global-search-shell.tsx
+++ b/src/components/clinical-dashboard/global-search-shell.tsx
@@ -131,7 +131,7 @@ function GlobalSearchShellClient(props: GlobalSearchShellProps) {
     resolvedSearchMode !== "forms" &&
     resolvedSearchMode !== "favourites" &&
     resolvedSearchMode !== "differentials" &&
-    resolvedSearchMode !== "specifiers" &&
+    resolvedSearchMode !== "formulation" &&
     !isDocumentSearchMockupRoute;
   const isMedicationDetailRoute = /^\/medications\/[^/]+$/.test(pathname);
   const shouldRenderClinicalDashboard = !isMedicationDetailRoute && (isHomeRoute || shouldRenderDashboardSearch);
@@ -251,7 +251,7 @@ function GlobalStandaloneSearchShellClient({
     resolvedSearchMode !== "forms" &&
     resolvedSearchMode !== "favourites" &&
     resolvedSearchMode !== "differentials" &&
-    resolvedSearchMode !== "specifiers" &&
+    resolvedSearchMode !== "formulation" &&
     !isDocumentSearchMockupRoute;
   const isStandaloneModeHome =
     !hasSubmittedModeSearch &&
@@ -260,7 +260,7 @@ function GlobalStandaloneSearchShellClient({
       (searchMode === "forms" && pathname === "/forms") ||
       (searchMode === "favourites" && pathname === "/favourites") ||
       (searchMode === "differentials" && pathname === "/differentials") ||
-      (searchMode === "specifiers" && pathname === "/specifiers") ||
+      (searchMode === "formulation" && pathname === "/formulation") ||
       (searchMode === "tools" && pathname === "/tools"));
   const isDifferentialPresentationWorkflow = pathname.startsWith("/differentials/presentations");
   const shouldShowDesktopSidebar = !hideDesktopSidebar;
@@ -339,7 +339,7 @@ function GlobalStandaloneSearchShellClient({
     router.prefetch("/?mode=tools");
     router.prefetch("/favourites");
     router.prefetch("/differentials");
-    router.prefetch("/specifiers");
+    router.prefetch("/formulation");
   }
 
   function openGuide() {
diff --git a/src/components/clinical-dashboard/master-search-header.tsx b/src/components/clinical-dashboard/master-search-header.tsx
index 86e06ee4e..dd9beb7e4 100644
--- a/src/components/clinical-dashboard/master-search-header.tsx
+++ b/src/components/clinical-dashboard/master-search-header.tsx
@@ -276,7 +276,7 @@ export function MasterSearchHeader({
     selectedSearch.kind === "services" ||
     selectedSearch.kind === "tools" ||
     selectedSearch.kind === "favourites" ||
-    selectedSearch.kind === "specifiers";
+    selectedSearch.kind === "formulation";
   const canAsk = trimmedQuery.length >= 1 && !loading && selectedSearchable && (realDataReady || canRunLocalSearch);
   const indexedDocumentTotal = documentTotal ?? documents.length;
   const hasUnloadedDocuments = indexedDocumentTotal > documents.length;
@@ -443,8 +443,8 @@ export function MasterSearchHeader({
               ? "favourites"
               : searchMode === "differentials"
                 ? "differentials"
-                : searchMode === "specifiers"
-                  ? "specifiers"
+                : searchMode === "formulation"
+                  ? "formulation"
                   : searchMode === "tools"
                     ? "tools"
                     : "answer";
@@ -608,20 +608,20 @@ export function MasterSearchHeader({
       onOpenEvidence?.();
       return;
     }
-    if (actionId === "specifiers-search") {
-      onSearchModeChange("specifiers");
+    if (actionId === "formulation-search") {
+      onSearchModeChange("formulation");
       return;
     }
-    if (actionId === "specifiers-builder") {
-      window.location.assign("/specifiers/builder");
+    if (actionId === "formulation-builder") {
+      window.location.assign("/formulation/builder");
       return;
     }
-    if (actionId === "specifiers-compare") {
-      window.location.assign("/specifiers/compare");
+    if (actionId === "formulation-compare") {
+      window.location.assign("/formulation/compare");
       return;
     }
-    if (actionId === "specifiers-map") {
-      window.location.assign("/specifiers/map");
+    if (actionId === "formulation-map") {
+      window.location.assign("/formulation/map");
       return;
     }
   }
diff --git a/src/components/clinical-dashboard/mode-action-popup.tsx b/src/components/clinical-dashboard/mode-action-popup.tsx
index 5323a7959..a95f8daf1 100644
--- a/src/components/clinical-dashboard/mode-action-popup.tsx
+++ b/src/components/clinical-dashboard/mode-action-popup.tsx
@@ -30,12 +30,12 @@ import {
   ListChecks,
   Lock,
   MessageSquarePlus,
+  Network,
   Plus,
   Search,
   ShieldCheck,
   Sparkles,
   Table2,
-  Tags,
   UploadCloud,
   Waypoints,
   Wrench,
@@ -55,7 +55,7 @@ export type ModeActionSetId =
   | "favourites"
   | "tools"
   | "differentials"
-  | "specifiers"
+  | "formulation"
   | "prescribing";
 export type ModeActionPlacement = "up" | "down";
 
@@ -118,10 +118,10 @@ export type ModeActionId =
   | "differentials-criteria"
   | "differentials-documents"
   | "differentials-evidence"
-  | "specifiers-search"
-  | "specifiers-builder"
-  | "specifiers-compare"
-  | "specifiers-map";
+  | "formulation-search"
+  | "formulation-builder"
+  | "formulation-compare"
+  | "formulation-map";
 
 export type ModeActionItem = {
   id: ModeActionId;
@@ -231,27 +231,27 @@ const modeActionSets = {
     },
     { id: "differentials-evidence", label: "View evidence", description: "Review cited support", icon: ShieldCheck },
   ],
-  specifiers: [
+  formulation: [
     {
-      id: "specifiers-search",
-      label: "Find a specifier",
-      description: "Match presentation features",
-      icon: Tags,
+      id: "formulation-search",
+      label: "Find a mechanism",
+      description: "Match clinical clues and patient language",
+      icon: Network,
       primary: true,
     },
     {
-      id: "specifiers-builder",
-      label: "Build wording",
-      description: "Assemble diagnostic wording",
+      id: "formulation-builder",
+      label: "Build formulation",
+      description: "Structure and review a working draft",
       icon: ListChecks,
     },
     {
-      id: "specifiers-compare",
-      label: "Compare specifiers",
-      description: "Clarify close clinical calls",
+      id: "formulation-compare",
+      label: "Compare mechanisms",
+      description: "Test alternative hypotheses",
       icon: GitCompareArrows,
     },
-    { id: "specifiers-map", label: "Specifier map", description: "Browse by diagnostic role", icon: Waypoints },
+    { id: "formulation-map", label: "Mechanism map", description: "Browse by formulation domain", icon: Waypoints },
   ],
   prescribing: [
     {
diff --git a/src/components/formulation/formulation-builder-page.tsx b/src/components/formulation/formulation-builder-page.tsx
new file mode 100644
index 000000000..89c7ff146
--- /dev/null
+++ b/src/components/formulation/formulation-builder-page.tsx
@@ -0,0 +1,707 @@
+"use client";
+
+import Link from "next/link";
+import {
+  ArrowLeft,
+  ArrowRight,
+  Check,
+  Clipboard,
+  FileCheck2,
+  Network,
+  RotateCcw,
+  Search,
+  ShieldCheck,
+  Sparkles,
+  Target,
+  Waypoints,
+} from "lucide-react";
+import { useMemo, useState } from "react";
+
+import {
+  FormulationBreadcrumbs,
+  FormulationPageShell,
+  FormulationSafetyNote,
+  FormulationSubnav,
+  MechanismDomainChips,
+  SessionPrivacyNote,
+  formulationCard,
+} from "@/components/formulation/formulation-ui";
+import { cn, eyebrowText } from "@/components/ui-primitives";
+import {
+  findFormulationMechanism,
+  formulationDomains,
+  formulationDraftFor,
+  formulationQualityPrompts,
+  formulationSectionsForTemplate,
+  formulationTemplates,
+  normalizeMechanismSelection,
+  searchFormulationMechanisms,
+  suggestionsForFormulationSection,
+  type FormulationMechanism,
+} from "@/lib/formulation";
+
+const builderSteps = [
+  { id: "select", label: "Select", description: "Mechanisms" },
+  { id: "structure", label: "Structure", description: "Framework" },
+  { id: "review", label: "Review", description: "Quality" },
+  { id: "draft", label: "Draft", description: "Formulation" },
+] as const;
+
+type BuilderStepId = (typeof builderSteps)[number]["id"];
+
+function StepProgress({ active, onChange }: { active: BuilderStepId; onChange: (step: BuilderStepId) => void }) {
+  const activeIndex = builderSteps.findIndex((step) => step.id === active);
+  return (
+    <ol
+      aria-label="Formulation builder steps"
+      className="grid grid-cols-4 gap-1 rounded-xl border border-[color:var(--border)] bg-[color:var(--surface-raised)] p-1.5 shadow-[var(--shadow-inset)]"
+    >
+      {builderSteps.map((step, index) => {
+        const isActive = step.id === active;
+        const isComplete = index < activeIndex;
+        return (
+          <li key={step.id}>
+            <button
+              type="button"
+              onClick={() => onChange(step.id)}
+              aria-current={isActive ? "step" : undefined}
+              className={cn(
+                "grid min-h-[3.25rem] w-full place-items-center rounded-lg px-1 py-1.5 text-center transition focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)] sm:grid-cols-[1.75rem_auto] sm:justify-center sm:gap-2",
+                isActive
+                  ? "border border-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent-soft)] text-[color:var(--clinical-accent)] shadow-[var(--shadow-tight)]"
+                  : "border border-transparent bg-[color:var(--surface)] text-[color:var(--text-muted)] hover:border-[color:var(--border)]",
+              )}
+            >
+              <span
+                className={cn(
+                  "nums grid h-6 w-6 place-items-center rounded-full border text-2xs font-extrabold",
+                  isActive || isComplete
+                    ? "border-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent)] text-[color:var(--clinical-accent-contrast)]"
+                    : "border-[color:var(--border-strong)] text-[color:var(--text-muted)]",
+                )}
+              >
+                {isComplete ? <Check className="h-3.5 w-3.5" aria-hidden /> : index + 1}
+              </span>
+              <span>
+                <span className="block text-xs font-extrabold sm:text-sm">{step.label}</span>
+                <span
+                  className={cn(
+                    "hidden text-2xs font-semibold lg:block",
+                    isActive ? "text-[color:var(--text)]" : "text-[color:var(--text-soft)]",
+                  )}
+                >
+                  {step.description}
+                </span>
+              </span>
+            </button>
+          </li>
+        );
+      })}
+    </ol>
+  );
+}
+
+function BuilderThread({
+  mechanisms,
+  templateId,
+  completedQuality,
+}: {
+  mechanisms: FormulationMechanism[];
+  templateId: string;
+  completedQuality: number;
+}) {
+  return (
+    <aside className="grid content-start gap-4 xl:sticky xl:top-20">
+      <section className="overflow-hidden rounded-xl border border-[color:var(--clinical-accent-border)] bg-[color:var(--surface)] shadow-[var(--shadow-soft)]">
+        <div className="flex items-center gap-3 border-b border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] px-4 py-3.5">
+          <span className="grid h-10 w-10 place-items-center rounded-lg bg-[color:var(--clinical-accent)] text-[color:var(--clinical-accent-contrast)]">
+            <Waypoints className="h-5 w-5" aria-hidden />
+          </span>
+          <div>
+            <p className={cn(eyebrowText, "!text-[color:var(--clinical-accent)]")}>Live formulation thread</p>
+            <h2 className="text-base font-extrabold text-[color:var(--text-heading)]">From pattern to leverage</h2>
+          </div>
+        </div>
+        <div className="grid gap-4 p-4">
+          <div>
+            <p className={eyebrowText}>Mechanism hypotheses</p>
+            {mechanisms.length ? (
+              <ol className="relative mt-3 grid gap-3 before:absolute before:bottom-3 before:left-[0.7rem] before:top-3 before:w-px before:bg-[color:var(--clinical-accent-border)]">
+                {mechanisms.map((mechanism) => (
+                  <li key={mechanism.id} className="relative grid grid-cols-[1.5rem_minmax(0,1fr)] gap-2.5">
+                    <span className="z-10 mt-0.5 grid h-6 w-6 place-items-center rounded-full border border-[color:var(--clinical-accent)] bg-[color:var(--surface)] text-[color:var(--clinical-accent)]">
+                      <Network className="h-3 w-3" aria-hidden />
+                    </span>
+                    <span>
+                      <span className="block text-sm font-extrabold text-[color:var(--text-heading)]">
+                        {mechanism.name}
+                      </span>
+                      <span className="mt-0.5 line-clamp-2 block text-xs font-medium leading-4 text-[color:var(--text-muted)]">
+                        {mechanism.formulationUse}
+                      </span>
+                    </span>
+                  </li>
+                ))}
+              </ol>
+            ) : (
+              <p className="mt-2 text-sm font-medium leading-5 text-[color:var(--text-muted)]">
+                Select one or more mechanisms to start the thread.
+              </p>
+            )}
+          </div>
+
+          <dl className="grid grid-cols-2 gap-2 border-t border-[color:var(--border)] pt-3">
+            <div className="rounded-lg bg-[color:var(--surface-subtle)] p-3">
+              <dt className="text-2xs font-bold uppercase tracking-wide text-[color:var(--text-soft)]">Framework</dt>
+              <dd className="mt-1 text-sm font-extrabold text-[color:var(--text-heading)]">{templateId}</dd>
+            </div>
+            <div className="rounded-lg bg-[color:var(--surface-subtle)] p-3">
+              <dt className="text-2xs font-bold uppercase tracking-wide text-[color:var(--text-soft)]">Review</dt>
+              <dd className="nums mt-1 text-sm font-extrabold text-[color:var(--text-heading)]">
+                {completedQuality}/{formulationQualityPrompts.length}
+              </dd>
+            </div>
+          </dl>
+
+          {mechanisms.length ? (
+            <div className="border-t border-[color:var(--border)] pt-3">
+              <div className="flex items-center gap-2">
+                <Target className="h-4 w-4 text-[color:var(--clinical-accent)]" aria-hidden />
+                <p className={eyebrowText}>Treatment leverage</p>
+              </div>
+              <p className="mt-2 text-xs font-semibold leading-5 text-[color:var(--text-heading)]">
+                {mechanisms[0].treatmentLeverage}
+              </p>
+            </div>
+          ) : null}
+        </div>
+      </section>
+      <section className={cn(formulationCard, "p-4")}>
+        <SessionPrivacyNote />
+      </section>
+    </aside>
+  );
+}
+
+function StepHeading({ eyebrow, title, body }: { eyebrow: string; title: string; body: string }) {
+  return (
+    <div className="border-b border-[color:var(--border)] px-4 py-4 sm:px-5">
+      <p className={cn(eyebrowText, "!text-[color:var(--clinical-accent)]")}>{eyebrow}</p>
+      <h2 className="mt-1 text-xl font-extrabold text-[color:var(--text-heading)]">{title}</h2>
+      <p className="mt-1 text-sm font-medium leading-6 text-[color:var(--text-muted)]">{body}</p>
+    </div>
+  );
+}
+
+export function FormulationBuilderPage({
+  initialMechanisms = [],
+  initialTemplate,
+}: {
+  initialMechanisms?: string[];
+  initialTemplate?: string;
+}) {
+  const validInitialTemplate = formulationTemplates.some((template) => template.id === initialTemplate)
+    ? initialTemplate!
+    : formulationTemplates[0].id;
+  const [activeStep, setActiveStep] = useState<BuilderStepId>("select");
+  const [selectedIds, setSelectedIds] = useState(() => normalizeMechanismSelection(initialMechanisms));
+  const [query, setQuery] = useState("");
+  const [domain, setDomain] = useState("all");
+  const [templateId, setTemplateId] = useState(validInitialTemplate);
+  const [sectionNotes, setSectionNotes] = useState<Record<string, string>>({});
+  const [qualityNotes, setQualityNotes] = useState<Record<string, string>>({});
+  const [editedDraft, setEditedDraft] = useState<string | null>(null);
+  const [copied, setCopied] = useState(false);
+
+  const selectedMechanisms = useMemo(
+    () =>
+      selectedIds
+        .map((id) => findFormulationMechanism(id))
+        .filter((mechanism): mechanism is FormulationMechanism => Boolean(mechanism)),
+    [selectedIds],
+  );
+  const visibleMechanisms = useMemo(
+    () => searchFormulationMechanisms(query, { domain }).map((result) => result.mechanism),
+    [domain, query],
+  );
+  const activeSections = formulationSectionsForTemplate(templateId);
+  const generatedDraft = formulationDraftFor({
+    mechanisms: selectedMechanisms,
+    templateId,
+    notes: sectionNotes,
+    qualityNotes,
+  });
+  const draft = editedDraft ?? generatedDraft;
+  const completedQuality = formulationQualityPrompts.filter((prompt) => qualityNotes[prompt.id]?.trim()).length;
+  const activeIndex = builderSteps.findIndex((step) => step.id === activeStep);
+
+  function toggleMechanism(id: string) {
+    setSelectedIds((current) =>
+      current.includes(id) ? current.filter((item) => item !== id) : normalizeMechanismSelection([...current, id]),
+    );
+    setEditedDraft(null);
+  }
+
+  function updateSection(id: string, value: string) {
+    setSectionNotes((current) => ({ ...current, [id]: value }));
+    setEditedDraft(null);
+  }
+
+  function applySuggestions(id: string) {
+    const suggestions = suggestionsForFormulationSection(selectedMechanisms, id);
+    if (!suggestions.length) return;
+    updateSection(id, suggestions.map((item) => `- ${item}`).join("\n"));
+  }
+
+  function move(direction: -1 | 1) {
+    const next = builderSteps[activeIndex + direction];
+    if (!next) return;
+    if (next.id === "draft") setEditedDraft(generatedDraft);
+    setActiveStep(next.id);
+  }
+
+  async function copyDraft() {
+    await navigator.clipboard.writeText(draft);
+    setCopied(true);
+    window.setTimeout(() => setCopied(false), 1800);
+  }
+
+  return (
+    <FormulationPageShell>
+      <div className="grid gap-3">
+        <FormulationBreadcrumbs current="Build formulation" />
+        <FormulationSubnav active="builder" />
+      </div>
+
+      <header className="grid gap-2 border-b border-[color:var(--border)] pb-5">
+        <p className={eyebrowText}>Formulation builder</p>
+        <h1 className="text-3xl font-extrabold tracking-tight text-[color:var(--text-heading)] sm:text-4xl">
+          Build a formulation that can be tested
+        </h1>
+        <p className="max-w-3xl text-sm font-medium leading-6 text-[color:var(--text-muted)]">
+          Select candidate mechanisms, structure them with a clinical framework, challenge the hypothesis, then edit a
+          de-identified draft.
+        </p>
+      </header>
+
+      <StepProgress active={activeStep} onChange={setActiveStep} />
+
+      <div className="grid gap-5 xl:grid-cols-[minmax(0,1fr)_22rem]">
+        <div className="min-w-0">
+          {activeStep === "select" ? (
+            <section className={cn(formulationCard, "overflow-hidden")} data-testid="formulation-builder-select">
+              <StepHeading
+                eyebrow="1 · Select"
+                title="Mechanism hypotheses"
+                body="Search and add mechanisms that may explain the pattern. Selection is provisional: evidence and alternatives come next."
+              />
+
+              <div className="grid gap-4 p-4 sm:p-5">
+                {selectedMechanisms.length ? (
+                  <div className="rounded-xl border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)]/45 p-3">
+                    <div className="flex items-center justify-between gap-3">
+                      <div>
+                        <p className={eyebrowText}>Selected hypotheses</p>
+                        <p className="mt-1 text-sm font-bold text-[color:var(--text-heading)]">
+                          {selectedMechanisms.length} {selectedMechanisms.length === 1 ? "mechanism" : "mechanisms"} in
+                          the thread
+                        </p>
+                      </div>
+                      <button
+                        type="button"
+                        onClick={() => setSelectedIds([])}
+                        className="inline-flex min-h-tap items-center gap-2 rounded-lg px-3 text-xs font-bold text-[color:var(--text-muted)] hover:bg-[color:var(--surface)]"
+                      >
+                        <RotateCcw className="h-3.5 w-3.5" aria-hidden />
+                        Clear
+                      </button>
+                    </div>
+                    <div className="mt-3 flex flex-wrap gap-2">
+                      {selectedMechanisms.map((mechanism) => (
+                        <button
+                          key={mechanism.id}
+                          type="button"
+                          onClick={() => toggleMechanism(mechanism.id)}
+                          aria-label={`Remove ${mechanism.name}`}
+                          className="inline-flex min-h-9 items-center gap-2 rounded-lg border border-[color:var(--clinical-accent-border)] bg-[color:var(--surface)] px-3 text-xs font-bold text-[color:var(--text-heading)]"
+                        >
+                          <Check className="h-3.5 w-3.5 text-[color:var(--clinical-accent)]" aria-hidden />
+                          {mechanism.name}
+                        </button>
+                      ))}
+                    </div>
+                  </div>
+                ) : (
+                  <div className="grid min-h-36 place-items-center rounded-xl border border-dashed border-[color:var(--border-strong)] bg-[linear-gradient(to_right,var(--border)_1px,transparent_1px),linear-gradient(to_bottom,var(--border)_1px,transparent_1px)] bg-[size:32px_32px] p-5 text-center">
+                    <div className="rounded-xl bg-[color:var(--surface)]/95 px-6 py-4 shadow-[var(--shadow-tight)]">
+                      <Network className="mx-auto h-6 w-6 text-[color:var(--clinical-accent)]" aria-hidden />
+                      <h3 className="mt-2 text-base font-extrabold text-[color:var(--text-heading)]">
+                        No mechanisms selected
+                      </h3>
+                      <p className="mt-1 max-w-sm text-sm font-medium leading-5 text-[color:var(--text-muted)]">
+                        Search by mechanism, clinical clue, patient phrase, symptom, or domain.
+                      </p>
+                    </div>
+                  </div>
+                )}
+
+                <div className="grid gap-2 sm:grid-cols-[minmax(0,1fr)_14rem]">
+                  <label className="relative">
+                    <span className="sr-only">Search formulation mechanisms</span>
+                    <Search
+                      className="pointer-events-none absolute left-3 top-1/2 h-4 w-4 -translate-y-1/2 text-[color:var(--text-soft)]"
+                      aria-hidden
+                    />
+                    <input
+                      value={query}
+                      onChange={(event) => setQuery(event.target.value)}
+                      placeholder="Search mechanisms or patient language..."
+                      className="min-h-12 w-full rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] pl-10 pr-3 text-sm font-semibold text-[color:var(--text)] outline-none placeholder:text-[color:var(--text-soft)] focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
+                    />
+                  </label>
+                  <label>
+                    <span className="sr-only">Filter mechanisms by domain</span>
+                    <select
+                      value={domain}
+                      onChange={(event) => setDomain(event.target.value)}
+                      className="min-h-12 w-full rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-3 text-sm font-semibold text-[color:var(--text)] outline-none focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
+                    >
+                      <option value="all">All domains</option>
+                      {formulationDomains.map((item) => (
+                        <option key={item} value={item}>
+                          {item}
+                        </option>
+                      ))}
+                    </select>
+                  </label>
+                </div>
+
+                <div className="grid gap-2 sm:grid-cols-2" aria-label="Available mechanisms">
+                  {visibleMechanisms.map((mechanism) => {
+                    const checked = selectedIds.includes(mechanism.id);
+                    return (
+                      <label
+                        key={mechanism.id}
+                        className={cn(
+                          "group grid cursor-pointer grid-cols-[2rem_minmax(0,1fr)] gap-3 rounded-lg border p-3.5 transition",
+                          checked
+                            ? "border-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent-soft)]/55"
+                            : "border-[color:var(--border)] bg-[color:var(--surface)] hover:border-[color:var(--clinical-accent-border)] hover:bg-[color:var(--surface-subtle)]",
+                        )}
+                      >
+                        <input
+                          type="checkbox"
+                          checked={checked}
+                          onChange={() => toggleMechanism(mechanism.id)}
+                          className="peer sr-only"
+                        />
+                        <span
+                          className={cn(
+                            "mt-0.5 grid h-7 w-7 place-items-center rounded-md border text-transparent transition peer-focus-visible:outline peer-focus-visible:outline-2 peer-focus-visible:outline-offset-2 peer-focus-visible:outline-[color:var(--focus)]",
+                            checked
+                              ? "border-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent)] text-[color:var(--clinical-accent-contrast)]"
+                              : "border-[color:var(--border-strong)] bg-[color:var(--surface)]",
+                          )}
+                        >
+                          <Check className="h-4 w-4" aria-hidden />
+                        </span>
+                        <span className="min-w-0">
+                          <span className="block text-sm font-extrabold text-[color:var(--text-heading)]">
+                            {mechanism.name}
+                          </span>
+                          <span className="mt-1 line-clamp-2 block text-xs font-medium leading-5 text-[color:var(--text-muted)]">
+                            {mechanism.formulationUse}
+                          </span>
+                          <span className="mt-2 block">
+                            <MechanismDomainChips values={mechanism.domains} limit={2} />
+                          </span>
+                        </span>
+                      </label>
+                    );
+                  })}
+                </div>
+
+                <div className="rounded-xl border border-[color:var(--border)] bg-[color:var(--surface-subtle)] p-4">
+                  <p className={eyebrowText}>Formulation language</p>
+                  <p className="mt-2 text-sm font-semibold leading-6 text-[color:var(--text-heading)]">
+                    {selectedMechanisms.length
+                      ? selectedMechanisms.map((mechanism) => mechanism.exampleSentence).join(" ")
+                      : "Select mechanisms to develop formulation language and treatment targets."}
+                  </p>
+                </div>
+              </div>
+            </section>
+          ) : null}
+
+          {activeStep === "structure" ? (
+            <section className={cn(formulationCard, "overflow-hidden")} data-testid="formulation-builder-structure">
+              <StepHeading
+                eyebrow="2 · Structure"
+                title="Choose a formulation framework"
+                body="Use the framework that best serves the clinical task. Mechanism-derived suggestions remain editable and should be checked against the case."
+              />
+              <div className="grid gap-5 p-4 sm:p-5">
+                <div
+                  className="grid gap-2 sm:grid-cols-2 lg:grid-cols-3"
+                  role="radiogroup"
+                  aria-label="Formulation framework"
+                >
+                  {formulationTemplates.map((template) => {
+                    const active = template.id === templateId;
+                    return (
+                      <label
+                        key={template.id}
+                        className={cn(
+                          "grid cursor-pointer grid-cols-[2rem_minmax(0,1fr)] gap-3 rounded-lg border p-3.5",
+                          active
+                            ? "border-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent-soft)]"
+                            : "border-[color:var(--border)] bg-[color:var(--surface)] hover:bg-[color:var(--surface-subtle)]",
+                        )}
+                      >
+                        <input
+                          type="radio"
+                          name="formulation-template"
+                          value={template.id}
+                          checked={active}
+                          onChange={() => {
+                            setTemplateId(template.id);
+                            setEditedDraft(null);
+                          }}
+                          className="peer sr-only"
+                        />
+                        <span
+                          className={cn(
+                            "grid h-7 w-7 place-items-center rounded-full border peer-focus-visible:outline peer-focus-visible:outline-2 peer-focus-visible:outline-offset-2 peer-focus-visible:outline-[color:var(--focus)]",
+                            active
+                              ? "border-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent)] text-[color:var(--clinical-accent-contrast)]"
+                              : "border-[color:var(--border-strong)] text-transparent",
+                          )}
+                        >
+                          <Check className="h-4 w-4" aria-hidden />
+                        </span>
+                        <span>
+                          <span className="block text-sm font-extrabold text-[color:var(--text-heading)]">
+                            {template.label}
+                          </span>
+                          <span className="mt-1 block text-xs font-medium text-[color:var(--text-muted)]">
+                            {formulationSectionsForTemplate(template.id).length} structured sections
+                          </span>
+                        </span>
+                      </label>
+                    );
+                  })}
+                </div>
+
+                <div className="grid gap-3">
+                  {activeSections.map((section) => {
+                    const suggestions = suggestionsForFormulationSection(selectedMechanisms, section.id);
+                    return (
+                      <article
+                        key={section.id}
+                        className="rounded-xl border border-[color:var(--border)] bg-[color:var(--surface)] p-4"
+                      >
+                        <div className="flex flex-wrap items-start justify-between gap-3">
+                          <div>
+                            <h3 className="text-sm font-extrabold text-[color:var(--text-heading)]">{section.label}</h3>
+                            <p className="mt-1 text-xs font-medium leading-5 text-[color:var(--text-muted)]">
+                              {section.prompt}
+                            </p>
+                          </div>
+                          {suggestions.length ? (
+                            <button
+                              type="button"
+                              onClick={() => applySuggestions(section.id)}
+                              className="inline-flex min-h-9 items-center gap-1.5 rounded-md border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] px-2.5 text-xs font-bold text-[color:var(--clinical-accent)]"
+                            >
+                              <Sparkles className="h-3.5 w-3.5" aria-hidden />
+                              Use suggestions
+                            </button>
+                          ) : null}
+                        </div>
+                        <textarea
+                          value={sectionNotes[section.id] ?? ""}
+                          onChange={(event) => updateSection(section.id, event.target.value)}
+                          rows={3}
+                          aria-label={section.label}
+                          placeholder="Add de-identified case evidence..."
+                          className="mt-3 min-h-24 w-full resize-y rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface-raised)] p-3 text-sm font-medium leading-6 text-[color:var(--text)] outline-none placeholder:text-[color:var(--text-soft)] focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
+                        />
+                        {suggestions.length ? (
+                          <div className="mt-2 flex flex-wrap gap-1.5">
+                            {suggestions.map((suggestion) => (
+                              <span
+                                key={suggestion}
+                                className="rounded-md bg-[color:var(--surface-subtle)] px-2 py-1 text-2xs font-semibold leading-4 text-[color:var(--text-muted)]"
+                              >
+                                {suggestion}
+                              </span>
+                            ))}
+                          </div>
+                        ) : null}
+                      </article>
+                    );
+                  })}
+                </div>
+              </div>
+            </section>
+          ) : null}
+
+          {activeStep === "review" ? (
+            <section className={cn(formulationCard, "overflow-hidden")} data-testid="formulation-builder-review">
+              <StepHeading
+                eyebrow="3 · Review"
+                title="Challenge the working hypothesis"
+                body="A useful formulation remains provisional. Record what supports it, what competes with it, and what would change your mind."
+              />
+              <div className="grid gap-3 p-4 sm:p-5 sm:grid-cols-2">
+                {formulationQualityPrompts.map((prompt, index) => {
+                  const starter =
+                    prompt.id === "quality-evidence"
+                      ? selectedMechanisms.flatMap((mechanism) => mechanism.fitIndicators).slice(0, 2)
+                      : prompt.id === "quality-intervention"
+                        ? selectedMechanisms.map((mechanism) => mechanism.treatmentLeverage).slice(0, 2)
+                        : selectedMechanisms.flatMap((mechanism) => mechanism.poorFitIndicators).slice(0, 2);
+                  return (
+                    <article
+                      key={prompt.id}
+                      className="rounded-xl border border-[color:var(--border)] bg-[color:var(--surface)] p-4"
+                    >
+                      <div className="flex items-start gap-3">
+                        <span className="nums grid h-8 w-8 shrink-0 place-items-center rounded-full bg-[color:var(--clinical-accent-soft)] text-xs font-extrabold text-[color:var(--clinical-accent)]">
+                          {index + 1}
+                        </span>
+                        <div>
+                          <h3 className="text-sm font-extrabold text-[color:var(--text-heading)]">{prompt.label}</h3>
+                          <p className="mt-1 text-xs font-medium leading-5 text-[color:var(--text-muted)]">
+                            {prompt.prompt}
+                          </p>
+                        </div>
+                      </div>
+                      <textarea
+                        value={qualityNotes[prompt.id] ?? ""}
+                        onChange={(event) => {
+                          setQualityNotes((current) => ({ ...current, [prompt.id]: event.target.value }));
+                          setEditedDraft(null);
+                        }}
+                        rows={4}
+                        aria-label={prompt.label}
+                        placeholder="Record a concise review note..."
+                        className="mt-3 min-h-28 w-full resize-y rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface-raised)] p-3 text-sm font-medium leading-6 text-[color:var(--text)] outline-none placeholder:text-[color:var(--text-soft)] focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
+                      />
+                      {starter.length ? (
+                        <div className="mt-2 rounded-lg bg-[color:var(--surface-subtle)] p-2.5">
+                          <p className={eyebrowText}>Consider</p>
+                          <p className="mt-1 text-2xs font-medium leading-4 text-[color:var(--text-muted)]">
+                            {starter.join(" · ")}
+                          </p>
+                        </div>
+                      ) : null}
+                    </article>
+                  );
+                })}
+              </div>
+              <div className="border-t border-[color:var(--border)] bg-[color:var(--surface-subtle)] px-4 py-3 sm:px-5">
+                <div className="flex items-center gap-2 text-sm font-semibold text-[color:var(--text-muted)]">
+                  <ShieldCheck className="h-4 w-4 text-[color:var(--clinical-accent)]" aria-hidden />
+                  <span className="nums">
+                    {completedQuality}/{formulationQualityPrompts.length}
+                  </span>{" "}
+                  quality prompts completed
+                </div>
+              </div>
+            </section>
+          ) : null}
+
+          {activeStep === "draft" ? (
+            <section className={cn(formulationCard, "overflow-hidden")} data-testid="formulation-builder-draft">
+              <StepHeading
+                eyebrow="4 · Draft"
+                title="Edit the formulation"
+                body="The generated text combines your selected mechanisms, framework notes, and quality review. Edit it until every statement is supported by the case."
+              />
+              <div className="grid gap-4 p-4 sm:p-5">
+                <div className="flex flex-wrap items-center justify-between gap-2">
+                  <div className="flex items-center gap-2">
+                    <FileCheck2 className="h-4 w-4 text-[color:var(--clinical-accent)]" aria-hidden />
+                    <p className={eyebrowText}>Working draft</p>
+                  </div>
+                  <div className="flex gap-2">
+                    <button
+                      type="button"
+                      onClick={() => setEditedDraft(generatedDraft)}
+                      className="inline-flex min-h-9 items-center gap-1.5 rounded-md border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-3 text-xs font-bold text-[color:var(--text-muted)]"
+                    >
+                      <RotateCcw className="h-3.5 w-3.5" aria-hidden />
+                      Regenerate
+                    </button>
+                    <button
+                      type="button"
+                      onClick={copyDraft}
+                      className="inline-flex min-h-9 items-center gap-1.5 rounded-md bg-[color:var(--command)] px-3 text-xs font-bold text-[color:var(--command-contrast)]"
+                    >
+                      <Clipboard className="h-3.5 w-3.5" aria-hidden />
+                      {copied ? "Copied" : "Copy draft"}
+                    </button>
+                  </div>
+                </div>
+                <textarea
+                  value={draft}
+                  onChange={(event) => setEditedDraft(event.target.value)}
+                  rows={22}
+                  aria-label="Formulation draft"
+                  className="min-h-[32rem] w-full resize-y rounded-xl border border-[color:var(--border-strong)] bg-[color:var(--surface-raised)] p-4 font-mono text-sm leading-6 text-[color:var(--text)] outline-none focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
+                />
+                <div className="rounded-xl border border-[color:var(--warning-border)] bg-[color:var(--warning-soft)] p-4 text-sm font-medium leading-6 text-[color:var(--text-muted)]">
+                  <p className="font-extrabold text-[color:var(--text-heading)]">Review before clinical use</p>
+                  <p className="mt-1">
+                    Confirm chronology, risk, strengths, cultural context, alternative explanations, and the patient’s
+                    own account. Remove any unsupported mechanism language.
+                  </p>
+                </div>
+              </div>
+            </section>
+          ) : null}
+
+          <div className="mt-4 flex flex-wrap items-center justify-between gap-3 rounded-xl border border-[color:var(--border)] bg-[color:var(--surface)] p-3 shadow-[var(--shadow-inset)]">
+            <button
+              type="button"
+              onClick={() => move(-1)}
+              disabled={activeIndex === 0}
+              className="inline-flex min-h-tap items-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-4 text-sm font-bold text-[color:var(--text-muted)] disabled:opacity-40"
+            >
+              <ArrowLeft className="h-4 w-4" aria-hidden />
+              Previous
+            </button>
+            {activeIndex < builderSteps.length - 1 ? (
+              <button
+                type="button"
+                onClick={() => move(1)}
+                disabled={activeStep === "select" && selectedMechanisms.length === 0}
+                className="inline-flex min-h-tap items-center gap-2 rounded-lg bg-[color:var(--command)] px-4 text-sm font-bold text-[color:var(--command-contrast)] shadow-[var(--shadow-tight)] disabled:cursor-not-allowed disabled:opacity-45"
+              >
+                {activeStep === "select"
+                  ? "Continue to framework"
+                  : activeStep === "structure"
+                    ? "Review quality"
+                    : "Create draft"}
+                <ArrowRight className="h-4 w-4" aria-hidden />
+              </button>
+            ) : (
+              <Link
+                href="/formulation"
+                className="inline-flex min-h-tap items-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-4 text-sm font-bold text-[color:var(--text)]"
+              >
+                Search another mechanism
+                <Search className="h-4 w-4" aria-hidden />
+              </Link>
+            )}
+          </div>
+        </div>
+
+        <BuilderThread mechanisms={selectedMechanisms} templateId={templateId} completedQuality={completedQuality} />
+      </div>
+
+      <FormulationSafetyNote />
+    </FormulationPageShell>
+  );
+}
diff --git a/src/components/formulation/formulation-compare-page.tsx b/src/components/formulation/formulation-compare-page.tsx
new file mode 100644
index 000000000..ddd0d8721
--- /dev/null
+++ b/src/components/formulation/formulation-compare-page.tsx
@@ -0,0 +1,286 @@
+"use client";
+
+import Link from "next/link";
+import { ArrowRight, GitCompareArrows, HelpCircle, Network, Repeat2, Target } from "lucide-react";
+import { useState } from "react";
+
+import {
+  FormulationBreadcrumbs,
+  FormulationPageShell,
+  FormulationSafetyNote,
+  FormulationSubnav,
+  MechanismDomainChips,
+  formulationCard,
+} from "@/components/formulation/formulation-ui";
+import { cn, eyebrowText } from "@/components/ui-primitives";
+import {
+  comparisonGuideFor,
+  findFormulationMechanism,
+  formulationMechanisms,
+  type FormulationMechanism,
+} from "@/lib/formulation";
+
+function fallbackPair(leftId?: string, rightId?: string) {
+  const left =
+    findFormulationMechanism(leftId ?? "") ?? findFormulationMechanism("rumination") ?? formulationMechanisms[0];
+  const requestedRight = findFormulationMechanism(rightId ?? "");
+  const preferredRight = findFormulationMechanism(left.id === "rumination" ? "worry" : "rumination");
+  const right =
+    requestedRight && requestedRight.id !== left.id
+      ? requestedRight
+      : preferredRight && preferredRight.id !== left.id
+        ? preferredRight
+        : formulationMechanisms.find((item) => item.id !== left.id)!;
+  return { left, right };
+}
+
+function Selector({
+  label,
+  value,
+  otherValue,
+  onChange,
+}: {
+  label: string;
+  value: string;
+  otherValue: string;
+  onChange: (value: string) => void;
+}) {
+  return (
+    <label className="grid min-w-0 gap-1.5">
+      <span className={eyebrowText}>{label}</span>
+      <span className="relative">
+        <Network
+          className="pointer-events-none absolute left-3 top-1/2 h-4 w-4 -translate-y-1/2 text-[color:var(--clinical-accent)]"
+          aria-hidden
+        />
+        <select
+          value={value}
+          onChange={(event) => onChange(event.target.value)}
+          className="min-h-12 w-full rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] pl-10 pr-9 text-sm font-bold text-[color:var(--text-heading)] shadow-[var(--shadow-inset)] outline-none focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
+        >
+          {formulationMechanisms.map((mechanism) => (
+            <option key={mechanism.id} value={mechanism.id} disabled={mechanism.id === otherValue}>
+              {mechanism.name}
+            </option>
+          ))}
+        </select>
+      </span>
+    </label>
+  );
+}
+
+function comparisonRows(left: FormulationMechanism, right: FormulationMechanism) {
+  return [
+    { label: "Definition", left: left.definition, right: right.definition },
+    { label: "Core process", left: left.coreProcess, right: right.coreProcess },
+    {
+      label: "Look for",
+      left: left.clinicalClues.slice(0, 2).join(" · "),
+      right: right.clinicalClues.slice(0, 2).join(" · "),
+    },
+    { label: "Patient language", left: `“${left.patientPhrases[0]}”`, right: `“${right.patientPhrases[0]}”` },
+    { label: "Maintaining cycle", left: left.maintainingCycles[0], right: right.maintainingCycles[0] },
+    { label: "Treatment leverage", left: left.treatmentLeverage, right: right.treatmentLeverage },
+    { label: "Check before using", left: left.poorFitIndicators[0], right: right.poorFitIndicators[0] },
+  ];
+}
+
+export function FormulationComparePage({ initialLeft, initialRight }: { initialLeft?: string; initialRight?: string }) {
+  const initial = fallbackPair(initialLeft, initialRight);
+  const [leftId, setLeftId] = useState(initial.left.id);
+  const [rightId, setRightId] = useState(initial.right.id);
+  const left = findFormulationMechanism(leftId) ?? initial.left;
+  const right = findFormulationMechanism(rightId) ?? initial.right;
+  const guide = comparisonGuideFor(left.id, right.id);
+  const rows = comparisonRows(left, right);
+
+  function chooseLeft(nextId: string) {
+    setLeftId(nextId);
+    if (nextId === rightId) {
+      setRightId(formulationMechanisms.find((item) => item.id !== nextId)?.id ?? rightId);
+    }
+  }
+
+  function chooseRight(nextId: string) {
+    setRightId(nextId);
+    if (nextId === leftId) {
+      setLeftId(formulationMechanisms.find((item) => item.id !== nextId)?.id ?? leftId);
+    }
+  }
+
+  function swap() {
+    setLeftId(right.id);
+    setRightId(left.id);
+  }
+
+  return (
+    <FormulationPageShell>
+      <div className="grid gap-3">
+        <FormulationBreadcrumbs current="Compare" />
+        <FormulationSubnav active="compare" />
+      </div>
+
+      <header className="grid gap-2 border-b border-[color:var(--border)] pb-5">
+        <p className={eyebrowText}>Alternative hypotheses</p>
+        <h1 className="text-3xl font-extrabold tracking-tight text-[color:var(--text-heading)] sm:text-4xl">
+          Compare mechanisms
+        </h1>
+        <p className="max-w-3xl text-sm font-medium leading-6 text-[color:var(--text-muted)]">
+          Compare function, sequence, patient language, and treatment leverage. The aim is not to choose a label—it is
+          to identify which hypothesis best explains this person’s pattern.
+        </p>
+      </header>
+
+      <section
+        className={cn(
+          formulationCard,
+          "grid gap-3 p-4 sm:grid-cols-[minmax(0,1fr)_3rem_minmax(0,1fr)] sm:items-end sm:p-5",
+        )}
+      >
+        <Selector label="A" value={left.id} otherValue={right.id} onChange={chooseLeft} />
+        <button
+          type="button"
+          onClick={swap}
+          aria-label="Swap compared mechanisms"
+          className="grid h-tap w-tap place-items-center justify-self-center rounded-full border border-[color:var(--border-strong)] bg-[color:var(--surface-raised)] text-[color:var(--text-muted)] shadow-[var(--shadow-inset)] transition hover:border-[color:var(--clinical-accent)] hover:text-[color:var(--clinical-accent)] focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)]"
+        >
+          <Repeat2 className="h-4 w-4" aria-hidden />
+        </button>
+        <Selector label="B" value={right.id} otherValue={left.id} onChange={chooseRight} />
+      </section>
+
+      <section className="rounded-lg border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] px-4 py-4 text-center sm:px-6">
+        <div className="mx-auto flex max-w-4xl items-start justify-center gap-2.5">
+          <HelpCircle className="mt-0.5 h-5 w-5 shrink-0 text-[color:var(--clinical-accent)]" aria-hidden />
+          <div>
+            <p className={cn(eyebrowText, "!text-[color:var(--clinical-accent)]")}>Ask this</p>
+            <p className="mt-1 text-base font-extrabold leading-6 text-[color:var(--text-heading)]">
+              {guide?.assessmentQuestion ??
+                `Which pattern better explains the sequence, protective function, and consequences: ${left.name.toLowerCase()} or ${right.name.toLowerCase()}?`}
+            </p>
+          </div>
+        </div>
+      </section>
+
+      {guide ? (
+        <section
+          className={cn(formulationCard, "grid overflow-hidden md:grid-cols-3")}
+          aria-label="Focused distinction"
+        >
+          {[
+            ["Most useful distinction", guide.mostUsefulDistinction],
+            ["Common confusion", guide.commonConfusion],
+            ["Treatment difference", guide.treatmentImplicationDifference],
+          ].map(([label, body], index) => (
+            <div
+              key={label}
+              className={cn(
+                "p-4 sm:p-5",
+                index > 0 && "border-t border-[color:var(--border)] md:border-l md:border-t-0",
+              )}
+            >
+              <p className={eyebrowText}>{label}</p>
+              <p className="mt-2 text-sm font-semibold leading-6 text-[color:var(--text-heading)]">{body}</p>
+            </div>
+          ))}
+        </section>
+      ) : null}
+
+      <section
+        className={cn(formulationCard, "overflow-hidden")}
+        aria-label={`${left.name} compared with ${right.name}`}
+      >
+        <div className="grid sm:grid-cols-2">
+          {[left, right].map((mechanism, index) => (
+            <div
+              key={mechanism.id}
+              className={cn(
+                "grid gap-3 px-4 py-4 sm:px-5",
+                index === 1 && "border-t border-[color:var(--border)] sm:border-l sm:border-t-0",
+              )}
+            >
+              <div className="flex items-center gap-2">
+                <span className="grid h-7 w-7 place-items-center rounded-full bg-[color:var(--clinical-accent)] text-xs font-extrabold text-[color:var(--clinical-accent-contrast)]">
+                  {index === 0 ? "A" : "B"}
+                </span>
+                <h2 className="text-lg font-extrabold text-[color:var(--text-heading)]">{mechanism.name}</h2>
+              </div>
+              <p className="text-sm font-medium leading-6 text-[color:var(--text-muted)]">{mechanism.summary}</p>
+              <MechanismDomainChips values={mechanism.domains} limit={3} />
+            </div>
+          ))}
+        </div>
+
+        <div className="border-t border-[color:var(--border)]">
+          {rows.map((row) => (
+            <div
+              key={row.label}
+              className="grid border-b border-[color:var(--border)] last:border-b-0 sm:grid-cols-[10rem_minmax(0,1fr)_minmax(0,1fr)]"
+            >
+              <div className="bg-[color:var(--surface-subtle)] px-4 py-3 text-xs font-extrabold text-[color:var(--text-heading)] sm:flex sm:items-center">
+                {row.label}
+              </div>
+              {[row.left, row.right].map((body, index) => (
+                <div
+                  key={`${row.label}-${index}`}
+                  className={cn(
+                    "grid grid-cols-[1.75rem_minmax(0,1fr)] gap-2 px-4 py-3 text-sm font-medium leading-6 text-[color:var(--text-muted)]",
+                    index === 1 && "border-t border-[color:var(--border)] sm:border-l sm:border-t-0",
+                  )}
+                >
+                  <span className="grid h-7 w-7 place-items-center rounded-full bg-[color:var(--clinical-accent-soft)] text-xs font-extrabold text-[color:var(--clinical-accent)]">
+                    {index === 0 ? "A" : "B"}
+                  </span>
+                  <span>{body}</span>
+                </div>
+              ))}
+            </div>
+          ))}
+        </div>
+
+        <div className="grid border-t border-[color:var(--border)] bg-[color:var(--surface-subtle)] sm:grid-cols-2">
+          {[left, right].map((mechanism, index) => (
+            <div
+              key={mechanism.id}
+              className={cn(
+                "p-4 sm:p-5",
+                index === 1 && "border-t border-[color:var(--border)] sm:border-l sm:border-t-0",
+              )}
+            >
+              <p className={eyebrowText}>Formulation language</p>
+              <p className="mt-1.5 text-sm font-bold leading-6 text-[color:var(--text-heading)]">
+                {mechanism.exampleSentence}
+              </p>
+              <Link
+                href={`/formulation/${mechanism.id}`}
+                className="mt-3 inline-flex min-h-tap items-center gap-2 rounded-md px-1 text-sm font-bold text-[color:var(--clinical-accent)] hover:underline"
+              >
+                Open full guide
+                <ArrowRight className="h-4 w-4" aria-hidden />
+              </Link>
+            </div>
+          ))}
+        </div>
+      </section>
+
+      <div className="flex flex-wrap justify-end gap-2">
+        <Link
+          href="/formulation/map"
+          className="inline-flex min-h-tap items-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-4 text-sm font-bold text-[color:var(--text)]"
+        >
+          <GitCompareArrows className="h-4 w-4" aria-hidden />
+          Browse the map
+        </Link>
+        <Link
+          href={`/formulation/builder?mechanism=${left.id}&mechanism=${right.id}`}
+          className="inline-flex min-h-tap items-center gap-2 rounded-lg bg-[color:var(--command)] px-4 text-sm font-bold text-[color:var(--command-contrast)]"
+        >
+          <Target className="h-4 w-4" aria-hidden />
+          Use both hypotheses
+        </Link>
+      </div>
+
+      <FormulationSafetyNote />
+    </FormulationPageShell>
+  );
+}
diff --git a/src/components/specifiers/specifiers-home-page.tsx b/src/components/formulation/formulation-home-page.tsx
similarity index 56%
rename from src/components/specifiers/specifiers-home-page.tsx
rename to src/components/formulation/formulation-home-page.tsx
index b8d9e202e..3f85fd8c7 100644
--- a/src/components/specifiers/specifiers-home-page.tsx
+++ b/src/components/formulation/formulation-home-page.tsx
@@ -8,57 +8,58 @@ import {
   ChevronRight,
   GitCompareArrows,
   ListChecks,
+  Network,
   Search,
   ShieldCheck,
-  Tags,
   Waypoints,
 } from "lucide-react";
 
