This skill handles the pre-protocol phase of a meta-analysis — from idea to ranked topic list.
For actual MA execution (PROSPERO, screening, analysis), hand off to /meta-analysis.
Mode Selection
| Signal | Mode |
|---|---|
| Professor name or profile URL provided | A: Professor-first |
| Clinical question, keyword, trend, or "find me a topic" | B: Topic-first |
| Both supplied (e.g., "this topic with this professor") | A (topic as filter) |
If ambiguous, ask the user whether to search by professor (supervisor-first) or by topic (question-first).
Inputs
Mode A: Professor-first
- Professor name (native-language + English); profile URL (ScholarWorks, SKKU Faculty, Google Scholar, ORCID); PubMed author link (preferably with cauthor_id for disambiguation); known specialty; affiliation history (e.g., "Hospital A → Hospital B → retired")
- Minimum required: name + at least one profile URL or PubMed link
Mode B: Topic-first
- Clinical question or keyword; radiology subspecialty scope; MA type preference (DTA, prognostic, intervention — optional); desired role (solo first author / co-first / supervisor-matched)
- Minimum required: clinical question or keyword
Workflow
Mode A (Professor-first): Phase 0 → 1 → 2 → 3 → 4 → 5 Mode B (Topic-first): T-Phase 0 → T-1 → T-2 → T-3 → T-4 → T-5 Phase 2 (MA Gap Analysis) and Phase 4 (README template) are shared between both modes.
Query PubMed with /search-lit's E-utilities scripts, not WebFetch — they are faster and return
structured JSON/XML: ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh and
parse_pubmed.py beside it. Rate limit: 350 ms between calls (100 ms with NCBI_API_KEY).
Phase 0: Disambiguation & Context Confirmation
Resolve the author's identity BEFORE any PubMed search:
- Resolve the full English name first. If a cauthor_id is provided, fetch that PMID page to
get the full name + affiliation. NEVER start with an initials-only search, because common
Korean/Asian initials (e.g., "Lee KS") return 300+ papers with massive contamination. The first
search must be
"[Full Name]"[Author]. - Confirm the affiliation chain with the user. Ask whether
{detected affiliation}matches the professor's history (professors move institutions — do not assume), and ask the user's relationship to the professor so topic proposals can be tuned. Skip only if the user already gave an explicit affiliation history. - Profile URL fallback chain:
- 1st: PubMed full-name search (always works)
- 2nd: Google Scholar profile (WebSearch
"[Full Name]" radiology scholar) - 3rd: ResearchGate profile (WebSearch
"[Full Name]" researchgate radiology) - 4th: ScholarWorks / SKKU / university faculty page (if URL provided)
- Last: Scopus/ScienceDirect — returns 403 or a login redirect; never rely on it
Phase 1: Profile Exploration (E-utilities API)
Goal: Identify the professor's 5-6 distinct research pillars.
Step 1 — Total publication count + PMID list:
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh search \
'"[Full Name]"[Author]' 200 \
| python3 ${CLAUDE_SKILL_DIR}/../search-lit/references/parse_pubmed.py esearch
If the parser exits non-zero (an error body, or no count), the count is unknown — re-run the
search; never record it as 0 papers or 0 MAs.
Step 2 — Fetch metadata for MeSH-based clustering (parallel):
# Get PMIDs from Step 1, then fetch summaries
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh fetch_json \
"PMID1,PMID2,..." \
| python3 ${CLAUDE_SKILL_DIR}/../search-lit/references/parse_pubmed.py esummary
Step 3 — Topic-specific counts (launch 4-5 searches in parallel Bash calls):
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh search \
'"[Full Name]"[Author] AND "keyword1"' 5
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh search \
'"[Full Name]"[Author] AND "keyword2"' 5
# ... repeat for each suspected pillar keyword
Step 4 — MeSH term extraction for automatic pillar clustering:
# Fetch full XML for top-cited papers to extract MeSH headings
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh fetch \
"PMID1,PMID2,...,PMID20" \
| python3 -c "
import sys, xml.etree.ElementTree as ET
from collections import Counter
root = ET.fromstring(sys.stdin.read())
mesh_counts = Counter()
for article in root.findall('.//PubmedArticle'):
for mh in article.findall('.//MeshHeading/DescriptorName'):
mesh_counts[mh.text] += 1
for term, count in mesh_counts.most_common(30):
print(f'{count:3d} {term}')
"
→ Top MeSH terms reveal natural research pillars (e.g., "Colonography, Computed Tomographic" = CTC pillar).
