They come from the evidence.
Pharmacy is built on evidence-based practice. Markoste+ applies that same rigour to clinical decision support — structured patient data, peer-reviewed guideline databases, deterministic rule evaluation. Reliable, repeatable, and consistent every single time.
Generative AI is a powerful tool for many tasks. Clinical guideline screening is not one of them.
Three steps. No black box. Every stage transparent and reviewable.
Extract & Review
Automated parameter extraction reads your clinical report — medications, medical conditions, blood test results, eGFR, falls history, and clinical observations.
Before analysis runs, you review the extracted parameters and can adjust any value. You stay in control of what gets evaluated.
You can adjust any parameter before screening begins.
Rules Engine
Patient parameters run against a structured database of published, peer-reviewed clinical guidelines. 95 STOPP/START v3 rules. ACB burden scoring. Cascade detection. 15 evidence-based deprescribing guides.
The rules engine is 100% deterministic. No probabilistic inference. No language model generation. Pure rule evaluation against structured guideline data.
100% deterministic. Same inputs, same output, every time.
Consistent Results
Reproducible clinical flags — every single time. STOPP flags for potentially inappropriate prescribing. START flags for omitted medications. ACB risk levels. Deprescribing guide recommendations.
Every flag cites its source rule, the published guideline it belongs to, and actionable clinical recommendations. Built for pharmacist review and clinical governance.
Every flag traces to a cited, peer-reviewed guideline.
Markoste+ is built on the same published clinical standards that pharmacists already know and trust — and maintained as that evidence evolves.
Gold Standard
O’Mahony et al., Eur Geriatr Med, 2023
73 STOPP rules · 22 START recommendations
The internationally recognised gold standard for identifying potentially inappropriate prescribing (STOPP) and prescribing omissions (START) in older adults. Version 3 (2023) is the most current iteration.
Cognitive Burden
King & Rabino, acbcalc.com, 2024
Per-drug burden scores · risk stratification
Anticholinergic Cognitive Burden scoring quantifies the cumulative cognitive and functional risk from a patient’s full medication profile. Scores of 3+ are associated with increased risk of cognitive impairment, falls, and hospitalisation.
NPS MedicineWise Endorsed
Primary Health Tasmania, 2022
15 evidence-based clinical guides
Step-by-step clinical guides covering when and how to safely deprescribe, including tapering schedules, monitoring parameters, and management of withdrawal. Endorsed by NPS MedicineWise.
Cascade Detection
Structured cascade pattern database
Precipitant → ADR → new drug identification
Detects when a medication is likely being used to treat an adverse effect caused by another medication in the patient’s profile — one of the most consistently under-recognised drivers of inappropriate polypharmacy.
Drug Classification
Continuously maintained classification database
18 drug class categories · brand → generic mapping
Brand names are normalised to generics, salts and formulations are stripped, and each drug is mapped to a standardised class for consistent, formulation-agnostic rule evaluation.
Always Current
Updated as new versions are released
STOPP/START · ACB · Deprescribing guides
As newer guideline versions are published and accepted into clinical practice, the Markoste+ CDS database is reviewed and updated. You are always working from current evidence, not a static snapshot.
Clinical efficacy isn't just about what you catch — it's about what never slips through.
Systematic screening covers every drug, every condition, every rule against the full STOPP/START v3 ruleset. Under time pressure, cognitive load can cause even experienced pharmacists to miss a flag. Markoste+ ensures it doesn’t.
Every pharmacist in your practice applies the same evidence-based rules to every patient. The same medication in the same clinical context always triggers the same guideline check — irrespective of who is reviewing or when.
Each flag cites its source: the guideline name, rule code, and recommendation text. You can explain every clinical decision to your patient, their GP, and your accreditation body — because the evidence is right there.
Parameters extracted from your clinical report are presented for your review before analysis runs. Adjust any value — medications, conditions, observations, lab results. The analysis reflects what you know about the patient.
What previously required cross-referencing multiple guideline documents — STOPP criteria, ACB tables, cascade patterns, deprescribing protocols — now surfaces in seconds, structured and linked, within your existing workflow.
Markoste+ is not here to replace your clinical judgement. It is here to ensure you have the full picture — promptly, reliably, and from the evidence — so your judgement is as informed as it can be.
Markoste began as a time-saving documentation tool for clinical pharmacists — AI-powered transcription so you spend less time writing and more time with patients.
It has grown into something more. Today, Markoste is the only platform in Australia that combines AI-assisted clinical documentation with a fully deterministic clinical decision support engine — built on the same evidence-based guidelines that underpin pharmacy practice.
Not just documentation. Not just scheduling. Complete clinical intelligence — from transcript to evidence-based medication review — in one platform.
Markoste Scribe
AI-powered transcription and clinical documentation
Markoste+ CDS
Deterministic clinical decision support on peer-reviewed guidelines
Analytics & Governance
Practice intelligence and clinical governance reporting
Join Australian clinical pharmacists who rely on Markoste+ for systematic, evidence-based medication reviews — where every recommendation is grounded in published guidelines, not inference.
Australian data residency · All clinical decisions remain with the reviewing pharmacist