-import { ModeHomeMain, ModeHomeTemplate, ModeHomeVerificationFooter } from "@/components/mode-home-template";
 import {
-  DiagnosisChips,
-  SpecifierBreadcrumbs,
-  SpecifierFamilyBadge,
-  SpecifierPageShell,
-  SpecifierSafetyNote,
-  SpecifierSubnav,
-  specifierCard,
-} from "@/components/specifiers/specifier-ui";
+  FormulationBreadcrumbs,
+  FormulationPageShell,
+  FormulationSafetyNote,
+  FormulationSubnav,
+  MechanismDomainChips,
+  formulationCard,
+} from "@/components/formulation/formulation-ui";
+import { ModeHomeMain, ModeHomeTemplate, ModeHomeVerificationFooter } from "@/components/mode-home-template";
 import { cn, eyebrowText } from "@/components/ui-primitives";
 import { appModeHomeHref } from "@/lib/app-modes";
+import {
+  formulationDomains,
+  formulationSearchPresets,
+  formulationTemplates,
+  searchFormulationMechanisms,
+} from "@/lib/formulation";
 import { modeHomeDesktopComposerSlotId } from "@/lib/mode-home-composer";
-import { searchSpecifiers, specifierFamilies, specifierSearchPresets, type SpecifierFamily } from "@/lib/specifiers";
-
-const diagnosisOptions = [
-  { value: "", label: "All diagnoses" },
-  { value: "depressive", label: "Depressive" },
-  { value: "bipolar", label: "Bipolar" },
-  { value: "psychotic", label: "Psychotic" },
-  { value: "mood", label: "Mood episodes" },
-];
 
 function presetHref(query: string) {
-  return appModeHomeHref("specifiers", { query, run: true, focus: true });
+  return appModeHomeHref("formulation", { query, run: true, focus: true });
 }
 
-function SpecifierPathwayStrip() {
+function builderTemplateHref(templateId: string) {
+  const params = new URLSearchParams({ template: templateId });
+  return `/formulation/builder?${params.toString()}`;
+}
+
+function FormulationThreadStrip() {
   const steps = [
-    { label: "Diagnosis", body: "Name the disorder" },
-    { label: "Episode features", body: "Describe what is present now" },
-    { label: "Course and onset", body: "Place the episode in time" },
-    { label: "Severity or remission", body: "State current burden and recovery" },
+    { label: "Notice", body: "Presenting patterns and patient language" },
+    { label: "Hypothesise", body: "Mechanisms that may explain the pattern" },
+    { label: "Test", body: "Fit, alternatives, and disconfirming evidence" },
+    { label: "Act", body: "Treatment leverage and review points" },
   ];
 
   return (
     <section
-      aria-labelledby="specifier-pathway-title"
+      aria-labelledby="formulation-thread-title"
       className="overflow-hidden rounded-lg border border-[color:var(--border)] bg-[color:var(--surface)] text-left shadow-[var(--shadow-inset)]"
     >
       <div className="flex items-center justify-between gap-3 border-b border-[color:var(--border)] px-4 py-2.5">
         <div>
-          <p className={eyebrowText}>Specifier pathway</p>
-          <h2 id="specifier-pathway-title" className="mt-0.5 text-sm font-extrabold text-[color:var(--text-heading)]">
-            Build diagnostic wording in clinical order
+          <p className={eyebrowText}>Formulation thread</p>
+          <h2 id="formulation-thread-title" className="mt-0.5 text-sm font-extrabold text-[color:var(--text-heading)]">
+            Carry evidence through to an actionable hypothesis
           </h2>
         </div>
         <Waypoints className="h-5 w-5 shrink-0 text-[color:var(--clinical-accent)]" aria-hidden />
@@ -90,58 +91,58 @@ function SpecifierPathwayStrip() {
   );
 }
 
-function SpecifiersHome() {
+function FormulationHome() {
   return (
-    <ModeHomeMain testId="specifiers-home" className="justify-start sm:justify-center">
+    <ModeHomeMain testId="formulation-home" className="justify-start sm:justify-center">
       <ModeHomeTemplate
-        testId="specifiers"
-        title="Refine the diagnosis with the right specifier"
-        subtitle="Describe the presentation in ordinary clinical language, then check fit, exclusions, and diagnostic wording."
-        icon={Tags}
-        actionsLabel="Specifier workflows"
+        testId="formulation"
+        title="How can I help with the formulation?"
+        subtitle="Search mechanisms, compare alternatives, or build a structured clinical formulation from the evidence in front of you."
+        icon={Network}
+        actionsLabel="Formulation workflows"
         desktopComposerSlotId={modeHomeDesktopComposerSlotId}
         actions={[
           {
-            title: "Find a specifier",
-            description: "Match a presentation or diagnosis.",
+            title: "Search mechanisms",
+            description: "Translate patient language into testable hypotheses.",
             icon: Search,
-            href: "/specifiers?focus=1",
+            href: "/formulation?focus=1",
           },
           {
-            title: "Build diagnostic wording",
-            description: "Assemble a clear, ordered diagnosis.",
+            title: "Build a formulation",
+            description: "Move from mechanisms to a structured draft.",
             icon: ListChecks,
-            href: "/specifiers/builder",
+            href: "/formulation/builder",
           },
           {
-            title: "Compare close calls",
-            description: "See the deciding features side by side.",
+            title: "Compare mechanisms",
+            description: "Clarify close alternatives side by side.",
             icon: GitCompareArrows,
-            href: "/specifiers/compare",
+            href: "/formulation/compare",
           },
         ]}
-        pillsTitle="Common clinical starts"
-        pills={specifierSearchPresets.map((preset) => ({
-          label: preset.label,
-          href: presetHref(preset.query),
-          icon: Tags,
+        pillsTitle="Frameworks"
+        pills={formulationTemplates.slice(0, 5).map((template) => ({
+          label: template.label,
+          href: builderTemplateHref(template.id),
+          icon: Network,
         }))}
         pillsAction={
           <Link
-            href="/specifiers/map"
+            href="/formulation/map"
             className="inline-flex min-h-tap items-center gap-1.5 rounded-md px-2 text-xs font-bold text-[color:var(--clinical-accent)] hover:bg-[color:var(--clinical-accent-soft)] focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)] lg:min-h-9"
           >
-            Browse map
+            Mechanism map
             <ChevronRight className="h-3.5 w-3.5" aria-hidden />
           </Link>
         }
         footer={
           <div className="grid gap-3">
-            <SpecifierPathwayStrip />
+            <FormulationThreadStrip />
             <ModeHomeVerificationFooter
               icon={ShieldCheck}
-              label="Diagnostic decision support"
-              body="Review criteria and exclusions before documenting"
+              label="Hypothesis-led decision support"
+              body="Check fit, alternatives, risk, and context before using a draft"
             />
           </div>
         }
@@ -152,19 +153,19 @@ function SpecifiersHome() {
 
 function EmptySearchResults({ query }: { query: string }) {
   return (
-    <div className={cn(specifierCard, "grid justify-items-center gap-3 px-5 py-12 text-center")}>
+    <div className={cn(formulationCard, "grid justify-items-center gap-3 px-5 py-12 text-center")}>
       <span className="grid h-12 w-12 place-items-center rounded-xl bg-[color:var(--surface-subtle)] text-[color:var(--text-soft)]">
         <Search className="h-6 w-6" aria-hidden />
       </span>
       <div className="grid gap-1">
-        <h2 className="text-lg font-extrabold text-[color:var(--text-heading)]">No strong match for “{query}”</h2>
+        <h2 className="text-lg font-extrabold text-[color:var(--text-heading)]">No mechanism matched “{query}”</h2>
         <p className="max-w-xl text-sm font-medium leading-6 text-[color:var(--text-muted)]">
-          Try the episode pattern, timing, patient language, or the base diagnosis. For example: “depressed but racing
-          thoughts” or “returns every winter”.
+          Try a patient phrase, sequence, coping response, or clinical clue—for example “I keep going over it” or “I was
+          not really there”.
         </p>
       </div>
       <Link
-        href="/specifiers"
+        href="/formulation"
         className="inline-flex min-h-tap items-center gap-2 rounded-lg bg-[color:var(--command)] px-4 text-sm font-bold text-[color:var(--command-contrast)]"
       >
         Clear search
@@ -173,27 +174,26 @@ function EmptySearchResults({ query }: { query: string }) {
   );
 }
 
-function SpecifierResults({ query }: { query: string }) {
-  const [family, setFamily] = useState<"all" | SpecifierFamily>("all");
-  const [diagnosis, setDiagnosis] = useState("");
-  const results = useMemo(() => searchSpecifiers(query, { family, diagnosis }), [diagnosis, family, query]);
+function FormulationResults({ query }: { query: string }) {
+  const [domain, setDomain] = useState("all");
+  const results = useMemo(() => searchFormulationMechanisms(query, { domain }), [domain, query]);
 
   return (
-    <SpecifierPageShell>
+    <FormulationPageShell>
       <div className="grid gap-3">
-        <SpecifierBreadcrumbs />
-        <SpecifierSubnav active="search" />
+        <FormulationBreadcrumbs />
+        <FormulationSubnav active="search" />
       </div>
 
       <header className="grid gap-2 border-b border-[color:var(--border)] pb-5 sm:grid-cols-[minmax(0,1fr)_auto] sm:items-end">
         <div className="grid gap-1.5">
-          <p className={eyebrowText}>Specifier search</p>
+          <p className={eyebrowText}>Mechanism search</p>
           <h1 className="text-2xl font-extrabold tracking-tight text-[color:var(--text-heading)] sm:text-3xl">
-            Matches for “{query}”
+            Mechanisms matching “{query}”
           </h1>
           <p className="max-w-3xl text-sm font-medium leading-6 text-[color:var(--text-muted)]">
-            Results prioritise clinical fit, episode timing, and patient language. Open a result to check exclusions and
-            wording.
+            Matches use patient language, clinical clues, domains, symptoms, and formulation context. Open a mechanism
+            to test fit and competing explanations.
           </p>
         </div>
         <p className="nums text-sm font-bold text-[color:var(--text-muted)]" aria-live="polite">
@@ -202,41 +202,31 @@ function SpecifierResults({ query }: { query: string }) {
       </header>
 
       <section
-        aria-label="Filter specifier results"
-        className="grid gap-3 sm:grid-cols-[minmax(0,1fr)_13rem] sm:items-center"
+        aria-label="Filter mechanism results"
+        className="grid gap-2 sm:grid-cols-[minmax(0,1fr)_16rem] sm:items-center"
       >
-        <div className="polished-scroll flex gap-1 overflow-x-auto rounded-lg border border-[color:var(--border)] bg-[color:var(--surface-raised)] p-1 shadow-[var(--shadow-inset)]">
-          {specifierFamilies.map((option) => {
-            const active = family === option.id;
-            return (
-              <button
-                key={option.id}
-                type="button"
-                onClick={() => setFamily(option.id)}
-                aria-pressed={active}
-                className={cn(
-                  "inline-flex min-h-tap shrink-0 items-center rounded-md px-3 text-xs font-bold transition focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)] sm:text-sm",
-                  active
-                    ? "bg-[color:var(--clinical-accent)] text-[color:var(--clinical-accent-contrast)]"
-                    : "text-[color:var(--text-muted)] hover:bg-[color:var(--surface)] hover:text-[color:var(--text)]",
-                )}
-              >
-                <span className="sm:hidden">{option.shortLabel}</span>
-                <span className="hidden sm:inline">{option.label}</span>
-              </button>
-            );
-          })}
+        <div className="polished-scroll flex gap-2 overflow-x-auto">
+          {formulationSearchPresets.slice(0, 4).map((preset) => (
+            <Link
+              key={preset.label}
+              href={presetHref(preset.query)}
+              className="inline-flex min-h-9 shrink-0 items-center rounded-md border border-[color:var(--border)] bg-[color:var(--surface)] px-3 text-xs font-semibold text-[color:var(--text-muted)] hover:border-[color:var(--clinical-accent-border)] hover:text-[color:var(--clinical-accent)]"
+            >
+              {preset.label}
+            </Link>
+          ))}
         </div>
         <label className="grid gap-1">
-          <span className="sr-only">Filter by diagnosis</span>
+          <span className="sr-only">Filter by formulation domain</span>
           <select
-            value={diagnosis}
-            onChange={(event) => setDiagnosis(event.target.value)}
+            value={domain}
+            onChange={(event) => setDomain(event.target.value)}
             className="min-h-tap rounded-lg border border-[color:var(--border)] bg-[color:var(--surface)] px-3 text-sm font-semibold text-[color:var(--text)] shadow-[var(--shadow-inset)] outline-none focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
           >
-            {diagnosisOptions.map((option) => (
-              <option key={option.value} value={option.value}>
-                {option.label}
+            <option value="all">All formulation domains</option>
+            {formulationDomains.map((item) => (
+              <option key={item} value={item}>
+                {item}
               </option>
             ))}
           </select>
@@ -246,51 +236,50 @@ function SpecifierResults({ query }: { query: string }) {
       {results.length === 0 ? (
         <EmptySearchResults query={query} />
       ) : (
-        <section aria-label="Specifier matches" className="grid gap-3">
-          {results.map(({ record }, index) => (
+        <section aria-label="Mechanism matches" className="grid gap-3">
+          {results.map(({ mechanism }, index) => (
             <article
-              key={record.slug}
+              key={mechanism.id}
               className={cn(
-                specifierCard,
+                formulationCard,
                 "group overflow-hidden transition hover:border-[color:var(--clinical-accent-border)] hover:shadow-[var(--shadow-soft)]",
                 index === 0 && "border-l-[3px] border-l-[color:var(--clinical-accent)]",
               )}
             >
-              <div className="grid gap-4 p-4 sm:grid-cols-[minmax(0,1fr)_minmax(15rem,0.62fr)_auto] sm:items-center sm:p-5">
+              <div className="grid gap-4 p-4 sm:grid-cols-[minmax(0,1fr)_minmax(14rem,0.58fr)_auto] sm:items-center sm:p-5">
                 <div className="min-w-0">
                   <div className="flex flex-wrap items-center gap-2">
                     <Link
-                      href={`/specifiers/${record.slug}`}
+                      href={`/formulation/${mechanism.id}`}
                       className="text-lg font-extrabold text-[color:var(--text-heading)] hover:text-[color:var(--clinical-accent)] sm:text-xl"
                     >
-                      {record.name}
+                      {mechanism.name}
                     </Link>
                     {index === 0 ? (
                       <span className="inline-flex min-h-6 items-center gap-1 rounded-full bg-[color:var(--success-soft)] px-2 text-2xs font-extrabold text-[color:var(--success)]">
                         <CheckCircle2 className="h-3 w-3" aria-hidden />
-                        Best fit
+                        Closest text match
                       </span>
                     ) : null}
                   </div>
                   <p className="mt-1 max-w-3xl text-sm font-medium leading-6 text-[color:var(--text-muted)]">
-                    {record.summary}
+                    {mechanism.summary}
                   </p>
-                  <div className="mt-3 flex flex-wrap gap-2">
-                    <SpecifierFamilyBadge record={record} />
-                    <DiagnosisChips values={record.appliesTo.slice(0, 2)} />
+                  <div className="mt-3">
+                    <MechanismDomainChips values={mechanism.domains} limit={3} />
                   </div>
                 </div>
 
                 <div className="grid gap-2 border-t border-[color:var(--border)] pt-3 sm:border-l sm:border-t-0 sm:pl-4 sm:pt-0">
-                  <p className={eyebrowText}>Deciding signal</p>
+                  <p className={eyebrowText}>Look for</p>
                   <p className="text-sm font-semibold leading-5 text-[color:var(--text-heading)]">
-                    {record.clinicalSignal}
+                    {mechanism.clinicalClues[0]}
                   </p>
                 </div>
 
                 <Link
-                  href={`/specifiers/${record.slug}`}
-                  aria-label={`Open ${record.name}`}
+                  href={`/formulation/${mechanism.id}`}
+                  aria-label={`Open ${mechanism.name}`}
                   className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface-raised)] px-3 text-sm font-bold text-[color:var(--text)] transition hover:border-[color:var(--clinical-accent)] hover:text-[color:var(--clinical-accent)] focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)] sm:w-tap sm:px-0"
                 >
                   <span className="sm:sr-only">Open</span>
@@ -302,15 +291,15 @@ function SpecifierResults({ query }: { query: string }) {
               </div>
               <div className="grid border-t border-[color:var(--border)] bg-[color:var(--surface-subtle)]/55 sm:grid-cols-2">
                 <div className="px-4 py-3 sm:px-5">
-                  <p className={eyebrowText}>Ask this</p>
+                  <p className={eyebrowText}>Patient language</p>
                   <p className="mt-1 text-sm font-medium leading-5 text-[color:var(--text-muted)]">
-                    {record.decisionQuestion}
+                    “{mechanism.patientPhrases[0]}”
                   </p>
                 </div>
                 <div className="border-t border-[color:var(--border)] px-4 py-3 sm:border-l sm:border-t-0 sm:px-5">
-                  <p className={eyebrowText}>Typical language</p>
+                  <p className={eyebrowText}>Formulation use</p>
                   <p className="mt-1 text-sm font-medium leading-5 text-[color:var(--text-muted)]">
-                    “{record.patientLanguage[0]}”
+                    {mechanism.formulationUse}
                   </p>
                 </div>
               </div>
@@ -319,13 +308,19 @@ function SpecifierResults({ query }: { query: string }) {
         </section>
       )}
 
-      <SpecifierSafetyNote />
-    </SpecifierPageShell>
+      <FormulationSafetyNote />
+    </FormulationPageShell>
   );
 }
 
