Cases / GOLD-STR-03 Case inputs
As of 2026-08-19
Patient 61 years, OH
Request Immunara for rheumatoid arthritis
Insurance CivicCare, CivicCare Plus · CCP-556012
Policy immunara-v0.1 Inputs sha256:bb04411a59ef… Documents 2 Physician note problem_list SYNTHETIC RECORD - Example Foothills Rheumatology - Problem List Update - 2026-08-19
Patient reference SYN-7734. 61-year-old woman.
- Seropositive rheumatoid arthritis, diagnosed 2021, currently active with synovitis at both wrists and multiple MCPs despite treatment.
- Methotrexate 20 mg weekly ongoing since 2026-02-02; disease activity remains high and she continues to report morning stiffness lasting over an hour.
- Hypertension, stable on amlodipine.
- Vitamin D deficiency, on supplementation.
- Plan: discuss Immunara given inadequate response to methotrexate; continue folic acid. SYNTHETIC RECORD - Example Foothills Rheumatology - Laboratory Report - 2026-07-30
Patient reference SYN-7734.
Rheumatoid factor: positive, 62 IU/mL (reference <14).
Anti-CCP antibody: positive, 88 U/mL (reference <20).
ESR: 38 mm/hr (elevated).
CRP: 2.1 mg/dL (elevated). Decisions by provider
· correct
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.
Documentation complete
auto 0.89 request info 0.60
0.940
Material contradiction
0.060
Missing evidence
NONE 0.900
others: TREATMENT_HISTORY 0.06 · DOSAGE 0.04
Gate path· 7 gates, in engine order
provider passed
all five decisions present and well-formed
age passed
patient.age=61, policy min_age=18
contradiction passed
p_yes(material_contradiction)=0.060, review at >= 0.8
documentation passed
p_yes(documentation_complete)=0.940, request info below 0.6
missing_evidence passed
missing_evidence=NONE (p=0.900), request info at >= 0.7
auto_process FIRED → AUTO_PROCESS
min(required p_yes)=0.940, auto at >= 0.89; p_yes(material_contradiction)=0.060, blocks at >= 0.2
default_review not 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) Evaluation only · never shown to the engine
Expected Jev q-v0.2: correct
diagnosis_supported true
step_therapy_satisfied true
documentation_complete true
contradiction_present false
missing_evidence NONE problem_list: seropositive RA diagnosed 2021; methotrexate ongoing since 2026-02-02, still active in the note dated on as_of_date (2026-08-19) = 198 days. lab_report supports the diagnosis with positive RF and anti-CCP.