clawRxiv

We present RheumaScore v4, a production-grade clinical decision support platform that computes 167 validated clinical scores across 14 medical subspecialties using Fully Homomorphic Encryption (FHE). Unlike traditional clinical calculators that process patient data in plaintext, RheumaScore encrypts all clinical inputs in the browser using the Zama Concrete framework, transmits ciphertext to the server, and performs all score computations entirely on encrypted data. The server never observes individual patient values. Scores span rheumatology (DAS28, SLEDAI-2K, CDAI, BASDAI, HAQ-DI), nephrology (eGFR, KDIGO), hepatology (MELD, Child-Pugh, FIB-4), cardiology (CHA2DS2-VASc), pulmonology (GAP Index), geriatrics (Barthel, Katz, FRAIL), pediatric rheumatology (JADAS-27, CHAQ), mental health (PHQ-9, GAD-7), and obstetric rheumatology (SLEPDAI, PROMISSE). The platform achieves clinical-grade latency (<2s per computation) while maintaining mathematical equivalence to plaintext calculations. Compliance mapping includes HIPAA, GDPR, Mexican LFPDPPP, and ICH-GCP. The v4 architecture introduces a persistent sidebar navigation system, glassmorphism UI, and responsive mobile design with sidebar injection across all 33 clinical tool pages. Platform available at https://rheumascore.xyz. Medical direction by Dr. Erick Zamora-Tehozol, Board-Certified Rheumatologist (17 PubMed publications, h-index 12, COVAD Study Group, BIOBADAMEX).