Step 5 — Google Scholar profile (parallel with PubMed calls): WebSearch
"[Full Name]" radiology scholar google for h-index and citation data; WebFetch any other profile
URL the user provided (skip Scopus).
Output: Pillar Summary Table. Publication counts and pillar assignments come from E-utilities output and the h-index from the Scholar profile — never estimate them.
| Pillar | Domain | Representative keywords | MeSH terms | Est. # papers |
|---|---|---|---|---|
| 1 | ... | ... | ... | ~N+ |
Phase 2: MA Gap Analysis (Multi-Source)
Goal: For each pillar, determine if a viable MA topic exists using PubMed + Consensus + Scholar Gateway + bioRxiv + PROSPERO.
Run pillars in parallel: up to 4 subagents, each covering 1-2 pillars and running 2a–2g, each reporting raw k, realistic k and every source checked. If PubMed returns 0 or Consensus/Scholar Gateway is unavailable, state that limitation rather than guessing.
2a. PubMed E-utilities — Existing MAs + Primary studies
# Existing MAs (structured count)
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh search \
'[pillar keywords] AND ("meta-analysis"[pt] OR "systematic review"[pt])' 50
# Primary studies with extractable outcomes
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh search \
'[pillar keywords] AND ("sensitivity" OR "specificity" OR "accuracy" OR "prognosis" OR "outcome")' 50
2b. Consensus MCP — Semantic MA gap detection
Use mcp__claude_ai_Consensus__search to find existing SRs/MAs that PubMed keyword search might miss:
query: "systematic review OR meta-analysis [pillar topic] [imaging modality]"
Consensus returns citation-ranked results — check if any highly-cited MA already covers the proposed scope. Limit: max 3 Consensus calls per Phase 2 batch, in total across all agents (rate limit). If rate-limited, wait 30 s and retry once.
2c. Scholar Gateway — Semantic similarity search
Use mcp__claude_ai_Scholar_Gateway__semanticSearch to find MAs under different terminology
(e.g., "pooled analysis" instead of "meta-analysis"), scope-overlapping MAs that use different
keywords, and methodological reviews that partially cover the topic.
2d. bioRxiv/medRxiv — In-press competition detection
Use mcp__claude_ai_bioRxiv__search_preprints to catch MAs posted as preprints but not yet in
PubMed, SR/MA protocols shared as preprints, and very recent primary studies that could change
feasibility.
query: "[pillar keywords] meta-analysis OR systematic review"
server: "medrxiv" (clinical topics; "biorxiv" for preclinical)
2e. Assessment matrix
| Factor | Criteria |
|---|---|
| MA gap | 0 existing = best, 1-3 = check scope overlap, >5 = saturated |
| Primary k | ≥8 for DTA, ≥6 for prognostic (minimum), ≥15 ideal |
| Recency | Last MA >5 years old = update opportunity |
| Competition | Check the last two years for very recent MAs that block entry |
2f. PROSPERO competition check (MANDATORY)
- Search PROSPERO via WebSearch
site:crd.york.ac.uk/prospero [topic keywords]; also try WebFetchhttps://www.crd.york.ac.uk/prospero/#searchadvanced - Look for registered-but-unpublished protocols that could block entry; if a PROSPERO match is found → flag as 🚫 competition risk in ranking
- Record the exact query, the search date and one status:
searched (match found),searched (no match), ornot checked (unavailable/failed); a fetch that returns the site shell or an error page instead of a result list isnot checked. Onlysearched (no match)clears the PROSPERO gate.
