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GOLD-TMP-04

Temporal reasoning · gold-v0.1

Case inputs

As of
2026-06-29
Patient
46 years, IL
Request
Immunara for rheumatoid arthritis
Insurance
Northstar, Northstar Choice · NSC-449213
Policy
immunara-v0.1
Inputs
sha256:5e65875645e8…

Documents 2

Physician note

problem_list
SYNTHETIC RECORD - Example Redwood Rheumatology - Problem List Update - 2026-06-26
Patient reference SYN-6004. 46-year-old woman.

- Seropositive rheumatoid arthritis, diagnosed 2022, followed at this practice since.
- Methotrexate 17.5 mg weekly from 2026-04-06 to 2026-06-22, discontinued for inadequate response; synovitis persisted at both wrists.
- Mild iron-deficiency anemia, on supplementation.
- Plan: proceed with Immunara given inadequate response to methotrexate.

Medication history

medication_history
SYNTHETIC RECORD - Example Redwood Rheumatology - Medication History - 2026-06-24
Patient reference SYN-6004.
METHOTREXATE 17.5 MG PO WEEKLY - status: inactive - start 2026-04-06 - end 2026-06-22 - reason: inadequate response
FOLIC ACID 1 MG PO DAILY - status: inactive - start 2026-04-06
FERROUS SULFATE 325 MG PO DAILY - status: active

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
0.980
Step therapy met
0.000
Documentation complete
0.960
Material contradiction
0.050
Missing evidence
NONE 0.970
others: DOSAGE 0.03
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=46, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.050, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.960, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=NONE (p=0.970), request info at >= 0.7

  6. auto_processpassed

    min(required p_yes)=0.000, auto at >= 0.89; p_yes(material_contradiction)=0.050, 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.

  • step_therapy p_yes=0.000 is below the 0.89 autonomous-action bar
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)