EVOLVE Health Hub / Protocol
SIIM
A measurement-discipline protocol for longevity practice
Or Hever, EVOLVE Health Hub, Warsaw. Core version 11, September 2026. Written for clinicians.
Most longevity reports tell you a number moved. SIIM asks whether it moved more than the test itself would.
Try it: a retest of maximal gait speed
Hypothetical client. Baseline 1.52 m/s. Move the retest value and change the test's precision.
Inconclusive
Hold the plan. Confirm adherence. Retest after a full window.
Change +0.09 m/s (+5.9%), noise band ±0.20 m/s
Test precision (illustrative)
Teaching tool with fixed hypothetical values. Band widths are illustrative; published reliability sources per test are listed in the Evidence Annex. Not for clinical decisions.
What the field already has
Longevity practice has good published frameworks. Each settles something specific.
Governance
The Swiss framework: named physician, ethics board, audit and a therapeutic ladder.
Care pathway
WHO ICOPE: basic assessment, in-depth assessment, care plan, implementation and monitoring.
Evidence grading
The 2026 Delphi consensus: AHA and ESC classes adapted to healthspan, plus Class IIc.
None of them states how large a measured change must be before it counts as a result. SIIM fills that gap, and separates checking whether the plan was delivered from checking whether anything changed.
The cycle
Four steps, each with one question and one rule that carries most of the weight. Select a step.
What do we measure, and why these measures?
A measure enters only with a decision rule written in advance: what will be done differently depending on the result.
Panel creep. Each extra test looks like value and costs little once the client is present.
Three to five scored measures with published repeatability, a written decision rule for each, and a log of what was left out.
The solid arrow is the loop every cycle takes: Monitoring returns to Interpretation. The dashed arrow back to Screen is a rare, deliberate battery revision.
Three thresholds, three questions
Published frameworks use reliability gates and clinical-importance thresholds. Both are useful. SIIM adds the one that answers the question an operator faces with two numbers from one person.
| Threshold | Question it answers | Where it comes from |
|---|---|---|
| ICC, e.g. 0.9 or above | Can this instrument be used at all? | Agreement of the instrument with itself across a population |
| Clinical gain, e.g. one MET | Is this change important? | Expert judgement |
| Minimum detectable change | Did a change happen in this person? | Test-retest data for the specific test |
Detectability comes first. A change below the minimum detectable change has not been observed, whatever its clinical meaning would have been.
Same number, two verdicts
A hypothetical 52-year-old woman records a grip strength of 24 kg. Choose the reference frame.
Above the median. The report reads as reassuring, and no action follows.
Positions are illustrative. The measurement is identical in both cases, so the reference frame must be named in every report and kept constant across a client's assessments.
Where is your practice today?
Tick what your practice already does. Nothing is saved or sent anywhere.
Overall: not yet compliant. Complete Level 1 in every step to reach compliance.
For most practices, the most valuable single step is Level 1 Monitoring. It needs no equipment and changes what you can honestly claim.
What SIIM leaves to others
Clinic governance. Covered by the Swiss framework.
Grading interventions. Covered by the Delphi consensus.
The care pathway. WHO ICOPE remains the reference.
Validating a measure. A poorly chosen test stays uninformative.
Individual prediction. Population evidence stays population evidence.
A business model. SIIM is the layer beneath both practice and business.
Read the paper
The Core sets out the protocol and changes rarely. The Evidence Annex holds every dated value and source, and is reviewed at least once a year.
Core version 11 and Annex version 2, September 2026. DOI: to be assigned on deposit.
Streszczenie
Praktyka długowieczności ma już kilka opublikowanych ram. Opisują one, co powinna zawierać klinika, jak powinna być zarządzana, które interwencje wspiera dany poziom dowodów i jaką ścieżką opieki powinna przejść osoba. Żadna z nich nie określa, jak duża musi być zmierzona różnica, aby uznać ją za wynik.
SIIM to czteroetapowy protokół: Screen (dobór pomiarów), Interpretation (interpretacja), Implementation (wdrożenie) i Monitoring (monitorowanie), zaprojektowany jako warstwa pod istniejącymi ramami. Oddziela wdrożenie od monitorowania, które obecne ścieżki łączą w jeden krok, i opiera ocenę każdej zmiany na błędzie pomiaru danego testu. Dokument jest przeznaczony dla profesjonalistów.
Notice
This page and the paper are written for health and exercise professionals, for information and discussion. They are not medical or legal advice and create no professional relationship or duty of care. All examples are hypothetical. Local law, scope of practice and clinical judgement take precedence.
Competing interests
The author is the founder and chief executive of EVOLVE Health Hub, Warsaw, which applies this protocol in its services. The paper received no external funding.
Frameworks referenced
- Mironov S, et al. A framework for an effective healthy longevity clinic. Aging and Disease. 2025;16(4):1971-1986.
- Bonnes SLR, et al. Establishing healthy longevity clinics in publicly funded hospitals. GeroScience. 2024;46:4217-4223.
- Pagani A, et al. Toward responsible longevity medicine: Swiss framework for healthy longevity medicine clinics. Longevity. 2026;6(1):2583907.
- Postula M, Kistkins S, et al. Delphi-derived framework for healthspan-oriented care. Aging and Disease. 2026; early access.
- World Health Organization. Integrated care for older people (ICOPE), 2nd ed. Geneva: WHO; 2024.
- Justice JN, et al. A framework for selection of blood-based biomarkers for geroscience-guided clinical trials. GeroScience. 2018;40:419-436.
- Johnson AA, Shokhirev MN. Contextualizing aging clocks and properly describing biological age. Aging Cell. 2024;23:e14377.
- Forman DE, Pignolo RJ. A pragmatic approach to introducing translational geroscience into the clinic. J Gerontol A. 2024;79(9):glae062.
- Zhavoronkov A, et al. Peakspan. Aging and Disease. 2026; early access.