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GOLD-TMP-09

Temporal reasoning · gold-v0.1

Case inputs

As of
2026-09-28
Patient
29 years, NM
Request
Immunara for rheumatoid arthritis
Insurance
CivicCare, CivicCare Plus · CCP-517620
Policy
immunara-v0.1
Inputs
sha256:c6de942cdded…

Documents 1

Physician note

physician_note
SYNTHETIC RECORD - Example Trailhead Rheumatology - Follow-up Visit - 2026-09-28
Patient reference SYN-6009.

Subjective: Continued swelling in both hands is now interfering with her ability to type at her desk job. She is 29 years old, with seropositive rheumatoid arthritis diagnosed in 2024, and has been followed at this practice since.
Objective: Synovitis present at bilateral wrists and second through fourth MCPs bilaterally. Vitals stable.
Assessment: Rheumatoid arthritis, active despite ongoing oral methotrexate 15 mg weekly since 2026-07-20, continuing today, inadequate response.
Plan: Recommend Immunara. Continue methotrexate and folic acid pending transition.

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
0.920
Material contradiction
0.120
Missing evidence
TREATMENT_HISTORY 0.530
others: NONE 0.45 · DOSAGE 0.01 · LAB_RESULT 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=29, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.120, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.920, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=TREATMENT_HISTORY (p=0.530), request info at >= 0.7

  6. auto_processpassed

    min(required p_yes)=0.000, auto at >= 0.89; p_yes(material_contradiction)=0.120, 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)