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id
stringclasses
8 values
care_setting
stringclasses
8 values
clinical_context
stringclasses
8 values
available_evidence
stringclasses
8 values
proposed_decision
stringclasses
8 values
clinical_pressure_sources
stringclasses
8 values
pressure_type_map
stringclasses
8 values
evidence_vs_pressure_conflicts
stringclasses
8 values
pressure_mitigation_actions
stringclasses
8 values
patient_safety_risk
stringclasses
8 values
constraints
stringclasses
1 value
gold_checklist
stringclasses
1 value
CDPM-001
emergency_department
ED overcrowded. Chest pain patient waiting 6 hours. Family distressed.
Initial ECG normal. Troponin pending.
Discharge patient.
bed pressure; time pressure; family reassurance demand
time; operational; emotional
Normal ECG overweighted before biomarker completion.
Observe until serial troponins; explain uncertainty; use chest pain pathway.
missed MI; death
Under 220 words.
pressures+conflict+mitigation
CDPM-002
medical_ward
ICU beds limited. Borderline sepsis case.
Rising lactate; tachycardia; cultures pending.
Keep on ward.
resource scarcity; escalation friction
operational; hierarchical
Bed scarcity overrides physiologic escalation criteria.
Early ICU consult; interim monitoring; objective escalation trigger.
clinical deterioration
Under 220 words.
pressures+conflict+mitigation
CDPM-003
outpatient_clinic
Patient demands antibiotics for viral symptoms.
Viral features; no bacterial signs.
Prescribe antibiotics.
patient expectation; satisfaction metrics
emotional; reputational
Demand overrides evidence.
Education; delayed script; safety net.
antibiotic resistance; side effects
Under 220 words.
pressures+conflict+mitigation
CDPM-004
surgical_service
OR schedule tight. Patient borderline unstable.
Hypotension responsive to fluids.
Proceed with surgery.
schedule pressure; senior surgeon authority
time; authority
Schedule pressure outweighs stabilization window.
Delay incision; stabilize; document risk.
intraoperative shock
Under 220 words.
pressures+conflict+mitigation
CDPM-005
night_shift
Junior covering multiple wards overnight.
Subtle neuro change reported by nurse.
Defer assessment until morning.
fatigue; workload; handover avoidance
cognitive; operational
Fatigue delays evaluation of neurologic risk.
Immediate bedside exam; escalate concerns.
missed stroke
Under 220 words.
pressures+conflict+mitigation
CDPM-006
discharge_planning
Hospital targets discharge before noon.
Borderline oxygen saturation.
Discharge home.
throughput targets; bed demand
operational; time
Target timing overrides physiologic stability.
Extend observation; reassess exertional sats.
readmission; hypoxia
Under 220 words.
pressures+conflict+mitigation
CDPM-007
oncology_clinic
Patient anxious about delay in chemotherapy.
Neutrophils low.
Proceed with chemo.
patient fear; relationship pressure
emotional; relational
Emotional pressure overrides safety thresholds.
Delay treatment; explain risk; support patient.
neutropenic sepsis
Under 220 words.
pressures+conflict+mitigation
CDPM-008
geriatrics
Family insists on aggressive treatment.
Advanced dementia; poor prognosis.
Escalate care.
family pressure; moral distress
emotional; ethical
Family demand conflicts with goals-of-care evidence.
Goals-of-care meeting; ethics consult.
non-beneficial treatment
Under 220 words.
pressures+conflict+mitigation

What this dataset tests

Whether a system can identify non-clinical forces
that distort medical decisions away from evidence.

Required outputs

  • clinical pressure sources
  • pressure type map
  • evidence vs pressure conflicts
  • pressure mitigation actions

Typical failures

  • treating urgency as evidence
  • deferring to hierarchy over physiology
  • letting throughput metrics override safety

Suggested prompt wrapper

System

You map clinical decision pressure.
You protect patient safety over urgency.

User

Clinical context
{clinical_context}

Evidence
{available_evidence}

Proposed decision
{proposed_decision}

Return

  • clinical pressure sources
  • pressure types
  • conflicts with evidence
  • mitigation actions

Citation

ClarusC64 dataset family

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