Skip to content

GOLD-TRK-08

Tricky or ambiguous · gold-v0.1

Case inputs

As of
2026-06-01
Patient
34 years, IL
Request
Immunara for rheumatoid arthritis
Insurance
ExampleHealth, ExampleHealth Gold · EXH-902441
Policy
immunara-v0.1
Inputs
sha256:4901da162219…

Documents 2

Physician note

clinic_note
SYNTHETIC RECORD - Example Dovetail Rheumatology - Clinic Note - 2026-01-20
Patient reference SYN-7285. A routine methotrexate check brought this 34-year-old woman to clinic today; she reports mild nausea the day after her weekly dose but no other side effects otherwise. Her seropositive rheumatoid arthritis, diagnosed 2021, remains stable on exam. Tolerating methotrexate, continue at the current dose of 15 mg weekly. Repeat liver panel in one month.

Physician note

progress_note
SYNTHETIC RECORD - Example Dovetail Rheumatology - Progress Note - 2026-06-01
Patient reference SYN-7285. Synovitis remains present at both wrists on today's exam for this 34-year-old woman.
- Assessment: seropositive rheumatoid arthritis, diagnosed 2021.
- Methotrexate 15 mg weekly, oral, started 2025-12-15.
- Nausea worsened over time despite antiemetic support; methotrexate was stopped on 2026-03-02.
- No further DMARD has been started since discontinuation.
- Plan: Request Immunara given the intolerance to methotrexate.

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
0.010
Documentation complete
0.950
Material contradiction
0.450
Missing evidence
NONE 0.870
others: TREATMENT_HISTORY 0.08 · DOSAGE 0.04 · LAB_RESULT 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=34, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.450, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.950, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=NONE (p=0.870), request info at >= 0.7

  6. auto_processpassed

    min(required p_yes)=0.010, auto at >= 0.89; p_yes(material_contradiction)=0.450, 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=0.010 is below the 0.89 autonomous-action bar
  • contradiction risk p=0.450 blocks autonomous processing (>= 0.2)
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)