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GOLD-TMP-11

Temporal reasoning · gold-v0.1

Case inputs

As of
2026-06-18
Patient
48 years, MI
Request
Immunara for rheumatoid arthritis
Insurance
ExampleHealth, ExampleHealth Gold · EXH-104488
Policy
immunara-v0.1
Inputs
sha256:63f3ce9847ad…

Documents 1

Physician note

physician_note
SYNTHETIC RECORD - Example Northgate Family Medicine - Office Visit - 06/10/2026
Patient reference SYN-6011. All dates in this note are written MM/DD/YYYY. This 48-year-old man returns today with ongoing swelling in his hands and feet; his seropositive rheumatoid arthritis was diagnosed in 2019 and he has been followed here since.

He took oral methotrexate 15 mg weekly from 04/01/2026 to 06/05/2026, which was discontinued because his joint symptoms had not improved. He mentions his knees have also become stiffer over the past month, and he has started using a cane occasionally for longer walks.

Given his inadequate response to methotrexate, Immunara is being requested for him.

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
0.970
Step therapy met
0.000
Documentation complete
0.950
Material contradiction
0.080
Missing evidence
NONE 0.900
others: TREATMENT_HISTORY 0.06 · 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=48, policy min_age=18

  3. contradictionpassed

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

  4. documentationpassed

    p_yes(documentation_complete)=0.950, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=NONE (p=0.900), 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)