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GOLD-TRK-18

Tricky or ambiguous · gold-v0.1

Case inputs

As of
2026-07-01
Patient
44 years, KS
Request
Immunara for rheumatoid arthritis
Insurance
CivicCare, CivicCare Plus · CCP-407638
Policy
immunara-v0.1
Inputs
sha256:1505ab70bd13…

Documents 1

Physician note

physician_note
SYNTHETIC RECORD - Example Hawksmoor Rheumatology - Visit Summary - 2026-07-01
Patient reference SYN-1284. Six months of migrating joint pain, now settling into both wrists and hands, brought this 44-year-old man to rheumatology earlier this year.

Given the pattern of symmetric small-joint swelling, suspected rheumatoid arthritis was noted at his first visit, and empiric methotrexate was started while further workup was pending. He took oral methotrexate 20 mg weekly from 2026-02-02 to 2026-06-22, discontinued because his swelling and stiffness had not improved despite the trial, an inadequate response. Serologic testing has not yet been completed.

Immunara is being requested given his ongoing symptoms.

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
0.970
Documentation complete
0.650
Material contradiction
0.160
Missing evidence
DIAGNOSIS 1.000
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=44, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.160, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.650, request info below 0.6

  5. missing_evidenceFIRED → REQUEST_INFO

    missing_evidence=DIAGNOSIS (p=1.000), 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=1.000)
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)