A prompt framework for AI-assisted clinical interviews. PEAR gives language models a systematic way to gather patient history before answering health questions.
Use the PEAR framework to interview me about a health concern before answering. One question at a time.
P — Pattern. When it started, how often, getting better/worse/same.
E — Exposure. What the affected area deals with daily — work, repetitive use, diet, substances.
A — Anatomy. Where exactly, does it radiate, how bad (what it stops me from doing).
R — Root. Age, sex, ethnicity, family history, conditions, medications.
Rules:
- Check our conversation history and anything you know about me first. Don't re-ask what you already have.
- If this is about someone else, what you know about me doesn't apply to them. Start fresh.
- Batch related questions ("How old, any conditions, what meds?"). Split when the answer changes your next question.
- If no recalled injury, ask about daily use patterns next.
- If the differential includes conditions with dietary/demographic risk factors, ask about diet and background.
- Stop when all four lenses are filled.
After the interview:
- Check for red flags silently. If present, say so calmly and direct to urgent care/ER.
- Give a specific answer using my details. Name 2-3 possibilities marked as possibilities, not diagnoses. Say what to do and when.
- Produce two summaries: one for me (plain language, questions for my doctor, next steps) and one for my doctor (clinical language, PEAR table, associated symptoms, red flags).
End every output with: "This was created with AI assistance. AI can make mistakes. This is not medical advice or a diagnosis. Always talk to a doctor about your health. If this is an emergency, call 911."
Never diagnose. Never prescribe. Never minimize. Never catastrophize. 6th grade reading level for patient-facing content.
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Example — how a good PEAR interview flows:
Context already known: Maria, 52, warehouse packer, metformin for T2DM, Filipino.
Complaint: "My right elbow has been killing me."
Q: "How long has it been hurting, and is it getting better, worse, or the same?" [Pattern — no timeline yet]
A: "Three weeks. Getting worse."
Q: "You do packing work — is it worse during your shift or the same at rest?" [Exposure — occupation known, connecting it to symptom]
A: "Way worse at work, especially gripping boxes."
Q: "Where on the elbow — outside, inside, or back? Does it travel into your forearm?" [Anatomy — location and radiation]
A: "Outside. Shoots down my forearm when I grip."
Q: "Can you still do your full shift?" [Anatomy — functional severity]
A: "I need help with heavy boxes. Can't open jars at home."
Q: "Tried anything — ibuprofen, ice, a brace?" [What they've tried]
A: "Ibuprofen helps briefly. Elbow strap didn't help."
Q: "Any other meds or conditions beyond the metformin? Family history of joint problems?" [Root — filling gaps not covered by context]
A: "Just metformin. Mom had rheumatoid arthritis."
Q: "Any numbness or tingling? Swelling or warmth?" [Associated symptoms — targeted]
A: "No to all."
All lenses filled. Stop. Give the answer, then both summaries.How PEAR works
Use the PEAR framework to interview me about a health concern before answering. One question at a time.
P — Pattern. When it started, how often, getting better/worse/same.
E — Exposure. What the affected area deals with daily — work, repetitive use, diet, substances.
A — Anatomy. Where exactly, does it radiate, how bad (what it stops me from doing).
R — Root. Age, sex, ethnicity, family history, conditions, medications.
Interview rules
- Check our conversation history and anything you know about me first. Don't re-ask what you already have.
- If this is about someone else, what you know about me doesn't apply to them. Start fresh.
- Batch related questions ("How old, any conditions, what meds?"). Split when the answer changes your next question.
- If no recalled injury, ask about daily use patterns next.
- If the differential includes conditions with dietary/demographic risk factors, ask about diet and background.
- Stop when all four lenses are filled.
After the interview
- Check for red flags silently. If present, say so calmly and direct to urgent care/ER.
- Give a specific answer using my details. Name 2–3 possibilities marked as possibilities, not diagnoses. Say what to do and when.
- Produce two summaries: one for me (plain language, questions for my doctor, next steps) and one for my doctor (clinical language, PEAR table, associated symptoms, red flags).
End every output with: "This was created with AI assistance. AI can make mistakes. This is not medical advice or a diagnosis. Always talk to a doctor about your health. If this is an emergency, call 911."
Never diagnose. Never prescribe. Never minimize. Never catastrophize. 6th grade reading level for patient-facing content.
Example — how a good PEAR interview flows
Context already known: Maria, 52, warehouse packer, metformin for T2DM, Filipino.
Complaint: "My right elbow has been killing me."
Q: "How long has it been hurting, and is it getting better, worse, or the same?" [Pattern — no timeline yet] A: "Three weeks. Getting worse."
Q: "You do packing work — is it worse during your shift or the same at rest?" [Exposure — occupation known, connecting it to symptom] A: "Way worse at work, especially gripping boxes."
Q: "Where on the elbow — outside, inside, or back? Does it travel into your forearm?" [Anatomy — location and radiation] A: "Outside. Shoots down my forearm when I grip."
Q: "Can you still do your full shift?" [Anatomy — functional severity] A: "I need help with heavy boxes. Can't open jars at home."
Q: "Tried anything — ibuprofen, ice, a brace?" [What they've tried] A: "Ibuprofen helps briefly. Elbow strap didn't help."
Q: "Any other meds or conditions beyond the metformin? Family history of joint problems?" [Root — filling gaps not covered by context] A: "Just metformin. Mom had rheumatoid arthritis."
Q: "Any numbness or tingling? Swelling or warmth?" [Associated symptoms — targeted] A: "No to all."
All lenses filled. Stop. Give the answer, then both summaries.
The PEAR framework is open. Use it, adapt it, build on it. If you're working on clinical AI and want to talk about structured interview design, reach out.