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
|
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