The framework of cascading medicine is proposed as a systemic protocol where treatment is not seen merely as a linear temporal sequence of phases but as an interconnected architecture. In such an architecture, each link performs its own function—weakening external factors, preparing the microenvironment, delivering the main strike, consolidation, and surveillance—and simultaneously creates conditions for the subsequent stage. Thus, therapy is transformed from a set of disparate actions into a holistic dynamic circuit, where success is determined not by the strength of a single intervention, but by the consistency of the entire cascade chain. This allows simultaneous reduction of pathological load, compensation of patient risks, and support of target organs, ensuring a transition from temporary palliation to sustainable outcomes.
Online calculator for evaluating the "Cascade index - E-Index: universal efficiency metric": https://muradnovruzov.org/e-index.html
The Cascade index - E-Index Calculator is a cross-disciplinary analytical tool that quantifies real therapeutic efficiency for any disease or treatment modality — from antiviral and metabolic therapies to oncology and regenerative interventions. It enables comparative evaluation of different therapeutic methods within the same disease, integrating stage improvement, toxicity, recurrence risk, and survival gain into a single standardized metric.
The calculator will continue to evolve, integrating multi-model datasets, treatment benchmarking, and automated meta-analysis modules for comprehensive clinical decision support.
Formula
E=[(B0−B1+C)−log(1+A+A1+M+P+ES/10+R)+(A2+S+log(1+LS+((TS−T)⋅H)))]×1.132
Interpretation
E < 0 — harmful or counter-therapeutic effect (toxic or worsening)
0–2 — minimal or supportive benefit (symptomatic only)
2–5 — moderate therapeutic effect (partial disease control)
5–7 — strong disease-modifying efficacy (functional remission)
E ≥ 7 — life-saving or curative outcome (complete or near-complete recovery)
Parameter Reference (compact)
B₀ — baseline disease stage before treatment (1–4) — within the context of the underlying conditionB₁ — post-treatment disease stage (0–4) — within the same clinical contextC — complete cure (1 = yes, 0 = no) — elimination of the diagnosisT — treatment duration (0.1 per week)TS — standard treatment duration per protocolH — urgency weight (0 = not important; 0.5 = preferred; 1 = critical)
A — toxicity (CTCAE → decimal): 0 none; 0.1 mild; 0.2 moderate; 0.3 severe; 0.4 life-threatening; 1 fatal — caused by therapy or disease during the therapeutic / treatment courseA₁ — life-threatening deterioration (0 none; 1 yes) — represents ICU admission or vital threat caused by treatment or disease during the courseA₂ — alleviation of side effects / symptoms (0 none; 0.5 partial; 1 both) — occurring during or after the therapeutic / treatment courseM — mortality rate / 100 (treatment-related deaths)P — permanent toxicity / irreversible effects (% / 100) — during or after therapy, remaining lifelong or for extended periodsR — recurrence risk (% / 100)ES — ECOG Performance Status (0–5)S — systemic support (0 none; 0.1 partial; 0.2 full)
Author’s related hypotheses applying the cascade concept:
Novruzov, M., Mammadova, M., Raval, K., Waseem, K., & Shiraliyeva, U. (2025). Second Breath: Systems-Level Model of Localized Immune Cascade Programming in Desmoplastic Tumors (In Silico-Validated, Literature-Anchored). Zenodo. https://doi.org/10.5281/zenodo.17196703