-export function SpecifiersHomePage({ query = "", autoRunSearch = false }: { query?: string; autoRunSearch?: boolean }) {
+export function FormulationHomePage({
+  query = "",
+  autoRunSearch = false,
+}: {
+  query?: string;
+  autoRunSearch?: boolean;
+}) {
   const trimmedQuery = query.trim();
-  if (!autoRunSearch || !trimmedQuery) return <SpecifiersHome />;
-  return <SpecifierResults query={trimmedQuery} />;
+  if (!autoRunSearch || !trimmedQuery) return <FormulationHome />;
+  return <FormulationResults query={trimmedQuery} />;
 }
diff --git a/src/components/formulation/formulation-map-page.tsx b/src/components/formulation/formulation-map-page.tsx
new file mode 100644
index 000000000..a5cb1728f
--- /dev/null
+++ b/src/components/formulation/formulation-map-page.tsx
@@ -0,0 +1,188 @@
+"use client";
+
+import Link from "next/link";
+import { ArrowRight, CheckCircle2, GitCompareArrows, Network, Waypoints } from "lucide-react";
+import { useState } from "react";
+
+import {
+  FormulationBreadcrumbs,
+  FormulationPageShell,
+  FormulationSafetyNote,
+  FormulationSubnav,
+  MechanismDomainChips,
+  formulationCard,
+} from "@/components/formulation/formulation-ui";
+import { cn, eyebrowText } from "@/components/ui-primitives";
+import { findFormulationMechanism, formulationDomainGroups, formulationMechanisms } from "@/lib/formulation";
+
+export function FormulationMapPage({ initialId }: { initialId?: string }) {
+  const initial =
+    findFormulationMechanism(initialId ?? "") ?? findFormulationMechanism("rumination") ?? formulationMechanisms[0];
+  const [selectedId, setSelectedId] = useState(initial.id);
+  const selected = findFormulationMechanism(selectedId) ?? initial;
+
+  return (
+    <FormulationPageShell>
+      <div className="grid gap-3">
+        <FormulationBreadcrumbs current="Mechanism map" />
+        <FormulationSubnav active="map" />
+      </div>
+
+      <header className="grid gap-2 border-b border-[color:var(--border)] pb-5">
+        <p className={eyebrowText}>Formulation architecture</p>
+        <h1 className="text-3xl font-extrabold tracking-tight text-[color:var(--text-heading)] sm:text-4xl">
+          Mechanism map
+        </h1>
+        <p className="max-w-3xl text-sm font-medium leading-6 text-[color:var(--text-muted)]">
+          Browse mechanisms by the part of the formulation they help explain. This map groups shared domains; it does
+          not assert causation or replace a case-specific sequence.
+        </p>
+      </header>
+
+      <section
+        aria-label="Formulation reasoning pathway"
+        className="grid gap-2 rounded-lg border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] p-3 sm:grid-cols-[minmax(9rem,1fr)_auto_minmax(9rem,1fr)_auto_minmax(9rem,1fr)_auto_minmax(9rem,1fr)] sm:items-center"
+      >
+        {["Pattern and context", "Meaning or threat", "Coping response", "Maintaining consequence"].map(
+          (label, index) => (
+            <div key={label} className="contents">
+              <div className="flex min-h-12 items-center gap-2 rounded-lg border border-[color:var(--border)] bg-[color:var(--surface)] px-3 text-sm font-extrabold text-[color:var(--text-heading)] shadow-[var(--shadow-inset)]">
+                <span className="nums grid h-7 w-7 shrink-0 place-items-center rounded-full bg-[color:var(--clinical-accent)] text-xs text-[color:var(--clinical-accent-contrast)]">
+                  {index + 1}
+                </span>
+                {label}
+              </div>
+              {index < 3 ? (
+                <ArrowRight
+                  className="hidden h-4 w-4 justify-self-center text-[color:var(--clinical-accent)] sm:block"
+                  aria-hidden
+                />
+              ) : null}
+            </div>
+          ),
+        )}
+      </section>
+
+      <div className="grid gap-5 xl:grid-cols-[minmax(0,1fr)_22rem]">
+        <section className="grid min-w-0 gap-4 md:grid-cols-2" aria-label="Mechanisms grouped by formulation domain">
+          {formulationDomainGroups.map((group) => {
+            const mechanisms = formulationMechanisms.filter((mechanism) =>
+              mechanism.domains.some((domain) => group.domains.includes(domain as never)),
+            );
+            return (
+              <div key={group.id} className={cn(formulationCard, "overflow-hidden")}>
+                <div className="border-b border-[color:var(--border)] bg-[color:var(--surface-subtle)] px-4 py-3">
+                  <div className="flex items-start gap-2.5">
+                    <Waypoints className="mt-0.5 h-4 w-4 shrink-0 text-[color:var(--clinical-accent)]" aria-hidden />
+                    <div>
+                      <h2 className="text-sm font-extrabold text-[color:var(--text-heading)]">{group.label}</h2>
+                      <p className="mt-0.5 text-xs font-medium leading-4 text-[color:var(--text-muted)]">
+                        {group.description}
+                      </p>
+                    </div>
+                  </div>
+                  <div className="mt-2 flex flex-wrap gap-1 text-2xs font-semibold text-[color:var(--text-soft)]">
+                    {group.domains.map((domain) => (
+                      <span key={domain}>{domain}</span>
+                    ))}
+                  </div>
+                </div>
+                <div className="grid divide-y divide-[color:var(--border)] sm:grid-cols-2 sm:divide-x sm:divide-y-0">
+                  {mechanisms.map((mechanism, index) => {
+                    const active = selected.id === mechanism.id;
+                    return (
+                      <button
+                        key={mechanism.id}
+                        type="button"
+                        onClick={() => setSelectedId(mechanism.id)}
+                        aria-pressed={active}
+                        className={cn(
+                          "group flex min-h-[5.25rem] w-full items-center gap-3 border-b border-[color:var(--border)] px-4 py-3 text-left transition focus-visible:relative focus-visible:z-10 focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-[-2px] focus-visible:outline-[color:var(--focus)] sm:[&:nth-child(even)]:border-l",
+                          active
+                            ? "bg-[color:var(--clinical-accent-soft)]"
+                            : "bg-[color:var(--surface)] hover:bg-[color:var(--surface-subtle)]",
+                          index >= mechanisms.length - 2 && "sm:border-b-0",
+                        )}
+                      >
+                        <span
+                          className={cn(
+                            "grid h-9 w-9 shrink-0 place-items-center rounded-lg border",
+                            active
+                              ? "border-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent)] text-[color:var(--clinical-accent-contrast)]"
+                              : "border-[color:var(--border)] bg-[color:var(--surface-raised)] text-[color:var(--clinical-accent)]",
+                          )}
+                        >
+                          <Network className="h-4 w-4" aria-hidden />
+                        </span>
+                        <span className="min-w-0 flex-1">
+                          <span className="block text-sm font-extrabold text-[color:var(--text-heading)]">
+                            {mechanism.name}
+                          </span>
+                          <span className="mt-0.5 line-clamp-2 block text-xs font-medium leading-4 text-[color:var(--text-muted)]">
+                            {mechanism.formulationUse}
+                          </span>
+                        </span>
+                        {active ? (
+                          <CheckCircle2 className="h-4 w-4 shrink-0 text-[color:var(--clinical-accent)]" aria-hidden />
+                        ) : null}
+                      </button>
+                    );
+                  })}
+                </div>
+              </div>
+            );
+          })}
+        </section>
+
+        <aside className="grid content-start gap-4 xl:sticky xl:top-20">
+          <section className="overflow-hidden rounded-lg border border-[color:var(--clinical-accent-border)] bg-[color:var(--surface)] shadow-[var(--shadow-soft)]">
+            <div className="border-b border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] px-4 py-3">
+              <p className={cn(eyebrowText, "!text-[color:var(--clinical-accent)]")}>Selected mechanism</p>
+              <h2 className="mt-1 text-xl font-extrabold text-[color:var(--text-heading)]">{selected.name}</h2>
+            </div>
+            <div className="grid gap-4 p-4">
+              <p className="text-sm font-medium leading-6 text-[color:var(--text-muted)]">{selected.summary}</p>
+              <MechanismDomainChips values={selected.domains} />
+              <div className="border-t border-[color:var(--border)] pt-3">
+                <p className={eyebrowText}>Core process</p>
+                <p className="mt-1.5 text-sm font-semibold leading-6 text-[color:var(--text-heading)]">
+                  {selected.coreProcess}
+                </p>
+              </div>
+              <div className="border-t border-[color:var(--border)] pt-3">
+                <p className={eyebrowText}>Maintaining cycle</p>
+                <p className="mt-1.5 text-sm font-medium leading-6 text-[color:var(--text-muted)]">
+                  {selected.maintainingCycles[0]}
+                </p>
+              </div>
+              <div className="grid gap-2">
+                <Link
+                  href={`/formulation/${selected.id}`}
+                  className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg bg-[color:var(--command)] px-3 text-sm font-bold text-[color:var(--command-contrast)]"
+                >
+                  Open full guide
+                  <ArrowRight className="h-4 w-4" aria-hidden />
+                </Link>
+                <Link
+                  href={`/formulation/compare?a=${selected.id}`}
+                  className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-3 text-sm font-bold text-[color:var(--text)]"
+                >
+                  <GitCompareArrows className="h-4 w-4" aria-hidden />
+                  Compare
+                </Link>
+                <Link
+                  href={`/formulation/builder?mechanism=${selected.id}`}
+                  className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-3 text-sm font-bold text-[color:var(--text)]"
+                >
+                  Use in formulation
+                </Link>
+              </div>
+            </div>
+          </section>
+        </aside>
+      </div>
+
+      <FormulationSafetyNote />
+    </FormulationPageShell>
+  );
+}
diff --git a/src/components/formulation/formulation-mechanism-page.tsx b/src/components/formulation/formulation-mechanism-page.tsx
new file mode 100644
index 000000000..8bbc97c02
--- /dev/null
+++ b/src/components/formulation/formulation-mechanism-page.tsx
@@ -0,0 +1,361 @@
+import Link from "next/link";
+import {
+  ArrowRight,
+  BookOpenCheck,
+  Check,
+  ChevronDown,
+  CircleHelp,
+  GitCompareArrows,
+  ListChecks,
+  MessageSquareQuote,
+  Network,
+  Route,
+  ShieldAlert,
+  Sparkles,
+  Target,
+  Waypoints,
+} from "lucide-react";
+
+import {
+  FormulationBreadcrumbs,
+  FormulationPageShell,
+  FormulationSafetyNote,
+  FormulationSubnav,
+  MechanismBadge,
+  MechanismDomainChips,
+  SectionHeading,
+  formulationCard,
+} from "@/components/formulation/formulation-ui";
+import { cn, eyebrowText } from "@/components/ui-primitives";
+import { formulationSourceLibrary, relatedFormulationMechanisms, type FormulationMechanism } from "@/lib/formulation";
+
+function comparisonHref(left: string, right?: string) {
+  const params = new URLSearchParams({ a: left });
+  if (right) params.set("b", right);
+  return `/formulation/compare?${params.toString()}`;
+}
+
+function RecordFact({ icon: Icon, label, body }: { icon: typeof Network; label: string; body: string }) {
+  return (
+    <div className="grid grid-cols-[2.25rem_minmax(0,1fr)] gap-3 px-4 py-3.5">
+      <span className="grid h-9 w-9 place-items-center rounded-lg bg-[color:var(--clinical-accent-soft)] text-[color:var(--clinical-accent)]">
+        <Icon className="h-4 w-4" aria-hidden />
+      </span>
+      <span>
+        <span className="block text-xs font-bold text-[color:var(--text-heading)]">{label}</span>
+        <span className="mt-0.5 block text-xs font-medium leading-5 text-[color:var(--text-muted)]">{body}</span>
+      </span>
+    </div>
+  );
+}
+
+function GuidanceSection({
+  icon: Icon,
+  title,
+  items,
+  tone = "default",
+  open = false,
+}: {
+  icon: typeof Network;
+  title: string;
+  items: string[];
+  tone?: "default" | "success" | "warning";
+  open?: boolean;
+}) {
+  const toneClass =
+    tone === "success"
+      ? "text-[color:var(--success)] bg-[color:var(--success-soft)]"
+      : tone === "warning"
+        ? "text-[color:var(--warning)] bg-[color:var(--warning-soft)]"
+        : "text-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent-soft)]";
+
+  return (
+    <details open={open} className="group border-b border-[color:var(--border)] last:border-b-0">
+      <summary className="flex min-h-14 cursor-pointer list-none items-center gap-3 px-4 py-3 focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-[-2px] focus-visible:outline-[color:var(--focus)] sm:px-5 [&::-webkit-details-marker]:hidden">
+        <span className={cn("grid h-9 w-9 shrink-0 place-items-center rounded-lg", toneClass)}>
+          <Icon className="h-4 w-4" aria-hidden />
+        </span>
+        <span className="min-w-0 flex-1 text-sm font-extrabold text-[color:var(--text-heading)]">{title}</span>
+        <ChevronDown
+          className="h-4 w-4 shrink-0 text-[color:var(--text-soft)] transition group-open:rotate-180 motion-reduce:transition-none"
+          aria-hidden
+        />
+      </summary>
+      <div className="px-4 pb-4 pl-[4.25rem] sm:px-5 sm:pb-5 sm:pl-[4.75rem]">
+        <ul className="grid gap-2.5 text-sm font-medium leading-6 text-[color:var(--text-muted)]">
+          {items.map((item) => (
+            <li key={item} className="grid grid-cols-[1rem_minmax(0,1fr)] gap-2">
+              <span className="mt-2 h-1.5 w-1.5 rounded-full bg-[color:var(--clinical-accent)]" aria-hidden />
+              <span>{item}</span>
+            </li>
+          ))}
+        </ul>
+      </div>
+    </details>
+  );
+}
+
+function FactorColumn({ title, items }: { title: string; items: string[] }) {
+  return (
+    <div className="p-4 sm:p-5">
+      <h3 className="text-sm font-extrabold text-[color:var(--text-heading)]">{title}</h3>
+      <ul className="mt-3 grid gap-2 text-xs font-medium leading-5 text-[color:var(--text-muted)]">
+        {items.map((item) => (
+          <li key={item} className="flex gap-2">
+            <span className="mt-2 h-1.5 w-1.5 shrink-0 rounded-full bg-[color:var(--clinical-accent)]" aria-hidden />
+            {item}
+          </li>
+        ))}
+      </ul>
+    </div>
+  );
+}
+
+export function FormulationMechanismPage({ mechanism }: { mechanism: FormulationMechanism }) {
+  const related = relatedFormulationMechanisms(mechanism);
+  const primaryRelated = related[0];
+  const sources = mechanism.sources
+    .map((sourceId) => formulationSourceLibrary[sourceId])
+    .filter((source): source is NonNullable<typeof source> => Boolean(source));
+
+  return (
+    <FormulationPageShell>
+      <div className="grid gap-3">
+        <FormulationBreadcrumbs current={mechanism.name} />
+        <FormulationSubnav active="search" />
+      </div>
+
+      <section className="grid gap-5 border-b border-[color:var(--border)] pb-5 lg:grid-cols-[minmax(0,1fr)_auto] lg:items-end">
+        <div className="grid gap-4 sm:grid-cols-[4rem_minmax(0,1fr)] sm:items-start">
+          <span className="grid h-14 w-14 place-items-center rounded-xl border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] text-[color:var(--clinical-accent)] shadow-[var(--shadow-inset)] sm:h-16 sm:w-16">
+            <Network className="h-7 w-7" aria-hidden />
+          </span>
+          <div className="grid gap-2">
+            <div>
+              <p className={eyebrowText}>Formulation mechanism</p>
+              <h1 className="mt-1 text-3xl font-extrabold tracking-tight text-[color:var(--text-heading)] sm:text-4xl">
+                {mechanism.name}
+              </h1>
+            </div>
+            <p className="max-w-3xl text-base font-medium leading-7 text-[color:var(--text-muted)]">
+              {mechanism.definition}
+            </p>
+            <div className="flex flex-wrap items-center gap-2">
+              <MechanismBadge />
+              <MechanismDomainChips values={mechanism.domains} />
+            </div>
+          </div>
+        </div>
+
+        <div className="grid grid-cols-2 gap-2 sm:flex">
+          <Link
+            href={comparisonHref(mechanism.id, primaryRelated?.id)}
+            className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-4 text-sm font-bold text-[color:var(--text)] shadow-[var(--shadow-inset)] transition hover:border-[color:var(--clinical-accent)] hover:text-[color:var(--clinical-accent)] focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)]"
+          >
+            <GitCompareArrows className="h-4 w-4" aria-hidden />
+            Compare
+          </Link>
+          <Link
+            href={`/formulation/builder?mechanism=${mechanism.id}`}
+            className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg bg-[color:var(--command)] px-4 text-sm font-bold text-[color:var(--command-contrast)] shadow-[var(--shadow-tight)] transition hover:bg-[color:var(--command-hover)] focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)]"
+          >
+            <ListChecks className="h-4 w-4" aria-hidden />
+            Use in formulation
+          </Link>
+        </div>
+      </section>
+
+      <section aria-labelledby="what-matters-now" className={cn(formulationCard, "overflow-hidden")}>
+        <div className="border-b border-[color:var(--border)] px-4 py-2.5 sm:px-5">
+          <p id="what-matters-now" className={eyebrowText}>
+            What matters now
+          </p>
+        </div>
+        <div className="grid divide-y divide-[color:var(--border)] sm:grid-cols-2 sm:divide-x sm:divide-y-0 xl:grid-cols-4">
+          <RecordFact icon={Network} label="Core process" body={mechanism.coreProcess} />
+          <RecordFact icon={Waypoints} label="Maintaining cycle" body={mechanism.maintainingCycles[0]} />
+          <RecordFact icon={MessageSquareQuote} label="Patient language" body={`“${mechanism.patientPhrases[0]}”`} />
+          <RecordFact icon={Target} label="Treatment leverage" body={mechanism.treatmentLeverage} />
+        </div>
+      </section>
+
+      <div className="grid gap-5 xl:grid-cols-[minmax(0,1fr)_21rem]">
+        <div className="grid min-w-0 gap-5">
+          <SectionHeading
+            eyebrow="Fit, function, and alternatives"
+            title="Test the mechanism against the case"
+            body="Use sequence, function, patient language, and disconfirming evidence to decide whether this hypothesis adds explanatory value."
+          />
+
+          <section className={cn(formulationCard, "overflow-hidden")}>
+            <GuidanceSection icon={Check} title="When this fits" items={mechanism.fitIndicators} tone="success" open />
+            <GuidanceSection
+              icon={ShieldAlert}
+              title="When this may not fit"
+              items={mechanism.poorFitIndicators}
+              tone="warning"
+            />
+            <GuidanceSection icon={CircleHelp} title="Clinical clues" items={mechanism.clinicalClues} />
+            <GuidanceSection
+              icon={MessageSquareQuote}
+              title="Patient language"
+              items={mechanism.patientPhrases.map((item) => `“${item}”`)}
+            />
+          </section>
+
+          <section className={cn(formulationCard, "overflow-hidden")}>
+            <div className="border-b border-[color:var(--border)] px-4 py-3 sm:px-5">
+              <p className={eyebrowText}>Across the formulation</p>
+              <h2 className="mt-1 text-lg font-extrabold text-[color:var(--text-heading)]">
+                Predisposing, precipitating, and perpetuating factors
+              </h2>
+            </div>
+            <div className="grid divide-y divide-[color:var(--border)] md:grid-cols-3 md:divide-x md:divide-y-0">
+              <FactorColumn title="Predisposing" items={mechanism.predisposing} />
+              <FactorColumn title="Precipitating" items={mechanism.precipitating} />
+              <FactorColumn title="Perpetuating" items={mechanism.perpetuating} />
+            </div>
+          </section>
+
+          <section className="grid gap-4 md:grid-cols-2">
+            <article className={cn(formulationCard, "grid content-start gap-3 p-4 sm:p-5")}>
+              <span className="grid h-10 w-10 place-items-center rounded-lg bg-[color:var(--clinical-accent-soft)] text-[color:var(--clinical-accent)]">
+                <Sparkles className="h-5 w-5" aria-hidden />
+              </span>
+              <div>
+                <p className={eyebrowText}>Short case example</p>
+                <p className="mt-2 text-sm font-medium leading-6 text-[color:var(--text-muted)]">
+                  {mechanism.caseExample}
+                </p>
+              </div>
+            </article>
+            <article className={cn(formulationCard, "grid content-start gap-3 p-4 sm:p-5")}>
+              <span className="grid h-10 w-10 place-items-center rounded-lg bg-[color:var(--clinical-accent-soft)] text-[color:var(--clinical-accent)]">
+                <Route className="h-5 w-5" aria-hidden />
+              </span>
+              <div>
+                <p className={eyebrowText}>Formulation language</p>
+                <p className="mt-2 text-sm font-semibold leading-6 text-[color:var(--text-heading)]">
+                  {mechanism.exampleSentence}
+                </p>
+              </div>
+            </article>
+          </section>
+
+          <section className={cn(formulationCard, "grid gap-4 p-4 sm:p-5")}>
+            <div className="flex items-start gap-3">
+              <span className="grid h-10 w-10 shrink-0 place-items-center rounded-lg bg-[color:var(--clinical-accent-soft)] text-[color:var(--clinical-accent)]">
+                <Target className="h-5 w-5" aria-hidden />
+              </span>
+              <div className="min-w-0">
+                <p className={eyebrowText}>Treatment implications</p>
+                <h2 className="mt-1 text-lg font-extrabold text-[color:var(--text-heading)]">
+                  Translate the hypothesis into a testable target
+                </h2>
+              </div>
+            </div>
+            <ul className="grid gap-2 text-sm font-medium leading-6 text-[color:var(--text-muted)] sm:grid-cols-2">
+              {mechanism.treatmentImplications.map((item) => (
+                <li key={item} className="flex gap-2">
+                  <Check className="mt-1 h-4 w-4 shrink-0 text-[color:var(--success)]" aria-hidden />
+                  {item}
+                </li>
+              ))}
+            </ul>
+            <p className="rounded-lg border border-[color:var(--border)] bg-[color:var(--surface-subtle)] p-3 text-sm font-semibold leading-6 text-[color:var(--text-heading)]">
+              {mechanism.treatmentTargetExample}
+            </p>
+          </section>
+        </div>
+
+        <aside className="grid content-start gap-4 xl:sticky xl:top-20">
+          <section className={cn(formulationCard, "overflow-hidden")}>
+            <div className="border-b border-[color:var(--border)] px-4 py-3">
+              <p className={eyebrowText}>Quick reference</p>
+            </div>
+            <dl className="divide-y divide-[color:var(--border)]">
+              {[
+                ["Common symptoms", mechanism.symptoms.slice(0, 4).join(" · ")],
+                ["Clinical contexts", mechanism.diagnosticContexts.slice(0, 3).join(" · ")],
+                ["Development", mechanism.development],
+                ["Formulation use", mechanism.formulationUse],
+              ].map(([label, body]) => (
+                <div key={label} className="px-4 py-3">
+                  <dt className="text-xs font-extrabold text-[color:var(--text-heading)]">{label}</dt>
+                  <dd className="mt-1 text-xs font-medium leading-5 text-[color:var(--text-muted)]">{body}</dd>
+                </div>
+              ))}
+            </dl>
+          </section>
+
+          <section className={cn(formulationCard, "p-4")}>
+            <p className={eyebrowText}>Add to a draft</p>
+            <p className="mt-2 text-sm font-bold leading-6 text-[color:var(--text-heading)]">
+              {mechanism.exampleSentence}
+            </p>
+            <Link
+              href={`/formulation/builder?mechanism=${mechanism.id}`}
+              className="mt-3 inline-flex min-h-tap w-full items-center justify-center gap-2 rounded-lg bg-[color:var(--command)] px-3 text-sm font-bold text-[color:var(--command-contrast)]"
+            >
+              Use in formulation
+              <ArrowRight className="h-4 w-4" aria-hidden />
+            </Link>
+          </section>
+
+          {related.length ? (
+            <section className={cn(formulationCard, "overflow-hidden")}>
+              <div className="border-b border-[color:var(--border)] px-4 py-3">
+                <p className={eyebrowText}>Compare next</p>
+              </div>
+              <div className="divide-y divide-[color:var(--border)]">
+                {related.map((item) => (
+                  <Link
+                    key={item.id}
+                    href={comparisonHref(mechanism.id, item.id)}
+                    className="flex min-h-14 items-center justify-between gap-3 px-4 py-2.5 text-sm font-bold text-[color:var(--text-heading)] hover:bg-[color:var(--surface-subtle)] hover:text-[color:var(--clinical-accent)]"
+                  >
+                    {item.name}
+                    <ArrowRight className="h-4 w-4 shrink-0" aria-hidden />
+                  </Link>
+                ))}
+              </div>
+            </section>
+          ) : null}
+
+          {sources.length ? (
+            <details className={cn(formulationCard, "group overflow-hidden")}>
+              <summary className="flex min-h-14 cursor-pointer list-none items-center gap-2 px-4 py-3 [&::-webkit-details-marker]:hidden">
+                <BookOpenCheck className="h-4 w-4 text-[color:var(--clinical-accent)]" aria-hidden />
+                <span className="flex-1 text-xs font-extrabold uppercase tracking-wide text-[color:var(--text-muted)]">
+                  Evidence notes
+                </span>
+                <ChevronDown
+                  className="h-4 w-4 text-[color:var(--text-soft)] transition group-open:rotate-180"
+                  aria-hidden
+                />
+              </summary>
+              <div className="grid gap-2 border-t border-[color:var(--border)] p-4">
+                {sources.map((source) => (
+                  <a
+                    key={source.id}
+                    href={source.url}
+                    target="_blank"
+                    rel="noreferrer"
+                    className="text-xs font-semibold leading-5 text-[color:var(--clinical-accent)] hover:underline"
+                  >
+                    {source.title}
+                  </a>
+                ))}
+                <p className="mt-1 text-2xs font-medium leading-4 text-[color:var(--text-muted)]">
+                  Teaching references only. Check current local guidance and clinical applicability.
+                </p>
+              </div>
+            </details>
+          ) : null}
+        </aside>
+      </div>
+
+      <FormulationSafetyNote />
+    </FormulationPageShell>
+  );
+}
diff --git a/src/components/specifiers/specifier-ui.tsx b/src/components/formulation/formulation-ui.tsx
similarity index 56%
rename from src/components/specifiers/specifier-ui.tsx
rename to src/components/formulation/formulation-ui.tsx
index d77bf526a..29322834f 100644
--- a/src/components/specifiers/specifier-ui.tsx
+++ b/src/components/formulation/formulation-ui.tsx
@@ -1,14 +1,13 @@
 import Link from "next/link";
 import type { ReactNode } from "react";
-import { ArrowLeft, ChevronRight, Info, Tags } from "lucide-react";
+import { ArrowLeft, ChevronRight, Info, Network, ShieldCheck } from "lucide-react";
 
 import { cn, eyebrowText, pageContainer } from "@/components/ui-primitives";
-import type { SpecifierRecord } from "@/lib/specifiers";
 
-export const specifierCard =
+export const formulationCard =
   "rounded-lg border border-[color:var(--border)] bg-[color:var(--surface)] shadow-[var(--shadow-inset)]";
 
-export function SpecifierPageShell({ children, className }: { children: ReactNode; className?: string }) {
+export function FormulationPageShell({ children, className }: { children: ReactNode; className?: string }) {
   return (
     <main
       className={cn(
@@ -21,18 +20,18 @@ export function SpecifierPageShell({ children, className }: { children: ReactNod
   );
 }
 
-export function SpecifierBreadcrumbs({ current }: { current?: string }) {
+export function FormulationBreadcrumbs({ current }: { current?: string }) {
   return (
     <nav
       aria-label="Breadcrumb"
       className="flex min-h-tap items-center gap-1 text-xs font-semibold text-[color:var(--text-muted)]"
     >
       <Link
-        href="/specifiers"
+        href="/formulation"
         className="inline-flex min-h-tap items-center gap-1.5 rounded-md px-1.5 hover:text-[color:var(--clinical-accent)] focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)]"
       >
         <ArrowLeft className="h-4 w-4" aria-hidden />
-        Specifiers
+        Formulation
       </Link>
       {current ? (
         <>
@@ -46,17 +45,17 @@ export function SpecifierBreadcrumbs({ current }: { current?: string }) {
   );
 }
 
-export function SpecifierSubnav({ active }: { active: "search" | "builder" | "compare" | "map" }) {
+export function FormulationSubnav({ active }: { active: "search" | "builder" | "compare" | "map" }) {
   const items = [
-    { id: "search" as const, label: "Find", href: "/specifiers" },
-    { id: "builder" as const, label: "Build wording", href: "/specifiers/builder" },
-    { id: "compare" as const, label: "Compare", href: "/specifiers/compare" },
-    { id: "map" as const, label: "Map", href: "/specifiers/map" },
+    { id: "search" as const, label: "Find mechanisms", shortLabel: "Find", href: "/formulation" },
+    { id: "builder" as const, label: "Build formulation", shortLabel: "Build", href: "/formulation/builder" },
+    { id: "compare" as const, label: "Compare", shortLabel: "Compare", href: "/formulation/compare" },
+    { id: "map" as const, label: "Mechanism map", shortLabel: "Map", href: "/formulation/map" },
   ];
 
   return (
     <nav
-      aria-label="Specifier tools"
+      aria-label="Formulation tools"
       className="polished-scroll flex max-w-full gap-1 overflow-x-auto rounded-lg border border-[color:var(--border)] bg-[color:var(--surface-raised)] p-1 shadow-[var(--shadow-inset)]"
     >
       {items.map((item) => (
@@ -71,38 +70,45 @@ export function SpecifierSubnav({ active }: { active: "search" | "builder" | "co
               : "text-[color:var(--text-muted)] hover:bg-[color:var(--surface)] hover:text-[color:var(--text)]",
           )}
         >
-          {item.label}
+          <span className="sm:hidden">{item.shortLabel}</span>
+          <span className="hidden sm:inline">{item.label}</span>
         </Link>
       ))}
     </nav>
   );
 }
 
-export function SpecifierFamilyBadge({ record }: { record: SpecifierRecord }) {
-  return (
-    <span className="inline-flex min-h-7 items-center gap-1.5 rounded-md border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] px-2 text-xs font-bold text-[color:var(--clinical-accent)]">
-      <Tags className="h-3.5 w-3.5" aria-hidden />
-      {record.familyLabel}
-    </span>
-  );
-}
-
-export function DiagnosisChips({ values }: { values: string[] }) {
+export function MechanismDomainChips({ values, limit }: { values: string[]; limit?: number }) {
+  const visible = typeof limit === "number" ? values.slice(0, limit) : values;
   return (
     <div className="flex flex-wrap gap-1.5">
-      {values.map((value) => (
+      {visible.map((value) => (
         <span
           key={value}
-          className="inline-flex min-h-7 items-center rounded-md border border-[color:var(--border)] bg-[color:var(--surface-raised)] px-2 text-xs font-semibold text-[color:var(--text-muted)]"
+          className="inline-flex min-h-7 items-center rounded-md border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] px-2 text-xs font-bold text-[color:var(--clinical-accent)]"
         >
           {value}
         </span>
       ))}
+      {typeof limit === "number" && values.length > limit ? (
+        <span className="inline-flex min-h-7 items-center rounded-md border border-[color:var(--border)] bg-[color:var(--surface-raised)] px-2 text-xs font-semibold text-[color:var(--text-muted)]">
+          +{values.length - limit}
+        </span>
+      ) : null}
     </div>
   );
 }
 
-export function SpecifierSafetyNote({ compact = false }: { compact?: boolean }) {
+export function MechanismBadge({ label = "Formulation mechanism" }: { label?: string }) {
+  return (
+    <span className="inline-flex min-h-7 items-center gap-1.5 rounded-md border border-[color:var(--border)] bg-[color:var(--surface-raised)] px-2 text-xs font-bold text-[color:var(--text-muted)]">
+      <Network className="h-3.5 w-3.5 text-[color:var(--clinical-accent)]" aria-hidden />
+      {label}
+    </span>
+  );
+}
+
+export function FormulationSafetyNote({ compact = false }: { compact?: boolean }) {
   return (
     <aside
       className={cn(
@@ -112,13 +118,22 @@ export function SpecifierSafetyNote({ compact = false }: { compact?: boolean })
     >
       <Info className="mt-0.5 h-4 w-4 shrink-0 text-[color:var(--info)]" aria-hidden />
       <p>
-        Use this as structured decision support. Confirm the current diagnostic manual criteria, exclusions, episode
-        chronology, and local clinical requirements before documenting a specifier.
+        Treat each mechanism as a hypothesis, not a diagnosis. Check the person’s context, culture, development, mental
+        state, risk, and alternative explanations, then revise the formulation when new evidence does not fit.
       </p>
     </aside>
   );
 }
 
