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Guideline Propagation
When a guideline you rely on changes, Suture compares the changed sections against your notes and raises a banner on every note affected — whether it cites the guideline or not, in any language.
Changed section · Pharmacotherapy in HFpEF
No therapy has convincingly reduced mortality in HFpEF.
HFpEF — diagnosis & management
Your note · cites ESC Heart Failure 2021
Diagnosis rests on symptoms, EF ≥ 50% and evidence of raised filling pressures…
The problem
Societies revise their recommendations continually. The note you wrote in third year doesn’t know that — it reads exactly as confidently as the day you wrote it.
A recommendation you wrote down years ago may have been rewritten since — but on the page, nothing changes. Stale knowledge looks identical to current knowledge.
A new guideline version publishes, and no signal reaches the hundreds of notes quietly built on the old one.
Nobody rereads years of notes against every new version of every guideline. Manual vigilance does not scale — so it simply doesn’t happen.
Watching the source
When a guideline publishes a new version, Suture diffs it against the prior one and extracts only the sections that actually changed. Those changed sections — not the whole document — are then compared against your notes via semantic similarity and fanned out as impact flags on the notes they touch.
2 changed sections → 3 notes flagged
Only what changed is compared — never the whole document
Two kinds of warning
Notes that formally cite a changed guideline get a stale-citation warning — the hard banner: your source has moved. Notes that are semantically about a changed section, even without citing it, get a softer “this note may be affected” banner. Both appear right in the editor, and both are dismissible.
Stale citation
Formally citedThis note cites ESC Heart Failure 2021 — superseded by the 2023 focused update.
This note may be affected
No citation neededA section about SGLT2 inhibitors in HFpEF changed — this note covers the same topic.
Hard when the note cites the guideline · soft when it only writes about it
Across languages
Propagation is semantic, not textual — so it crosses languages. When an English-language guideline changes, notes you wrote in Dutch about the same recommendation are still found and flagged. Your notes stay current in whichever language you think in.
ESC 2023 · changed section
“SGLT2 inhibitors are recommended in HFpEF to reduce HF hospitalisation (Class I).”
Your note · Dutch
Hartfalen met behouden ejectiefractie
Behandeling: diuretica bij congestie; SGLT2-remmers verlagen HF-opnames…
This note may be affected — matched across languages
Built for professionals
Practicing specialists are notified when guidelines in their field change — a genuine continuing-development signal from their own notes. The system is deliberately tuned for recall: better to raise a dismissible banner too often than to miss a change that matters. One dismiss, and a flag is gone.
ESC Heart Failure — 2023 focused update published
1 note in your corpus flagged for review
Detection tuning
Recall-firstA dismissible over-flag beats a missed change — and dismissed stays dismissed.
A note is a snapshot of the evidence on the day you wrote it. Guideline propagation turns that snapshot into a document that reacts when its sources move.
Notes left alone
With Guideline Propagation
Students keep study notes aligned with the current recommendation; specialists get a CPD signal from their own writing — all fed by the same guideline library that powers the rest of Prognia.
Suture watches the source, diffs the versions and flags the affected notes — the only step left for you is the review itself.
A guideline you rely on publishes a new version.
Only the changed sections are extracted and compared to your notes.
Affected notes get a banner — hard for citations, soft for topic matches.
Update the note, or dismiss the banner if it doesn’t apply.
Guidelines are living documents — these are the sources and the science of keeping up.
Write it once, and let Suture watch the source — every affected note flagged the moment a guideline changes.
Free forever for students · No credit card required