2g. Realistic k estimation
- Raw PubMed hit count is NOT the real k — most studies lack 2x2 data or HR, so raw counts overestimate by 3-7x
- Apply conservative discount: k_realistic ≈ raw_count × 0.15–0.30 for DTA topics
- Flag if k_realistic < 8 (DTA) or < 6 (prognostic) as ⚠️ feasibility risk
- Report both raw and realistic estimates, e.g.,
estimated k: ~130 (raw) → ~20–40 (extractable DTA data)
2h. Niche subtopic discovery (if pillar appears saturated, >5 prior MAs)
Try these angles, and use Consensus to check whether the niche angle has already been covered:
- "First MA" rule: the professor's most unique/niche subtopic where MA = 0
- AI/radiomics overlay: classical imaging topic + AI approach
- Treatment response: diagnosis MAs are often saturated; treatment monitoring is often open
- Modality comparison: head-to-head (e.g., CEUS vs MRI) is often underserved
- Guideline gap: professor-authored guidelines → MA supporting/updating them
- Population niche: specific subpopulation, disease subtype, or regional population (e.g., parasitic diseases, TB)
- Temporal update: last MA >5 years old + significant new primary studies since
Phase 3: Topic Ranking
Goal: Rank all viable topics by composite score. Score each candidate on 5 criteria (★1-5):
| Criteria | Weight | Description |
|---|---|---|
| Professor fit | Highest | Core area of the professor's career, publication count, distinctive contribution |
| MA gap | High | No prior MA > ≥5 yr since last MA > recent MA exists |
| Feasibility (k) | High | Number of includable studies and extractability of 2×2 or HR data |
| Clinical impact | Medium | Whether the topic directly informs clinical decision-making |
| Execution ease | Medium | Completable from literature alone; difficulty of managing heterogeneity |
Output: Ranked Topic Table
| Rank | Topic | Professor's Pillar | Prior MA | Estimated k (raw→realistic) | PROSPERO competition | Verdict |
|---|---|---|---|---|---|---|
| 1 | ... | ... | 0 | ~98 → 15–30 | None | ✅ Best fit |
Phase 4: Folder & README Scaffolding
Goal: Create project folders and README for each viable topic.
- Folder location:
{working_dir}/ma-scout/{initials}_{professor_name}/{NN}_{topic_slug}/- Professor folder:
{initials}_{name}(e.g.,KDK_Kim,LKS_Lee) - NN: sequential number within professor (01, 02, ...); topic_slug: English, underscore-separated
- Check existing folders with
lsbefore creating
- Professor folder:
- README.md (PROSPERO-ready): copy the template block from
${CLAUDE_SKILL_DIR}/references/project_readme_template.mdinto{topic_folder}/README.mdand fill it (PICO/PIRD frame, preliminary search, target journal table, backward-planned timeline). Write the research question, PICO/PIRD and README content in English, medical terms always in English, unless the user asks for the Korean PI-facing variant that reference names.
Phase 5: Output Summary
- Save the ranked topic table and README files to the working directory.
- Summarize: total topics scanned, viable topics found, recommended next steps (see Handoff).
T-Phase 0: Topic Clarification & Scope
Goal: Refine the user's clinical question into a searchable, PROSPERO-registrable scope. When
the user asks for topic suggestions without a specific idea, read
${CLAUDE_SKILL_DIR}/references/topic_discovery_heuristics.md first to generate candidate questions.
- Parse the input — disease/condition (e.g., "hepatocellular carcinoma"); imaging modality or intervention (e.g., "dual-energy CT", "AI CAD"); outcome type: DTA (Se/Sp), prognostic (HR/OR), intervention (RR/MD), dosimetry; population specifics (e.g., "screening setting", "cirrhotic patients").