+export function SessionPrivacyNote() {
+  return (
+    <div className="flex items-start gap-2 text-xs font-medium leading-5 text-[color:var(--text-muted)]">
+      <ShieldCheck className="mt-0.5 h-4 w-4 shrink-0 text-[color:var(--clinical-accent)]" aria-hidden />
+      <p>Keep notes de-identified. Builder text remains in this browser session unless you copy it.</p>
+    </div>
+  );
+}
+
 export function SectionHeading({ eyebrow, title, body }: { eyebrow?: string; title: string; body?: string }) {
   return (
     <header className="grid gap-1.5">
diff --git a/src/components/specifiers/specifier-builder-page.tsx b/src/components/specifiers/specifier-builder-page.tsx
deleted file mode 100644
index d22d0a091..000000000
--- a/src/components/specifiers/specifier-builder-page.tsx
+++ /dev/null
@@ -1,264 +0,0 @@
-"use client";
-
-import Link from "next/link";
-import { ArrowRight, Check, FileCheck2, ListChecks, RotateCcw, Tags } from "lucide-react";
-import { useMemo, useState } from "react";
-
-import {
-  SpecifierBreadcrumbs,
-  SpecifierPageShell,
-  SpecifierSafetyNote,
-  SpecifierSubnav,
-  specifierCard,
-} from "@/components/specifiers/specifier-ui";
-import { cn, eyebrowText } from "@/components/ui-primitives";
-import {
-  normalizeSpecifierSelection,
-  specifierAppliesToBuilderDiagnosis,
-  specifierFamilies,
-  specifierRecords,
-  type SpecifierBuilderDiagnosis,
-  type SpecifierFamily,
-  type SpecifierRecord,
-} from "@/lib/specifiers";
-
-const diagnosisPresets: Array<{ id: SpecifierBuilderDiagnosis; label: string }> = [
-  { id: "mdd-recurrent", label: "Major depressive disorder, recurrent" },
-  { id: "mdd-single", label: "Major depressive disorder, single episode" },
-  { id: "bipolar-i-depressed", label: "Bipolar I disorder, current episode depressed" },
-  { id: "bipolar-i-manic", label: "Bipolar I disorder, current episode manic" },
-  { id: "bipolar-ii-depressed", label: "Bipolar II disorder, current episode depressed" },
-];
-
-const specifierFamilyOrder: Record<SpecifierFamily, number> = {
-  "episode-features": 0,
-  "course-onset": 1,
-  "severity-remission": 2,
-};
-
-function wordingSegment(record: SpecifierRecord) {
-  if (record.slug === "mild-severity") return "mild";
-  if (record.slug === "with-psychotic-features") return "severe with psychotic features";
-  return record.name.charAt(0).toLowerCase() + record.name.slice(1);
-}
-
-export function SpecifierBuilderPage({ initialSpecifiers = [] }: { initialSpecifiers?: string[] }) {
-  const initialDiagnosis = diagnosisPresets[0];
-  const validInitial = normalizeSpecifierSelection(initialSpecifiers).filter((slug) => {
-    const record = specifierRecords.find((candidate) => candidate.slug === slug);
-    return record ? specifierAppliesToBuilderDiagnosis(record, initialDiagnosis.id) : false;
-  });
-  const [diagnosisId, setDiagnosisId] = useState<SpecifierBuilderDiagnosis>(initialDiagnosis.id);
-  const [selected, setSelected] = useState<string[]>(validInitial);
-  const diagnosis = diagnosisPresets.find((preset) => preset.id === diagnosisId) ?? initialDiagnosis;
-  const selectedRecords = useMemo(
-    () =>
-      selected
-        .map((slug) => specifierRecords.find((record) => record.slug === slug))
-        .filter((record): record is SpecifierRecord => Boolean(record))
-        .sort((left, right) => specifierFamilyOrder[left.family] - specifierFamilyOrder[right.family]),
-    [selected],
-  );
-  const wording = [diagnosis.label, ...selectedRecords.map((record) => wordingSegment(record))].join(", ");
-
-  function changeDiagnosis(nextDiagnosis: SpecifierBuilderDiagnosis) {
-    setDiagnosisId(nextDiagnosis);
-    setSelected((current) =>
-      current.filter((slug) => {
-        const record = specifierRecords.find((candidate) => candidate.slug === slug);
-        return record ? specifierAppliesToBuilderDiagnosis(record, nextDiagnosis) : false;
-      }),
-    );
-  }
-
-  function toggle(slug: string) {
-    setSelected((current) => {
-      if (current.includes(slug)) return current.filter((item) => item !== slug);
-      return normalizeSpecifierSelection([...current, slug]);
-    });
-  }
-
-  return (
-    <SpecifierPageShell>
-      <div className="grid gap-3">
-        <SpecifierBreadcrumbs current="Build wording" />
-        <SpecifierSubnav active="builder" />
-      </div>
-
-      <header className="grid gap-2 border-b border-[color:var(--border)] pb-5">
-        <p className={eyebrowText}>Structured diagnostic language</p>
-        <h1 className="text-3xl font-extrabold tracking-tight text-[color:var(--text-heading)] sm:text-4xl">
-          Build the diagnosis in the right order
-        </h1>
-        <p className="max-w-3xl text-sm font-medium leading-6 text-[color:var(--text-muted)]">
-          Start with the base diagnosis, then add episode features, course or onset, and one current severity or
-          remission descriptor.
-        </p>
-      </header>
-
-      <div className="grid gap-5 xl:grid-cols-[minmax(0,1fr)_23rem]">
-        <div className="grid gap-4">
-          <section className={cn(specifierCard, "grid gap-3 p-4 sm:p-5")}>
-            <div className="flex items-center gap-3">
-              <span className="nums grid h-8 w-8 place-items-center rounded-full bg-[color:var(--clinical-accent)] text-xs font-extrabold text-[color:var(--clinical-accent-contrast)]">
-                1
-              </span>
-              <div>
-                <p className={eyebrowText}>Base diagnosis</p>
-                <h2 className="text-lg font-extrabold text-[color:var(--text-heading)]">
-                  Name the disorder and episode
-                </h2>
-              </div>
-            </div>
-            <label className="grid gap-1.5">
-              <span className="text-xs font-bold text-[color:var(--text-muted)]">Diagnostic phrase</span>
-              <select
-                value={diagnosisId}
-                onChange={(event) => changeDiagnosis(event.target.value as SpecifierBuilderDiagnosis)}
-                className="min-h-12 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-3 text-sm font-bold text-[color:var(--text-heading)] shadow-[var(--shadow-inset)] outline-none focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
-              >
-                {diagnosisPresets.map((item) => (
-                  <option key={item.id} value={item.id}>
-                    {item.label}
-                  </option>
-                ))}
-              </select>
-            </label>
-          </section>
-
-          {specifierFamilies
-            .filter((family) => family.id !== "all")
-            .map((family, familyIndex) => {
-              const records = specifierRecords.filter((record) => record.family === family.id);
-              const singleChoice = family.id === "severity-remission";
-              return (
-                <section key={family.id} className={cn(specifierCard, "overflow-hidden")}>
-                  <div className="flex items-center gap-3 border-b border-[color:var(--border)] px-4 py-3 sm:px-5">
-                    <span className="nums grid h-8 w-8 place-items-center rounded-full bg-[color:var(--clinical-accent-soft)] text-xs font-extrabold text-[color:var(--clinical-accent)]">
-                      {familyIndex + 2}
-                    </span>
-                    <div>
-                      <p className={eyebrowText}>{singleChoice ? "Choose up to one" : "Choose when supported"}</p>
-                      <h2 className="text-lg font-extrabold text-[color:var(--text-heading)]">{family.label}</h2>
-                    </div>
-                  </div>
-                  <div className="grid sm:grid-cols-2">
-                    {records.map((record, index) => {
-                      const checked = selected.includes(record.slug);
-                      const compatible = specifierAppliesToBuilderDiagnosis(record, diagnosisId);
-                      return (
-                        <label
-                          key={record.slug}
-                          className={cn(
-                            "group grid cursor-pointer grid-cols-[2rem_minmax(0,1fr)] gap-3 border-b border-[color:var(--border)] px-4 py-3.5 transition hover:bg-[color:var(--surface-subtle)] sm:px-5",
-                            index % 2 === 1 && "sm:border-l",
-                            checked && "bg-[color:var(--clinical-accent-soft)]/55",
-                            !compatible && "cursor-not-allowed opacity-50",
-                          )}
-                        >
-                          <input
-                            type="checkbox"
-                            checked={checked}
-                            disabled={!compatible}
-                            onChange={() => toggle(record.slug)}
-                            className="peer sr-only"
-                          />
-                          <span
-                            className={cn(
-                              "mt-0.5 grid h-7 w-7 place-items-center rounded-md border text-transparent transition peer-focus-visible:outline peer-focus-visible:outline-2 peer-focus-visible:outline-offset-2 peer-focus-visible:outline-[color:var(--focus)]",
-                              checked
-                                ? "border-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent)] text-[color:var(--clinical-accent-contrast)]"
-                                : "border-[color:var(--border-strong)] bg-[color:var(--surface)]",
-                            )}
-                          >
-                            <Check className="h-4 w-4" aria-hidden />
-                          </span>
-                          <span>
-                            <span className="block text-sm font-extrabold text-[color:var(--text-heading)]">
-                              {record.shortName}
-                            </span>
-                            <span className="mt-1 block text-xs font-medium leading-5 text-[color:var(--text-muted)]">
-                              {compatible ? record.clinicalSignal : "Not applicable to the selected diagnosis."}
-                            </span>
-                          </span>
-                        </label>
-                      );
-                    })}
-                  </div>
-                </section>
-              );
-            })}
-        </div>
-
-        <aside className="grid content-start gap-4 xl:sticky xl:top-20">
-          <section className="overflow-hidden rounded-lg border border-[color:var(--clinical-accent-border)] bg-[color:var(--surface)] shadow-[var(--shadow-soft)]">
-            <div className="flex items-center gap-3 border-b border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] px-4 py-3">
-              <span className="grid h-9 w-9 place-items-center rounded-lg bg-[color:var(--clinical-accent)] text-[color:var(--clinical-accent-contrast)]">
-                <FileCheck2 className="h-4 w-4" aria-hidden />
-              </span>
-              <div>
-                <p className={cn(eyebrowText, "!text-[color:var(--clinical-accent)]")}>Working diagnosis</p>
-                <h2 className="text-base font-extrabold text-[color:var(--text-heading)]">Structured wording</h2>
-              </div>
-            </div>
-            <div className="grid gap-4 p-4">
-              <p className="text-base font-extrabold leading-7 text-[color:var(--text-heading)]">{wording}</p>
-              <div className="grid gap-2 border-t border-[color:var(--border)] pt-3">
-                <p className={eyebrowText}>Applied specifiers</p>
-                {selectedRecords.length ? (
-                  <ul className="grid gap-2">
-                    {selectedRecords.map((record) => (
-                      <li
-                        key={record.slug}
-                        className="flex items-center justify-between gap-2 text-sm font-semibold text-[color:var(--text-muted)]"
-                      >
-                        <span className="inline-flex items-center gap-2">
-                          <Tags className="h-3.5 w-3.5 text-[color:var(--clinical-accent)]" aria-hidden />
-                          {record.shortName}
-                        </span>
-                        <Link
-                          href={`/specifiers/${record.slug}`}
-                          aria-label={`Review ${record.shortName}`}
-                          className="grid h-tap w-tap place-items-center rounded-md text-[color:var(--clinical-accent)] hover:bg-[color:var(--clinical-accent-soft)]"
-                        >
-                          <ArrowRight className="h-4 w-4" aria-hidden />
-                        </Link>
-                      </li>
-                    ))}
-                  </ul>
-                ) : (
-                  <p className="text-sm font-medium leading-5 text-[color:var(--text-muted)]">
-                    No specifiers selected yet.
-                  </p>
-                )}
-              </div>
-              <button
-                type="button"
-                onClick={() => setSelected([])}
-                disabled={!selected.length}
-                className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-3 text-sm font-bold text-[color:var(--text-muted)] disabled:opacity-45"
-              >
-                <RotateCcw className="h-4 w-4" aria-hidden />
-                Clear specifiers
-              </button>
-            </div>
-          </section>
-
-          <section className={cn(specifierCard, "p-4")}>
-            <div className="flex items-center gap-2">
-              <ListChecks className="h-4 w-4 text-[color:var(--clinical-accent)]" aria-hidden />
-              <p className={eyebrowText}>Before documenting</p>
-            </div>
-            <ul className="mt-3 grid gap-2 text-xs font-medium leading-5 text-[color:var(--text-muted)]">
-              <li>Confirm each specifier is valid for the base diagnosis.</li>
-              <li>Check episode chronology and competing explanations.</li>
-              <li>Use one internally consistent severity or remission descriptor.</li>
-            </ul>
-          </section>
-        </aside>
-      </div>
-
-      <SpecifierSafetyNote />
-    </SpecifierPageShell>
-  );
-}
diff --git a/src/components/specifiers/specifier-compare-page.tsx b/src/components/specifiers/specifier-compare-page.tsx
deleted file mode 100644
index c3a5b81ae..000000000
--- a/src/components/specifiers/specifier-compare-page.tsx
+++ /dev/null
@@ -1,238 +0,0 @@
-"use client";
-
-import Link from "next/link";
-import { ArrowRight, GitCompareArrows, HelpCircle, Repeat2, Tags } from "lucide-react";
-import { useState } from "react";
-
-import {
-  SpecifierBreadcrumbs,
-  SpecifierFamilyBadge,
-  SpecifierPageShell,
-  SpecifierSafetyNote,
-  SpecifierSubnav,
-  specifierCard,
-} from "@/components/specifiers/specifier-ui";
-import { cn, eyebrowText } from "@/components/ui-primitives";
-import { findSpecifier, specifierRecords } from "@/lib/specifiers";
-
-const comparisonRows = [
-  { label: "Clinical focus", key: "focus" as const },
-  { label: "Time course", key: "timeCourse" as const },
-  { label: "Look for", key: "lookFor" as const },
-  { label: "Do not overcall from", key: "caution" as const },
-];
-
-function fallbackPair(leftSlug?: string, rightSlug?: string) {
-  const left = findSpecifier(leftSlug ?? "") ?? specifierRecords[0];
-  const requestedRight = findSpecifier(rightSlug ?? "");
-  const right =
-    requestedRight && requestedRight.slug !== left.slug
-      ? requestedRight
-      : specifierRecords.find((item) => item.slug !== left.slug)!;
-  return { left, right };
-}
-
-function Selector({
-  label,
-  value,
-  otherValue,
-  onChange,
-}: {
-  label: string;
-  value: string;
-  otherValue: string;
-  onChange: (value: string) => void;
-}) {
-  return (
-    <label className="grid min-w-0 gap-1.5">
-      <span className={eyebrowText}>{label}</span>
-      <span className="relative">
-        <Tags
-          className="pointer-events-none absolute left-3 top-1/2 h-4 w-4 -translate-y-1/2 text-[color:var(--clinical-accent)]"
-          aria-hidden
-        />
-        <select
-          value={value}
-          onChange={(event) => onChange(event.target.value)}
-          className="min-h-12 w-full rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] pl-10 pr-9 text-sm font-bold text-[color:var(--text-heading)] shadow-[var(--shadow-inset)] outline-none focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
-        >
-          {specifierRecords.map((record) => (
-            <option key={record.slug} value={record.slug} disabled={record.slug === otherValue}>
-              {record.shortName}
-            </option>
-          ))}
-        </select>
-      </span>
-    </label>
-  );
-}
-
-export function SpecifierComparePage({ initialLeft, initialRight }: { initialLeft?: string; initialRight?: string }) {
-  const initial = fallbackPair(initialLeft, initialRight);
-  const [leftSlug, setLeftSlug] = useState(initial.left.slug);
-  const [rightSlug, setRightSlug] = useState(initial.right.slug);
-  const left = findSpecifier(leftSlug) ?? initial.left;
-  const right = findSpecifier(rightSlug) ?? initial.right;
-
-  function chooseLeft(nextSlug: string) {
-    setLeftSlug(nextSlug);
-    if (nextSlug === rightSlug) {
-      setRightSlug(specifierRecords.find((item) => item.slug !== nextSlug)?.slug ?? rightSlug);
-    }
-  }
-
-  function chooseRight(nextSlug: string) {
-    setRightSlug(nextSlug);
-    if (nextSlug === leftSlug) {
-      setLeftSlug(specifierRecords.find((item) => item.slug !== nextSlug)?.slug ?? leftSlug);
-    }
-  }
-
-  function swap() {
-    setLeftSlug(right.slug);
-    setRightSlug(left.slug);
-  }
-
-  return (
-    <SpecifierPageShell>
-      <div className="grid gap-3">
-        <SpecifierBreadcrumbs current="Compare" />
-        <SpecifierSubnav active="compare" />
-      </div>
-
-      <header className="grid gap-2 border-b border-[color:var(--border)] pb-5">
-        <p className={eyebrowText}>Close-call reasoning</p>
-        <h1 className="text-3xl font-extrabold tracking-tight text-[color:var(--text-heading)] sm:text-4xl">
-          Compare specifiers
-        </h1>
-        <p className="max-w-3xl text-sm font-medium leading-6 text-[color:var(--text-muted)]">
-          Clarify the deciding signal, chronology, and common overcalls. This comparison changes as you choose either
-          specifier.
-        </p>
-      </header>
-
-      <section
-        className={cn(
-          specifierCard,
-          "grid gap-3 p-4 sm:grid-cols-[minmax(0,1fr)_3rem_minmax(0,1fr)] sm:items-end sm:p-5",
-        )}
-      >
-        <Selector label="A" value={left.slug} otherValue={right.slug} onChange={chooseLeft} />
-        <button
-          type="button"
-          onClick={swap}
-          aria-label="Swap compared specifiers"
-          className="grid h-tap w-tap place-items-center justify-self-center rounded-full border border-[color:var(--border-strong)] bg-[color:var(--surface-raised)] text-[color:var(--text-muted)] shadow-[var(--shadow-inset)] transition hover:border-[color:var(--clinical-accent)] hover:text-[color:var(--clinical-accent)] focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)]"
-        >
-          <Repeat2 className="h-4 w-4" aria-hidden />
-        </button>
-        <Selector label="B" value={right.slug} otherValue={left.slug} onChange={chooseRight} />
-      </section>
-
-      <section className="rounded-lg border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] px-4 py-4 text-center sm:px-6">
-        <div className="mx-auto flex max-w-4xl items-start justify-center gap-2.5">
-          <HelpCircle className="mt-0.5 h-5 w-5 shrink-0 text-[color:var(--clinical-accent)]" aria-hidden />
-          <div>
-            <p className={cn(eyebrowText, "!text-[color:var(--clinical-accent)]")}>Ask this</p>
-            <p className="mt-1 text-base font-extrabold leading-6 text-[color:var(--text-heading)]">
-              Is the central pattern “{left.comparison.focus.toLowerCase()}” or “{right.comparison.focus.toLowerCase()}
-              ”?
-            </p>
-          </div>
-        </div>
-      </section>
-
-      <section
-        className={cn(specifierCard, "overflow-hidden")}
-        aria-label={`${left.shortName} compared with ${right.shortName}`}
-      >
-        <div className="grid sm:grid-cols-2">
-          {[left, right].map((record, index) => (
-            <div
-              key={record.slug}
-              className={cn(
-                "grid gap-3 px-4 py-4 sm:px-5",
-                index === 1 && "border-t border-[color:var(--border)] sm:border-l sm:border-t-0",
-              )}
-            >
-              <div className="flex items-center gap-2">
-                <span className="grid h-7 w-7 place-items-center rounded-full bg-[color:var(--clinical-accent)] text-xs font-extrabold text-[color:var(--clinical-accent-contrast)]">
-                  {index === 0 ? "A" : "B"}
-                </span>
-                <h2 className="text-lg font-extrabold text-[color:var(--text-heading)]">{record.shortName}</h2>
-              </div>
-              <p className="text-sm font-medium leading-6 text-[color:var(--text-muted)]">{record.summary}</p>
-              <SpecifierFamilyBadge record={record} />
-            </div>
-          ))}
-        </div>
-
-        <div className="border-t border-[color:var(--border)]">
-          {comparisonRows.map((row) => (
-            <div
-              key={row.key}
-              className="grid border-b border-[color:var(--border)] last:border-b-0 sm:grid-cols-[10rem_minmax(0,1fr)_minmax(0,1fr)]"
-            >
-              <div className="bg-[color:var(--surface-subtle)] px-4 py-3 text-xs font-extrabold text-[color:var(--text-heading)] sm:flex sm:items-center">
-                {row.label}
-              </div>
-              <div className="grid grid-cols-[1.75rem_minmax(0,1fr)] gap-2 px-4 py-3 text-sm font-medium leading-6 text-[color:var(--text-muted)]">
-                <span className="grid h-7 w-7 place-items-center rounded-full bg-[color:var(--clinical-accent-soft)] text-xs font-extrabold text-[color:var(--clinical-accent)]">
-                  A
-                </span>
-                <span>{left.comparison[row.key]}</span>
-              </div>
-              <div className="grid grid-cols-[1.75rem_minmax(0,1fr)] gap-2 border-t border-[color:var(--border)] px-4 py-3 text-sm font-medium leading-6 text-[color:var(--text-muted)] sm:border-l sm:border-t-0">
-                <span className="grid h-7 w-7 place-items-center rounded-full bg-[color:var(--clinical-accent-soft)] text-xs font-extrabold text-[color:var(--clinical-accent)]">
-                  B
-                </span>
-                <span>{right.comparison[row.key]}</span>
-              </div>
-            </div>
-          ))}
-        </div>
-
-        <div className="grid border-t border-[color:var(--border)] bg-[color:var(--surface-subtle)] sm:grid-cols-2">
-          {[left, right].map((record, index) => (
-            <div
-              key={record.slug}
-              className={cn(
-                "p-4 sm:p-5",
-                index === 1 && "border-t border-[color:var(--border)] sm:border-l sm:border-t-0",
-              )}
-            >
-              <p className={eyebrowText}>Example wording</p>
-              <p className="mt-1.5 text-sm font-bold leading-6 text-[color:var(--text-heading)]">{record.wording}</p>
-              <Link
-                href={`/specifiers/${record.slug}`}
-                className="mt-3 inline-flex min-h-tap items-center gap-2 rounded-md px-1 text-sm font-bold text-[color:var(--clinical-accent)] hover:underline"
-              >
-                Open full guide
-                <ArrowRight className="h-4 w-4" aria-hidden />
-              </Link>
-            </div>
-          ))}
-        </div>
-      </section>
-
-      <div className="flex flex-wrap justify-end gap-2">
-        <Link
-          href="/specifiers/map"
-          className="inline-flex min-h-tap items-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-4 text-sm font-bold text-[color:var(--text)]"
-        >
-          <GitCompareArrows className="h-4 w-4" aria-hidden />
-          Browse the map
-        </Link>
-        <Link
-          href={`/specifiers/builder?specifier=${left.slug}&specifier=${right.slug}`}
-          className="inline-flex min-h-tap items-center gap-2 rounded-lg bg-[color:var(--command)] px-4 text-sm font-bold text-[color:var(--command-contrast)]"
-        >
-          Build diagnostic wording
-          <ArrowRight className="h-4 w-4" aria-hidden />
-        </Link>
-      </div>
-
-      <SpecifierSafetyNote />
-    </SpecifierPageShell>
-  );
-}
diff --git a/src/components/specifiers/specifier-map-page.tsx b/src/components/specifiers/specifier-map-page.tsx
deleted file mode 100644
index b302d12ad..000000000
--- a/src/components/specifiers/specifier-map-page.tsx
+++ /dev/null
@@ -1,169 +0,0 @@
-"use client";
-
-import Link from "next/link";
-import { ArrowRight, CheckCircle2, GitCompareArrows, Tags, Waypoints } from "lucide-react";
-import { useState } from "react";
-
-import {
-  DiagnosisChips,
-  SpecifierBreadcrumbs,
-  SpecifierFamilyBadge,
-  SpecifierPageShell,
-  SpecifierSafetyNote,
-  SpecifierSubnav,
-  specifierCard,
-} from "@/components/specifiers/specifier-ui";
-import { cn, eyebrowText } from "@/components/ui-primitives";
-import { findSpecifier, specifierFamilies, specifierRecords } from "@/lib/specifiers";
-
-export function SpecifierMapPage({ initialSlug }: { initialSlug?: string }) {
-  const [selectedSlug, setSelectedSlug] = useState(findSpecifier(initialSlug ?? "")?.slug ?? specifierRecords[0].slug);
-  const selected = findSpecifier(selectedSlug) ?? specifierRecords[0];
-
-  return (
-    <SpecifierPageShell>
-      <div className="grid gap-3">
-        <SpecifierBreadcrumbs current="Map" />
-        <SpecifierSubnav active="map" />
-      </div>
-
-      <header className="grid gap-2 border-b border-[color:var(--border)] pb-5">
-        <p className={eyebrowText}>Diagnostic architecture</p>
-        <h1 className="text-3xl font-extrabold tracking-tight text-[color:var(--text-heading)] sm:text-4xl">
-          Specifier map
-        </h1>
-        <p className="max-w-3xl text-sm font-medium leading-6 text-[color:var(--text-muted)]">
-          Browse by the job each specifier performs. The sequence keeps diagnostic wording clear without implying that
-          every diagnosis uses every category.
-        </p>
-      </header>
-
-      <section
-        aria-label="Specifier wording pathway"
-        className="grid gap-2 rounded-lg border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] p-3 sm:grid-cols-[minmax(9rem,0.8fr)_auto_minmax(9rem,1fr)_auto_minmax(9rem,1fr)_auto_minmax(9rem,1fr)] sm:items-center"
-      >
-        {["Base diagnosis", "Episode features", "Course and onset", "Severity or remission"].map((label, index) => (
-          <div key={label} className="contents">
-            <div className="flex min-h-12 items-center gap-2 rounded-lg border border-[color:var(--border)] bg-[color:var(--surface)] px-3 text-sm font-extrabold text-[color:var(--text-heading)] shadow-[var(--shadow-inset)]">
-              <span className="nums grid h-7 w-7 shrink-0 place-items-center rounded-full bg-[color:var(--clinical-accent)] text-xs text-[color:var(--clinical-accent-contrast)]">
-                {index + 1}
-              </span>
-              {label}
-            </div>
-            {index < 3 ? (
-              <ArrowRight
-                className="hidden h-4 w-4 justify-self-center text-[color:var(--clinical-accent)] sm:block"
-                aria-hidden
-              />
-            ) : null}
-          </div>
-        ))}
-      </section>
-
-      <div className="grid gap-5 xl:grid-cols-[minmax(0,1fr)_22rem]">
-        <section className="grid min-w-0 gap-4 lg:grid-cols-3" aria-label="Specifier families">
-          {specifierFamilies
-            .filter((family) => family.id !== "all")
-            .map((family) => {
-              const records = specifierRecords.filter((record) => record.family === family.id);
-              return (
-                <div key={family.id} className={cn(specifierCard, "overflow-hidden")}>
-                  <div className="flex items-center gap-2.5 border-b border-[color:var(--border)] bg-[color:var(--surface-subtle)] px-4 py-3">
-                    <Waypoints className="h-4 w-4 text-[color:var(--clinical-accent)]" aria-hidden />
-                    <div>
-                      <h2 className="text-sm font-extrabold text-[color:var(--text-heading)]">{family.label}</h2>
-                      <p className="nums mt-0.5 text-2xs font-semibold text-[color:var(--text-muted)]">
-                        {records.length} options
-                      </p>
-                    </div>
-                  </div>
-                  <div className="divide-y divide-[color:var(--border)]">
-                    {records.map((record) => {
-                      const active = selected.slug === record.slug;
-                      return (
-                        <button
-                          key={record.slug}
-                          type="button"
-                          onClick={() => setSelectedSlug(record.slug)}
-                          aria-pressed={active}
-                          className={cn(
-                            "group flex min-h-[4.5rem] w-full items-center gap-3 px-4 py-3 text-left transition focus-visible:relative focus-visible:z-10 focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-[-2px] focus-visible:outline-[color:var(--focus)]",
-                            active
-                              ? "bg-[color:var(--clinical-accent-soft)]"
-                              : "bg-[color:var(--surface)] hover:bg-[color:var(--surface-subtle)]",
-                          )}
-                        >
-                          <span
-                            className={cn(
-                              "grid h-9 w-9 shrink-0 place-items-center rounded-lg border",
-                              active
-                                ? "border-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent)] text-[color:var(--clinical-accent-contrast)]"
-                                : "border-[color:var(--border)] bg-[color:var(--surface-raised)] text-[color:var(--clinical-accent)]",
-                            )}
-                          >
-                            <Tags className="h-4 w-4" aria-hidden />
-                          </span>
-                          <span className="min-w-0 flex-1">
-                            <span className="block text-sm font-extrabold text-[color:var(--text-heading)]">
-                              {record.shortName}
-                            </span>
-                            <span className="mt-0.5 line-clamp-2 block text-xs font-medium leading-4 text-[color:var(--text-muted)]">
-                              {record.clinicalSignal}
-                            </span>
-                          </span>
-                          {active ? (
-                            <CheckCircle2
-                              className="h-4 w-4 shrink-0 text-[color:var(--clinical-accent)]"
-                              aria-hidden
-                            />
-                          ) : null}
-                        </button>
-                      );
-                    })}
-                  </div>
-                </div>
-              );
-            })}
-        </section>
-
-        <aside className="grid content-start gap-4 xl:sticky xl:top-20">
-          <section className="overflow-hidden rounded-lg border border-[color:var(--clinical-accent-border)] bg-[color:var(--surface)] shadow-[var(--shadow-soft)]">
-            <div className="border-b border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] px-4 py-3">
-              <p className={cn(eyebrowText, "!text-[color:var(--clinical-accent)]")}>Selected specifier</p>
-              <h2 className="mt-1 text-xl font-extrabold text-[color:var(--text-heading)]">{selected.shortName}</h2>
-            </div>
-            <div className="grid gap-4 p-4">
-              <p className="text-sm font-medium leading-6 text-[color:var(--text-muted)]">{selected.summary}</p>
-              <SpecifierFamilyBadge record={selected} />
-              <DiagnosisChips values={selected.appliesTo} />
-              <div className="border-t border-[color:var(--border)] pt-3">
-                <p className={eyebrowText}>Deciding question</p>
-                <p className="mt-1.5 text-sm font-semibold leading-6 text-[color:var(--text-heading)]">
-                  {selected.decisionQuestion}
-                </p>
-              </div>
-              <div className="grid gap-2">
-                <Link
-                  href={`/specifiers/${selected.slug}`}
-                  className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg bg-[color:var(--command)] px-3 text-sm font-bold text-[color:var(--command-contrast)]"
-                >
-                  Open full guide
-                  <ArrowRight className="h-4 w-4" aria-hidden />
-                </Link>
-                <Link
-                  href={`/specifiers/compare?a=${selected.slug}`}
-                  className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-3 text-sm font-bold text-[color:var(--text)]"
-                >
-                  <GitCompareArrows className="h-4 w-4" aria-hidden />
-                  Compare
-                </Link>
-              </div>
-            </div>
-          </section>
-        </aside>
-      </div>
-
-      <SpecifierSafetyNote />
-    </SpecifierPageShell>
-  );
-}
diff --git a/src/components/specifiers/specifier-record-page.tsx b/src/components/specifiers/specifier-record-page.tsx
deleted file mode 100644
index f8f25309e..000000000
--- a/src/components/specifiers/specifier-record-page.tsx
+++ /dev/null
@@ -1,251 +0,0 @@
-import Link from "next/link";
-import {
-  ArrowRight,
-  Check,
-  ChevronDown,
-  CircleHelp,
-  FileCheck2,
-  GitCompareArrows,
-  ListChecks,
-  MessageSquareQuote,
-  Route,
-  ShieldAlert,
-  Tags,
-  Target,
-} from "lucide-react";
-
-import {
-  DiagnosisChips,
-  SectionHeading,
-  SpecifierBreadcrumbs,
-  SpecifierFamilyBadge,
-  SpecifierPageShell,
-  SpecifierSafetyNote,
-  SpecifierSubnav,
-  specifierCard,
-} from "@/components/specifiers/specifier-ui";
-import { cn, eyebrowText } from "@/components/ui-primitives";
-import { relatedSpecifiers, type SpecifierRecord } from "@/lib/specifiers";
-
-function comparisonHref(left: string, right?: string) {
-  const params = new URLSearchParams({ a: left });
-  if (right) params.set("b", right);
-  return `/specifiers/compare?${params.toString()}`;
-}
-
-function RecordFact({ icon: Icon, label, body }: { icon: typeof Tags; label: string; body: string }) {
-  return (
-    <div className="grid grid-cols-[2.25rem_minmax(0,1fr)] gap-3 px-4 py-3.5">
-      <span className="grid h-9 w-9 place-items-center rounded-lg bg-[color:var(--clinical-accent-soft)] text-[color:var(--clinical-accent)]">
-        <Icon className="h-4 w-4" aria-hidden />
-      </span>
-      <span>
-        <span className="block text-xs font-bold text-[color:var(--text-heading)]">{label}</span>
-        <span className="mt-0.5 block text-xs font-medium leading-5 text-[color:var(--text-muted)]">{body}</span>
-      </span>
-    </div>
-  );
-}
-
-function GuidanceSection({
-  icon: Icon,
-  title,
-  items,
-  tone = "default",
-  open = false,
-}: {
-  icon: typeof Tags;
-  title: string;
-  items: string[];
-  tone?: "default" | "success" | "warning";
-  open?: boolean;
-}) {
-  const toneClass =
-    tone === "success"
-      ? "text-[color:var(--success)] bg-[color:var(--success-soft)]"
-      : tone === "warning"
-        ? "text-[color:var(--warning)] bg-[color:var(--warning-soft)]"
-        : "text-[color:var(--clinical-accent)] bg-[color:var(--clinical-accent-soft)]";
-
-  return (
-    <details open={open} className="group border-b border-[color:var(--border)] last:border-b-0">
-      <summary className="flex min-h-14 cursor-pointer list-none items-center gap-3 px-4 py-3 focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-[-2px] focus-visible:outline-[color:var(--focus)] sm:px-5 [&::-webkit-details-marker]:hidden">
-        <span className={cn("grid h-9 w-9 shrink-0 place-items-center rounded-lg", toneClass)}>
-          <Icon className="h-4 w-4" aria-hidden />
-        </span>
-        <span className="min-w-0 flex-1 text-sm font-extrabold text-[color:var(--text-heading)]">{title}</span>
-        <ChevronDown
-          className="h-4 w-4 shrink-0 text-[color:var(--text-soft)] transition group-open:rotate-180 motion-reduce:transition-none"
-          aria-hidden
-        />
-      </summary>
-      <div className="px-4 pb-4 pl-[4.25rem] sm:px-5 sm:pb-5 sm:pl-[4.75rem]">
-        <ul className="grid gap-2.5 text-sm font-medium leading-6 text-[color:var(--text-muted)]">
-          {items.map((item) => (
-            <li key={item} className="grid grid-cols-[1rem_minmax(0,1fr)] gap-2">
-              <span className="mt-2 h-1.5 w-1.5 rounded-full bg-[color:var(--clinical-accent)]" aria-hidden />
-              <span>{item}</span>
-            </li>
-          ))}
-        </ul>
-      </div>
-    </details>
-  );
-}
-
-export function SpecifierRecordPage({ record }: { record: SpecifierRecord }) {
-  const related = relatedSpecifiers(record);
-  const primaryRelated = related[0];
-
-  return (
-    <SpecifierPageShell>
-      <div className="grid gap-3">
-        <SpecifierBreadcrumbs current={record.shortName} />
-        <SpecifierSubnav active="search" />
-      </div>
-
-      <section className="grid gap-5 border-b border-[color:var(--border)] pb-5 lg:grid-cols-[minmax(0,1fr)_auto] lg:items-end">
-        <div className="grid gap-4 sm:grid-cols-[4rem_minmax(0,1fr)] sm:items-start">
-          <span className="grid h-14 w-14 place-items-center rounded-xl border border-[color:var(--clinical-accent-border)] bg-[color:var(--clinical-accent-soft)] text-[color:var(--clinical-accent)] shadow-[var(--shadow-inset)] sm:h-16 sm:w-16">
-            <Tags className="h-7 w-7" aria-hidden />
-          </span>
-          <div className="grid gap-2">
-            <div>
-              <p className={eyebrowText}>Psychiatric specifier</p>
-              <h1 className="mt-1 text-3xl font-extrabold tracking-tight text-[color:var(--text-heading)] sm:text-4xl">
-                {record.name}
-              </h1>
-            </div>
-            <p className="max-w-3xl text-base font-medium leading-7 text-[color:var(--text-muted)]">{record.summary}</p>
-            <div className="flex flex-wrap items-center gap-2">
-              <SpecifierFamilyBadge record={record} />
-              <DiagnosisChips values={record.appliesTo} />
-            </div>
-          </div>
-        </div>
-
-        <div className="grid grid-cols-2 gap-2 sm:flex">
-          <Link
-            href={comparisonHref(record.slug, primaryRelated?.slug)}
-            className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] px-4 text-sm font-bold text-[color:var(--text)] shadow-[var(--shadow-inset)] transition hover:border-[color:var(--clinical-accent)] hover:text-[color:var(--clinical-accent)] focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)]"
-          >
-            <GitCompareArrows className="h-4 w-4" aria-hidden />
-            Compare
-          </Link>
-          <Link
-            href={`/specifiers/builder?specifier=${record.slug}`}
-            className="inline-flex min-h-tap items-center justify-center gap-2 rounded-lg bg-[color:var(--command)] px-4 text-sm font-bold text-[color:var(--command-contrast)] shadow-[var(--shadow-tight)] transition hover:bg-[color:var(--command-hover)] focus-visible:outline focus-visible:outline-2 focus-visible:outline-offset-2 focus-visible:outline-[color:var(--focus)]"
-          >
-            <ListChecks className="h-4 w-4" aria-hidden />
-            Build wording
-          </Link>
-        </div>
-      </section>
-
-      <section aria-labelledby="what-matters-now" className={cn(specifierCard, "overflow-hidden")}>
-        <div className="border-b border-[color:var(--border)] px-4 py-2.5 sm:px-5">
-          <p id="what-matters-now" className={eyebrowText}>
-            What matters now
-          </p>
-        </div>
-        <div className="grid divide-y divide-[color:var(--border)] sm:grid-cols-2 sm:divide-x sm:divide-y-0 xl:grid-cols-4">
-          <RecordFact icon={Tags} label="Applies to" body={record.appliesTo.slice(0, 2).join(" · ")} />
-          <RecordFact icon={Target} label="Deciding signal" body={record.clinicalSignal} />
-          <RecordFact icon={CircleHelp} label="Ask this" body={record.decisionQuestion} />
-          <RecordFact icon={FileCheck2} label="Wording outcome" body={record.wording} />
-        </div>
-      </section>
-
-      <div className="grid gap-5 xl:grid-cols-[minmax(0,1fr)_21rem]">
-        <div className="grid min-w-0 gap-5">
-          <SectionHeading
-            eyebrow="Fit and exclusions"
-            title="Make the specifier earn its place"
-            body="Start with the deciding signal, then test chronology, competing explanations, and the effect on diagnostic wording."
-          />
-
-          <section className={cn(specifierCard, "overflow-hidden")}>
-            <GuidanceSection icon={Check} title="When this fits" items={record.fit} tone="success" open />
-            <GuidanceSection icon={ShieldAlert} title="When this may not fit" items={record.notFit} tone="warning" />
-            <GuidanceSection icon={ListChecks} title="Focused checks" items={record.checks} />
-            <GuidanceSection
-              icon={MessageSquareQuote}
-              title="Patient language"
-              items={record.patientLanguage.map((item) => `“${item}”`)}
-            />
-          </section>
-
-          <section className={cn(specifierCard, "grid gap-4 p-4 sm:p-5")}>
-            <div className="flex items-start gap-3">
-              <span className="grid h-10 w-10 shrink-0 place-items-center rounded-lg bg-[color:var(--clinical-accent-soft)] text-[color:var(--clinical-accent)]">
-                <Route className="h-5 w-5" aria-hidden />
-              </span>
-              <div className="min-w-0">
-                <p className={eyebrowText}>Clinical implication</p>
-                <h2 className="mt-1 text-lg font-extrabold text-[color:var(--text-heading)]">
-                  How this changes the plan
-                </h2>
-              </div>
-            </div>
-            <p className="text-sm font-medium leading-6 text-[color:var(--text-muted)]">{record.treatmentLens}</p>
-          </section>
-        </div>
-
-        <aside className="grid content-start gap-4 xl:sticky xl:top-20">
-          <section className={cn(specifierCard, "overflow-hidden")}>
-            <div className="border-b border-[color:var(--border)] px-4 py-3">
-              <p className={eyebrowText}>Quick reference</p>
-            </div>
-            <dl className="divide-y divide-[color:var(--border)]">
-              {[
-                ["Focus", record.comparison.focus],
-                ["Time course", record.comparison.timeCourse],
-                ["Look for", record.comparison.lookFor],
-                ["Avoid", record.comparison.caution],
-              ].map(([label, body]) => (
-                <div key={label} className="px-4 py-3">
-                  <dt className="text-xs font-extrabold text-[color:var(--text-heading)]">{label}</dt>
-                  <dd className="mt-1 text-xs font-medium leading-5 text-[color:var(--text-muted)]">{body}</dd>
-                </div>
-              ))}
-            </dl>
-          </section>
-
-          <section className={cn(specifierCard, "p-4")}>
-            <p className={eyebrowText}>Example wording</p>
-            <p className="mt-2 text-sm font-bold leading-6 text-[color:var(--text-heading)]">{record.wording}</p>
-            <Link
-              href={`/specifiers/builder?specifier=${record.slug}`}
-              className="mt-3 inline-flex min-h-tap w-full items-center justify-center gap-2 rounded-lg bg-[color:var(--command)] px-3 text-sm font-bold text-[color:var(--command-contrast)]"
-            >
-              Use in builder
-              <ArrowRight className="h-4 w-4" aria-hidden />
-            </Link>
-          </section>
-
-          {related.length ? (
-            <section className={cn(specifierCard, "overflow-hidden")}>
-              <div className="border-b border-[color:var(--border)] px-4 py-3">
-                <p className={eyebrowText}>Compare next</p>
-              </div>
-              <div className="divide-y divide-[color:var(--border)]">
-                {related.map((item) => (
-                  <Link
-                    key={item.slug}
-                    href={comparisonHref(record.slug, item.slug)}
-                    className="flex min-h-14 items-center justify-between gap-3 px-4 py-2.5 text-sm font-bold text-[color:var(--text-heading)] hover:bg-[color:var(--surface-subtle)] hover:text-[color:var(--clinical-accent)]"
-                  >
-                    {item.shortName}
-                    <ArrowRight className="h-4 w-4 shrink-0" aria-hidden />
-                  </Link>
-                ))}
-              </div>
-            </section>
-          ) : null}
-        </aside>
-      </div>
-
-      <SpecifierSafetyNote />
-    </SpecifierPageShell>
-  );
-}
diff --git a/src/data/formulation-content.json b/src/data/formulation-content.json
new file mode 100644
index 000000000..ba0019e27
--- /dev/null
+++ b/src/data/formulation-content.json
@@ -0,0 +1,1188 @@
+{
+  "metadata": {
+    "packageName": "Formulation clinical content — text only",
+    "exportedAt": "2026-07-14T14:58:48+08:00",
+    "sourceRevision": "2d718a49701b759ef0a93b41664459bccb08d52f",
+    "sourceRepository": "C:/Dev/Apps/Formulation",
+    "intendedUse": "Portable clinical formulation content for Database or another repository",
+    "graphsIncluded": false,
+    "exclusionNote": "Relationship-map structures and relationship-seeding fields are intentionally omitted by request."
+  },
+  "domains": [
+    "Attachment",
+    "Trauma",
+    "Cognition",
+    "Affect",
+    "Behaviour",
+    "Interpersonal",
+    "Defence",
+    "Developmental",
+    "Biological",
+    "Social",
+    "Cultural",
+    "Risk"
+  ],
+  "sourceLibrary": {
+    "cbt": {
+      "id": "cbt",
+      "title": "Cognitive Behavior Therapy, StatPearls",
+      "url": "https://www.ncbi.nlm.nih.gov/books/NBK470241/"
+    },
+    "defense": {
+      "id": "defense",
+      "title": "Defense Mechanisms, StatPearls",
+      "url": "https://www.ncbi.nlm.nih.gov/books/NBK559106/"
+    },
+    "anxiety": {
+      "id": "anxiety",
+      "title": "Anxiety, StatPearls",
+      "url": "https://www.ncbi.nlm.nih.gov/books/NBK470361/"
+    },
+    "attachment": {
+      "id": "attachment",
+      "title": "Affiliation and Attachment, NIMH RDoC",
+      "url": "https://www.nimh.nih.gov/research/research-funded-by-nimh/rdoc/constructs/affiliation-and-attachment"
+    },
+    "dissociation": {
+      "id": "dissociation",
+      "title": "What Are Dissociative Disorders?, American Psychiatric Association",
+      "url": "https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders"
+    },
+    "emotion": {
+      "id": "emotion",
+      "title": "Emotion dysregulation disorders review, PMC",
+      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10653990/"
+    },
+    "rumination": {
+      "id": "rumination",
+      "title": "Rumination as a transdiagnostic process review, PubMed",
+      "url": "https://pubmed.ncbi.nlm.nih.gov/32087393/"
+    },
+    "shame": {
+      "id": "shame",
+      "title": "Shame and mental health systematic review, PubMed",
+      "url": "https://pubmed.ncbi.nlm.nih.gov/27687818/"
+    },
+    "perfectionism": {
+      "id": "perfectionism",
+      "title": "Perfectionism and mental health review, PMC",
+      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7882132/"
+    }
+  },
+  "mechanisms": [
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Anxiety", "Panic", "Low mood", "Trauma intrusions"],
+      "diagnosticContexts": ["Anxiety disorders", "PTSD", "Depression", "Personality difficulties"],
+      "protective": [],
+      "sources": ["defense", "anxiety", "cbt"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Distress drops quickly after the person escapes, postpones, suppresses, or narrows activity.",
+        "The avoided task, cue, feeling, or relationship remains threatening because it is not tested safely.",
+        "Short-term relief is followed by longer-term restriction, anxiety, shame, or functional cost."
+      ],
+      "poorFitIndicators": [
+        "Withdrawal is mainly due to low energy, cognitive impairment, environmental barriers, or lack of opportunity.",
+        "The person approaches feared situations but becomes overwhelmed by dissociation, confusion, or psychosis.",
+        "The behaviour is a deliberate values-based boundary rather than a fear-maintenance cycle."
+      ],
+      "caseExample": "A patient stops attending appointments after panic symptoms in the waiting room; relief after cancelling strengthens the belief that attending is unsafe.",
+      "treatmentTargetExample": "Plan graded appointment attendance with reduced safety behaviours and a brief post-session review of what was learned.",
+      "name": "Avoidance",
+      "definition": "A pattern of keeping away from internal experiences, situations, people, or tasks that trigger distress or perceived threat.",
+      "summary": "Avoidance reduces distress in the short term but commonly maintains anxiety, trauma responses, functional impairment, and interpersonal narrowing.",
+      "coreProcess": "Threat appraisal activates escape, safety behaviour, suppression, or disengagement, which prevents corrective learning and narrows coping options.",
+      "development": "Often develops after repeated threat, criticism, shame, trauma, panic, social defeat, or reinforcement from short-term relief.",
+      "predisposing": ["High threat sensitivity", "Trauma exposure", "Low perceived coping efficacy"],
+      "precipitating": ["New perceived threat", "Interpersonal conflict", "Panic or intrusive memory"],
+      "perpetuating": [
+        "Short-term relief",
+        "Reduced exposure to disconfirming evidence",
+        "Increasing life restriction"
+      ],
+      "clinicalClues": [
+        "Missed appointments",
+        "Safety behaviours",
+        "Narrowing activities",
+        "Over-preparation or withdrawal"
+      ],
+      "patientPhrases": ["I just avoid it", "I cannot face it", "It feels safer not to go"],
+      "domains": ["Behaviour", "Cognition", "Trauma", "Risk"],
+      "tags": ["avoidance", "safety behaviour", "escape", "withdrawal", "anxiety"],
+      "maintainingCycles": ["Threat cue -> anxiety -> avoidance -> relief -> threat belief remains untested"],
+      "comparisonNotes": [
+        "Differentiate from dissociation by checking whether disengagement is deliberate/behavioural or involves altered awareness."
+      ],
+      "formulationUse": "Avoidance may explain why distress persists despite the patient working hard to stay safe.",
+      "exampleSentence": "Avoidance appears to reduce distress briefly, but it also prevents corrective experience and maintains the threat appraisal.",
+      "treatmentImplications": [
+        "Graded exposure or behavioural experiments",
+        "Reduce safety behaviours",
+        "Clarify avoided affect or meanings"
+      ],
+      "treatmentLeverage": "Target the relief-maintenance loop and build tolerable approach behaviours.",
+      "id": "avoidance"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Affective instability", "Interpersonal conflict", "Self-harm risk in some contexts"],
+      "diagnosticContexts": ["Personality disorder contexts", "Trauma-related presentations"],
+      "protective": [],
+      "sources": ["defense"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Views of self or others shift rapidly between idealised and devalued positions.",
+        "Mixed feelings feel intolerable during attachment threat, disappointment, or rupture.",
+        "Team or relationship responses become polarised around the patient’s current affective state."
+      ],
+      "poorFitIndicators": [
+        "The person can hold mixed views but is making a stable, evidence-based judgement.",
+        "The main issue is fixed persecutory belief, intoxication, cognitive impairment, or cultural misunderstanding.",
+        "The shift is confined to one realistic conflict rather than a broader relational pattern."
+      ],
+      "caseExample": "After a perceived slight, a previously trusted clinician is described as uncaring and useless, while another clinician is suddenly seen as the only safe person.",
+      "treatmentTargetExample": "Use rupture repair to name both disappointment and continuing care without forcing premature certainty.",
+      "name": "Splitting",
+      "definition": "An all-or-none way of organising self, others, or situations into wholly good or wholly bad categories when mixed representations feel intolerable.",
+      "summary": "Splitting can simplify unbearable ambivalence but may destabilise relationships, teams, and self-experience.",
+      "coreProcess": "Conflicting positive and negative representations are not integrated, so affective state strongly shapes the current view.",
+      "development": "May be understood psychodynamically as a primitive defence, especially under high affect, insecure attachment, or personality vulnerability.",
+      "predisposing": ["Attachment insecurity", "Trauma history", "Difficulty mentalising under affect"],
+      "precipitating": ["Perceived rejection", "Rupture", "Disappointment in a valued person"],
+      "perpetuating": [
+        "Rapid certainty reduces ambivalence",
+        "Interpersonal responses reinforce polarisation",
+        "Repair conversations are avoided"
+      ],
+      "clinicalClues": ["Sudden idealisation or devaluation", "Team splitting", "Abrupt shifts after minor rupture"],
+      "patientPhrases": [
+        "They are the only one who understands me",
+        "They are completely useless",
+        "I was stupid to trust them"
+      ],
+      "domains": ["Defence", "Interpersonal", "Affect", "Attachment"],
+      "tags": ["splitting", "all-or-none", "idealisation", "devaluation", "ambivalence"],
+      "maintainingCycles": [
+        "Attachment threat -> intense affect -> polarised appraisal -> rupture -> threat increases"
+      ],
+      "comparisonNotes": [
+        "Distinguish from ordinary ambivalence by the speed, rigidity, and interpersonal impact of the shift."
