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GOLD-TRK-01

Tricky or ambiguous · gold-v0.1

Case inputs

As of
2026-07-14
Patient
52 years, OR
Request
Immunara for rheumatoid arthritis
Insurance
Northstar, Northstar Choice · NSC-274918
Policy
immunara-v0.1
Inputs
sha256:6075499b0b28…

Documents 1

Physician note

physician_note
SYNTHETIC RECORD - Example Amberwood Rheumatology - Follow-up Visit - 2026-07-14
Patient reference SYN-7701. Morning stiffness lasting nearly two hours brought this 52-year-old woman back to clinic this week, along with new swelling across both hands.

Her rheumatoid arthritis, seropositive and diagnosed in 2021, remains active; synovitis is present today at the wrists and MCP joints bilaterally. She mentioned that her mother had also been treated for rheumatoid arthritis, taking methotrexate for six months, from March 2019 through September 2019. This patient herself has taken hydroxychloroquine 200 mg twice daily for the past year without adequate control of her joint symptoms; she has not taken methotrexate.

Plan: Request Immunara given the inadequate response to hydroxychloroquine. Continue current supportive care and repeat labs in six weeks.

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
0.960
Step therapy met
0.000
Documentation complete
0.930
Material contradiction
0.170
Missing evidence
TREATMENT_HISTORY 0.490
others: NONE 0.48 · DOSAGE 0.02 · DIAGNOSIS 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=52, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.170, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.930, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=TREATMENT_HISTORY (p=0.490), request info at >= 0.7

  6. auto_processpassed

    min(required p_yes)=0.000, auto at >= 0.89; p_yes(material_contradiction)=0.170, 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)