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GOLD-STR-19

Straightforward · gold-v0.1

Case inputs

As of
2026-06-05
Patient
48 years, TN
Request
Immunara for rheumatoid arthritis
Insurance
ExampleHealth, ExampleHealth Gold · EXH-661120
Policy
immunara-v0.1
Inputs
sha256:7ed33db4251d…

Documents 1

Physician note

referral_letter
SYNTHETIC RECORD - Example Countryview Rheumatology - Consultation Letter - 2026-06-01
Patient reference SYN-4456.

Dear Referring Provider,

I evaluated this 48-year-old woman for inflammatory arthritis affecting her hands, wrists, and several toe joints. The differential includes rheumatoid arthritis versus psoriatic arthritis, and I have ordered additional serology and imaging before committing to either diagnosis.

Empirically, she was treated with oral methotrexate from January 5, 2026 to May 25, 2026, but her joint swelling and pain did not improve, so it was discontinued for inadequate response. She works as a veterinary technician and finds handling animals increasingly difficult because of her hand pain. She has no other chronic medical conditions.

I will finalize the diagnosis once the pending workup returns and will follow up regarding Immunara at that time.

Sincerely,
The consulting rheumatologist

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
0.030
Step therapy met
0.960
Documentation complete
0.370
Material contradiction
0.140
Missing evidence
DIAGNOSIS 1.000
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=48, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.140, review at >= 0.8

  4. documentationFIRED → REQUEST_INFO

    p_yes(documentation_complete)=0.370, 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=0.370)
  • most likely missing: diagnosis (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)