Skip to content

GOLD-TRK-10

Tricky or ambiguous · gold-v0.1

Case inputs

As of
2026-06-25
Patient
49 years, NC
Request
Immunara for rheumatoid arthritis
Insurance
Northstar, Northstar Choice · NSC-238671
Policy
immunara-v0.1
Inputs
sha256:f1a8f51a22db…

Documents 1

Physician note

physician_note
SYNTHETIC RECORD - Example Larkspur Rheumatology - Visit Summary - 2026-06-25
Patient reference SYN-9042. A referral from primary care for worsening hand swelling brought this 49-year-old woman to rheumatology last fall, and she returns today for a treatment update.

Seropositive rheumatoid arthritis was diagnosed in 2024. Prior DMARDs: leflunomide only, taken from September 2025 to April 2026, discontinued because her synovitis and morning stiffness had not improved on the medication, an inadequate response. She has never been prescribed methotrexate. She also takes lisinopril for hypertension and reports no new symptoms today.

Immunara is being requested given her sustained disease activity despite leflunomide.

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
0.940
Material contradiction
0.120
Missing evidence
TREATMENT_HISTORY 0.510
others: NONE 0.48 · DOSAGE 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=49, policy min_age=18

  3. contradictionpassed

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

  4. documentationpassed

    p_yes(documentation_complete)=0.940, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=TREATMENT_HISTORY (p=0.510), 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)