Guide
Guide | Reference

44  Appendix H: When Not to Label Yet

Purpose. Clarify when delaying a prototype label improves accuracy and safety. Reinforce uncertainty-aware documentation. Optional reference material; not required for routine use.

44.1 Consider Deferring Labels When

  • First episode with acute onset and unclear course.
  • Prominent substance or medication change, intoxication, or withdrawal.
  • Medical or neurologic workup is incomplete.
  • Severe sleep or circadian disruption likely drives symptoms.
  • Recent major stressor or bereavement with unclear persistence.
  • Insufficient longitudinal history or collateral information.
  • High risk requires stabilization before classification.
  • Two or more competing explanations remain plausible.

44.2 What to Do Instead

  • Use domain ratings with time-course specifiers.
  • Document competing explanations and confidence level.
  • Use “provisional” if a label is required for access.
  • Set a reassessment interval and triggers.
  • Use measurement prompts to track change.

44.3 When Labeling Is Appropriate

  • Time-course is established and persistent or recurrent.
  • Rule-outs are addressed and contributors documented.
  • Functional impact is clear and linked to the pattern.
  • A prototype adds communication value for care coordination.

44.4 Documentation Snippet (1 line)

  • “Prototype deferred; Domains: Threat 2, Arousal 3; competing explanations noted; reassess in 4 weeks.”