| id,setting,patient_summary,evidence_signals,narrative_chain,planned_action,gold_debt_level,gold_debt_item,gold_paydown_step | |
| 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" | |