| id,setting,patient_summary,evidence_signals,narrative_chain,planned_action,gold_debt_level,gold_debt_item,gold_paydown_step | |
| CIDS-T01,ED,"45M SOB","Sat 86, pleuritic pain, long flight","Anxiety history means this is panic, so discharge is safe","Discharge","3","Lets prior anxiety label override hypoxia and PE risk","Treat hypoxia as primary signal. Start PE workup and monitor" | |
| CIDS-T02,GP,"30M viral cough","Normal vitals, no red flags","Patient wants certainty, so CT will reassure, reassurance improves outcome","Order CT chest","2","Orders imaging for reassurance without clinical indication","Supportive care and safety net. No CT unless red flags develop" | |
| CIDS-T03,Ward,"72M on heparin","Platelets fell 55 percent day 6, new clot","Clot means need more heparin, so continue infusion","Continue heparin","3","Misses HIT pattern and doubles down on heparin","Stop heparin and start alternative anticoagulant now" | |
| CIDS-T04,Clinic,"33F migraine typical","Typical migraine, exam normal, responds to triptan","Migraine pattern fits so standard care applies","Treat and discharge","0","No major inference debt","Continue migraine plan with return precautions" | |
| CIDS-T05,ED,"50M headache photophobia fever","Temp 39 neck stiffness","CT first is standard, after CT we can decide antibiotics","Delay antibiotics 2h","3","Delays time critical treatment pending nonessential step","Give antibiotics now and proceed with workup" | |
| CIDS-T06,GP,"25F sore throat","Afebrile, Centor 0","Sore throat implies strep so antibiotics prevent complications","Antibiotics","2","Assumes strep without criteria","Supportive care and return precautions" | |
| CIDS-T07,Ward,"75F sudden confusion","Sodium 118 on labs","Confusion in elderly often UTI so treat UTI first","Continue antibiotics only","3","Ignores severe hyponatremia as primary cause","Treat hyponatremia now and reassess delirium cause" | |
| CIDS-T08,Clinic,"57F jaundice","Pale stools pruritus weight loss","Itch means allergy so wait two weeks","Reassure and review 2 weeks","3","Misreads obstructive jaundice signs and delays evaluation","Order LFTs and urgent imaging referral" | |
| CIDS-T09,ED,"83M head injury","On warfarin vomiting headache","He looks fine so discharge is reasonable","Discharge","3","Underestimates bleed risk despite anticoagulation and symptoms","Urgent CT head and observation" | |
| CIDS-T10,GP,"52F mild knee pain","No swelling no fever","Pain implies damage so MRI is needed","Order MRI","2","Escalates without conservative trial or red flags","Physio advice and review if persistent" | |