- Expand to neighboring angles — propose 3-5 variations, e.g.:
user input: "AI for lung nodule malignancy prediction" → variant 1: AI vs radiologist for lung nodule malignancy prediction (DTA) → variant 2: Radiomics for lung nodule malignancy (DTA) → variant 3: Deep learning for incidental pulmonary nodule management (prognostic) - User selects 1-3 angles to investigate further.
T-Phase 1: Landscape Scan (Multi-Source)
Goal: For each selected angle, rapidly assess the MA landscape. Run all angles in parallel. For each angle:
1a. PubMed — Existing MA count
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh search \
'[topic keywords] AND ("meta-analysis"[pt] OR "systematic review"[pt])' 50
1b. PubMed — Primary study pool
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh search \
'[topic keywords] AND ("sensitivity" OR "specificity" OR "hazard" OR "outcome")' 100
1c. Consensus MCP — Semantic MA discovery
query: "systematic review [topic] [modality]"
Check for MAs using different terminology.
1d. bioRxiv/medRxiv — Preprint competition
query: "[topic] meta-analysis"
server: "medrxiv"
1e. PROSPERO — Registered protocols
WebSearch: site:crd.york.ac.uk/prospero [topic keywords]
Output: Landscape Summary Table
| Variant | Existing MAs | Primary k (raw) | k (realistic) | PROSPERO | Preprint MA | Verdict |
|---|---|---|---|---|---|---|
| 1 | 3 | 120 | 18-36 | 1 | 0 | ⚠️ Competitive |
| 2 | 0 | 85 | 13-25 | 0 | 0 | ✅ Optimal |
T-Phase 2: Feasibility Deep-Dive
Goal: For viable angles (MA ≤ 2, no PROSPERO conflict), run the same Phase 2 (MA Gap Analysis) as Mode A — steps 2a through 2h. With no "Professor fit" to evaluate, focus on:
- Gap certainty — are existing MAs truly non-overlapping with proposed scope?
- k quality — are primary studies heterogeneous enough to warrant MA, or too uniform?
- User's domain fit — does this align with user's radiology AI / imaging expertise?
T-Phase 3: Topic Ranking (Topic-first weights)
| Criteria | Weight | Description |
|---|---|---|
| MA gap | Highest | No existing MA > update opportunity > saturated |
| Feasibility (k) | Highest | k_realistic ≥ 8 (DTA) or ≥ 6 (prognostic) |
| User domain fit | High | Does it match the user's area of expertise? |
| Clinical impact | Medium | Potential to change guidelines; directly tied to clinical decisions |
| Co-author availability | Medium | Access to a domain expert (existing relationship or easy to reach) |
| Execution ease | Medium | Can be done solo vs requires expert interpretation |
Output: Ranked Topic Table
| Rank | Topic | Existing MAs | Est. k | PROSPERO | Co-author needed | Overall |
|---|---|---|---|---|---|---|
| 1 | ... | 0 | 25 | None | Optional | ✅ Optimal |
T-Phase 4: Co-Author Matching (Optional)
Goal: If the user wants a senior co-author, find candidates.
Strategy 1 — Existing network: check memory files and existing professor folders in the working directory for professors whose pillar naturally covers this topic (best match).
Strategy 2 — PubMed reverse search:
# Find prolific authors in this specific topic
bash ${CLAUDE_SKILL_DIR}/../search-lit/references/pubmed_eutils.sh search \
'[topic keywords] AND ("{user_country}"[Affiliation])' 100
Then E-utilities efetch → author frequency; the top 5 most-published authors in this niche are potential co-authors. Cross-check Google Scholar for h-index and recent activity.
Strategy 3 — Self-led (no senior co-author): viable when the user has 2+ published MAs and the topic is methodologically straightforward. A 2nd reviewer (junior colleague or peer) is still needed — flag this in the README. Corresponding author = user.
Output: Co-author recommendation table or a "solo-viable" judgment.