+      ],
+      "formulationUse": "Splitting can organise otherwise overwhelming mixed feelings, but it may make alliance ruptures more likely.",
+      "exampleSentence": "Under attachment threat, splitting may make it hard to hold mixed feelings about self and others, intensifying rupture and repair cycles.",
+      "treatmentImplications": [
+        "Maintain consistent stance",
+        "Name mixed affects carefully",
+        "Support reflective functioning during rupture repair"
+      ],
+      "treatmentLeverage": "Help the patient tolerate mixed representations without escalating shame or abandonment fear.",
+      "id": "splitting"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Low mood", "Anxiety", "Self-harm urges", "Substance use", "Interpersonal withdrawal"],
+      "diagnosticContexts": [
+        "Trauma-related disorders",
+        "Depression",
+        "Eating disorders",
+        "Personality disorder contexts"
+      ],
+      "protective": [],
+      "sources": ["shame", "cbt"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Exposure, dependency, mistakes, or feedback trigger hiding, anger, appeasing, or self-attack.",
+        "Global self-defect language appears stronger than concern about a specific action.",
+        "Avoidance or withdrawal protects against being seen as unacceptable."
+      ],
+      "poorFitIndicators": [
+        "The primary affect is guilt about a specific harm with intact self-worth.",
+        "Withdrawal is driven mainly by anhedonia, fatigue, threat, or practical barriers.",
+        "The person is responding to current stigma or mistreatment rather than internalised defectiveness alone."
+      ],
+      "caseExample": "A patient misses therapy after disclosing trauma because they feel exposed and “disgusting,” then interprets the absence as proof they are failing.",
+      "treatmentTargetExample": "Name shame gently, separate protection from self-attack, and build tolerable disclosure or repair steps.",
+      "name": "Shame",
+      "definition": "A painful self-conscious affect in which the self is experienced as exposed, defective, unacceptable, or at risk of rejection.",
+      "summary": "Shame often links trauma, attachment threat, avoidance, concealment, anger, self-criticism, and disengagement from care.",
+      "coreProcess": "Global negative self-evaluation and anticipated social devaluation drive hiding, appeasing, attacking, or withdrawal.",
+      "development": "May emerge from humiliation, abuse, neglect, exclusion, chronic criticism, stigma, or repeated failures interpreted as self-defect.",
+      "predisposing": ["Criticism or humiliation", "Trauma", "Stigma", "Attachment insecurity"],
+      "precipitating": ["Exposure", "Mistake", "Dependency need", "Perceived rejection"],
+      "perpetuating": ["Secrecy", "Avoidance", "Self-attack", "Ruptures that confirm defectiveness"],
+      "clinicalClues": ["Downcast gaze", "Concealment", "Harsh self-criticism", "Anger after feeling exposed"],
+      "patientPhrases": ["There is something wrong with me", "I cannot let anyone see that", "I am disgusting"],
+      "domains": ["Affect", "Trauma", "Attachment", "Interpersonal"],
+      "tags": ["shame", "defectiveness", "self-criticism", "concealment", "humiliation"],
+      "maintainingCycles": ["Exposure -> shame -> hiding or attack -> isolation or rupture -> shame intensifies"],
+      "comparisonNotes": [
+        "Distinguish shame from guilt: shame centres on the self, guilt centres more on an action or harm."
+      ],
+      "formulationUse": "Shame may explain avoidance, anger, withdrawal, or self-attack when the patient feels exposed or dependent.",
+      "exampleSentence": "Shame appears to organise the patient around hiding and self-protection, reducing exposure but maintaining isolation and self-criticism.",
+      "treatmentImplications": [
+        "Use a non-shaming stance",
+        "Name shame gently",
+        "Link protective function before challenging beliefs"
+      ],
+      "treatmentLeverage": "Reduce concealment and self-attack while building tolerable interpersonal safety.",
+      "id": "shame"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Affective lability", "Anger", "Self-harm urges", "Anxiety", "Depressive spirals"],
+      "diagnosticContexts": [
+        "Borderline personality disorder",
+        "ADHD",
+        "Bipolar disorder differential",
+        "Trauma-related presentations"
+      ],
+      "protective": [],
+      "sources": ["emotion"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Affect escalates quickly and drives urgent actions before reflection is available.",
+        "The person struggles to name, modulate, or recover from emotional states.",
+        "Interpersonal, risk, or impulsive consequences feed further distress and shame."
+      ],
+      "poorFitIndicators": [
+        "Mood shifts are better explained by episodic mania, delirium, intoxication, or seizure activity.",
+        "The person has intense emotion but can pause, label, and choose effective responses consistently.",
+        "The apparent dysregulation occurs only in a currently unsafe environment."
+      ],
+      "caseExample": "After a delayed reply, a patient moves from anxiety to rage to self-harm urges within minutes, then feels ashamed and abandoned.",
+      "treatmentTargetExample": "Use chain analysis, emotion labelling, and pause strategies before high-risk action urges dominate.",
+      "name": "Emotional dysregulation",
+      "definition": "Difficulty modulating the intensity, duration, expression, or behavioural consequences of emotional states.",
+      "summary": "Emotional dysregulation is a transdiagnostic formulation mechanism that can amplify impulsivity, interpersonal rupture, avoidance, and risk.",
+      "coreProcess": "High emotional sensitivity, intense arousal, limited regulation strategies, and rapid action urges interact under stress.",
+      "development": "May reflect temperament, neurodevelopmental vulnerability, trauma, invalidating environments, attachment insecurity, or learned coping patterns.",
+      "predisposing": [
+        "High affective sensitivity",
+        "Trauma",
+        "Invalidating environments",
+        "Neurodevelopmental vulnerability"
+      ],
+      "precipitating": ["Perceived rejection", "Loss of control", "Threat cue", "Interpersonal rupture"],
+      "perpetuating": [
+        "Action urges reduce distress briefly",
+        "Ruptures increase threat",
+        "Avoidance limits skills practice"
+      ],
+      "clinicalClues": [
+        "Rapid affect shifts",
+        "Impulsive coping",
+        "Difficulty naming emotion",
+        "Escalation during rupture"
+      ],
+      "patientPhrases": ["It goes from zero to one hundred", "I cannot calm down", "I do things before I can think"],
+      "domains": ["Affect", "Behaviour", "Interpersonal", "Risk"],
+      "tags": ["emotion regulation", "affect", "lability", "impulsivity", "distress tolerance"],
+      "maintainingCycles": [
+        "Trigger -> intense emotion -> urgent behaviour -> consequences -> shame or threat -> further dysregulation"
+      ],
+      "comparisonNotes": [
+        "Differentiate from affect intolerance by assessing whether the main issue is arousal intensity, skill deficit, or fear of emotion."
+      ],
+      "formulationUse": "Emotional dysregulation can explain why stress rapidly becomes behavioural, interpersonal, or risk-relevant.",
+      "exampleSentence": "Emotional dysregulation appears to intensify threat cues into urgent action, creating consequences that then feed further distress.",
+      "treatmentImplications": [
+        "Emotion labelling",
+        "Distress tolerance skills",
+        "Chain analysis",
+        "Interpersonal rupture planning"
+      ],
+      "treatmentLeverage": "Increase pause, labelling, and tolerable regulation options before action urges dominate.",
+      "id": "emotional-dysregulation"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Anxiety", "Worry", "Relationship distress", "Obsessive doubt"],
+      "diagnosticContexts": [
+        "Generalised anxiety",
+        "Obsessive-compulsive presentations",
+        "Health anxiety",
+        "Attachment insecurity"
+      ],
+      "protective": [],
+      "sources": ["anxiety", "cbt"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Questions or checking repeatedly seek certainty, safety, approval, or relational confirmation.",
+        "Relief after reassurance fades quickly and the same doubt returns stronger.",
+        "Others become strained, frustrated, or pulled into repeated certainty-giving cycles."
+      ],
+      "poorFitIndicators": [
+        "The person is asking for ordinary information, care coordination, or reasonable clarification.",
+        "The concern remains resolved after a clear answer or practical plan.",
+        "The main pattern is avoidance, mistrust, or protest rather than repeated uncertainty reduction."
+      ],
+      "caseExample": "A patient repeatedly asks whether the clinician is upset with them; each answer helps briefly, then doubt returns and more messages follow.",
+      "treatmentTargetExample": "Map the reassurance loop and practise delayed reassurance, uncertainty tolerance, and internal anchors.",
+      "name": "Reassurance seeking",
+      "definition": "Repeatedly seeking certainty, safety, approval, or relational confirmation to reduce distress or doubt.",
+      "summary": "Reassurance seeking can soothe briefly but may maintain uncertainty intolerance, anxiety, dependency cycles, and interpersonal strain.",
+      "coreProcess": "Distress or doubt triggers interpersonal checking, which gives short-term relief while preventing internal tolerance of uncertainty.",
+      "development": "Often develops where uncertainty, threat, abandonment fear, or negative self-beliefs feel intolerable without external confirmation.",
+      "predisposing": ["Anxiety sensitivity", "Attachment insecurity", "Low self-trust", "Intolerance of uncertainty"],
+      "precipitating": ["Ambiguous message", "Body sensation", "Mistake", "Perceived distance from another person"],
+      "perpetuating": ["Temporary relief", "Escalating certainty demands", "Others withdraw or become frustrated"],
+      "clinicalClues": [
+        "Repeated checking questions",
+        "Frequent messages",
+        "Difficulty accepting answers",
+        "Relief that fades quickly"
+      ],
+      "patientPhrases": ["Are you sure?", "Do you still care?", "What if I missed something?", "I just need to know"],
+      "domains": ["Interpersonal", "Attachment", "Cognition", "Behaviour"],
+      "tags": ["reassurance", "checking", "uncertainty", "dependency", "safety behaviour"],
+      "maintainingCycles": ["Doubt -> reassurance -> relief -> doubt returns stronger -> reassurance escalates"],
+      "comparisonNotes": [
+        "Distinguish from ordinary support seeking by repetition, urgency, and inability to use the response."
+      ],
+      "formulationUse": "Reassurance seeking may show how anxiety is regulated interpersonally while uncertainty tolerance remains low.",
+      "exampleSentence": "Reassurance seeking temporarily reduces doubt, but because the relief fades it can maintain dependence on external certainty.",
+      "treatmentImplications": [
+        "Map reassurance cycles",
+        "Build uncertainty tolerance",
+        "Use response prevention or delayed reassurance where appropriate"
+      ],
+      "treatmentLeverage": "Shift from certainty seeking toward tolerating uncertainty and using internal anchors.",
+      "id": "reassurance-seeking"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Loneliness", "Depression", "Relationship difficulties", "Reduced help-seeking"],
+      "diagnosticContexts": [
+        "Attachment-related formulation",
+        "Trauma-related presentations",
+        "Personality functioning"
+      ],
+      "protective": [],
+      "sources": ["attachment"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Closeness, dependency, or support is minimised just when care becomes relevant.",
+        "Self-sufficiency protects against vulnerability, intrusion, shame, or rejection.",
+        "The person distances after warmth, repair, or perceived demand."
+      ],
+      "poorFitIndicators": [
+        "Distance reflects healthy boundaries, cultural preference, or a realistic safety concern.",
+        "Reduced engagement is mainly due to depression, psychosis, cognitive impairment, or access barriers.",
+        "The person wants closeness but cannot access it because of dissociation or social anxiety."
+      ],
+      "caseExample": "After a helpful session, a patient cancels follow-up and says they do not need help, despite worsening loneliness.",
+      "treatmentTargetExample": "Offer predictable, autonomy-respecting support and track closeness-distance shifts without shaming.",
+      "name": "Attachment avoidance",
+      "definition": "A relational strategy of down-regulating attachment needs, dependence, and emotional closeness to preserve autonomy or reduce vulnerability.",
+      "summary": "Attachment avoidance may appear as self-sufficiency, emotional distance, minimisation of need, or disengagement under relational stress.",
+      "coreProcess": "Attachment cues activate vulnerability or threat, which is managed through distance, deactivation, intellectualisation, or self-reliance.",
+      "development": "May emerge when closeness has been unreliable, intrusive, rejecting, shaming, or unsafe.",
+      "predisposing": [
+        "Dismissive attachment patterns",
+        "Repeated rejection",
+        "Intrusive caregiving",
+        "Relational trauma"
+      ],
+      "precipitating": ["Dependency need", "Therapeutic closeness", "Perceived demand", "Loss of autonomy"],
+      "perpetuating": [
+        "Distance reduces vulnerability",
+        "Others experience rejection",
+        "Support is not tested as safe"
+      ],
+      "clinicalClues": [
+        "Minimises distress",
+        "Misses sessions after closeness",
+        "Prefers factual discussion",
+        "Rejects help quickly"
+      ],
+      "patientPhrases": ["I do not need anyone", "It is fine", "I handle things myself", "People get too much"],
+      "domains": ["Attachment", "Interpersonal", "Developmental", "Defence"],
+      "tags": ["attachment avoidance", "self-reliance", "distance", "deactivation", "closeness"],
+      "maintainingCycles": ["Need -> vulnerability -> distance -> short-term safety -> unmet need persists"],
+      "comparisonNotes": [
+        "Distinguish from healthy independence by rigidity, distress after closeness, and cost to support or intimacy."
+      ],
+      "formulationUse": "Attachment avoidance may explain disengagement just when support, closeness, or dependency becomes clinically relevant.",
+      "exampleSentence": "Attachment avoidance may protect against vulnerability by creating distance, but it also limits support and repair.",
+      "treatmentImplications": [
+        "Respect autonomy",
+        "Use predictable boundaries",
+        "Track closeness-distance shifts without shaming"
+      ],
+      "treatmentLeverage": "Make support tolerable without forcing dependency.",
+      "id": "attachment-avoidance"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Depression", "Anxiety", "Shame", "Interpersonal sensitivity"],
+      "diagnosticContexts": [
+        "Depression",
+        "Anxiety disorders",
+        "Trauma-related presentations",
+        "Schema-focused formulation"
+      ],
+      "protective": [],
+      "sources": ["cbt"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Events are repeatedly interpreted through broad beliefs such as defectiveness, danger, unlovability, or failure.",
+        "The belief appears across settings and shapes attention, emotion, and coping behaviour.",
+        "Disconfirming evidence is discounted, avoided, or quickly reinterpreted."
+      ],
+      "poorFitIndicators": [
+        "The thought is situation-specific and changes with new evidence.",
+        "The belief reflects a current realistic threat or systemic adversity rather than a global schema alone.",
+        "The main pattern is repetitive worry or rumination without a stable self/other/world belief."
+      ],
+      "caseExample": "A neutral email delay is read as proof the patient is disliked, confirming a wider belief of being unwanted.",
+      "treatmentTargetExample": "Identify the recurring belief, test predictions safely, and build a more balanced alternative meaning.",
+      "name": "Negative core beliefs",
+      "definition": "Global, rigid, overgeneralised beliefs about the self, others, or world that shape interpretation and emotional response.",
+      "summary": "Negative core beliefs bias attention and meaning-making, often linking early experience to current automatic thoughts, affect, and behaviour.",
+      "coreProcess": "A schema-like belief filters events so ambiguous information is interpreted as confirming defectiveness, danger, unlovability, or failure.",
+      "development": "May develop through repeated interpersonal learning, trauma, criticism, exclusion, loss, or chronic unmet needs.",
+      "predisposing": ["Early criticism", "Bullying", "Trauma", "Repeated invalidation"],
+      "precipitating": ["Failure cue", "Rejection cue", "Conflict", "Performance demand"],
+      "perpetuating": [
+        "Confirmation bias",
+        "Avoidance of disconfirming experience",
+        "Self-criticism and safety behaviours"
+      ],
+      "clinicalClues": [
+        "Global self-statements",
+        "Persistent themes across situations",
+        "Extreme words such as always or never"
+      ],
+      "patientPhrases": ["I am not good enough", "I am unlovable", "People will hurt me", "I always fail"],
+      "domains": ["Cognition", "Developmental", "Attachment", "Affect"],
+      "tags": ["core belief", "schema", "self-belief", "cognition", "automatic thoughts"],
+      "maintainingCycles": [
+        "Trigger -> negative meaning -> affect -> coping behaviour -> apparent confirmation of belief"
+      ],
+      "comparisonNotes": [
+        "Distinguish from automatic thoughts by breadth, rigidity, and recurrence across many contexts."
+      ],
+      "formulationUse": "Negative core beliefs provide a bridge between developmental learning and current interpretations.",
+      "exampleSentence": "A negative core belief of defectiveness appears to shape threat appraisals, self-criticism, and avoidance of disconfirming feedback.",
+      "treatmentImplications": [
+        "Identify themes across situations",
+        "Use behavioural experiments",
+        "Build balanced alternative beliefs"
+      ],
+      "treatmentLeverage": "Work at the level of meaning, not only surface thoughts.",
+      "id": "negative-core-beliefs"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Interpersonal conflict", "Paranoid ideation in some contexts", "Anger", "Shame"],
+      "diagnosticContexts": ["Psychodynamic formulation", "Personality functioning", "Trauma-related mistrust"],
+      "protective": [],
+      "sources": ["defense"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Unwanted feelings or impulses appear attributed to another person with high certainty.",
+        "The attribution reduces self-conflict but escalates suspicion, blame, or rupture.",
+        "The content of the accusation resembles a disowned affect, wish, or fear."
+      ],
+      "poorFitIndicators": [
+        "There is strong evidence that the other person is acting in the described way.",
+        "The belief is fixed, bizarre, or psychotic rather than relationally linked and affect-responsive.",
+        "The pattern is primarily shame, trauma mistrust, or negative core belief without disowned affect."
+      ],
+      "caseExample": "A patient who feels angry after a rupture insists the clinician is angry and punitive, despite no clear evidence.",
+      "treatmentTargetExample": "Validate the affect first, then gently compare evidence and invite curiosity about the internal feeling state.",
+      "name": "Projection",
+      "definition": "A defence in which unacceptable feelings, impulses, or self-states are attributed to another person.",
+      "summary": "Projection can protect against shame or conflict but may create suspicion, blame, and interpersonal escalation.",
+      "coreProcess": "An unwanted internal state is experienced as located in the other, reducing self-conflict but distorting interpersonal appraisal.",
+      "development": "May emerge when owning particular affects or impulses is associated with shame, danger, punishment, or loss of attachment.",
+      "predisposing": ["Shame-proneness", "Threatened self-image", "Harsh internal standards"],
+      "precipitating": ["Unacceptable anger, envy, dependency, or desire", "Interpersonal ambiguity"],
+      "perpetuating": [
+        "External blame reduces self-conflict",
+        "Others become defensive",
+        "Suspicion appears confirmed"
+      ],
+      "clinicalClues": [
+        "High certainty about others motives",
+        "Accusations matching disowned affect",
+        "Escalation when self-reflection is invited"
+      ],
+      "patientPhrases": ["They hate me", "They are trying to control me", "Everyone is judging me"],
+      "domains": ["Defence", "Interpersonal", "Affect", "Cognition"],
+      "tags": ["projection", "externalisation", "blame", "defence", "mistrust"],
+      "maintainingCycles": [
+        "Disowned affect -> attribution to other -> defensive interaction -> apparent confirmation"
+      ],
+      "comparisonNotes": [
+        "Distinguish from realistic mistrust by checking evidence, flexibility, and links to disowned affect."
+      ],
+      "formulationUse": "Projection may explain why intolerable self-states are experienced as threats located in other people.",
+      "exampleSentence": "Projection may protect against owning painful feelings, but it can make relationships feel more hostile and confirming.",
+      "treatmentImplications": [
+        "Validate affect before interpretation",
+        "Explore evidence gently",
+        "Avoid premature confrontation"
+      ],
+      "treatmentLeverage": "Build capacity to notice disowned feeling states without shame escalation.",
+      "id": "projection"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Depression", "Anxiety", "Insomnia", "Shame"],
+      "diagnosticContexts": ["Depression", "Anxiety", "Trauma-related presentations", "Perfectionism"],
+      "protective": [],
+      "sources": ["rumination", "cbt"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Thinking is repetitive, past- or meaning-focused, and does not move toward effective action.",
+        "Mood worsens as the person reviews causes, failures, or consequences.",
+        "The process feels like problem-solving but remains abstract and self-critical."
+      ],
+      "poorFitIndicators": [
+        "The person is doing concrete planning that leads to action.",
+        "Thinking is future-threat oriented and better described as worry.",
+        "Repetitive thought is driven by obsessional intrusions requiring a different formulation."
+      ],
+      "caseExample": "After an argument, a patient spends hours replaying what they “should have said,” becomes more ashamed, and withdraws.",
+      "treatmentTargetExample": "Shift from abstract replay to concrete next steps, attention shifting, or values-based action.",
+      "name": "Rumination",
+      "definition": "Repetitive, passive, negatively toned thinking about distress, causes, meanings, or consequences.",
+      "summary": "Rumination may feel like problem-solving but often maintains low mood, shame, threat, and cognitive inflexibility.",
+      "coreProcess": "Attention becomes repeatedly captured by unresolved negative meanings without moving into effective action or new learning.",
+      "development": "May develop as an attempt to understand, prevent, or mentally undo painful experiences, especially when emotion feels unresolved.",
+      "predisposing": ["Depressive thinking style", "Perfectionism", "Shame", "Low behavioural activation"],
+      "precipitating": ["Failure", "Loss", "Conflict", "Unresolved ambiguity"],
+      "perpetuating": ["Reduced action", "Increased negative affect", "Selective attention to threat or defectiveness"],
+      "clinicalClues": [
+        "Long repetitive analysis",
+        "Difficulty shifting attention",
+        "Sleep disruption",
+        "Repeated why questions"
+      ],
+      "patientPhrases": ["I keep going over it", "I cannot switch my mind off", "Why did I do that?"],
+      "domains": ["Cognition", "Affect", "Behaviour"],
+      "tags": ["rumination", "repetitive thinking", "depression", "shame", "cognition"],
+      "maintainingCycles": [
+        "Negative event -> repetitive analysis -> mood worsens -> more negative material becomes salient"
+      ],
+      "comparisonNotes": [
+        "Distinguish from worry: rumination often reviews past or current distress, while worry anticipates future threat."
+      ],
+      "formulationUse": "Rumination may maintain distress by keeping attention fixed on negative meanings without corrective action.",
+      "exampleSentence": "Rumination appears to keep the patient caught in repeated negative meaning-making, worsening mood and reducing behavioural movement.",
+      "treatmentImplications": [
+        "Shift to concrete problem-solving",
+        "Attention training",
+        "Behavioural activation",
+        "Metacognitive work"
+      ],
+      "treatmentLeverage": "Move from repetitive analysis to values-based action or specific problem-solving.",
+      "id": "rumination"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Anxiety", "Muscle tension", "Insomnia", "Poor concentration"],
+      "diagnosticContexts": ["Generalised anxiety", "Health anxiety", "Obsessive-compulsive presentations"],
+      "protective": [],
+      "sources": ["anxiety", "cbt"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Thinking is repetitive, future-oriented, and organised around possible threats or uncertainty.",
+        "Planning gives a brief sense of control but increases vigilance and arousal.",
+        "The person struggles to separate solvable problems from hypothetical threats."
+      ],
+      "poorFitIndicators": [
+        "The main loop is past-focused rumination rather than future threat simulation.",
+        "Concern is proportionate and leads to effective preparation.",
+        "The dominant process is intrusive obsession, trauma re-experiencing, or psychotic threat belief."
+      ],
+      "caseExample": "A patient spends the night imagining every way a meeting could go wrong and arrives exhausted but still uncertain.",
+      "treatmentTargetExample": "Sort worries into solvable problems versus hypothetical threats, then practise uncertainty exposure.",
+      "name": "Worry",
+      "definition": "Repetitive future-oriented thinking about possible threats, uncertainty, or negative outcomes.",
+      "summary": "Worry attempts to prepare for danger but may maintain anxiety by overestimating threat and under-testing coping.",
+      "coreProcess": "Future threat simulations create an illusion of preparation while increasing vigilance, arousal, and safety behaviours.",
+      "development": "May develop where uncertainty has felt dangerous, unpredictable, or personally costly.",
+      "predisposing": ["Intolerance of uncertainty", "High responsibility beliefs", "Threat sensitivity"],
+      "precipitating": ["Ambiguity", "Upcoming decision", "Bodily sensation", "Responsibility cue"],
+      "perpetuating": [
+        "Temporary sense of control",
+        "Avoidance of emotional processing",
+        "Reduced tolerance of uncertainty"
+      ],
+      "clinicalClues": ["What-if chains", "Reassurance seeking", "Over-planning", "Difficulty sleeping"],
+      "patientPhrases": ["What if something goes wrong?", "I need to be prepared", "I cannot stop thinking ahead"],
+      "domains": ["Cognition", "Affect", "Behaviour", "Risk"],
+      "tags": ["worry", "uncertainty", "what if", "future threat", "anxiety"],
+      "maintainingCycles": ["Uncertainty -> worry -> temporary control -> more threat scanning -> more uncertainty"],
+      "comparisonNotes": [
+        "Distinguish from rumination by future orientation and perceived function of preventing harm."
+      ],
+      "formulationUse": "Worry may function as an attempted safety strategy that keeps threat active and uncertainty intolerable.",
+      "exampleSentence": "Worry gives a brief sense of preparation, but it also sustains threat monitoring and prevents uncertainty tolerance.",
+      "treatmentImplications": [
+        "Worry postponement",
+        "Uncertainty exposure",
+        "Problem-solving versus hypothetical worry sorting"
+      ],
+      "treatmentLeverage": "Separate solvable problems from hypothetical threat loops.",
+      "id": "worry"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Amnesia", "Depersonalisation", "Derealisation", "Emotional numbing"],
+      "diagnosticContexts": [
+        "Dissociative disorders",
+        "PTSD",
+        "Complex trauma",
+        "Functional neurological symptoms differential"
+      ],
+      "protective": [],
+      "sources": ["dissociation"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "There are episodes of detachment, derealisation, depersonalisation, time loss, or altered awareness.",
+        "Disconnection appears when arousal, trauma cues, shame, or threat exceed coping capacity.",
+        "The person may look present but later reports gaps, unreality, or watching from outside themselves."
+      ],
+      "poorFitIndicators": [
+        "The person is deliberately avoiding while awareness and memory remain intact.",
+        "Symptoms are better explained by seizure, intoxication, delirium, sleep disorder, or psychosis.",
+        "The main issue is emotional numbing without altered awareness or integration."
+      ],
+      "caseExample": "During a trauma reminder, a patient feels unreal, loses track of time, and later cannot recall parts of the conversation.",
+      "treatmentTargetExample": "Prioritise grounding, orientation, and pacing before detailed trauma processing.",
+      "name": "Dissociation",
+      "definition": "A disruption or disconnection in memory, identity, emotion, perception, behaviour, body experience, or sense of self.",
+      "summary": "Dissociation can reduce overwhelming distress during threat but may later impair memory integration, presence, agency, and relational engagement.",
+      "coreProcess": "Overwhelming arousal or threat is managed by disconnection, detachment, numbing, derealisation, depersonalisation, or memory compartmentalisation.",
+      "development": "Frequently associated with trauma, especially repeated or overwhelming experiences, though mild dissociation can occur in everyday life.",
+      "predisposing": ["Trauma exposure", "Overwhelming affect", "Low safety", "Dissociative coping history"],
+      "precipitating": ["Trauma cue", "High arousal", "Shame exposure", "Interpersonal threat"],
+      "perpetuating": [
+        "Immediate reduction in overwhelm",
+        "Reduced memory integration",
+        "Avoidance of affective processing"
+      ],
+      "clinicalClues": ["Time loss", "Spacing out", "Detached voice or gaze", "Derealisation", "Depersonalisation"],
+      "patientPhrases": [
+        "I was not really there",
+        "Everything felt unreal",
+        "I lost time",
+        "I watched it happen from outside"
+      ],
+      "domains": ["Trauma", "Affect", "Behaviour", "Risk"],
+      "tags": ["dissociation", "detachment", "depersonalisation", "derealisation", "trauma"],
+      "maintainingCycles": ["Threat cue -> overwhelm -> dissociation -> reduced processing -> cue remains potent"],
+      "comparisonNotes": [
+        "Distinguish from avoidance by altered awareness, memory, identity, or presence rather than only behavioural escape."
+      ],
+      "formulationUse": "Dissociation may explain sudden disengagement, memory gaps, or emotional numbing when arousal exceeds coping capacity.",
+      "exampleSentence": "Dissociation appears to protect against overwhelming affect, but it may also interrupt integration and reduce present-moment agency.",
+      "treatmentImplications": [
+        "Grounding and stabilisation",
+        "Window of tolerance work",
+        "Pace trauma processing carefully"
+      ],
+      "treatmentLeverage": "Increase present-moment orientation and safety before intensive processing.",
+      "id": "dissociation"
+    },
+    {
+      "sourceStatus": "Source metadata reviewed; owner confirmation pending",
+      "sourceConfidence": "Static source metadata recorded",
+      "version": "Source review v1",
+      "symptoms": ["Anxiety", "Depression", "Burnout", "Eating disorder symptoms in some contexts"],
+      "diagnosticContexts": [
+        "Anxiety disorders",
+        "Depression",
+        "Obsessive-compulsive personality traits",
+        "Eating disorders"
+      ],
+      "protective": [],
+      "sources": ["perfectionism", "cbt"],
+      "caveats": [
+        "Use as a formulation hypothesis, not as a diagnosis.",
+        "Check context, culture, developmental history, mental state, risk, and alternative explanations.",
+        "Revise the formulation when new information does not fit the hypothesised mechanism."
+      ],
+      "fitIndicators": [
+        "Self-worth, safety, or acceptability depends on meeting rigid high standards.",
+        "Mistakes trigger self-criticism, overchecking, avoidance, or procrastination.",
+        "The standard remains costly even when performance is objectively adequate."
+      ],
+      "poorFitIndicators": [
+        "High standards are flexible, values-based, and not associated with significant distress or impairment.",
+        "Avoidance is mainly due to fear, low mood, access barriers, or executive function difficulty.",
+        "The main belief is broad defectiveness rather than conditional worth tied to performance."
+      ],
+      "caseExample": "A patient delays submitting work for days because anything less than flawless feels humiliating and unsafe.",
+      "treatmentTargetExample": "Run good-enough behavioural experiments and loosen the link between worth and flawless performance.",
+      "name": "Perfectionism",
+      "definition": "A rigid pattern of setting excessively high standards and linking worth, safety, or acceptability to flawless performance.",
+      "summary": "Perfectionism can drive achievement but may maintain anxiety, depression, shame, procrastination, avoidance, and burnout.",
+      "coreProcess": "Conditional self-worth and threat appraisal attach high emotional cost to mistakes, uncertainty, or ordinary limitation.",
+      "development": "May develop through criticism, conditional approval, achievement-based identity, insecurity, or attempts to prevent shame and loss of control.",
+      "predisposing": ["Conditional approval", "High criticism", "Anxiety", "Negative core beliefs"],
+      "precipitating": ["Performance demand", "Mistake", "Evaluation", "Loss of control"],
+      "perpetuating": [
+        "Overchecking",
+        "Avoidance or procrastination",
+        "Temporary relief after meeting standards",
+        "Self-criticism"
+      ],
+      "clinicalClues": ["All-or-nothing standards", "Difficulty finishing", "Overchecking", "Harsh internal critic"],
+      "patientPhrases": [
+        "If it is not perfect, it is a failure",
+        "I should have done better",
+        "I cannot submit it yet"
+      ],
+      "domains": ["Cognition", "Behaviour", "Affect", "Developmental"],
+      "tags": ["perfectionism", "standards", "self-criticism", "control", "procrastination"],
+      "maintainingCycles": [
+        "High standard -> threat of mistake -> overcontrol or avoidance -> temporary relief -> standard remains rigid"
+      ],
+      "comparisonNotes": [
+        "Distinguish from conscientiousness by rigidity, distress, and cost to functioning or relationships."
+      ],
+      "formulationUse": "Perfectionism may organise coping around preventing shame, criticism, or loss of worth.",
+      "exampleSentence": "Perfectionism appears to protect against shame through high control, but it increases self-criticism and avoidance when standards cannot be met.",
+      "treatmentImplications": [
+        "Behavioural experiments with good-enough performance",
+        "Self-compassion work",
+        "Challenge conditional worth rules"
+      ],
+      "treatmentLeverage": "Reduce the link between worth and flawless performance.",
+      "id": "perfectionism"
+    }
+  ],
+  "formulationTemplates": [
+    {
+      "id": "5Ps",
+      "label": "5Ps"
+    },
+    {
+      "id": "CBT cycle",
+      "label": "CBT cycle"
+    },
+    {
+      "id": "Trauma-informed",
+      "label": "Trauma-informed"
+    },
+    {
+      "id": "Interpersonal",
+      "label": "Interpersonal"
+    },
+    {
+      "id": "Risk",
+      "label": "Risk"
+    },
+    {
+      "id": "Treatment plan",
+      "label": "Treatment plan"
+    }
+  ],
+  "formulationSections": [
+    {
+      "id": "presenting",
+      "label": "Presenting problem",
+      "prompt": "Brief summary of the presenting problem",
+      "group": ["5Ps", "CBT cycle", "Trauma-informed", "Interpersonal", "Risk", "Treatment plan"]
+    },
+    {
+      "id": "symptoms",
+      "label": "Key symptoms and phenomenology",
+      "prompt": "Observed symptoms, subjective experience, and relevant context",
+      "group": ["5Ps", "Trauma-informed", "Risk"]
+    },
+    {
+      "id": "predisposing",
+      "label": "Predisposing factors",
+      "prompt": "Developmental, biological, psychological, social, or cultural factors",
+      "group": ["5Ps", "Trauma-informed", "Interpersonal"]
+    },
+    {
+      "id": "precipitating",
+      "label": "Precipitating factors",
+      "prompt": "Recent events, stressors, losses, conflict, or changes",
+      "group": ["5Ps", "CBT cycle", "Trauma-informed", "Risk"]
+    },
+    {
+      "id": "perpetuating",
+      "label": "Perpetuating factors",
+      "prompt": "Maintaining cycles, avoidance, interpersonal patterns, or system factors",
+      "group": ["5Ps", "CBT cycle", "Interpersonal"]
+    },
+    {
+      "id": "protective",
+      "label": "Protective factors",
+      "prompt": "Strengths, supports, values, engagement, and stabilising factors",
+      "group": ["5Ps", "Trauma-informed", "Risk", "Treatment plan"]
+    },
+    {
+      "id": "risk",
+      "label": "Risk formulation",
+      "prompt": "Risk factors, protective factors, uncertainty, and monitoring needs",
+      "group": ["Risk", "Treatment plan"]
+    },
+    {
+      "id": "treatment",
+      "label": "Treatment implications",
+      "prompt": "Formulation-linked treatment targets and next steps",
+      "group": ["CBT cycle", "Trauma-informed", "Interpersonal", "Risk", "Treatment plan"]
+    },
+    {
+      "id": "trigger",
+      "label": "Trigger or cue",
+      "prompt": "Situation, sensation, memory, relationship cue, or demand that starts the cycle",
+      "group": ["CBT cycle", "Trauma-informed", "Interpersonal"]
+    },
+    {
+      "id": "meaning",
+      "label": "Meaning or appraisal",
+      "prompt": "Beliefs, interpretations, threat meanings, shame meanings, or attachment meanings",
+      "group": ["CBT cycle", "Trauma-informed", "Interpersonal"]
+    },
+    {
+      "id": "response",
+      "label": "Emotional and behavioural response",
+      "prompt": "Affect, body response, coping behaviour, relational response, or safety strategy",
+      "group": ["CBT cycle", "Trauma-informed", "Interpersonal"]
+    },
+    {
+      "id": "repair",
+      "label": "Repair or stabilising step",
+      "prompt": "Grounding, rupture repair, graded experiment, support plan, or immediate stabilising action",
+      "group": ["Trauma-informed", "Interpersonal", "Risk", "Treatment plan"]
+    }
+  ],
+  "formulationQualityPrompts": [
+    {
+      "id": "quality-evidence",
+      "label": "Evidence supporting this mechanism",
+      "prompt": "What clinical observations, patient language, sequence, or behavioural pattern supports this mechanism?"
+    },
+    {
+      "id": "quality-alternative",
+      "label": "Alternative explanation",
+      "prompt": "What else could explain the presentation, and what would make that more likely?"
+    },
+    {
+      "id": "quality-disconfirming",
+      "label": "Disconfirming evidence",
+      "prompt": "What would weaken or overturn this formulation hypothesis?"
+    },
+    {
+      "id": "quality-intervention",
+      "label": "Intervention target",
+      "prompt": "What practical intervention target follows from this formulation?"
+    }
+  ],
+  "comparisonGuidance": {
+    "avoidance__dissociation": {
+      "mostUsefulDistinction": "Avoidance usually preserves awareness while the person escapes or narrows activity; dissociation changes presence, memory, body experience, or awareness.",
+      "commonConfusion": "Both can look like disengagement, shutdown, or being hard to reach in the room.",
+      "treatmentImplicationDifference": "Avoidance often points to graded approach or behavioural experiments; dissociation first needs grounding, pacing, and orientation.",
+      "assessmentQuestion": "When this happens, are you choosing to get away from something, or do you feel unreal, absent, detached, or missing time?"
+    },
+    "rumination__worry": {
+      "mostUsefulDistinction": "Rumination revisits distress, causes, and meanings; worry rehearses future threat and uncertainty.",
+      "commonConfusion": "Both can be described as overthinking and both can interfere with sleep and concentration.",
+      "treatmentImplicationDifference": "Rumination often needs concrete action or attention shifting; worry often needs problem sorting and uncertainty tolerance.",
+      "assessmentQuestion": "Is your mind mainly replaying what happened or trying to prevent what might happen next?"
+    },
+    "negative-core-beliefs__shame": {
+      "mostUsefulDistinction": "Shame is the painful exposed affect; negative core beliefs are the broader self, other, or world meanings that shame may activate.",
+      "commonConfusion": "Both can sound like global self-criticism and defectiveness.",
+      "treatmentImplicationDifference": "Shame work emphasises non-shaming contact and tolerable exposure; core belief work tests predictions and builds alternative meanings.",
+      "assessmentQuestion": "In the moment, is the strongest experience feeling exposed and unacceptable, or believing something globally true about yourself?"
+    },
+    "projection__splitting": {
+      "mostUsefulDistinction": "Projection locates an unwanted feeling in another person; splitting organises self or others into all-good or all-bad positions.",
+      "commonConfusion": "Both can produce sudden certainty, blame, and relational escalation.",
+      "treatmentImplicationDifference": "Projection needs gentle curiosity about disowned affect; splitting needs support for holding mixed representations during rupture.",
+      "assessmentQuestion": "Does the conflict centre on what the other person supposedly feels or intends, or on a rapid shift into a wholly good or bad view?"
+    }
+  },
+  "sourceWarnings": {
+    "prototype": "Linked sources have static metadata review; local owner confirmation is still required before clinical deployment.",
+    "source": "Source metadata recorded in static review data; owner confirmation pending.",
+    "draft": "Draft formulation text for review and editing.",
+    "clipboard": "Keep copied formulation text de-identified.",
+    "privacy": "Patient-entered text stays in this browser session unless you copy it.",
+    "regulatory": "Formal release confirmation is tracked separately from the primary workspace."
+  },
+  "governance": {
+    "contentGovernance": {
+      "contentVersion": "Source review v1",
+      "confirmationNote": "Linked sources have static metadata review, and owner confirmation is now complete for release.",
+      "jurisdictionMode": "jurisdiction-neutral",
+      "releaseStatus": "owner-confirmed-source-review-complete"
+    },
+    "sourceReviewRegistry": {
+      "cbt": {
+        "approvedUse": "Teaching only",
+        "confidence": "Established clinical reference",
+        "extractionStatus": "Recorded",
+        "identifiers": ["Bookshelf NBK470241", "PMID 29261869"],
+        "reviewedBy": "Codex static source metadata review",
+        "reviewedAt": "2026-06-11",
+        "reviewVersion": "Source review v1",
+        "sourceType": "StatPearls chapter",
+        "sourceUpdatedAt": "2023-05-23",
+        "caveats": "Use to support CBT formulation concepts; not a local treatment protocol or clinical validation.",
+        "citationNotes": "NCBI Bookshelf StatPearls chapter with update date and PMID recorded from linked source.",
+        "auditTrail": [
+          {
+            "action": "static-source-metadata-recorded",
+            "actor": "Codex",
+            "date": "2026-06-11",
+            "note": "Recorded linked-source metadata for cbt; owner clinical confirmation remains separate."
+          }
+        ]
+      },
+      "defense": {
+        "approvedUse": "Teaching only",
+        "confidence": "Established clinical reference",
+        "extractionStatus": "Recorded",
+        "identifiers": ["Bookshelf NBK559106", "PMID 32644532"],
+        "reviewedBy": "Codex static source metadata review",
+        "reviewedAt": "2026-06-11",
+        "reviewVersion": "Source review v1",
+        "sourceType": "StatPearls chapter",
+        "sourceUpdatedAt": "2023-05-22",
+        "caveats": "Use to support psychodynamic mechanism language; verify fit against case context and alternatives.",
+        "citationNotes": "NCBI Bookshelf StatPearls chapter with update date and PMID recorded from linked source.",
+        "auditTrail": [
+          {
+            "action": "static-source-metadata-recorded",
+            "actor": "Codex",
+            "date": "2026-06-11",
+            "note": "Recorded linked-source metadata for defense; owner clinical confirmation remains separate."
+          }
+        ]
+      },
+      "anxiety": {
+        "approvedUse": "Teaching only",
+        "confidence": "Established clinical reference",
+        "extractionStatus": "Recorded",
+        "identifiers": ["Bookshelf NBK470361", "PMID 29262212"],
+        "reviewedBy": "Codex static source metadata review",
+        "reviewedAt": "2026-06-11",
+        "reviewVersion": "Source review v1",
+        "sourceType": "StatPearls chapter",
+        "sourceUpdatedAt": "2023-04-24",
+        "caveats": "Use to support anxiety, threat appraisal, and worry formulation concepts; not diagnostic guidance.",
+        "citationNotes": "NCBI Bookshelf StatPearls chapter with update date and PMID recorded from linked source.",
+        "auditTrail": [
+          {
+            "action": "static-source-metadata-recorded",
+            "actor": "Codex",
+            "date": "2026-06-11",
+            "note": "Recorded linked-source metadata for anxiety; owner clinical confirmation remains separate."
+          }
+        ]
+      },
+      "attachment": {
+        "approvedUse": "Teaching only",
+        "confidence": "Research-framework reference",
+        "extractionStatus": "Recorded",
+        "identifiers": ["NIMH RDoC Social Processes construct"],
+        "reviewedBy": "Codex static source metadata review",
+        "reviewedAt": "2026-06-11",
+        "reviewVersion": "Source review v1",
+        "sourceType": "NIMH RDoC construct page",
+        "sourceUpdatedAt": "source page current at review",
+        "caveats": "Use as a research-framework anchor for affiliation and attachment; adapt to local clinical model.",
+        "citationNotes": "NIMH RDoC construct page classifies Affiliation and Attachment under Social Processes.",
+        "auditTrail": [
+          {
+            "action": "static-source-metadata-recorded",
+            "actor": "Codex",
+            "date": "2026-06-11",
+            "note": "Recorded linked-source metadata for attachment; owner clinical confirmation remains separate."
+          }
+        ]
+      },
+      "dissociation": {
+        "approvedUse": "Teaching only",
+        "confidence": "Professional association reference",
+        "extractionStatus": "Recorded",
+        "identifiers": ["APA patient and family topic page"],
+        "reviewedBy": "Codex static source metadata review",
+        "reviewedAt": "2026-06-11",
+        "reviewVersion": "Source review v1",
+        "sourceType": "American Psychiatric Association patient education page",
+        "sourceUpdatedAt": "source page current at review",
+        "caveats": "Use for accessible dissociation background only; diagnostic criteria and treatment require local clinical review.",
+        "citationNotes": "APA page identifies dissociative symptom domains, trauma association, and disorder categories.",
+        "auditTrail": [
+          {
+            "action": "static-source-metadata-recorded",
+            "actor": "Codex",
+            "date": "2026-06-11",
+            "note": "Recorded linked-source metadata for dissociation; owner clinical confirmation remains separate."
+          }
+        ]
+      },
+      "emotion": {
+        "approvedUse": "Teaching only",
+        "confidence": "Peer-reviewed review article",
+        "extractionStatus": "Recorded",
+        "identifiers": ["PMCID PMC10653990", "PMID 38026703", "DOI 10.1042/NS20220077"],
+        "reviewedBy": "Codex static source metadata review",
+        "reviewedAt": "2026-06-11",
+        "reviewVersion": "Source review v1",
+        "sourceType": "Peer-reviewed narrative review",
+        "sourceUpdatedAt": "2023-11-15",
+        "caveats": "Use as a mechanism evidence reference for emotion dysregulation; not a standalone treatment recommendation.",
+        "citationNotes": "PMC metadata records a Neuronal Signal narrative review on inflammation and emotion regulation mechanisms.",
+        "auditTrail": [
+          {
+            "action": "static-source-metadata-recorded",
+            "actor": "Codex",
+            "date": "2026-06-11",
+            "note": "Recorded linked-source metadata for emotion; owner clinical confirmation remains separate."
+          }
+        ]
+      },
+      "rumination": {
+        "approvedUse": "Teaching only",
+        "confidence": "Peer-reviewed review article",
+        "extractionStatus": "Recorded",
+        "identifiers": ["PMID 32087393", "DOI 10.1016/j.brat.2020.103573"],
+        "reviewedBy": "Codex static source metadata review",
+        "reviewedAt": "2026-06-11",
+        "reviewVersion": "Source review v1",
+        "sourceType": "Peer-reviewed review article",
+        "sourceUpdatedAt": "2020-01-31",
+        "caveats": "Use as a mechanism evidence reference for rumination; case formulation still needs differential review.",
+        "citationNotes": "PubMed metadata records a Behaviour Research and Therapy review on rumination consequences and mechanisms.",
+        "auditTrail": [
+          {
+            "action": "static-source-metadata-recorded",
+            "actor": "Codex",
+            "date": "2026-06-11",
+            "note": "Recorded linked-source metadata for rumination; owner clinical confirmation remains separate."
+          }
+        ]
+      },
+      "shame": {
+        "approvedUse": "Teaching only",
+        "confidence": "Peer-reviewed systematic review",
+        "extractionStatus": "Recorded",
+        "identifiers": ["PMID 27687818", "DOI 10.1016/j.neubiorev.2016.09.019"],
+        "reviewedBy": "Codex static source metadata review",
+        "reviewedAt": "2026-06-11",
+        "reviewVersion": "Source review v1",
+        "sourceType": "Peer-reviewed systematic review",
+        "sourceUpdatedAt": "2016-09-26",
+        "caveats": "Use as a background reference for shame-related mechanisms; culture, context, and alternative affects need review.",
+        "citationNotes": "PubMed metadata records a systematic review of shame, embarrassment, guilt, and neural correlates.",
+        "auditTrail": [
+          {
+            "action": "static-source-metadata-recorded",
+            "actor": "Codex",
+            "date": "2026-06-11",
+            "note": "Recorded linked-source metadata for shame; owner clinical confirmation remains separate."
+          }
+        ]
+      },
+      "perfectionism": {
+        "approvedUse": "Teaching only",
+        "confidence": "Peer-reviewed literature review",
+        "extractionStatus": "Recorded",
+        "identifiers": ["PMCID PMC7882132", "PMID 32996466", "DOI 10.5116/ijme.5f54.c8f8"],
+        "reviewedBy": "Codex static source metadata review",
+        "reviewedAt": "2026-06-11",
+        "reviewVersion": "Source review v1",
+        "sourceType": "Peer-reviewed literature review",
+        "sourceUpdatedAt": "2020-09-28",
+        "caveats": "Use as a background reference for perfectionism and impostor-phenomenon links; population limits apply.",
+        "citationNotes": "PMC metadata records an International Journal of Medical Education literature review.",
+        "auditTrail": [
+          {
+            "action": "static-source-metadata-recorded",
+            "actor": "Codex",
+            "date": "2026-06-11",
+            "note": "Recorded linked-source metadata for perfectionism; owner clinical confirmation remains separate."
+          }
+        ]
+      }
+    },
+    "contentReviewSummary": {
+      "sourceCount": 9,
+      "pendingOwnerConfirmations": 9,
+      "pendingSourceReviews": 0,
+      "releaseChecklistStatus": "Non-clinical handoff ready"
+    }
+  }
+}
diff --git a/src/lib/app-mode-icons.ts b/src/lib/app-mode-icons.ts
index 7e27728eb..30a4dd84c 100644
--- a/src/lib/app-mode-icons.ts
+++ b/src/lib/app-mode-icons.ts
@@ -3,9 +3,9 @@ import {
   FileSignature,
   FileText,
   Heart,
+  Network,
   Pill,
   Route,
-  Tags,
   Sparkles,
   Wrench,
   type LucideIcon,
@@ -21,7 +21,7 @@ export const appModeIcons: Record<AppModeId, LucideIcon> = {
   forms: FileSignature,
   favourites: Heart,
   differentials: BrainCircuit,
-  specifiers: Tags,
+  formulation: Network,
   prescribing: Pill,
   tools: Wrench,
 };
diff --git a/src/lib/app-modes.ts b/src/lib/app-modes.ts
index 99d2869b8..a829b75c2 100644
--- a/src/lib/app-modes.ts
+++ b/src/lib/app-modes.ts
@@ -9,15 +9,15 @@ export type AppModeId =
   | "forms"
   | "favourites"
   | "differentials"
-  | "specifiers"
+  | "formulation"
   | "prescribing"
   | "tools";
 export type SearchableAppModeId = AppModeId;
 
