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GOLD-MIS-13

Missing information · gold-v0.1

Case inputs

As of
2026-07-28
Patient
49 years, NY
Request
Immunara for rheumatoid arthritis
Insurance
Northstar, Northstar Choice
Policy
immunara-v0.1
Inputs
sha256:e834a404cc32…

Documents 2

Physician note

physician_note
SYNTHETIC RECORD - Example Eastgate Rheumatology Associates - Follow-up Visit - 2026-07-25
Patient reference SYN-9987.

Subjective: 49-year-old woman reports her hand swelling never fully settled during her methotrexate trial.
Objective: Synovitis persists at bilateral wrists and MCPs. Vitals stable.
Assessment: Seropositive rheumatoid arthritis (diagnosis dates to 2020) with inadequate response to oral methotrexate, taken from January 6, 2026 through June 1, 2026.
Plan: Discontinue methotrexate, start Immunara. Insurance is on file per the front desk, though no member number appears in today's chart or intake paperwork.

Medication history

medication_history
SYNTHETIC RECORD - Example Eastgate Rheumatology Associates - Medication History - 2026-07-25
Patient reference SYN-9987.
METHOTREXATE 15 MG PO WEEKLY - status: inactive - start 2026-01-06 - end 2026-06-01 - reason: inadequate response
FOLIC ACID 1 MG PO DAILY - status: active

Decisions by provider

REQUEST_INFOcorrect

Decided by: documentation gate · auto_process 0.89

Judgments

p_yes for yes/no questions; ticks are the thresholds a gate compares each one with.

Diagnosis supported
0.970
Step therapy met
0.980
Documentation complete
0.070
Material contradiction
0.070
Missing evidence
INSURANCE_INFORMATION 1.000
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=49, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.070, review at >= 0.8

  4. documentationFIRED → REQUEST_INFO

    p_yes(documentation_complete)=0.070, request info below 0.6

  5. missing_evidencenot reached
  6. auto_processnot reached
  7. default_reviewnot reached

passed = the gate checked and did not fire; not reached = an earlier gate decided.

  • documentation is likely incomplete (p_yes=0.070)
  • most likely missing: insurance information (p=1.000)
Run details· q-v0.2

run_20260925T170857Z_b95be9 · q-v0.2 · immunara-v0.1 (v0.1)

auto_process 0.89, chosen on gen-v0.2-dev.

questions: q-v0.2 →

Show expected answer (evaluation only)