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GOLD-MIS-20

Missing information · gold-v0.1

Case inputs

As of
2026-06-08
Patient
31 years, NM
Request
Immunara for rheumatoid arthritis
Insurance
CivicCare, CivicCare Plus · CCP-887744
Policy
immunara-v0.1
Inputs
sha256:55eb0aaa0818…

Documents 3

Physician note

clinic_note
SYNTHETIC RECORD - Example Ridgeline Family Practice - Office Visit - 2026-05-10
Patient reference SYN-3350. A 31-year-old woman presents for a new-patient visit after relocating. She reports she was diagnosed with rheumatoid arthritis last year by a rheumatology practice in her previous city and was treated there for a period of time before her move.

Records of that diagnosis and her prior treatment have been requested from the outside practice but have not yet arrived at this office. She currently takes no arthritis medication. She will be scheduled for a follow-up visit once those records are received, and Immunara will be considered at that time.

Physician note

referral_letter
SYNTHETIC RECORD - Example Outside Rheumatology Partners - Referral Letter - 2026-05-20

Dear Colleague,

Enclosed are the requested treatment records for this 31-year-old woman, who carries a diagnosis of rheumatoid arthritis established at our practice. Her methotrexate course is detailed in the enclosed medication history.

Please let us know if any further documentation would be helpful as she transitions her care to your office.

Sincerely,
The former treating rheumatologist

Medication history

outside_records
SYNTHETIC RECORD - Example Outside Rheumatology Partners - Medication History - 2026-05-20
Patient reference SYN-3350.
METHOTREXATE 15 MG PO WEEKLY - status: inactive - start 2026-03-02 - end 2026-05-04 - reason: nausea
FOLIC ACID 1 MG PO DAILY - status: discontinued

Decisions by provider

HUMAN_REVIEWcorrect

Decided by: default_review gate · auto_process 0.89

Judgments

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

Diagnosis supported
0.880
Step therapy met
0.000
Documentation complete
0.740
Material contradiction
0.360
Missing evidence
NONE 0.740
others: DIAGNOSIS 0.24 · DOSAGE 0.01 · TREATMENT_HISTORY 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=31, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.360, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.740, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=NONE (p=0.740), request info at >= 0.7

  6. auto_processpassed

    min(required p_yes)=0.000, auto at >= 0.89; p_yes(material_contradiction)=0.360, blocks at >= 0.2

  7. default_reviewFIRED → HUMAN_REVIEW

    case does not meet the autonomous-action bar

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

  • diagnosis_support p_yes=0.880 is below the 0.89 autonomous-action bar
  • step_therapy p_yes=0.000 is below the 0.89 autonomous-action bar
  • documentation_complete p_yes=0.740 is below the 0.89 autonomous-action bar
  • contradiction risk p=0.360 blocks autonomous processing (>= 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)