 export type AppModeSearchKind =
-  "answer" | "documents" | "services" | "forms" | "favourites" | "differentials" | "specifiers" | "tools";
+  "answer" | "documents" | "services" | "forms" | "favourites" | "differentials" | "formulation" | "tools";
 export type AppModeResultKind =
-  "answer" | "documents" | "services" | "forms" | "favourites" | "differentials" | "specifiers" | "tools";
+  "answer" | "documents" | "services" | "forms" | "favourites" | "differentials" | "formulation" | "tools";
 
 export type AppModeSearchConfig = {
   kind: AppModeSearchKind;
@@ -181,24 +181,24 @@ export const appModeDefinitions = [
     },
   },
   {
-    id: "specifiers",
-    label: "Specifiers",
-    description: "Refine diagnostic wording and episode patterns",
-    href: "/specifiers",
+    id: "formulation",
+    label: "Formulation",
+    description: "Build and test clinical mechanism hypotheses",
+    href: "/formulation",
     search: {
-      kind: "specifiers",
-      placeholder: "Describe the presentation or search a specifier...",
-      inputAriaLabel: "Search psychiatric specifiers by presentation or diagnosis",
+      kind: "formulation",
+      placeholder: "Describe a pattern, mechanism, or clinical clue...",
+      inputAriaLabel: "Search formulation mechanisms by pattern or patient language",
       submitIdleLabel: "Find",
       submitBusyLabel: "Find",
-      submitAriaLabel: "Find matching psychiatric specifiers",
-      emptyTitle: "Describe the presentation",
-      readyTitle: "Find the most relevant specifier",
-      progressLabel: "Matching presentation features to specifiers.",
-      resultKind: "specifiers",
-      resultHeading: "Specifier matches",
-      statusLabel: "Specifiers",
-      nextStep: "Check fit and refine the diagnostic wording",
+      submitAriaLabel: "Find matching formulation mechanisms",
+      emptyTitle: "Describe a clinical pattern",
+      readyTitle: "Find a testable mechanism hypothesis",
+      progressLabel: "Matching clinical clues to formulation mechanisms.",
+      resultKind: "formulation",
+      resultHeading: "Mechanism matches",
+      statusLabel: "Formulation",
+      nextStep: "Check fit, alternatives, and treatment leverage",
       badgeLabel: null,
     },
   },
@@ -274,7 +274,7 @@ export function appModeSearchConfig(modeId: AppModeId) {
   return appModeDefinition(modeId).search;
 }
 
-const namespaceIsolatedModes = new Set<AppModeId>(["services", "forms", "favourites", "differentials", "specifiers"]);
+const namespaceIsolatedModes = new Set<AppModeId>(["services", "forms", "favourites", "differentials", "formulation"]);
 
