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GOLD-TMP-05

Temporal reasoning · gold-v0.1

Case inputs

As of
2026-06-26
Patient
50 years, PA
Request
Immunara for rheumatoid arthritis
Insurance
ExampleHealth, ExampleHealth Gold · EXH-208846
Policy
immunara-v0.1
Inputs
sha256:b276297d3548…

Documents 1

Physician note

progress_note
SYNTHETIC RECORD - Example Sequoia Rheumatology - Follow-up Visit - 2026-06-24
Patient reference SYN-6005.

Subjective: This 50-year-old man returns reporting that his hands and feet remain swollen despite treatment, and he has had to modify his work schedule because of morning stiffness lasting nearly two hours. He carries a seropositive rheumatoid arthritis diagnosis dating back to 2018.
Objective: Synovitis at bilateral wrists, MCPs, and MTPs. Weight stable. No rash.
Assessment: Rheumatoid arthritis with persistent disease activity despite oral methotrexate 15 mg weekly, started in March 2026 and stopped on 2026-06-20 for inadequate response.
Plan: Move forward with Immunara. Continue routine monitoring.

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
0.940
Material contradiction
0.080
Missing evidence
NONE 0.700
others: TREATMENT_HISTORY 0.26 · DOSAGE 0.03 · LAB_RESULT 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=50, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.080, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.940, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=NONE (p=0.700), request info at >= 0.7

  6. auto_processpassed

    min(required p_yes)=0.000, auto at >= 0.89; p_yes(material_contradiction)=0.080, 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)