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GOLD-TRK-17

Tricky or ambiguous · gold-v0.1

Case inputs

As of
2026-06-08
Patient
27 years, UT
Request
Immunara for rheumatoid arthritis
Insurance
ExampleHealth, ExampleHealth Gold · EXH-448820
Policy
immunara-v0.1
Inputs
sha256:9020c422b81c…

Documents 2

Physician note

physician_note
SYNTHETIC RECORD - Example Briarcliff Rheumatology - New Patient Evaluation - 2026-06-08
Patient reference SYN-6621.
Subjective: This 27-year-old woman reports six weeks of symmetric hand and wrist swelling with morning stiffness lasting over an hour.
Objective: Synovitis at the bilateral wrists and MCPs. Hand X-rays obtained today show periarticular changes consistent with rheumatoid arthritis, but serology is still pending.
Assessment: Findings consistent with rheumatoid arthritis; the diagnosis is to be confirmed at follow-up once serology results return. No DMARD has been started yet.
Plan: Order rheumatoid factor and anti-CCP antibody testing. Return in three weeks to review results and finalize the diagnosis.

Lab report

lab_report
SYNTHETIC RECORD - Example Briarcliff Rheumatology - Laboratory Order - 2026-06-08
Patient reference SYN-6621. Rheumatoid factor: ordered, pending. Anti-CCP antibody: ordered, pending. Complete blood count and comprehensive metabolic panel: ordered, pending. Results expected within one week.

Decisions by provider

REQUEST_INFOcorrect

Decided by: missing_evidence gate · auto_process 0.89

Judgments

p_yes for yes/no questions; ticks are the thresholds a gate compares each one with.

Diagnosis supported
0.040
Step therapy met
0.000
Documentation complete
0.740
Material contradiction
0.080
Missing evidence
DIAGNOSIS 0.850
others: TREATMENT_HISTORY 0.15
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=27, policy min_age=18

  3. contradictionpassed

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

  4. documentationpassed

    p_yes(documentation_complete)=0.740, request info below 0.6

  5. missing_evidenceFIRED → REQUEST_INFO

    missing_evidence=DIAGNOSIS (p=0.850), request info at >= 0.7

  6. auto_processnot reached
  7. default_reviewnot reached

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

  • missing diagnosis (p=0.850)
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)