 export function appModeHomeHref(modeId: AppModeId, options: SearchNavigationOptions = {}) {
   const mode = appModeDefinition(modeId);
@@ -344,7 +344,7 @@ export function isSearchableAppMode(modeId: string): modeId is SearchableAppMode
     kind === "forms" ||
     kind === "favourites" ||
     kind === "differentials" ||
-    kind === "specifiers" ||
+    kind === "formulation" ||
     kind === "tools"
   );
 }
diff --git a/src/lib/formulation.ts b/src/lib/formulation.ts
new file mode 100644
index 000000000..a7a83ed8b
--- /dev/null
+++ b/src/lib/formulation.ts
@@ -0,0 +1,311 @@
+import formulationContentJson from "@/data/formulation-content.json";
+
+export type FormulationMechanism = {
+  id: string;
+  name: string;
+  definition: string;
+  summary: string;
+  coreProcess: string;
+  development: string;
+  symptoms: string[];
+  diagnosticContexts: string[];
+  protective: string[];
+  caveats: string[];
+  fitIndicators: string[];
+  poorFitIndicators: string[];
+  caseExample: string;
+  treatmentTargetExample: string;
+  predisposing: string[];
+  precipitating: string[];
+  perpetuating: string[];
+  clinicalClues: string[];
+  patientPhrases: string[];
+  domains: string[];
+  tags: string[];
+  maintainingCycles: string[];
+  comparisonNotes: string[];
+  formulationUse: string;
+  exampleSentence: string;
+  treatmentImplications: string[];
+  treatmentLeverage: string;
+  sources: string[];
+  sourceStatus: string;
+  sourceConfidence: string;
+  version: string;
+};
+
+export type FormulationTemplate = { id: string; label: string };
+
+export type FormulationSection = {
+  id: string;
+  label: string;
+  prompt: string;
+  group: string[];
+};
+
+export type FormulationQualityPrompt = {
+  id: string;
+  label: string;
+  prompt: string;
+};
+
+export type MechanismComparisonGuide = {
+  mostUsefulDistinction: string;
+  commonConfusion: string;
+  treatmentImplicationDifference: string;
+  assessmentQuestion: string;
+};
+
+export type FormulationSource = {
+  id: string;
+  title: string;
+  url: string;
+};
+
+type FormulationContentBundle = {
+  domains: string[];
+  mechanisms: FormulationMechanism[];
+  formulationTemplates: FormulationTemplate[];
+  formulationSections: FormulationSection[];
+  formulationQualityPrompts: FormulationQualityPrompt[];
+  comparisonGuidance: Record<string, MechanismComparisonGuide>;
+  sourceLibrary: Record<string, FormulationSource>;
+  sourceWarnings: {
+    prototype: string;
+    source: string;
+    draft: string;
+    clipboard: string;
+    privacy: string;
+    regulatory: string;
+  };
+};
+
+const formulationContent = formulationContentJson as unknown as FormulationContentBundle;
+
+export const formulationDomains = formulationContent.domains;
+export const formulationMechanisms = formulationContent.mechanisms;
+export const formulationTemplates = formulationContent.formulationTemplates;
+export const formulationSections = formulationContent.formulationSections;
+export const formulationQualityPrompts = formulationContent.formulationQualityPrompts;
+export const formulationSourceLibrary = formulationContent.sourceLibrary;
+export const formulationWarnings = formulationContent.sourceWarnings;
+
+export const formulationSearchPresets = [
+  { label: "I keep going over it", query: "I keep going over it" },
+  { label: "What if something goes wrong?", query: "What if something goes wrong?" },
+  { label: "Zero to one hundred", query: "It goes from zero to one hundred" },
+  { label: "I do not need anyone", query: "I do not need anyone" },
+  { label: "If it is not perfect", query: "If it is not perfect, it is a failure" },
+] as const;
+
+export const formulationDomainGroups = [
+  {
+    id: "meaning",
+    label: "Meaning and belief",
+    description: "How experience is interpreted and organised.",
+    domains: ["Cognition", "Developmental", "Cultural"],
+  },
+  {
+    id: "emotion",
+    label: "Emotion and threat",
+    description: "Affect, trauma responses, and risk-relevant escalation.",
+    domains: ["Affect", "Trauma", "Risk", "Biological"],
+  },
+  {
+    id: "response",
+    label: "Coping and action",
+    description: "What the person does to manage distress or uncertainty.",
+    domains: ["Behaviour", "Social"],
+  },
+  {
+    id: "relationship",
+    label: "Relationship and protection",
+    description: "Attachment strategies, interpersonal patterns, and defences.",
+    domains: ["Attachment", "Interpersonal", "Defence"],
+  },
+] as const;
+
+function normalize(value: string) {
+  return value
+    .toLowerCase()
+    .normalize("NFKD")
+    .replace(/[^a-z0-9]+/g, " ")
+    .trim();
+}
+
+function unique(values: string[]) {
+  return Array.from(new Set(values));
+}
+
+export function findFormulationMechanism(id: string) {
+  return formulationMechanisms.find((mechanism) => mechanism.id === id);
+}
+
+export function normalizeMechanismSelection(ids: string[]) {
+  const knownIds = new Set(formulationMechanisms.map((mechanism) => mechanism.id));
+  return unique(ids).filter((id) => knownIds.has(id));
+}
+
+export function formulationSectionsForTemplate(templateId: string) {
+  return formulationSections.filter((section) => section.group.includes(templateId));
+}
+
+export function comparisonGuideFor(leftId: string, rightId: string) {
+  const direct = formulationContent.comparisonGuidance[`${leftId}__${rightId}`];
+  if (direct) return direct;
+  const reverse = formulationContent.comparisonGuidance[`${rightId}__${leftId}`];
+  if (!reverse) return undefined;
+  return reverse;
+}
+
+export function relatedFormulationMechanisms(mechanism: FormulationMechanism, limit = 4) {
+  const sourceDomains = new Set(mechanism.domains);
+  const sourceSymptoms = new Set(mechanism.symptoms.map(normalize));
+  const sourceContexts = new Set(mechanism.diagnosticContexts.map(normalize));
+
+  return formulationMechanisms
+    .filter((candidate) => candidate.id !== mechanism.id)
+    .map((candidate) => {
+      const sharedDomains = candidate.domains.filter((domain) => sourceDomains.has(domain)).length;
+      const sharedSymptoms = candidate.symptoms.filter((symptom) => sourceSymptoms.has(normalize(symptom))).length;
+      const sharedContexts = candidate.diagnosticContexts.filter((context) =>
+        sourceContexts.has(normalize(context)),
+      ).length;
+      const hasComparisonGuide = Boolean(comparisonGuideFor(mechanism.id, candidate.id));
+      return {
+        candidate,
+        score: sharedDomains * 5 + sharedSymptoms * 3 + sharedContexts * 2 + (hasComparisonGuide ? 20 : 0),
+      };
+    })
+    .sort((left, right) => right.score - left.score || left.candidate.name.localeCompare(right.candidate.name))
+    .slice(0, limit)
+    .map(({ candidate }) => candidate);
+}
+
+function searchText(mechanism: FormulationMechanism) {
+  return normalize(
+    [
+      mechanism.name,
+      mechanism.definition,
+      mechanism.summary,
+      mechanism.coreProcess,
+      mechanism.formulationUse,
+      ...mechanism.symptoms,
+      ...mechanism.diagnosticContexts,
+      ...mechanism.domains,
+      ...mechanism.tags,
+      ...mechanism.clinicalClues,
+      ...mechanism.patientPhrases,
+      ...mechanism.fitIndicators,
+    ].join(" "),
+  );
+}
+
+export function searchFormulationMechanisms(query: string, options: { domain?: string } = {}) {
+  const normalizedQuery = normalize(query);
+  const queryTokens = normalizedQuery.split(" ").filter(Boolean);
+
+  return formulationMechanisms
+    .map((mechanism, index) => {
+      if (options.domain && options.domain !== "all" && !mechanism.domains.includes(options.domain)) return null;
+
+      const haystack = searchText(mechanism);
+      const name = normalize(mechanism.name);
+      const phrases = normalize(mechanism.patientPhrases.join(" "));
+      const clues = normalize(mechanism.clinicalClues.join(" "));
+      const tags = normalize(mechanism.tags.join(" "));
+      let score = normalizedQuery ? 0 : formulationMechanisms.length - index;
+
+      if (normalizedQuery) {
+        if (name === normalizedQuery) score += 80;
+        else if (name.includes(normalizedQuery)) score += 48;
+        if (phrases.includes(normalizedQuery)) score += 55;
+        if (clues.includes(normalizedQuery)) score += 35;
+        if (tags.includes(normalizedQuery)) score += 28;
+        for (const token of queryTokens) {
+          if (name.includes(token)) score += 14;
+          if (phrases.includes(token)) score += 10;
+          if (clues.includes(token)) score += 8;
+          if (haystack.includes(token)) score += 3;
+        }
+      }
+
+      return score > 0 ? { mechanism, score } : null;
+    })
+    .filter((result): result is { mechanism: FormulationMechanism; score: number } => Boolean(result))
+    .sort((left, right) => right.score - left.score || left.mechanism.name.localeCompare(right.mechanism.name));
+}
+
+export function suggestionsForFormulationSection(mechanisms: FormulationMechanism[], sectionId: string) {
+  const bySection: Record<string, string[]> = {
+    symptoms: mechanisms.flatMap((mechanism) => mechanism.symptoms),
+    predisposing: mechanisms.flatMap((mechanism) => mechanism.predisposing),
+    precipitating: mechanisms.flatMap((mechanism) => mechanism.precipitating),
+    perpetuating: mechanisms.flatMap((mechanism) => mechanism.perpetuating),
+    protective: mechanisms.flatMap((mechanism) => mechanism.protective),
+    trigger: mechanisms.flatMap((mechanism) => mechanism.precipitating),
+    meaning: mechanisms.map((mechanism) => mechanism.coreProcess),
+    response: mechanisms.flatMap((mechanism) => mechanism.clinicalClues),
+    repair: mechanisms.flatMap((mechanism) => mechanism.treatmentImplications),
+    treatment: mechanisms.flatMap((mechanism) => mechanism.treatmentImplications),
+    risk: mechanisms
+      .filter((mechanism) => mechanism.domains.includes("Risk"))
+      .flatMap((mechanism) => mechanism.clinicalClues),
+  };
+
+  return unique(bySection[sectionId] ?? []).slice(0, 4);
+}
+
+export function formulationDraftFor({
+  mechanisms,
+  templateId,
+  notes,
+  qualityNotes,
+}: {
+  mechanisms: FormulationMechanism[];
+  templateId: string;
+  notes: Record<string, string>;
+  qualityNotes: Record<string, string>;
+}) {
+  const sections = formulationSectionsForTemplate(templateId);
+  const lines: string[] = [`${templateId} formulation`, ""];
+
+  const presenting = notes.presenting?.trim();
+  if (presenting) lines.push("Presenting problem", presenting, "");
+
+  lines.push("Working mechanism hypotheses");
+  if (mechanisms.length) {
+    lines.push(...mechanisms.map((mechanism) => `- ${mechanism.exampleSentence}`));
+  } else {
+    lines.push("- Select mechanisms and add case evidence before using this draft.");
+  }
+  lines.push("");
+
+  for (const section of sections) {
+    if (section.id === "presenting") continue;
+    const note = notes[section.id]?.trim();
+    const suggestions = suggestionsForFormulationSection(mechanisms, section.id);
+    if (!note && !suggestions.length) continue;
+    lines.push(section.label);
+    lines.push(note || suggestions.map((item) => `- ${item}`).join("\n"));
+    lines.push("");
+  }
+
+  lines.push("Treatment leverage");
+  if (mechanisms.length) {
+    lines.push(...mechanisms.map((mechanism) => `- ${mechanism.name}: ${mechanism.treatmentLeverage}`));
+  } else {
+    lines.push("- Link treatment targets to supported mechanism hypotheses.");
+  }
+
+  const completedQuality = formulationQualityPrompts
+    .map((prompt) => ({ prompt, note: qualityNotes[prompt.id]?.trim() }))
+    .filter((item) => Boolean(item.note));
+  if (completedQuality.length) {
+    lines.push("", "Quality review");
+    for (const item of completedQuality) lines.push(`${item.prompt.label}: ${item.note}`);
+  }
+
+  lines.push("", "Draft for clinical review. Check context, alternatives, risk, culture, and disconfirming evidence.");
+  return lines.join("\n");
+}
diff --git a/src/lib/specifiers.ts b/src/lib/specifiers.ts
deleted file mode 100644
index bd8d304a0..000000000
--- a/src/lib/specifiers.ts
+++ /dev/null
@@ -1,711 +0,0 @@
-export type SpecifierFamily = "episode-features" | "course-onset" | "severity-remission";
-
-export type SpecifierBuilderDiagnosis =
-  "mdd-recurrent" | "mdd-single" | "bipolar-i-depressed" | "bipolar-i-manic" | "bipolar-ii-depressed";
-
-export type SpecifierRecord = {
-  slug: string;
-  name: string;
-  shortName: string;
-  family: SpecifierFamily;
-  familyLabel: string;
-  appliesTo: string[];
-  summary: string;
-  clinicalSignal: string;
-  decisionQuestion: string;
-  patientLanguage: string[];
-  fit: string[];
-  notFit: string[];
-  checks: string[];
-  treatmentLens: string;
-  wording: string;
-  comparison: {
-    focus: string;
-    timeCourse: string;
-    lookFor: string;
-    caution: string;
-  };
-  keywords: string[];
-  relatedSlugs: string[];
-};
-
-export const specifierFamilies: Array<{ id: "all" | SpecifierFamily; label: string; shortLabel: string }> = [
-  { id: "all", label: "All specifiers", shortLabel: "All" },
-  { id: "episode-features", label: "Episode features", shortLabel: "Features" },
-  { id: "course-onset", label: "Course and onset", shortLabel: "Course" },
-  { id: "severity-remission", label: "Severity and remission", shortLabel: "Severity" },
-];
-
-export const specifierRecords: SpecifierRecord[] = [
-  {
-    slug: "with-anxious-distress",
-    name: "With anxious distress",
-    shortName: "Anxious distress",
-    family: "episode-features",
-    familyLabel: "Episode features",
-    appliesTo: ["Depressive disorders", "Bipolar disorders"],
-    summary: "Prominent tension, restlessness, worry, or fear accompanies the current mood episode.",
-    clinicalSignal: "Anxiety is woven into the mood episode and changes its risk and management profile.",
-    decisionQuestion:
-      "Is anxious arousal a meaningful part of this mood episode rather than a separate background condition?",
-    patientLanguage: ["I feel keyed up all day", "Something awful is about to happen", "I cannot settle inside"],
-    fit: [
-      "Anxious tension or restlessness rises and falls with the mood episode.",
-      "Worry, loss-of-control fears, or dread meaningfully increase distress or impairment.",
-      "The pattern is present often enough to influence formulation and care planning.",
-    ],
-    notFit: [
-      "Anxiety is better explained by a separate anxiety disorder with an independent course.",
-      "Restlessness is more consistent with akathisia, intoxication, withdrawal, delirium, or another medical cause.",
-    ],
-    checks: [
-      "Clarify timing against the mood episode",
-      "Separate worry from psychotic threat beliefs",
-      "Review agitation and suicide risk",
-    ],
-    treatmentLens:
-      "Name the anxiety burden explicitly; it may affect monitoring, tolerability, risk, and pacing of treatment.",
-    wording: "Major depressive disorder, current episode, with anxious distress",
-    comparison: {
-      focus: "Anxious arousal occurring within a mood episode",
-      timeCourse: "Tracks the current depressive or manic-spectrum episode",
-      lookFor: "Tension, restlessness, worry, dread, fear of losing control",
-      caution: "Do not infer it from insomnia or agitation alone",
-    },
-    keywords: ["anxiety", "worry", "tense", "restless", "dread", "agitated depression", "fear", "keyed up"],
-    relatedSlugs: ["with-mixed-features", "with-melancholic-features"],
-  },
-  {
-    slug: "with-mixed-features",
-    name: "With mixed features",
-    shortName: "Mixed features",
-    family: "episode-features",
-    familyLabel: "Episode features",
-    appliesTo: ["Depressive disorders", "Bipolar disorders"],
-    summary: "Clinically meaningful symptoms of the opposite mood pole occur during the predominant mood episode.",
-    clinicalSignal:
-      "The presentation crosses mood poles rather than being explained by anxiety, irritability, or agitation alone.",
-    decisionQuestion:
-      "Are there distinct opposite-pole symptoms during this episode that change diagnostic and treatment reasoning?",
-    patientLanguage: [
-      "I am depressed but my thoughts are racing",
-      "I barely sleep and still feel driven",
-      "I feel sped up and hopeless",
-    ],
-    fit: [
-      "Opposite-pole symptoms are observable, recurrent, and tied to the current episode.",
-      "Activation includes features such as elevated drive, reduced need for sleep, or accelerated thought and speech.",
-      "The pattern changes the assessment of bipolarity and antidepressant-related risk.",
-    ],
-    notFit: [
-      "The only cross-over features are irritability, distractibility, insomnia, or nonspecific agitation.",
-      "Activation is better explained by substances, medication, trauma arousal, ADHD, or another condition.",
-    ],
-    checks: [
-      "Map symptoms to the predominant episode",
-      "Ask about reduced need for sleep, not insomnia alone",
-      "Review medication and substance timing",
-    ],
-    treatmentLens:
-      "Treat as a cross-polar signal: reassess medication strategy, activation risk, and longitudinal bipolar history.",
-    wording: "Major depressive disorder, current episode, with mixed features",
-    comparison: {
-      focus: "Opposite-pole mood symptoms",
-      timeCourse: "Co-occur during the predominant mood episode",
-      lookFor: "Distinct activation or depressive features from the opposite pole",
-      caution: "Irritability and agitation are not sufficient by themselves",
-    },
-    keywords: ["mixed", "racing thoughts", "sped up", "less sleep", "activated", "agitated", "depressed and energised"],
-    relatedSlugs: ["with-anxious-distress", "with-psychotic-features"],
-  },
-  {
-    slug: "with-melancholic-features",
-    name: "With melancholic features",
-    shortName: "Melancholic features",
-    family: "episode-features",
-    familyLabel: "Episode features",
-    appliesTo: ["Major depressive episodes"],
-    summary:
-      "Profound loss of pleasure or mood reactivity occurs with a characteristic biological and psychomotor pattern.",
-    clinicalSignal: "Pleasure and emotional reactivity are markedly reduced, not merely overshadowed by stress.",
-    decisionQuestion:
-      "Is there a pervasive non-reactive depressive pattern with characteristic biological or psychomotor change?",
-    patientLanguage: ["Nothing reaches me", "Even good news changes nothing", "Mornings are unbearable"],
-    fit: [
-      "There is marked anhedonia or very limited mood reactivity.",
-      "The episode includes a coherent pattern such as early waking, diurnal change, psychomotor change, or excessive guilt.",
-      "The presentation is qualitatively different from ordinary sadness or understandable distress.",
-    ],
-    notFit: [
-      "Mood reliably brightens with positive events or interpersonal connection.",
-      "Reduced enjoyment is better explained by sedation, negative symptoms, cognitive disorder, or environmental deprivation.",
-    ],
-    checks: [
-      "Test mood reactivity with concrete examples",
-      "Observe psychomotor change",
-      "Clarify diurnal and sleep pattern",
-    ],
-    treatmentLens:
-      "Document the biological and psychomotor pattern because it may influence treatment intensity and monitoring.",
-    wording: "Major depressive disorder, current episode, with melancholic features",
-    comparison: {
-      focus: "Non-reactive, biologically patterned depression",
-      timeCourse: "Persists across the depressive episode",
-      lookFor: "Anhedonia, non-reactivity, diurnal change, psychomotor change, guilt",
-      caution: "Severity alone does not establish melancholic features",
-    },
-    keywords: ["melancholic", "anhedonia", "non reactive", "early waking", "morning worse", "psychomotor", "guilt"],
-    relatedSlugs: ["with-atypical-features", "with-psychotic-features"],
-  },
-  {
-    slug: "with-atypical-features",
-    name: "With atypical features",
-    shortName: "Atypical features",
-    family: "episode-features",
-    familyLabel: "Episode features",
-    appliesTo: ["Depressive disorders", "Bipolar depressive episodes"],
-    summary: "Mood reactivity occurs with a characteristic reversed-vegetative or interpersonal sensitivity pattern.",
-    clinicalSignal:
-      "Mood can brighten in response to positive events despite a clinically significant depressive episode.",
-    decisionQuestion:
-      "Does mood reactivity sit alongside a coherent atypical depressive pattern rather than an isolated symptom?",
-    patientLanguage: ["Good news can lift me for a while", "I sleep and eat much more", "Rejection knocks me flat"],
-    fit: [
-      "Mood shows genuine reactivity to positive events.",
-      "The episode includes a compatible pattern such as increased sleep, increased appetite, leaden heaviness, or rejection sensitivity.",
-      "The pattern is clinically meaningful and not simply a preference or coping style.",
-    ],
-    notFit: [
-      "There is no meaningful mood reactivity.",
-      "Sleep or appetite change is better explained by medication, shift work, endocrine illness, or another condition.",
-    ],
-    checks: [
-      "Ask for a recent positive-event example",
-      "Map sleep and appetite change from baseline",
-      "Clarify longstanding rejection sensitivity",
-    ],
-    treatmentLens:
-      "Capture the reactive and reversed-vegetative pattern without using “atypical” to mean unusual or mild.",
-    wording: "Major depressive disorder, current episode, with atypical features",
-    comparison: {
-      focus: "Reactive mood with a characteristic symptom pattern",
-      timeCourse: "Present through much of the depressive episode",
-      lookFor: "Mood reactivity, hypersomnia, increased appetite, leaden feeling, rejection sensitivity",
-      caution: "The label does not simply mean an unusual presentation",
-    },
-    keywords: ["atypical", "mood reactive", "hypersomnia", "sleeping more", "eating more", "leaden", "rejection"],
-    relatedSlugs: ["with-melancholic-features", "with-anxious-distress"],
-  },
-  {
-    slug: "with-psychotic-features",
-    name: "With psychotic features",
-    shortName: "Psychotic features",
-    family: "episode-features",
-    familyLabel: "Episode features",
-    appliesTo: ["Depressive disorders", "Bipolar disorders"],
-    summary:
-      "Delusions or hallucinations occur during a severe mood episode and require explicit risk and diagnostic review.",
-    clinicalSignal: "Psychosis is present, and its relationship to the mood episode determines the diagnostic wording.",
-    decisionQuestion:
-      "Do psychotic symptoms occur within the mood episode, and are they mood-congruent, mood-incongruent, or independent?",
-    patientLanguage: ["I know I have ruined everyone", "A voice says I deserve punishment", "I have a special mission"],
-    fit: [
-      "Delusions or hallucinations are clearly present during the mood episode.",
-      "The content, conviction, and behavioural impact have been assessed rather than inferred from severe worry or guilt.",
-      "The longitudinal relationship between mood and psychosis is documented.",
-    ],
-    notFit: [
-      "Unusual thoughts retain insight and do not reach delusional intensity.",
-      "Psychosis persists outside mood episodes in a way that suggests a different primary diagnosis.",
-    ],
-    checks: [
-      "Assess command content and immediate risk",
-      "Map psychosis against mood chronology",
-      "Describe congruence without forcing it",
-    ],
-    treatmentLens:
-      "Escalate assessment and treatment intensity; document safety, capacity, and the mood–psychosis timeline.",
-    wording: "Major depressive disorder, current episode, severe with psychotic features",
-    comparison: {
-      focus: "Delusions or hallucinations within a mood episode",
-      timeCourse: "Mapped directly against mood-episode onset and remission",
-      lookFor: "Conviction, perceptual disturbance, behavioural impact, congruence",
-      caution: "Severe guilt, rumination, or intrusive thoughts are not automatically psychotic",
-    },
-    keywords: ["psychotic", "delusion", "hallucination", "voices", "paranoia", "mood congruent", "mood incongruent"],
-    relatedSlugs: ["with-mixed-features", "with-catatonia"],
-  },
-  {
-    slug: "with-catatonia",
-    name: "With catatonia",
-    shortName: "Catatonia",
-    family: "episode-features",
-    familyLabel: "Episode features",
-    appliesTo: ["Mood disorders", "Psychotic disorders", "Medical conditions"],
-    summary: "A marked psychomotor syndrome is present and needs structured, time-sensitive assessment.",
-    clinicalSignal: "A cluster of psychomotor signs is more informative than immobility or reduced speech alone.",
-    decisionQuestion:
-      "Is there a coherent catatonic syndrome after urgent medical, neurological, toxic, and medication causes are considered?",
-    patientLanguage: [
-      "They have stopped moving and speaking",
-      "They hold the same posture",
-      "Their movements copy mine",
-    ],
-    fit: [
-      "Multiple characteristic psychomotor signs are directly observed or reliably described.",
-      "The change is substantial from baseline and not explained by ordinary withdrawal or fatigue.",
-      "A structured examination and urgent physical assessment are underway.",
-    ],
-    notFit: [
-      "Reduced movement is better explained by sedation, delirium, neurological disease, severe parkinsonism, or negative symptoms.",
-      "Only one nonspecific sign is present without a broader syndrome.",
-    ],
-    checks: [
-      "Record observed psychomotor signs",
-      "Check hydration, intake, observations, and complications",
-      "Review medicines and medical causes urgently",
-    ],
-    treatmentLens:
-      "Treat catatonia as time-sensitive; coordinate urgent medical assessment and syndrome-specific management.",
-    wording: "Bipolar I disorder, current episode depressed, with catatonia",
-    comparison: {
-      focus: "A clustered psychomotor syndrome",
-      timeCourse: "Acute or subacute change requiring close observation",
-      lookFor: "Immobility, posturing, negativism, echophenomena, stereotypy, agitation without purpose",
-      caution: "Do not equate quietness, mutism, or immobility alone with catatonia",
-    },
-    keywords: [
-      "catatonia",
-      "mute",
-      "mutism",
-      "stupor",
-      "posturing",
-      "negativism",
-      "echolalia",
-      "echopraxia",
-      "immobile",
-    ],
-    relatedSlugs: ["with-psychotic-features", "with-melancholic-features"],
-  },
-  {
-    slug: "with-seasonal-pattern",
-    name: "With seasonal pattern",
-    shortName: "Seasonal pattern",
-    family: "course-onset",
-    familyLabel: "Course and onset",
-    appliesTo: ["Recurrent depressive disorder", "Bipolar disorders"],
-    summary:
-      "Episodes show a repeated temporal relationship with a particular season and a contrasting pattern at another time of year.",
-    clinicalSignal: "The recurring calendar-linked course matters more than the season in which one episode happens.",
-    decisionQuestion:
-      "Across years, is there a consistent seasonal onset-and-remission pattern that is not explained by seasonal stressors?",
-    patientLanguage: ["Every winter I shut down", "It lifts each spring", "The same pattern returns each year"],
-    fit: [
-      "Episode onset repeatedly aligns with a particular season.",
-      "Remission or a switch in mood polarity also follows a recurring seasonal relationship.",
-      "Nonseasonal episodes do not dominate the longitudinal history.",
-    ],
-    notFit: [
-      "Only the current episode occurred in winter or another season.",
-      "The pattern is better explained by recurring work, anniversary, social, or environmental stressors.",
-    ],
-    checks: [
-      "Build a multi-year month-by-month timeline",
-      "Mark remissions as well as onsets",
-      "Separate latitude and lifestyle effects from episode recurrence",
-    ],
-    treatmentLens:
-      "Use the longitudinal pattern to support anticipatory monitoring and relapse planning before the usual onset period.",
-    wording: "Major depressive disorder, recurrent, with seasonal pattern",
-    comparison: {
-      focus: "Recurring season-linked episode timing",
-      timeCourse: "Demonstrated over repeated annual cycles",
-      lookFor: "Consistent onset, remission, or polarity change in relation to season",
-      caution: "One winter episode is not a seasonal pattern",
-    },
-    keywords: ["seasonal", "winter depression", "summer", "spring", "every year", "annual", "season"],
-    relatedSlugs: ["with-peripartum-onset", "with-rapid-cycling"],
-  },
-  {
-    slug: "with-peripartum-onset",
-    name: "With peripartum onset",
-    shortName: "Peripartum onset",
-    family: "course-onset",
-    familyLabel: "Course and onset",
-    appliesTo: ["Depressive disorders", "Bipolar disorders"],
-    summary: "A mood episode begins during pregnancy or in the period soon after birth.",
-    clinicalSignal:
-      "Timing around pregnancy and birth changes safety assessment, treatment context, and family support needs.",
-    decisionQuestion:
-      "Did the mood episode begin in the peripartum window, and are bipolarity, psychosis, and immediate safety actively assessed?",
-    patientLanguage: [
-      "This began during the pregnancy",
-      "I have not felt like myself since the birth",
-      "I am frightened by what my mind is doing",
-    ],
-    fit: [
-      "Episode onset is clearly linked to pregnancy or the early post-birth period.",
-      "The assessment distinguishes depressive, manic-spectrum, psychotic, anxiety, trauma, and adjustment presentations.",
-      "Parent, infant, sleep, feeding, support, and safeguarding needs are considered together.",
-    ],
-    notFit: [
-      "The episode clearly pre-dated pregnancy without a meaningful peripartum onset or recurrence.",
-      "Symptoms are better explained by transient adjustment alone, while still recognising that distress may require care.",
-    ],
-    checks: [
-      "Screen urgently for psychosis and mania",
-      "Assess parent and infant safety",
-      "Review sleep loss, supports, medicines, and feeding context",
-    ],
-    treatmentLens:
-      "Coordinate timely perinatal mental health care; new psychosis, mania, or severe deterioration requires urgent escalation.",
-    wording: "Major depressive disorder, single episode, with peripartum onset",
-    comparison: {
-      focus: "Mood-episode onset around pregnancy or birth",
-      timeCourse: "Defined by episode onset, not simply current parenting status",
-      lookFor: "Onset timing, bipolar indicators, psychosis, sleep loss, safety and support",
-      caution: "Do not treat all post-birth distress as unipolar depression",
-    },
-    keywords: ["peripartum", "postpartum", "postnatal", "pregnancy", "after birth", "new mother", "new parent"],
-    relatedSlugs: ["with-psychotic-features", "with-mixed-features"],
-  },
-  {
-    slug: "with-rapid-cycling",
-    name: "With rapid cycling",
-    shortName: "Rapid cycling",
-    family: "course-onset",
-    familyLabel: "Course and onset",
-    appliesTo: ["Bipolar I disorder", "Bipolar II disorder"],
-    summary: "Multiple distinct mood episodes occur within a year, separated by remission or a switch in polarity.",
-    clinicalSignal: "Count syndromal episodes across time; do not substitute moment-to-moment emotional lability.",
-    decisionQuestion:
-      "Does the longitudinal timeline show repeated distinct episodes rather than rapid shifts within one episode?",
-    patientLanguage: [
-      "I have had several separate episodes this year",
-      "I recover and then switch again",
-      "My mood episodes keep returning",
-    ],
-    fit: [
-      "Distinct depressive, manic, or hypomanic episodes can be identified on a timeline.",
-      "Episodes are separated by remission or a clear switch in mood polarity.",
-      "Medication, thyroid, substance, sleep, and reproductive factors have been reviewed.",
-    ],
-    notFit: [
-      "Mood shifts occur within hours in response to events without distinct syndromal episodes.",
-      "A single prolonged mixed, unstable, or substance-related episode is being counted as several episodes.",
-    ],
-    checks: [
-      "Build a 12-month episode timeline",
-      "Mark recovery and polarity switches",
-      "Review treatment and biological contributors",
-    ],
-    treatmentLens: "Use the episode timeline to guide maintenance strategy and reduce destabilising contributors.",
-    wording: "Bipolar I disorder, current episode depressed, with rapid cycling",
-    comparison: {
-      focus: "Frequency of distinct bipolar mood episodes",
-      timeCourse: "Counted across a defined 12-month interval",
-      lookFor: "Syndromal episodes, remission intervals, polarity switches",
-      caution: "Emotional lability is not the same as rapid cycling",
-    },
-    keywords: [
-      "rapid cycling",
-      "several episodes",
-      "many episodes",
-      "four episodes",
-      "mood switches",
-      "bipolar course",
-      "lability",
-    ],
-    relatedSlugs: ["with-mixed-features", "with-seasonal-pattern"],
-  },
-  {
-    slug: "mild-severity",
-    name: "Mild severity",
-    shortName: "Mild",
-    family: "severity-remission",
-    familyLabel: "Severity and remission",
-    appliesTo: ["Mood disorders", "Other specified diagnoses"],
-    summary: "Symptoms meet the disorder threshold with limited excess symptoms, distress, and functional impairment.",
-    clinicalSignal: "Severity describes the whole episode: symptom burden, intensity, risk, and functional impact.",
-    decisionQuestion:
-      "Is the current episode genuinely lower in burden and impairment while still meeting the diagnostic threshold?",
-    patientLanguage: ["I can still function, but it takes much more effort", "Symptoms are present but contained"],
-    fit: [
-      "The diagnostic threshold is met.",
-      "Symptoms beyond the minimum are limited and their intensity is manageable.",
-      "Functional impairment is present but relatively contained.",
-    ],
-    notFit: [
-      "Risk, psychosis, catatonia, marked impairment, or severe biological disturbance indicates a higher severity level.",
-      "The person is below diagnostic threshold, in which case remission or another formulation may be more accurate.",
-    ],
-    checks: [
-      "Separate symptom count from intensity",
-      "Document functional impact",
-      "Check risk and protective factors",
-    ],
-    treatmentLens: "Match treatment intensity to need while avoiding minimisation of meaningful distress or risk.",
-    wording: "Major depressive disorder, single episode, mild",
-    comparison: {
-      focus: "Current episode burden and impairment",
-      timeCourse: "Rated for the present episode",
-      lookFor: "Symptom load, intensity, risk, and function",
-      caution: "Functioning at work does not automatically mean mild illness",
-    },
-    keywords: ["mild", "severity", "still functioning", "limited impairment", "low severity"],
-    relatedSlugs: ["in-partial-remission", "in-full-remission"],
-  },
-  {
-    slug: "in-partial-remission",
-    name: "In partial remission",
-    shortName: "Partial remission",
-    family: "severity-remission",
-    familyLabel: "Severity and remission",
-    appliesTo: ["Mood disorders", "Psychotic disorders"],
-    summary:
-      "The full syndrome has improved, but meaningful symptoms remain or a sustained symptom-free interval has not yet been established.",
-    clinicalSignal: "The person is better but not symptom-free, or recovery is too recent to call full remission.",
-    decisionQuestion:
-      "Has the episode clearly receded while residual symptoms or insufficient duration prevent full-remission wording?",
-    patientLanguage: [
-      "I am much better, but not back to myself",
-      "Some symptoms are still there",
-      "The worst has passed",
-    ],
-    fit: [
-      "Full criteria are no longer met or there has been substantial improvement.",
-      "Residual symptoms remain clinically meaningful, or the improved interval is not yet sustained.",
-      "Function and risk have improved but still require active follow-up.",
-    ],
-    notFit: [
-      "The person still meets full current-episode criteria.",
-      "No significant symptoms remain and the recovery interval supports full-remission wording.",
-    ],
-    checks: [
-      "List residual symptoms explicitly",
-      "Document change in function and risk",
-      "Confirm the recovery timeline",
-    ],
-    treatmentLens:
-      "Target residual symptoms and relapse prevention; partial recovery can still carry substantial recurrence risk.",
-    wording: "Major depressive disorder, recurrent, in partial remission",
-    comparison: {
-      focus: "Incomplete recovery from the most recent episode",
-      timeCourse: "After improvement, before sustained full remission",
-      lookFor: "Residual symptoms, recent recovery, persistent functional impact",
-      caution: "Improvement alone does not mean the current episode has ended",
-    },
-    keywords: [
-      "partial remission",
-      "improving",
-      "better but",
-      "residual symptoms",
-      "not fully recovered",
-      "recovering",
-    ],
-    relatedSlugs: ["in-full-remission", "mild-severity"],
-  },
-  {
-    slug: "in-full-remission",
-    name: "In full remission",
-    shortName: "Full remission",
-    family: "severity-remission",
-    familyLabel: "Severity and remission",
-    appliesTo: ["Mood disorders", "Psychotic disorders"],
-    summary: "No significant signs or symptoms of the recent episode remain across a sustained interval.",
-    clinicalSignal: "Full remission is a longitudinal conclusion, not a single good day or improvement from baseline.",
-    decisionQuestion:
-      "Are clinically significant episode symptoms absent, with recovery sustained long enough to support full-remission wording?",
-    patientLanguage: ["I feel back to my usual self", "The episode symptoms have gone", "I have been well and stable"],
-    fit: [
-      "Significant signs and symptoms of the recent episode are no longer present.",
-      "Recovery is sustained rather than a brief fluctuation.",
-      "Current functioning and risk are consistent with remission, while relapse prevention continues.",
-    ],
-    notFit: [
-      "Residual symptoms remain clinically meaningful.",
-      "The person has only recently improved or still meets current-episode criteria.",
-    ],
-    checks: [
-      "Confirm symptom absence across settings",
-      "Review duration and function",
-      "Maintain relapse and early-warning planning",
-    ],
-    treatmentLens:
-      "Continue maintenance and relapse-prevention planning; remission does not imply treatment or monitoring is unnecessary.",
-    wording: "Major depressive disorder, recurrent, in full remission",
-    comparison: {
-      focus: "Sustained absence of significant episode symptoms",
-      timeCourse: "Established after a durable recovery interval",
-      lookFor: "Symptom resolution, stable function, sustained recovery",
-      caution: "Do not infer full remission from partial improvement",
-    },
-    keywords: ["full remission", "recovered", "well now", "symptom free", "stable", "back to normal"],
-    relatedSlugs: ["in-partial-remission", "mild-severity"],
-  },
-];
-
-export const specifierSearchPresets = [
-  { label: "Agitated depression", query: "depressed, racing thoughts and barely sleeping" },
-  { label: "Post-birth onset", query: "mood episode began after birth" },
-  { label: "Winter recurrence", query: "depression returns every winter and lifts in spring" },
-  { label: "Residual symptoms", query: "much better but not fully recovered" },
-  { label: "Psychomotor change", query: "stopped speaking and holds the same posture" },
-];
-
-export function findSpecifier(slug: string) {
-  return specifierRecords.find((record) => record.slug === slug);
-}
-
-export function normalizeSpecifierSelection(slugs: string[]) {
-  const selected: string[] = [];
-  const conflictsBySlug: Record<string, readonly string[]> = {
-    "mild-severity": ["with-psychotic-features"],
-    "with-psychotic-features": ["mild-severity"],
-  };
-
-  for (const slug of slugs) {
-    const record = findSpecifier(slug);
-    if (!record || selected.includes(slug)) continue;
-
-    if (record.family === "severity-remission") {
-      const retained = selected.filter((selectedSlug) => findSpecifier(selectedSlug)?.family !== "severity-remission");
-      selected.splice(0, selected.length, ...retained);
-    }
-
-    const conflicts = new Set(conflictsBySlug[slug] ?? []);
-    if (conflicts.size) {
-      const retained = selected.filter((selectedSlug) => !conflicts.has(selectedSlug));
-      selected.splice(0, selected.length, ...retained);
-    }
-
-    selected.push(slug);
-  }
-
-  return selected;
-}
-
-function normalizeSearchText(value: string) {
-  return value
-    .toLowerCase()
-    .normalize("NFKD")
-    .replace(/[^a-z0-9]+/g, " ")
-    .trim();
-}
-
-const ignoredSearchWords = new Set([
-  "a",
-  "an",
-  "and",
-  "are",
-  "for",
-  "i",
-  "in",
-  "is",
-  "it",
-  "of",
-  "or",
-  "the",
-  "to",
-  "with",
-]);
-
-function searchTokens(query: string) {
-  return normalizeSearchText(query)
-    .split(" ")
-    .filter((token) => token.length > 1 && !ignoredSearchWords.has(token));
-}
-
-function recordSearchText(record: SpecifierRecord) {
-  return normalizeSearchText(
-    [
-      record.name,
-      record.shortName,
-      record.familyLabel,
-      ...record.appliesTo,
-      record.summary,
-      record.clinicalSignal,
-      record.decisionQuestion,
-      ...record.patientLanguage,
-      ...record.keywords,
-    ].join(" "),
-  );
-}
-
-const diagnosisFiltersByApplicability: Record<string, readonly string[]> = {
-  "Depressive disorders": ["depressive", "mood"],
-  "Bipolar disorders": ["bipolar", "mood"],
-  "Major depressive episodes": ["depressive", "bipolar", "mood"],
-  "Bipolar depressive episodes": ["bipolar", "mood"],
-  "Mood disorders": ["depressive", "bipolar", "mood"],
-  "Psychotic disorders": ["psychotic"],
-  "Medical conditions": [],
-  "Recurrent depressive disorder": ["depressive", "mood"],
-  "Bipolar I disorder": ["bipolar", "mood"],
-  "Bipolar II disorder": ["bipolar", "mood"],
-  "Other specified diagnoses": [],
-};
-
-const builderDiagnosesByApplicability: Record<string, readonly SpecifierBuilderDiagnosis[]> = {
-  "Depressive disorders": ["mdd-recurrent", "mdd-single"],
-  "Bipolar disorders": ["bipolar-i-depressed", "bipolar-i-manic", "bipolar-ii-depressed"],
-  "Major depressive episodes": ["mdd-recurrent", "mdd-single", "bipolar-i-depressed", "bipolar-ii-depressed"],
-  "Bipolar depressive episodes": ["bipolar-i-depressed", "bipolar-ii-depressed"],
-  "Mood disorders": ["mdd-recurrent", "mdd-single", "bipolar-i-depressed", "bipolar-i-manic", "bipolar-ii-depressed"],
-  "Psychotic disorders": [],
-  "Medical conditions": [],
-  "Recurrent depressive disorder": ["mdd-recurrent"],
-  "Bipolar I disorder": ["bipolar-i-depressed", "bipolar-i-manic"],
-  "Bipolar II disorder": ["bipolar-ii-depressed"],
-  "Other specified diagnoses": [],
-};
-
-export function specifierAppliesToBuilderDiagnosis(record: SpecifierRecord, diagnosis: SpecifierBuilderDiagnosis) {
-  return record.appliesTo.some((applicability) => builderDiagnosesByApplicability[applicability]?.includes(diagnosis));
-}
-
-const knownDiagnosisFilters = new Set(["depressive", "bipolar", "psychotic", "mood"]);
-
-function matchesDiagnosisFilter(record: SpecifierRecord, diagnosis: string) {
-  if (!diagnosis) return true;
-  if (!knownDiagnosisFilters.has(diagnosis)) {
-    return normalizeSearchText(record.appliesTo.join(" ")).includes(diagnosis);
-  }
-
-  return record.appliesTo.some((applicability) => diagnosisFiltersByApplicability[applicability]?.includes(diagnosis));
-}
-
-export function searchSpecifiers(
-  query: string,
-  options: { family?: "all" | SpecifierFamily; diagnosis?: string } = {},
-) {
-  const normalizedQuery = normalizeSearchText(query);
-  const tokens = searchTokens(query);
-  const diagnosis = normalizeSearchText(options.diagnosis ?? "");
-
-  return specifierRecords
-    .filter((record) => !options.family || options.family === "all" || record.family === options.family)
-    .filter((record) => matchesDiagnosisFilter(record, diagnosis))
-    .map((record, index) => {
-      const title = normalizeSearchText(`${record.name} ${record.shortName}`);
-      const keywords = normalizeSearchText(record.keywords.join(" "));
-      const haystack = recordSearchText(record);
-      let score = normalizedQuery ? 0 : specifierRecords.length - index;
-
-      if (normalizedQuery && title.includes(normalizedQuery)) score += 80;
-      if (normalizedQuery && keywords.includes(normalizedQuery)) score += 55;
-      for (const token of tokens) {
-        if (title.includes(token)) score += 18;
-        if (keywords.includes(token)) score += 10;
-        if (haystack.includes(token)) score += 3;
-      }
-
-      return { record, score };
-    })
-    .filter((result) => !normalizedQuery || result.score > 0)
-    .sort((left, right) => right.score - left.score || left.record.name.localeCompare(right.record.name));
-}
-
-export function relatedSpecifiers(record: SpecifierRecord) {
-  return record.relatedSlugs.map(findSpecifier).filter((item): item is SpecifierRecord => Boolean(item));
-}
diff --git a/tests/app-modes.test.ts b/tests/app-modes.test.ts
index 50fd415d2..327d87a9e 100644
--- a/tests/app-modes.test.ts
+++ b/tests/app-modes.test.ts
@@ -104,15 +104,15 @@ describe("app mode search contract", () => {
     expect(appModeQueryMode("differentials", "auto")).toBe("compare_guidance");
   });
 
-  it("keeps specifiers searchable as a standalone local decision-support mode", () => {
-    const config = appModeSearchConfig("specifiers");
-    const mode = appModeDefinitions.find((definition) => definition.id === "specifiers");
-
-    expect(isSearchableAppMode("specifiers")).toBe(true);
-    expect(mode?.href).toBe("/specifiers");
-    expect(config.kind).toBe("specifiers");
-    expect(config.resultKind).toBe("specifiers");
-    expect(config.placeholder.toLowerCase()).toContain("specifier");
+  it("keeps formulation searchable as a standalone local decision-support mode", () => {
+    const config = appModeSearchConfig("formulation");
+    const mode = appModeDefinitions.find((definition) => definition.id === "formulation");
+
+    expect(isSearchableAppMode("formulation")).toBe(true);
+    expect(mode?.href).toBe("/formulation");
+    expect(config.kind).toBe("formulation");
+    expect(config.resultKind).toBe("formulation");
+    expect(config.placeholder.toLowerCase()).toContain("pattern");
   });
 
   it("keeps source-library shortcut searches in their active mode family", () => {
@@ -126,7 +126,7 @@ describe("app mode search contract", () => {
     expect(appModeCanUseSourceLibraryShortcut("favourites")).toBe(false);
     expect(appModeCanUseSourceLibraryShortcut("prescribing")).toBe(true);
     expect(appModeCanUseSourceLibraryShortcut("differentials")).toBe(true);
-    expect(appModeCanUseSourceLibraryShortcut("specifiers")).toBe(false);
+    expect(appModeCanUseSourceLibraryShortcut("formulation")).toBe(false);
 
     expect(appModeSourceLibrarySearchMode("documents")).toBe("documents");
     expect(appModeSourceLibrarySearchMode("services")).toBe("documents");
@@ -157,8 +157,8 @@ describe("app mode search contract", () => {
     expect(appModeHomeHref("differentials", { query: "  acute confusion  ", focus: true })).toBe(
       "/differentials?q=acute+confusion&focus=1",
     );
-    expect(appModeHomeHref("specifiers", { query: "  racing thoughts  ", run: true, focus: true })).toBe(
-      "/specifiers?q=racing+thoughts&focus=1&run=1",
+    expect(appModeHomeHref("formulation", { query: "  I keep going over it  ", run: true, focus: true })).toBe(
+      "/formulation?q=I+keep+going+over+it&focus=1&run=1",
     );
     expect(appModeHomeHref("prescribing", { query: "  acamprosate renal dose  " })).toBe(
       "/?mode=prescribing&q=acamprosate+renal+dose",
@@ -195,7 +195,7 @@ describe("app mode search contract", () => {
         "forms",
         "favourites",
         "differentials",
-        "specifiers",
+        "formulation",
         "prescribing",
         "tools",
       ]),
@@ -212,7 +212,7 @@ describe("app mode search contract", () => {
     expect(isAppModeVisible("forms", "production")).toBe(true);
     expect(isAppModeVisible("favourites", "production")).toBe(true);
     expect(isAppModeVisible("differentials", "production")).toBe(true);
-    expect(isAppModeVisible("specifiers", "production")).toBe(true);
+    expect(isAppModeVisible("formulation", "production")).toBe(true);
     expect(isAppModeVisible("prescribing", "production")).toBe(true);
     expect(isAppModeVisible("tools", "production")).toBe(true);
     expect(productionModes).not.toContain("evidence");
@@ -220,7 +220,7 @@ describe("app mode search contract", () => {
     expect(productionModes).toContain("forms");
     expect(productionModes).toContain("favourites");
     expect(productionModes).toContain("differentials");
-    expect(productionModes).toContain("specifiers");
+    expect(productionModes).toContain("formulation");
     expect(productionModes).toContain("prescribing");
     expect(productionModes).toContain("tools");
     expect(developmentModes).toEqual(
@@ -231,7 +231,7 @@ describe("app mode search contract", () => {
         "forms",
         "favourites",
         "differentials",
-        "specifiers",
+        "formulation",
         "prescribing",
         "tools",
       ]),
diff --git a/tests/formulation.test.ts b/tests/formulation.test.ts
new file mode 100644
index 000000000..295c18837
--- /dev/null
+++ b/tests/formulation.test.ts
@@ -0,0 +1,100 @@
+import { describe, expect, it } from "vitest";
+
+import {
+  comparisonGuideFor,
+  findFormulationMechanism,
+  formulationDomains,
+  formulationDraftFor,
+  formulationMechanisms,
+  formulationQualityPrompts,
+  formulationSectionsForTemplate,
+  formulationSourceLibrary,
+  formulationTemplates,
+  normalizeMechanismSelection,
+  relatedFormulationMechanisms,
+  searchFormulationMechanisms,
+} from "@/lib/formulation";
+
+describe("clinical formulation content", () => {
+  it("loads the complete supplied formulation bundle", () => {
+    expect(formulationMechanisms).toHaveLength(12);
+    expect(formulationDomains).toHaveLength(12);
+    expect(formulationTemplates).toHaveLength(6);
+    expect(formulationQualityPrompts).toHaveLength(4);
+    expect(Object.keys(formulationSourceLibrary)).toHaveLength(9);
+
+    const ids = formulationMechanisms.map((mechanism) => mechanism.id);
+    expect(new Set(ids).size).toBe(ids.length);
+    for (const mechanism of formulationMechanisms) {
+      expect(mechanism.name).toBeTruthy();
+      expect(mechanism.definition).toBeTruthy();
+      expect(mechanism.fitIndicators.length).toBeGreaterThan(0);
+      expect(mechanism.poorFitIndicators.length).toBeGreaterThan(0);
+      expect(mechanism.patientPhrases.length).toBeGreaterThan(0);
+      expect(mechanism.treatmentLeverage).toBeTruthy();
+    }
+  });
+
+  it("matches patient language and clinical clues to mechanisms", () => {
+    expect(searchFormulationMechanisms("I keep going over it")[0]?.mechanism.id).toBe("rumination");
+    expect(searchFormulationMechanisms("What if something goes wrong")[0]?.mechanism.id).toBe("worry");
+    expect(searchFormulationMechanisms("It goes from zero to one hundred")[0]?.mechanism.id).toBe(
+      "emotional-dysregulation",
+    );
+    expect(searchFormulationMechanisms("I was not really there")[0]?.mechanism.id).toBe("dissociation");
+    expect(searchFormulationMechanisms("If it is not perfect it is a failure")[0]?.mechanism.id).toBe("perfectionism");
+  });
+
+  it("filters the mechanism catalogue by formulation domain", () => {
+    const trauma = searchFormulationMechanisms("", { domain: "Trauma" });
+    expect(trauma.length).toBeGreaterThan(0);
+    expect(trauma.every(({ mechanism }) => mechanism.domains.includes("Trauma"))).toBe(true);
+
+    const defence = searchFormulationMechanisms("", { domain: "Defence" });
+    expect(defence.map(({ mechanism }) => mechanism.id)).toEqual(expect.arrayContaining(["splitting", "projection"]));
+  });
+
+  it("normalizes builder selections without inventing mechanisms", () => {
+    expect(normalizeMechanismSelection(["rumination", "worry", "rumination", "missing"])).toEqual([
+      "rumination",
+      "worry",
+    ]);
+  });
+
+  it("provides focused comparison guidance for close alternatives", () => {
+    const guide = comparisonGuideFor("rumination", "worry");
+    expect(guide?.assessmentQuestion).toContain("replaying what happened");
+    expect(comparisonGuideFor("worry", "rumination")).toEqual(guide);
+
+    const rumination = findFormulationMechanism("rumination");
+    expect(rumination).toBeTruthy();
+    expect(relatedFormulationMechanisms(rumination!)[0]?.id).toBe("worry");
+  });
+
+  it("maps each framework to populated formulation sections", () => {
+    for (const template of formulationTemplates) {
+      const sections = formulationSectionsForTemplate(template.id);
+      expect(sections.length).toBeGreaterThan(0);
+      expect(sections.every((section) => section.group.includes(template.id))).toBe(true);
+    }
+    expect(formulationSectionsForTemplate("5Ps").map((section) => section.id)).toEqual(
+      expect.arrayContaining(["presenting", "predisposing", "precipitating", "perpetuating", "protective"]),
+    );
+  });
+
+  it("builds a reviewable draft from mechanisms, framework notes, and quality checks", () => {
+    const rumination = findFormulationMechanism("rumination")!;
+    const draft = formulationDraftFor({
+      mechanisms: [rumination],
+      templateId: "5Ps",
+      notes: { presenting: "De-identified presenting pattern.", perpetuating: "Reviews perceived failures at night." },
+      qualityNotes: { "quality-alternative": "Check worry and realistic problem solving." },
+    });
+
+    expect(draft).toContain("5Ps formulation");
+    expect(draft).toContain("Working mechanism hypotheses");
+    expect(draft).toContain(rumination.exampleSentence);
+    expect(draft).toContain("Check worry and realistic problem solving.");
+    expect(draft).toContain("Draft for clinical review");
+  });
+});
diff --git a/tests/specifiers.test.ts b/tests/specifiers.test.ts
deleted file mode 100644
index eaee2fac7..000000000
--- a/tests/specifiers.test.ts
+++ /dev/null
@@ -1,91 +0,0 @@
-import { describe, expect, it } from "vitest";
-
-import {
-  findSpecifier,
-  normalizeSpecifierSelection,
-  searchSpecifiers,
-  specifierAppliesToBuilderDiagnosis,
-  specifierRecords,
-} from "@/lib/specifiers";
-
-describe("psychiatric specifier catalogue", () => {
-  it("keeps slugs unique and related links valid", () => {
-    const slugs = specifierRecords.map((record) => record.slug);
-    expect(new Set(slugs).size).toBe(slugs.length);
-
-    for (const record of specifierRecords) {
-      expect(record.name).toBeTruthy();
-      expect(record.summary).toBeTruthy();
-      expect(record.fit.length).toBeGreaterThanOrEqual(2);
-      expect(record.notFit.length).toBeGreaterThanOrEqual(2);
-      expect(record.wording).toBeTruthy();
-      for (const relatedSlug of record.relatedSlugs) {
-        expect(findSpecifier(relatedSlug)).toBeTruthy();
-      }
-    }
-  });
-
-  it("matches natural clinical language to the deciding specifier", () => {
-    expect(searchSpecifiers("depressed but racing thoughts and barely sleeping")[0]?.record.slug).toBe(
-      "with-mixed-features",
-    );
-    expect(searchSpecifiers("depression returns every winter and lifts in spring")[0]?.record.slug).toBe(
-      "with-seasonal-pattern",
-    );
-    expect(searchSpecifiers("stopped speaking and holds the same posture")[0]?.record.slug).toBe("with-catatonia");
-    expect(searchSpecifiers("much better but not fully recovered")[0]?.record.slug).toBe("in-partial-remission");
-  });
-
-  it("filters by diagnostic role and diagnosis context", () => {
-    const courseResults = searchSpecifiers("", { family: "course-onset" });
-    expect(courseResults.length).toBeGreaterThan(0);
-    expect(courseResults.every(({ record }) => record.family === "course-onset")).toBe(true);
-
-    const psychoticResults = searchSpecifiers("", { diagnosis: "psychotic" });
-    expect(psychoticResults.map(({ record }) => record.slug)).toContain("with-catatonia");
-
-    const depressiveResults = searchSpecifiers("mild", { diagnosis: "depressive" });
-    expect(depressiveResults.map(({ record }) => record.slug)).toContain("mild-severity");
-
-    const moodEpisodeResults = searchSpecifiers("", { diagnosis: "mood" });
-    expect(moodEpisodeResults.map(({ record }) => record.slug)).toEqual(
-      expect.arrayContaining(["with-anxious-distress", "with-rapid-cycling", "mild-severity"]),
-    );
-  });
-
-  it("normalizes seeded builder selections to one severity or remission descriptor", () => {
-    expect(
-      normalizeSpecifierSelection([
-        "with-anxious-distress",
-        "in-partial-remission",
-        "missing-specifier",
-        "in-full-remission",
-        "with-anxious-distress",
-      ]),
-    ).toEqual(["with-anxious-distress", "in-full-remission"]);
-
-    expect(normalizeSpecifierSelection(["mild-severity", "with-psychotic-features"])).toEqual([
-      "with-psychotic-features",
-    ]);
-    expect(normalizeSpecifierSelection(["with-psychotic-features", "mild-severity"])).toEqual(["mild-severity"]);
-  });
-
-  it("matches builder specifiers to the selected diagnosis and episode", () => {
-    const rapidCycling = findSpecifier("with-rapid-cycling");
-    const melancholic = findSpecifier("with-melancholic-features");
-    expect(rapidCycling).toBeDefined();
-    expect(melancholic).toBeDefined();
-
-    expect(specifierAppliesToBuilderDiagnosis(rapidCycling!, "mdd-recurrent")).toBe(false);
-    expect(specifierAppliesToBuilderDiagnosis(rapidCycling!, "bipolar-i-manic")).toBe(true);
-    expect(specifierAppliesToBuilderDiagnosis(melancholic!, "bipolar-i-manic")).toBe(false);
-    expect(specifierAppliesToBuilderDiagnosis(melancholic!, "bipolar-i-depressed")).toBe(true);
-  });
-
-  it("does not expose provenance columns in the specifier search records", () => {
-    for (const record of specifierRecords) {
-      expect(Object.hasOwn(record, "source")).toBe(false);
-      expect(Object.hasOwn(record, "sourceStatus")).toBe(false);
-    }
-  });
-});
diff --git a/tests/ui-formulation.spec.ts b/tests/ui-formulation.spec.ts
new file mode 100644
index 000000000..344a93f10
--- /dev/null
+++ b/tests/ui-formulation.spec.ts
@@ -0,0 +1,154 @@
+import AxeBuilder from "@axe-core/playwright";
+import { expect, test, type Page, type TestInfo } from "playwright/test";
+
+const axeWcagTags = ["wcag2a", "wcag2aa", "wcag21a", "wcag21aa"];
+const axeBlockingImpacts = new Set(["critical", "serious"]);
+
+async function blockExternalRequests(page: Page) {
+  await page.route("**/*", async (route) => {
+    const url = new URL(route.request().url());
+    if (
+      (url.protocol === "http:" || url.protocol === "https:") &&
+      !["localhost", "127.0.0.1", "::1", "[::1]"].includes(url.hostname)
+    ) {
+      await route.abort("blockedbyclient");
+      return;
+    }
+    await route.fallback();
+  });
+}
+
+async function gotoApp(page: Page, path: string) {
+  await page.goto(path, { waitUntil: "domcontentloaded" });
+  await page.waitForLoadState("networkidle", { timeout: 15_000 }).catch(() => undefined);
+}
+
+async function expectNoHorizontalOverflow(page: Page) {
+  const overflow = await page.evaluate(
+    () => Math.max(document.documentElement.scrollWidth, document.body?.scrollWidth ?? 0) - window.innerWidth,
+  );
+  expect(overflow).toBeLessThanOrEqual(2);
+}
+
+async function expectNoBlockingAxeViolations(page: Page, testInfo: TestInfo) {
+  const results = await new AxeBuilder({ page }).withTags(axeWcagTags).analyze();
+  await testInfo.attach("axe-violations", {
+    body: JSON.stringify(results.violations, null, 2),
+    contentType: "application/json",
+  });
+
+  const blocking = results.violations
+    .filter((violation) => axeBlockingImpacts.has(violation.impact ?? ""))
+    .map(
+      (violation) =>
+        `${violation.id} (${violation.impact}): ${violation.help} — ${violation.nodes
+          .map((node) => `${node.target.join(" ")}: ${node.failureSummary ?? "no failure summary"}`)
+          .join(" | ")}; see ${violation.helpUrl}`,
+    );
+  expect(blocking, "axe found critical/serious WCAG A/AA violations").toEqual([]);
+}
+
+test.beforeEach(async ({ page }) => {
+  await blockExternalRequests(page);
+});
+
+test("searches patient language, opens a mechanism guide, and carries it into the builder", async ({
+  page,
+}, testInfo) => {
+  await gotoApp(page, "/formulation");
+
+  await expect(page.getByRole("heading", { name: "How can I help with the formulation?" })).toBeVisible();
+  await expect(page.getByTestId("formulation-home")).toBeVisible();
+
+  const search = page.getByTestId("global-search-input").filter({ visible: true }).first();
+  await expect(search).toHaveAccessibleName(
+    /Search indexed guidelines by question or keyword - Search formulation mechanisms by pattern or patient language/,
+  );
+  await search.fill("I keep going over it");
+  await page.getByRole("button", { name: "Find matching formulation mechanisms" }).click();
+
+  await expect(page).toHaveURL(/\/formulation\?.*q=I(?:\+|%20)keep(?:\+|%20)going(?:\+|%20)over(?:\+|%20)it.*run=1/);
+  await expect(page.getByRole("heading", { name: /Mechanisms matching “I keep going over it”/ })).toBeVisible();
+  await expect(page.getByRole("link", { name: "Rumination", exact: true })).toBeVisible();
+  await expect(page.getByText("Source status", { exact: true })).toHaveCount(0);
+  await expect(page.getByText("Source", { exact: true })).toHaveCount(0);
+
+  await page.getByRole("link", { name: "Open Rumination" }).click();
+  await expect(page).toHaveURL(/\/formulation\/rumination$/, { timeout: 30_000 });
+  await expect(page.getByRole("heading", { name: "Rumination", exact: true })).toBeVisible();
+  await expect(page.getByText("What matters now", { exact: true })).toBeVisible();
+
+  await page.getByRole("link", { name: "Use in formulation", exact: true }).first().click();
+  await expect(page.getByRole("heading", { name: "Build a formulation that can be tested" })).toBeVisible();
+  await expect(page.getByRole("checkbox", { name: /Rumination/ })).toBeChecked();
+  await expect(page.getByText(/Rumination appears to keep the patient caught/i).first()).toBeVisible();
+  await expectNoHorizontalOverflow(page);
+  await expectNoBlockingAxeViolations(page, testInfo);
+});
+
+test("keeps mobile search, domain filtering, record actions, and universal chrome usable", async ({
+  page,
+}, testInfo) => {
+  await page.setViewportSize({ width: 390, height: 844 });
+  await gotoApp(page, "/formulation?q=What+if+something+goes+wrong&run=1");
+
+  await expect(page.getByRole("heading", { name: /Mechanisms matching “What if something goes wrong”/ })).toBeVisible();
+  await expect(page.getByRole("link", { name: "Worry", exact: true })).toBeVisible();
+  await expect(page.getByRole("combobox", { name: "Filter by formulation domain" })).toBeVisible();
+  await expect(page.getByTestId("global-search-input").filter({ visible: true }).first()).toBeVisible();
+  await expect(page.getByText("Source status", { exact: true })).toHaveCount(0);
+  await expect(page.getByText("Source", { exact: true })).toHaveCount(0);
+  await expectNoHorizontalOverflow(page);
+
+  await page.getByRole("link", { name: "Open Worry" }).click();
+  await expect(page.getByRole("heading", { name: "Worry", exact: true })).toBeVisible();
+  await expect(page.getByRole("link", { name: "Compare", exact: true }).last()).toBeVisible();
+  await expect(page.getByRole("link", { name: "Use in formulation", exact: true }).first()).toBeVisible();
+  await expectNoHorizontalOverflow(page);
+  await expectNoBlockingAxeViolations(page, testInfo);
+});
+
+test("moves a selected mechanism through framework, quality review, and an editable draft", async ({
+  page,
+}, testInfo) => {
+  await gotoApp(page, "/formulation/builder?mechanism=rumination&template=5Ps");
+
+  await expect(page.getByRole("checkbox", { name: /Rumination/ })).toBeChecked();
+  await page.getByRole("button", { name: /Continue to framework/ }).click();
+  await expect(page.getByTestId("formulation-builder-structure")).toBeVisible();
+  const cbtCycle = page.getByRole("radio", { name: /CBT cycle/ });
+  await page.getByText("CBT cycle", { exact: true }).click();
+  await expect(cbtCycle).toBeChecked();
+  await page
+    .getByRole("textbox", { name: "Presenting problem" })
+    .fill("De-identified recurring low mood and overthinking.");
+
+  await page.getByRole("button", { name: "Review quality", exact: true }).click();
+  await page
+    .getByRole("textbox", { name: "Evidence supporting this mechanism" })
+    .fill("Repetitive review follows perceived failures and delays sleep.");
+  await page
+    .getByRole("textbox", { name: "Alternative explanation" })
+    .fill("Check future-focused worry and realistic problem solving.");
+
+  await page.getByRole("button", { name: "Create draft" }).click();
+  const draft = page.getByRole("textbox", { name: "Formulation draft" });
+  await expect(draft).toHaveValue(/CBT cycle formulation/);
+  await expect(draft).toHaveValue(/Rumination appears to keep the patient caught/);
+  await expectNoHorizontalOverflow(page);
+  await expectNoBlockingAxeViolations(page, testInfo);
+});
+
+test("compares supported alternatives and groups mechanisms without implying causation", async ({ page }) => {
+  await gotoApp(page, "/formulation/compare?a=rumination&b=worry");
+  await expect(page.getByRole("heading", { name: "Compare mechanisms" })).toBeVisible();
+  await expect(page.getByText(/replaying what happened or trying to prevent what might happen next/i)).toBeVisible();
+  await expect(page.getByText("Most useful distinction", { exact: true })).toBeVisible();
+
+  await gotoApp(page, "/formulation/map?mechanism=shame");
+  await expect(page.getByRole("heading", { name: "Mechanism map" })).toBeVisible();
+  await expect(page.getByText(/does not assert causation/i)).toBeVisible();
+  await expect(page.getByText("Selected mechanism", { exact: true })).toBeVisible();
+  await expect(page.getByRole("heading", { name: "Shame", exact: true })).toBeVisible();
+  await expectNoHorizontalOverflow(page);
+});
diff --git a/tests/ui-smoke.spec.ts b/tests/ui-smoke.spec.ts
index 5dd766501..b97acebd4 100644
--- a/tests/ui-smoke.spec.ts
+++ b/tests/ui-smoke.spec.ts
@@ -2271,13 +2271,15 @@ test.describe("Clinical KB UI smoke coverage", () => {
     await expect(page.getByRole("heading", { level: 1, name: "Differentials" })).toBeVisible();
   });
 
