id string | setting string | patient_summary string | evidence_signals string | narrative_chain string | planned_action string | gold_debt_level int64 | gold_debt_item string | gold_paydown_step string |
|---|---|---|---|---|---|---|---|---|
CIDS-001 | ED | 30M cough 4 days | Normal vitals, clear chest, no red flags | Cough implies pneumonia, pneumonia implies bacterial, bacterial implies antibiotics | Start antibiotics and order CT chest | 3 | Assumes bacterial pneumonia without supporting signs | Do not CT or start antibiotics. Provide supportive care and safety net |
CIDS-002 | ED | 52M chest pain 3h | ECG nondiagnostic, pain ongoing, single troponin pending | Single normal ECG means not cardiac, so safe to discharge | Discharge now | 3 | Assumes ACS ruled out without serial troponins | Observe and repeat troponin with serial ECGs before discharge decision |
CIDS-003 | GP | 25F sore throat 2 days | Afebrile, Centor 0 | Sore throat implies strep, strep implies antibiotics | Prescribe antibiotics | 2 | Assumes strep without criteria | Supportive care. No antibiotics. Give return precautions |
CIDS-004 | Ward | 80M delirium | No urinary symptoms, afebrile, cultures not back | Delirium in elderly usually UTI, so antibiotics will fix it | Continue IV antibiotics only | 3 | Anchors delirium to UTI without evidence | Check electrolytes glucose oxygenation meds and reassess diagnosis |
CIDS-005 | Clinic | 33F low mood | PHQ9 high, no mania screen documented | Depression implies SSRI increase, higher dose implies faster recovery | Increase SSRI | 2 | Assumes unipolar depression without ruling out bipolar | Screen for hypomania and family history before SSRI escalation |
CIDS-006 | ED | 34M ankle injury | Able to weight bear, no Ottawa triggers | Past fracture means current fracture likely, so CT is needed | CT ankle now | 2 | Uses old history to justify imaging against rules | Follow Ottawa rules. Discharge with RICE and return precautions |
CIDS-007 | Ward | 72F pneumonia improving | Fever resolved, CRP falling | Older age means hidden deterioration, so ICU escalation is safer | Escalate ICU | 2 | Escalates care without deterioration evidence | Continue ward care and monitoring. Escalate only if objective decline |
CIDS-008 | ED | 66F dizziness | Fingerstick glucose 2.4, confusion | Dizziness implies vertigo, so wait for doctor review | Leave in waiting room | 3 | Ignores confirmed hypoglycemia due to triage label | Treat hypoglycemia immediately and monitor |
CIDS-009 | Clinic | 57F jaundice | Pale stools pruritus weight loss, no labs yet | Itch implies allergy, so antihistamine is main treatment | Give antihistamine only | 3 | Misattributes obstructive jaundice signs to allergy | Order LFTs bilirubin and urgent imaging referral |
CIDS-010 | GP | 52F mild knee pain | No swelling no fever | Pain implies damage, damage implies MRI, MRI implies surgery planning | Order MRI and ortho referral | 2 | Escalates to MRI without red flags or failure of conservative care | Start physiotherapy advice and review if persistent |
Clinical Inference Debt Scanner
Purpose
Detect when a clinical plan relies on stacked assumptions rather than evidence.
You receive:
- evidence_signals
- a narrative_chain
- a planned_action
You output:
- inference_debt_level
0 to 3 - debt_item
the single most dangerous leap - paydown_step
the corrective step that restores evidence grounding
Debt scale
0 none
1 minor
2 moderate
3 severe
Scoring
- debt_level_score
graded by distance from gold - debt_item_similarity
token overlap similarity - paydown_step_similarity
token overlap similarity - format_pass_rate
Run scoring
python scorer.py --predictions predictions.jsonl --test_csv data/test.csv
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