mcp-clinical-reasoner

Part of fhir-mcp-suite — v1.0.0

An MCP server providing four clinical pharmacology tools backed by the free NLM RxNav REST API and a built-in rule-based reference table. No API key required. No PHI processed.

Tools

Architecture

Claude Desktop / LangGraph agent
          │  MCP (stdio or SSE)
          ▼
 mcp-clinical-reasoner  (:8002 in SSE mode)
    ├── lookup_drug ────────────────► rxnav.nlm.nih.gov/REST
    ├── check_drug_interactions ────► rxnav.nlm.nih.gov/REST
    ├── check_dose ─────────────────► built-in DOSE_TABLE (20 drugs)
    └── check_allergy_conflicts ────► built-in ALLERGEN_CLASSES (12 classes)

All tool calls traced via LangFuse (session-scoped, latency + response bytes).

Built-in Dose Table

Covers 20 common drugs: acetaminophen, ibuprofen, aspirin, naproxen, metformin, lisinopril, atorvastatin, metoprolol, amlodipine, omeprazole, amoxicillin, azithromycin, warfarin, furosemide, sertraline, gabapentin, clopidogrel, hydrochlorothiazide, prednisone, albuterol.

Brand aliases are resolved automatically (e.g. "Tylenol" → acetaminophen, "Advil" → ibuprofen).

Built-in Allergen Classes

12 classes: penicillin, cephalosporin, sulfonamide, nsaid, macrolide, fluoroquinolone, statin, ace_inhibitor, angiotensin_receptor_blocker, beta_blocker, thiazide_diuretic, tetracycline.

Quick start

# Install (uv workspace from repo root)
uv sync --all-packages

# Run (stdio, default)
uv run mcp-clinical-reasoner

# Run (SSE on port 8002)
MCP_TRANSPORT=sse uv run mcp-clinical-reasoner

Environment variables

Claude Desktop configuration

{
  "mcpServers": {
    "clinical-reasoner": {
      "command": "uv",
      "args": [
        "--directory", "/path/to/fhir-mcp-suite",
        "run", "--package", "mcp-clinical-reasoner",
        "mcp-clinical-reasoner"
      ]
    }
  }
}

Tests

# Unit tests (36 tests, no network required)
uv run pytest packages/mcp-clinical-reasoner/tests/ -v -m "not integration and not eval"

# Offline eval (dose + allergy + error validation)
uv run python evals/mcp-clinical-reasoner/run_eval.py --tags dose allergy error

# Full eval suite (requires rxnav.nlm.nih.gov)
uv run python evals/mcp-clinical-reasoner/run_eval.py

Eval results (offline, no network)

Disclaimer

This server is for research and educational purposes only. It does not replace clinical judgement, pharmacist review, or professional medical advice. All dose limits and cross-reactivity rules are from general adult references and must be individualised for each patient.

License

Apache-2.0 — see LICENSE.