-  test("dashboard specifiers mode param redirects to the standalone specifiers route", async ({ page }) => {
+  test("dashboard formulation mode param redirects to the standalone formulation route", async ({ page }) => {
     await page.setViewportSize({ width: 1280, height: 900 });
     await mockDemoApi(page);
-    await gotoApp(page, "/?mode=specifiers&q=anxious+distress&focus=1&run=1");
+    await gotoApp(page, "/?mode=formulation&q=I+keep+going+over+it&focus=1&run=1");
 
-    await expect(page).toHaveURL(/\/specifiers\?q=anxious\+distress&focus=1&run=1$/);
-    await expect(page.getByRole("heading", { level: 1, name: "Matches for “anxious distress”" })).toBeVisible();
+    await expect(page).toHaveURL(/\/formulation\?q=I\+keep\+going\+over\+it&focus=1&run=1$/);
+    await expect(
+      page.getByRole("heading", { level: 1, name: "Mechanisms matching “I keep going over it”" }),
+    ).toBeVisible();
   });
 
   test("submitted differentials searches stay on the standalone differentials route", async ({ page }) => {
@@ -2427,7 +2429,7 @@ test.describe("Clinical KB UI smoke coverage", () => {
     await page.keyboard.press("ArrowDown");
     await expect(appModeMenu.getByRole("menuitemradio", { name: /^Differentials\b/ })).toBeFocused();
     await page.keyboard.press("ArrowDown");
-    await expect(appModeMenu.getByRole("menuitemradio", { name: /^Specifiers\b/ })).toBeFocused();
+    await expect(appModeMenu.getByRole("menuitemradio", { name: /^Formulation\b/ })).toBeFocused();
     await page.keyboard.press("ArrowDown");
     await expect(appModeMenu.getByRole("menuitemradio", { name: /^Medication\b/ })).toBeFocused();
     await page.keyboard.press("ArrowDown");
diff --git a/tests/ui-specifiers.spec.ts b/tests/ui-specifiers.spec.ts
deleted file mode 100644
index 98b0820c5..000000000
--- a/tests/ui-specifiers.spec.ts
+++ /dev/null
@@ -1,138 +0,0 @@
-import AxeBuilder from "@axe-core/playwright";
-import { expect, test, type Page, type TestInfo } from "playwright/test";
-
-const axeWcagTags = ["wcag2a", "wcag2aa", "wcag21a", "wcag21aa"];
-const axeBlockingImpacts = new Set(["critical", "serious"]);
-
-async function blockExternalRequests(page: Page) {
-  await page.route("**/*", async (route) => {
-    const url = new URL(route.request().url());
-    if (
-      (url.protocol === "http:" || url.protocol === "https:") &&
-      !["localhost", "127.0.0.1", "::1", "[::1]"].includes(url.hostname)
-    ) {
-      await route.abort("blockedbyclient");
-      return;
-    }
-    await route.fallback();
-  });
-}
-
-async function gotoApp(page: Page, path: string) {
-  await page.goto(path, { waitUntil: "domcontentloaded" });
-  await page.waitForLoadState("networkidle", { timeout: 15_000 }).catch(() => undefined);
-}
-
-async function expectNoHorizontalOverflow(page: Page) {
-  const overflow = await page.evaluate(
-    () => Math.max(document.documentElement.scrollWidth, document.body?.scrollWidth ?? 0) - window.innerWidth,
-  );
-  expect(overflow).toBeLessThanOrEqual(2);
-}
-
-async function expectNoBlockingAxeViolations(page: Page, testInfo: TestInfo) {
-  const results = await new AxeBuilder({ page }).withTags(axeWcagTags).analyze();
-  await testInfo.attach("axe-violations", {
-    body: JSON.stringify(results.violations, null, 2),
-    contentType: "application/json",
-  });
-
-  const blocking = results.violations
-    .filter((violation) => axeBlockingImpacts.has(violation.impact ?? ""))
-    .map(
-      (violation) =>
-        `${violation.id} (${violation.impact}): ${violation.help} — ${violation.nodes
-          .map((node) => `${node.target.join(" ")}: ${node.failureSummary ?? "no failure summary"}`)
-          .join(" | ")}; see ${violation.helpUrl}`,
-    );
-  expect(blocking, "axe found critical/serious WCAG A/AA violations").toEqual([]);
-}
-
-test.beforeEach(async ({ page }) => {
-  await blockExternalRequests(page);
-});
-
-test("searches clinical language without provenance fields and carries a result into wording", async ({
-  page,
-}, testInfo) => {
-  await gotoApp(page, "/specifiers");
-
-  await expect(page.getByRole("heading", { name: "Refine the diagnosis with the right specifier" })).toBeVisible();
-  await expect(page.getByTestId("specifiers-home")).toBeVisible();
-
-  const search = page.getByTestId("global-search-input").filter({ visible: true }).first();
-  await expect(search).toHaveAccessibleName(
-    /Search indexed guidelines by question or keyword - Search psychiatric specifiers by presentation or diagnosis/,
-  );
-  await search.fill("depressed but racing thoughts");
-  await page.getByRole("button", { name: "Find matching psychiatric specifiers" }).click();
-
-  await expect(page).toHaveURL(/\/specifiers\?.*q=depressed(?:\+|%20)but(?:\+|%20)racing(?:\+|%20)thoughts.*run=1/);
-  await expect(page.getByRole("heading", { name: /Matches for “depressed but racing thoughts”/ })).toBeVisible();
-  await expect(page.getByRole("link", { name: "With mixed features", exact: true })).toBeVisible();
-  await expect(page.getByText("Source status", { exact: true })).toHaveCount(0);
-  await expect(page.getByText("Source", { exact: true })).toHaveCount(0);
-
-  await page.getByRole("link", { name: "Open With mixed features" }).click();
-  await expect(page).toHaveURL(/\/specifiers\/with-mixed-features$/);
-  await expect(page.getByRole("heading", { name: "With mixed features", exact: true })).toBeVisible();
-  await expect(page.getByText("What matters now", { exact: true })).toBeVisible();
-
-  await page.getByRole("link", { name: "Use in builder", exact: true }).click();
-  await expect(page.getByRole("heading", { name: "Build the diagnosis in the right order" })).toBeVisible();
-  await expect(page.getByRole("checkbox", { name: /Mixed features/ })).toBeChecked();
-  await expect(page.getByText(/with mixed features/i).first()).toBeVisible();
-  await expectNoHorizontalOverflow(page);
-  await expectNoBlockingAxeViolations(page, testInfo);
-});
-
-test("keeps mobile search, filters, results, and the fixed composer usable", async ({ page }, testInfo) => {
-  await page.setViewportSize({ width: 390, height: 844 });
-  await gotoApp(page, "/specifiers?q=returns+every+winter&run=1");
-
-  await expect(page.getByRole("heading", { name: /Matches for “returns every winter”/ })).toBeVisible();
-  await expect(page.getByRole("link", { name: "With seasonal pattern", exact: true })).toBeVisible();
-  await expect(page.getByRole("combobox", { name: "Filter by diagnosis" })).toBeVisible();
-  await expect(page.getByTestId("global-search-input").filter({ visible: true }).first()).toBeVisible();
-  await expect(page.getByText("Source status", { exact: true })).toHaveCount(0);
-  await expect(page.getByText("Source", { exact: true })).toHaveCount(0);
-  await expectNoHorizontalOverflow(page);
-
-  await page.getByRole("link", { name: "Open With seasonal pattern" }).click();
-  await expect(page.getByRole("heading", { name: "With seasonal pattern", exact: true })).toBeVisible();
-  await expect(page.getByRole("link", { name: "Compare", exact: true }).last()).toBeVisible();
-  await expect(page.getByRole("link", { name: "Build wording", exact: true }).last()).toBeVisible();
-  await expectNoHorizontalOverflow(page);
-  await expectNoBlockingAxeViolations(page, testInfo);
-});
-
-test("keeps the base diagnosis severity-neutral when applying a severity descriptor", async ({ page }) => {
-  await gotoApp(page, "/specifiers/builder?specifier=mild-severity");
-
-  await expect(page.getByRole("combobox", { name: "Diagnostic phrase" })).toHaveValue("mdd-recurrent");
-  await expect(page.getByText("Major depressive disorder, recurrent, mild", { exact: true })).toBeVisible();
-  await expect(page.getByText(/severe, mild|moderate, mild/i)).toHaveCount(0);
-
-  const anxiousDistress = page.getByRole("checkbox", { name: /Anxious distress/ });
-  await page.getByText("Anxious distress", { exact: true }).click();
-  await expect(anxiousDistress).toBeChecked();
-  await expect(
-    page.getByText("Major depressive disorder, recurrent, with anxious distress, mild", { exact: true }),
-  ).toBeVisible();
-});
-
-test("blocks incompatible specifiers and preserves severe psychotic-features wording", async ({ page }) => {
-  await gotoApp(page, "/specifiers/builder?specifier=with-rapid-cycling&specifier=with-psychotic-features");
-
-  const rapidCycling = page.getByRole("checkbox", { name: /Rapid cycling/ });
-  await expect(rapidCycling).toBeDisabled();
-  await expect(rapidCycling).not.toBeChecked();
-  await expect(
-    page.getByText("Major depressive disorder, recurrent, severe with psychotic features", { exact: true }),
-  ).toBeVisible();
-
-  await page.getByRole("combobox", { name: "Diagnostic phrase" }).selectOption("bipolar-i-manic");
-  await expect(rapidCycling).toBeEnabled();
-  await page.getByText("Rapid cycling", { exact: true }).click();
-  await expect(rapidCycling).toBeChecked();
-});

From 5d1e00ecce97e84f335731b4768e6bd301abfb74 Mon Sep 17 00:00:00 2001
From: BigSimmo <87357024+BigSimmo@users.noreply.github.com>
Date: Tue, 14 Jul 2026 20:54:43 +0800
Subject: [PATCH 2/5] fix(formulation): preserve safe legacy and draft flows

---
 src/app/specifiers/[[...path]]/page.tsx           | 15 ++++++++++++++-
 .../formulation/formulation-builder-page.tsx      |  7 ++++++-
 tests/ui-formulation.spec.ts                      | 15 +++++++++++++++
 3 files changed, 35 insertions(+), 2 deletions(-)

diff --git a/src/app/specifiers/[[...path]]/page.tsx b/src/app/specifiers/[[...path]]/page.tsx
index d5f23fe32..35641bf7f 100644
--- a/src/app/specifiers/[[...path]]/page.tsx
+++ b/src/app/specifiers/[[...path]]/page.tsx
@@ -1,5 +1,7 @@
 import { redirect } from "next/navigation";
 
+import { findFormulationMechanism } from "@/lib/formulation";
+
 type LegacySpecifierRouteProps = {
   params: Promise<{ path?: string[] }>;
   searchParams?: Promise<Record<string, string | string[] | undefined>>;
@@ -13,7 +15,18 @@ export default async function LegacySpecifierRoute({ params, searchParams }: Leg
     if (Array.isArray(value)) value.forEach((item) => nextParams.append(key === "specifier" ? "mechanism" : key, item));
     else if (value) nextParams.set(key === "specifier" ? "mechanism" : key, value);
   }
-  const pathname = ["/formulation", ...path].join("/");
+
+  const [legacyDestination] = path;
+  const canPreserveDestination =
+    path.length === 1 &&
+    (["builder", "compare", "map"].includes(legacyDestination) || Boolean(findFormulationMechanism(legacyDestination)));
+  const pathname = canPreserveDestination ? `/formulation/${legacyDestination}` : "/formulation";
+
+  if (path.length && !canPreserveDestination && !nextParams.has("q")) {
+    nextParams.set("q", path.join(" ").replaceAll("-", " "));
+    nextParams.set("run", "1");
+  }
+
   const suffix = nextParams.toString();
   redirect(suffix ? `${pathname}?${suffix}` : pathname);
 }
diff --git a/src/components/formulation/formulation-builder-page.tsx b/src/components/formulation/formulation-builder-page.tsx
index 89c7ff146..674c8b90e 100644
--- a/src/components/formulation/formulation-builder-page.tsx
+++ b/src/components/formulation/formulation-builder-page.tsx
@@ -242,6 +242,11 @@ export function FormulationBuilderPage({
     setEditedDraft(null);
   }
 
+  function clearMechanisms() {
+    setSelectedIds([]);
+    setEditedDraft(null);
+  }
+
   function updateSection(id: string, value: string) {
     setSectionNotes((current) => ({ ...current, [id]: value }));
     setEditedDraft(null);
@@ -309,7 +314,7 @@ export function FormulationBuilderPage({
                       </div>
                       <button
                         type="button"
-                        onClick={() => setSelectedIds([])}
+                        onClick={clearMechanisms}
                         className="inline-flex min-h-tap items-center gap-2 rounded-lg px-3 text-xs font-bold text-[color:var(--text-muted)] hover:bg-[color:var(--surface)]"
                       >
                         <RotateCcw className="h-3.5 w-3.5" aria-hidden />
diff --git a/tests/ui-formulation.spec.ts b/tests/ui-formulation.spec.ts
index 344a93f10..973b922be 100644
--- a/tests/ui-formulation.spec.ts
+++ b/tests/ui-formulation.spec.ts
@@ -135,10 +135,25 @@ test("moves a selected mechanism through framework, quality review, and an edita
   const draft = page.getByRole("textbox", { name: "Formulation draft" });
   await expect(draft).toHaveValue(/CBT cycle formulation/);
   await expect(draft).toHaveValue(/Rumination appears to keep the patient caught/);
+
+  await draft.fill("Stale edited draft");
+  await page.getByRole("button", { name: /Select\s+Mechanisms/ }).click();
+  await page.getByRole("button", { name: "Clear" }).click();
+  await page.getByRole("button", { name: /Draft\s+Formulation/ }).click();
+  await expect(draft).not.toHaveValue("Stale edited draft");
+  await expect(draft).toHaveValue(/Select mechanisms and add case evidence/);
   await expectNoHorizontalOverflow(page);
   await expectNoBlockingAxeViolations(page, testInfo);
 });
 
+test("keeps legacy specifier detail links on a valid formulation route", async ({ page }) => {
+  await gotoApp(page, "/specifiers/with-anxious-distress");
+
+  await expect(page).toHaveURL(/\/formulation\?q=with\+anxious\+distress&run=1$/);
+  await expect(page.getByRole("heading", { name: /Mechanisms matching “with anxious distress”/ })).toBeVisible();
+  await expect(page.getByText("Page not found", { exact: true })).toHaveCount(0);
+});
+
 test("compares supported alternatives and groups mechanisms without implying causation", async ({ page }) => {
   await gotoApp(page, "/formulation/compare?a=rumination&b=worry");
   await expect(page.getByRole("heading", { name: "Compare mechanisms" })).toBeVisible();

From 27a30363cd5c9e0c641b663cd753e5c75236212a Mon Sep 17 00:00:00 2001
From: BigSimmo <87357024+BigSimmo@users.noreply.github.com>
Date: Tue, 14 Jul 2026 21:02:37 +0800
Subject: [PATCH 3/5] fix(formulation): align legacy compare and governance
 state

---
 src/app/formulation/compare/page.tsx                  | 10 +++++++++-
 src/app/specifiers/[[...path]]/page.tsx               | 11 ++++++++---
 .../formulation/formulation-compare-page.tsx          |  1 +
 src/data/formulation-content.json                     |  4 ++--
 tests/formulation.test.ts                             |  7 +++++++
 tests/ui-formulation.spec.ts                          |  5 +++++
 6 files changed, 32 insertions(+), 6 deletions(-)

diff --git a/src/app/formulation/compare/page.tsx b/src/app/formulation/compare/page.tsx
index ac29c74f4..ec5cef21a 100644
--- a/src/app/formulation/compare/page.tsx
+++ b/src/app/formulation/compare/page.tsx
@@ -10,5 +10,13 @@ function firstParam(value: string | string[] | undefined) {
 
 export default async function FormulationCompareRoute({ searchParams }: CompareRouteProps) {
   const params = searchParams ? await searchParams : {};
-  return <FormulationComparePage initialLeft={firstParam(params.a)} initialRight={firstParam(params.b)} />;
+  const initialLeft = firstParam(params.a);
+  const initialRight = firstParam(params.b);
+  return (
+    <FormulationComparePage
+      key={`${initialLeft ?? ""}:${initialRight ?? ""}`}
+      initialLeft={initialLeft}
+      initialRight={initialRight}
+    />
+  );
 }
diff --git a/src/app/specifiers/[[...path]]/page.tsx b/src/app/specifiers/[[...path]]/page.tsx
index 35641bf7f..df5422024 100644
--- a/src/app/specifiers/[[...path]]/page.tsx
+++ b/src/app/specifiers/[[...path]]/page.tsx
@@ -10,13 +10,18 @@ type LegacySpecifierRouteProps = {
 export default async function LegacySpecifierRoute({ params, searchParams }: LegacySpecifierRouteProps) {
   const { path = [] } = await params;
   const values = searchParams ? await searchParams : {};
+  const [legacyDestination] = path;
+  const isLegacyCompare = path.length === 1 && legacyDestination === "compare";
   const nextParams = new URLSearchParams();
   for (const [key, value] of Object.entries(values)) {
-    if (Array.isArray(value)) value.forEach((item) => nextParams.append(key === "specifier" ? "mechanism" : key, item));
-    else if (value) nextParams.set(key === "specifier" ? "mechanism" : key, value);
+    const items = Array.isArray(value) ? value : value ? [value] : [];
+    if (key === "specifier" && isLegacyCompare) {
+      items.slice(0, 2).forEach((item, index) => nextParams.append(index === 0 ? "a" : "b", item));
+    } else {
+      items.forEach((item) => nextParams.append(key === "specifier" ? "mechanism" : key, item));
+    }
   }
 
-  const [legacyDestination] = path;
   const canPreserveDestination =
     path.length === 1 &&
     (["builder", "compare", "map"].includes(legacyDestination) || Boolean(findFormulationMechanism(legacyDestination)));
diff --git a/src/components/formulation/formulation-compare-page.tsx b/src/components/formulation/formulation-compare-page.tsx
index ddd0d8721..1c943258b 100644
--- a/src/components/formulation/formulation-compare-page.tsx
+++ b/src/components/formulation/formulation-compare-page.tsx
@@ -54,6 +54,7 @@ function Selector({
           aria-hidden
         />
         <select
+          aria-label={`Mechanism ${label}`}
           value={value}
           onChange={(event) => onChange(event.target.value)}
           className="min-h-12 w-full rounded-lg border border-[color:var(--border-strong)] bg-[color:var(--surface)] pl-10 pr-9 text-sm font-bold text-[color:var(--text-heading)] shadow-[var(--shadow-inset)] outline-none focus:border-[color:var(--focus)] focus:ring-4 focus:ring-[color:var(--focus)]/20"
diff --git a/src/data/formulation-content.json b/src/data/formulation-content.json
index ba0019e27..0f3d27e47 100644
--- a/src/data/formulation-content.json
+++ b/src/data/formulation-content.json
@@ -983,9 +983,9 @@
   "governance": {
     "contentGovernance": {
       "contentVersion": "Source review v1",
-      "confirmationNote": "Linked sources have static metadata review, and owner confirmation is now complete for release.",
+      "confirmationNote": "Linked sources have static metadata review; local owner confirmation remains pending before clinical deployment.",
       "jurisdictionMode": "jurisdiction-neutral",
-      "releaseStatus": "owner-confirmed-source-review-complete"
+      "releaseStatus": "source-review-complete-owner-confirmation-pending"
     },
     "sourceReviewRegistry": {
       "cbt": {
diff --git a/tests/formulation.test.ts b/tests/formulation.test.ts
index 295c18837..5e17a451e 100644
--- a/tests/formulation.test.ts
+++ b/tests/formulation.test.ts
@@ -1,5 +1,6 @@
 import { describe, expect, it } from "vitest";
 
+import formulationContent from "@/data/formulation-content.json";
 import {
   comparisonGuideFor,
   findFormulationMechanism,
@@ -35,6 +36,12 @@ describe("clinical formulation content", () => {
     }
   });
 
+  it("keeps release readiness separate from pending owner confirmation", () => {
+    expect(formulationContent.governance.contentReviewSummary.pendingOwnerConfirmations).toBeGreaterThan(0);
+    expect(formulationContent.governance.contentGovernance.confirmationNote).toMatch(/confirmation remains pending/i);
+    expect(formulationContent.governance.contentGovernance.releaseStatus).not.toMatch(/^owner-confirmed/);
+  });
+
   it("matches patient language and clinical clues to mechanisms", () => {
     expect(searchFormulationMechanisms("I keep going over it")[0]?.mechanism.id).toBe("rumination");
     expect(searchFormulationMechanisms("What if something goes wrong")[0]?.mechanism.id).toBe("worry");
diff --git a/tests/ui-formulation.spec.ts b/tests/ui-formulation.spec.ts
index 973b922be..70c59c803 100644
--- a/tests/ui-formulation.spec.ts
+++ b/tests/ui-formulation.spec.ts
@@ -152,6 +152,11 @@ test("keeps legacy specifier detail links on a valid formulation route", async (
   await expect(page).toHaveURL(/\/formulation\?q=with\+anxious\+distress&run=1$/);
   await expect(page.getByRole("heading", { name: /Mechanisms matching “with anxious distress”/ })).toBeVisible();
   await expect(page.getByText("Page not found", { exact: true })).toHaveCount(0);
+
+  await gotoApp(page, "/specifiers/compare?specifier=rumination&specifier=worry");
+  await expect(page).toHaveURL(/\/formulation\/compare\?a=rumination&b=worry$/);
+  await expect(page.getByRole("combobox", { name: "Mechanism A" })).toHaveValue("rumination");
+  await expect(page.getByRole("combobox", { name: "Mechanism B" })).toHaveValue("worry");
 });
 
 test("compares supported alternatives and groups mechanisms without implying causation", async ({ page }) => {

From 2a6cb56b2a6a1055892703dd2b0f691c01e8ab3b Mon Sep 17 00:00:00 2001
From: BigSimmo <87357024+BigSimmo@users.noreply.github.com>
Date: Tue, 14 Jul 2026 21:06:03 +0800
Subject: [PATCH 4/5] fix(formulation): preserve legacy search queries

---
 src/app/specifiers/[[...path]]/page.tsx | 3 ++-
 tests/ui-formulation.spec.ts            | 5 +++++
 2 files changed, 7 insertions(+), 1 deletion(-)

diff --git a/src/app/specifiers/[[...path]]/page.tsx b/src/app/specifiers/[[...path]]/page.tsx
index df5422024..c2cdc84a6 100644
--- a/src/app/specifiers/[[...path]]/page.tsx
+++ b/src/app/specifiers/[[...path]]/page.tsx
@@ -18,7 +18,8 @@ export default async function LegacySpecifierRoute({ params, searchParams }: Leg
     if (key === "specifier" && isLegacyCompare) {
       items.slice(0, 2).forEach((item, index) => nextParams.append(index === 0 ? "a" : "b", item));
     } else {
-      items.forEach((item) => nextParams.append(key === "specifier" ? "mechanism" : key, item));
+      const destinationKey = key === "specifier" ? "mechanism" : key === "query" ? "q" : key;
+      items.forEach((item) => nextParams.append(destinationKey, item));
     }
   }
 
diff --git a/tests/ui-formulation.spec.ts b/tests/ui-formulation.spec.ts
index 70c59c803..711b535fa 100644
--- a/tests/ui-formulation.spec.ts
+++ b/tests/ui-formulation.spec.ts
@@ -157,6 +157,11 @@ test("keeps legacy specifier detail links on a valid formulation route", async (
   await expect(page).toHaveURL(/\/formulation\/compare\?a=rumination&b=worry$/);
   await expect(page.getByRole("combobox", { name: "Mechanism A" })).toHaveValue("rumination");
   await expect(page.getByRole("combobox", { name: "Mechanism B" })).toHaveValue("worry");
+
+  await gotoApp(page, "/specifiers?query=I+keep+going+over+it&run=1");
+  await expect(page).toHaveURL(/\/formulation\?q=I\+keep\+going\+over\+it&run=1$/);
+  await expect(page.getByRole("heading", { name: /Mechanisms matching “I keep going over it”/ })).toBeVisible();
+  await expect(page.getByRole("link", { name: "Rumination", exact: true })).toBeVisible();
 });
 
 test("compares supported alternatives and groups mechanisms without implying causation", async ({ page }) => {

From ce6baa31ffe9647d736a18e95f9d95a95bda313c Mon Sep 17 00:00:00 2001
From: BigSimmo <87357024+BigSimmo@users.noreply.github.com>
Date: Tue, 14 Jul 2026 21:23:14 +0800
Subject: [PATCH 5/5] fix(formulation): route unsupported legacy selections
 safely

---
 src/app/specifiers/[[...path]]/page.tsx | 34 +++++++++++++++++++++++--
 tests/ui-formulation.spec.ts            | 10 ++++++++
 2 files changed, 42 insertions(+), 2 deletions(-)

diff --git a/src/app/specifiers/[[...path]]/page.tsx b/src/app/specifiers/[[...path]]/page.tsx
index c2cdc84a6..ef39e3729 100644
--- a/src/app/specifiers/[[...path]]/page.tsx
+++ b/src/app/specifiers/[[...path]]/page.tsx
@@ -7,6 +7,10 @@ type LegacySpecifierRouteProps = {
   searchParams?: Promise<Record<string, string | string[] | undefined>>;
 };
 
+function humanizeLegacyMechanism(value: string) {
+  return value.replaceAll("-", " ").trim();
+}
+
 export default async function LegacySpecifierRoute({ params, searchParams }: LegacySpecifierRouteProps) {
   const { path = [] } = await params;
   const values = searchParams ? await searchParams : {};
@@ -23,13 +27,39 @@ export default async function LegacySpecifierRoute({ params, searchParams }: Leg
     }
   }
 
-  const canPreserveDestination =
+  let canPreserveDestination =
     path.length === 1 &&
     (["builder", "compare", "map"].includes(legacyDestination) || Boolean(findFormulationMechanism(legacyDestination)));
+
+  const mechanismParamKeys =
+    legacyDestination === "compare"
+      ? ["a", "b"]
+      : legacyDestination === "builder" || legacyDestination === "map"
+        ? ["mechanism"]
+        : [];
+  const requestedMechanisms = mechanismParamKeys.flatMap((key) => nextParams.getAll(key));
+  const hasUnsupportedMechanism = requestedMechanisms.some((id) => !findFormulationMechanism(id));
+
+  if (hasUnsupportedMechanism) {
+    canPreserveDestination = false;
+    mechanismParamKeys.forEach((key) => nextParams.delete(key));
+    if (!nextParams.has("q")) {
+      nextParams.set("q", requestedMechanisms.map(humanizeLegacyMechanism).join(" versus "));
+    }
+    nextParams.set("run", "1");
+  }
+
+  if (!path.length && nextParams.has("mechanism")) {
+    const requested = nextParams.getAll("mechanism");
+    nextParams.delete("mechanism");
+    if (!nextParams.has("q")) nextParams.set("q", requested.map(humanizeLegacyMechanism).join(" "));
+    nextParams.set("run", "1");
+  }
+
   const pathname = canPreserveDestination ? `/formulation/${legacyDestination}` : "/formulation";
 
   if (path.length && !canPreserveDestination && !nextParams.has("q")) {
-    nextParams.set("q", path.join(" ").replaceAll("-", " "));
+    nextParams.set("q", humanizeLegacyMechanism(path.join(" ")));
     nextParams.set("run", "1");
   }
 
diff --git a/tests/ui-formulation.spec.ts b/tests/ui-formulation.spec.ts
index 711b535fa..ca14a5205 100644
--- a/tests/ui-formulation.spec.ts
+++ b/tests/ui-formulation.spec.ts
@@ -162,6 +162,16 @@ test("keeps legacy specifier detail links on a valid formulation route", async (
   await expect(page).toHaveURL(/\/formulation\?q=I\+keep\+going\+over\+it&run=1$/);
   await expect(page.getByRole("heading", { name: /Mechanisms matching “I keep going over it”/ })).toBeVisible();
   await expect(page.getByRole("link", { name: "Rumination", exact: true })).toBeVisible();
+
+  await gotoApp(page, "/specifiers/builder?specifier=with-psychotic-features");
+  await expect(page).toHaveURL(/\/formulation\?q=with\+psychotic\+features&run=1$/);
+  await expect(page.getByRole("heading", { name: /Mechanisms matching “with psychotic features”/ })).toBeVisible();
+
+  await gotoApp(page, "/specifiers/compare?a=with-anxious-distress&b=with-mixed-features");
+  await expect(page).toHaveURL(/\/formulation\?q=with\+anxious\+distress\+versus\+with\+mixed\+features&run=1$/);
+  await expect(
+    page.getByRole("heading", { name: /Mechanisms matching “with anxious distress versus with mixed features”/ }),
+  ).toBeVisible();
 });
 
 test("compares supported alternatives and groups mechanisms without implying causation", async ({ page }) => {