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GOLD-MIS-18

Missing information · gold-v0.1

Case inputs

As of
2026-08-05
Patient
42 years, OR
Request
Immunara for rheumatoid arthritis
Insurance
ExampleHealth, ExampleHealth Gold · EXH-334415
Policy
immunara-v0.1
Inputs
sha256:3b0a9787428a…

Documents 2

Physician note

physician_note
SYNTHETIC RECORD - Example Cobalt Rheumatology - Follow-up Visit - 2026-08-01
Patient reference SYN-8801.

Subjective: 42-year-old man returns saying his joint swelling never fully resolved while on methotrexate.
Objective: Synovitis persists at bilateral wrists. Vitals stable.
Assessment: Seropositive rheumatoid arthritis, a diagnosis carried since 2022, with inadequate response to methotrexate. Per pharmacy records, his course began at the time of his first fill and continued until it was discontinued in June 2026 for this inadequate response.
Plan: Discontinue methotrexate. Start Immunara. Continue routine monitoring.

Other document

pharmacy_fills
SYNTHETIC RECORD - Example Central Pharmacy - Fill History - 2026-07-30
Patient reference SYN-8801.
METHOTREXATE 15 MG TABLET - first fill 2026-01-05, quantity 4
Refills dispensed monthly through May 2026, last fill 2026-05-04.

Decisions by provider

AUTO_PROCESScorrect

Decided by: auto_process gate · auto_process 0.89

Judgments

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

Diagnosis supported
0.980
Step therapy met
0.970
Documentation complete
0.960
Material contradiction
0.150
Missing evidence
NONE 0.890
others: DOSAGE 0.05 · TREATMENT_HISTORY 0.05 · LAB_RESULT 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=42, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.150, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.960, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=NONE (p=0.890), request info at >= 0.7

  6. auto_processFIRED → AUTO_PROCESS

    min(required p_yes)=0.960, auto at >= 0.89; p_yes(material_contradiction)=0.150, blocks at >= 0.2

  7. default_reviewnot reached

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

  • all required judgments are at or above 0.89 and contradiction risk is below 0.2
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)