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GOLD-TRK-14

Tricky or ambiguous · gold-v0.1

Case inputs

As of
2026-07-01
Patient
55 years, SC
Request
Immunara for rheumatoid arthritis
Insurance
ExampleHealth, ExampleHealth Gold · EXH-771905
Policy
immunara-v0.1
Inputs
sha256:181f3464c1f3…

Documents 2

Physician note

problem_list
SYNTHETIC RECORD - Example Thistledown Rheumatology - Problem List Update - 2026-07-01
Patient reference SYN-3317. 55-year-old man.
- Dx: seropositive RA since 2023, active synovitis at both wrists and MCPs today.
- MTX 20 mg weekly, oral, 2026-01-26 to 2026-06-22, discontinued for inadequate response.
- Hypertension, controlled on lisinopril.
- Plan: Request Immunara given the inadequate response to MTX.

Insurance card

insurance_card
SYNTHETIC RECORD - ExampleHealth Gold - Member Insurance Card
Payer: ExampleHealth
Plan: ExampleHealth Gold
Member ID: EXH-771905
Group Number: EH-40218
Member Services: 555-0142

Decisions by provider

AUTO_PROCESScorrect

Decided by: auto_process 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
0.980
Documentation complete
0.950
Material contradiction
0.060
Missing evidence
NONE 0.960
others: DOSAGE 0.03 · TREATMENT_HISTORY 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=55, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.060, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.950, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=NONE (p=0.960), request info at >= 0.7

  6. auto_processFIRED → AUTO_PROCESS

    min(required p_yes)=0.950, auto at >= 0.89; p_yes(material_contradiction)=0.060, blocks at >= 0.2

  7. default_reviewnot reached

passed = the gate checked and did not fire; not reached = an earlier gate decided.

  • all required judgments are at or above 0.89 and contradiction risk is below 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)