T-Phase 5: Folder & README Scaffolding (Topic-first)
- Folder location:
{working_dir}/ma-scout/TOPIC/{NN}_{Topic_Abbreviation}/(e.g.,01_AI_Lung_Nodule_DTA/). Topic-first projects use theTOPIC/prefix, not professor initials; if a co-author is matched later, the folder can move under the professor folder. - README.md: the Phase 4 template with the Solo-Mode Adaptations in
${CLAUDE_SKILL_DIR}/references/project_readme_template.md(Lead/Domain rows, Team Expertise, self-led timeline). - Summary: same as Mode A Phase 5 — save ranked results and recommend next steps.
Quality Gates
Before finalizing a topic as viable:
- (A) Author identity confirmed — full name resolved via E-utilities efetch, no initials-only contamination
- (A) Affiliation confirmed with user (or from reliable source)
- (A) Professor's publication record demonstrates clear authority in this area
- (B) Clinical question refined to PICO/PIRD (not just a keyword)
- (A) Confirmed MA = 0 or last MA >5 years (via PubMed E-utilities, not assumption)
- Cross-validated via PubMed plus every connected semantic or preprint source (Consensus, Scholar Gateway, bioRxiv/medRxiv); a source that was unavailable is named and recorded as not checked, never as "no competing work found" — no hidden MAs with different terminology, no preprint MA in progress
- Confirmed k_realistic ≥ 8 (DTA) or ≥ 6 (prognostic), where k_realistic = raw count × 0.15–0.30 (§2g: keep 15–30% of raw hits, i.e. a 70–85% discount — not a 15–30% discount)
- PROSPERO searched — the search ran and returned results (query + date recorded, §2f), and no registered competing protocol was found. A PROSPERO search that failed or was unavailable is "not checked", never "none found": this item stays open
- No competing MA from the last two years in press or preprint
- Research question is specific enough for PROSPERO registration
- (B) User's domain expertise sufficient for clinical interpretation (or co-author identified); 2nd reviewer identified or plan to recruit
- (B) If self-led: user has ≥ 2 published MAs (otherwise, recommend co-author)
- README contains: complete PICO/PIRD, PubMed search strategy, Embase draft, target journal with IF, timeline
Handoff
- To
/meta-analysis: when a topic is approved and ready for the PROSPERO protocol (README has PICO + search strategy) - To
/manage-project: when the project folder needs full scaffolding or the user wants results saved to project management - To
/search-lit: when a deeper preliminary search is needed before committing - To
/analyze-stats: when feasibility requires power/sample-size calculation for the estimated k
Phase 6: Pre-Proposal Pipeline (Post-Scout)
After MA Scout identifies viable topics, prepare a "ready-to-propose" package before contacting the professor. Topics are independent: run up to 4 agents per wave, each doing search → fetch → triage → write files.
- Search Execution — E-utilities with broadened synonyms (retmax=200)
- Primary search:
[topic] AND [outcome keywords] - Existing MA search:
[topic] AND ("meta-analysis"[pt] OR "systematic review"[pt])
- Primary search:
- Metadata Collection —
fetch_json→esummary(batch 40-50 PMIDs) - Title-Based Triage — classify as INCLUDE / MAYBE / EXCLUDE
- Check for existing MAs within the results — the initial scout may have missed them
- Separate sub-approaches that contaminate the pool (e.g., bronchoscopic vs percutaneous)
- Flag the professor's own papers (authority evidence) and retracted papers
- PRISMA Flow Draft — Identification → Screening → Eligibility → Included (estimated)
- Gap Re-assessment — update the MA count and re-position if needed: MA=0 → "first MA" | MA=1 (>5yr) → "update MA" | MA≥3 (recent) → skip/niche
- Output Files:
candidates.md— full triage table + PRISMA flow + gap findingREADME.md— updated Preliminary Search section with actual numbers
Professor Contact Package — the pre-proposal gives the professor: candidate count + gap evidence (e.g., "MA = 0, 35 studies to include"), a clear role description (e.g., "independent screening review + discussion only"), and the urgency of PROSPERO pre-registration to secure the topic.