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sessions/b9d14f2b-3fa4-48a7-88b1-c75583ebfd8b.json

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+{
+  "session_id": "b9d14f2b-3fa4-48a7-88b1-c75583ebfd8b",
+  "created_at": "2026-03-17T08:16:02.323328",
+  "last_updated": "2026-03-17T08:20:20.305623",
+  "query_count": 5,
+  "established_facts": [],
+  "knowledge_anchors": [],
+  "patient_context": {
+    "age": "67",
+    "sex": "male",
+    "diagnoses": [
+      "heart failure",
+      "##bri"
+    ],
+    "medications": [
+      "glucose -",
+      "metformin",
+      "sglt2 inhibitor",
+      "warfarin",
+      "medications"
+    ],
+    "contraindications": [],
+    "lab_values": {},
+    "allergies": [],
+    "procedures": []
+  },
+  "pending_contradictions": [
+    {
+      "claim_a": "In conclusion, treatment of patients with metabolic syndrome and elevated FPG levels did not cause sustained negative effects on glucose metabolism or insulin sensitivity if given in combination with ",
+      "source_a": "14983408",
+      "claim_b": "CONCLUSION: Initiation of metformin as a first line monotherapy for T2D, when compared to other non-insulin monotherapies, was not associated with decreased risk of developing AF in this retrospective",
+      "source_b": "36208567",
+      "contradiction_type": "outcome",
+      "severity": "high",
+      "explanation": "Excerpt A suggests metformin does not negatively affect glucose metabolism, while Excerpt B finds no reduction in AF incidence with metformin compared to other treatments.",
+      "detected_at_query": 2,
+      "resolved": false
+    },
+    {
+      "claim_a": "INTRODUCTION: Metformin is widely considered a first-line antiglycemic agent due to its cost-effectiveness and favorable adverse effect profile. However, its use is prohibited in patients with an esti",
+      "source_a": "37776126",
+      "claim_b": "Our objective was to investigate if initial therapy with metformin is associated with reduced incidence of AF in comparison to other non-insulin anti-hyperglycemic agents in patients with newly diagno",
+      "source_b": "36208567",
+      "contradiction_type": "outcome",
+      "severity": "high",
+      "explanation": "Excerpt A suggests metformin can be used in patients with low GFR, while Excerpt B warns against its use in such patients due to risk of lactic acidosis.",
+      "detected_at_query": 2,
+      "resolved": false
+    }
+  ],
+  "resolved_contradictions": [],
+  "query_history": [
+    {
+      "query_num": 1,
+      "query": "67-year-old male with type 2 diabetes and CKD stage 3. What is the best glucose-lowering agent?",
+      "retrieved_pmids": [
+        "40184140",
+        "41517726",
+        "41327646",
+        "28985276",
+        "41346190",
+        "41352558",
+        "40929556",
+        "41501207",
+        "40396302",
+        "36731453",
+        "39022890",
+        "37667406"
+      ],
+      "contradictions_flagged": 0,
+      "anchors_count": 0,
+      "latency": 52.93
+    },
+    {
+      "query_num": 2,
+      "query": "His eGFR is 38 and HbA1c is 8.5. Is metformin still safe at this level of renal function?",
+      "retrieved_pmids": [
+        "41273400",
+        "20880345",
+        "19488607",
+        "14983408",
+        "37776126",
+        "36208567",
+        "36208567",
+        "28609252",
+        "31333070",
+        "15526505",
+        "24285770",
+        "22641582"
+      ],
+      "contradictions_flagged": 2,
+      "anchors_count": 0,
+      "latency": 55.84
+    },
+    {
+      "query_num": 3,
+      "query": "He also has heart failure with reduced ejection fraction. Should we add an SGLT2 inhibitor?",
+      "retrieved_pmids": [
+        "28726654",
+        "37100231",
+        "38708982",
+        "35357604",
+        "14739726",
+        "40680000",
+        "37310921",
+        "34935699",
+        "30497746",
+        "29434126",
+        "30895821",
+        "11263853"
+      ],
+      "contradictions_flagged": 0,
+      "anchors_count": 0,
+      "latency": 56.09
+    },
+    {
+      "query_num": 4,
+      "query": "He is on warfarin for atrial fibrillation. Are there drug interactions with the medications we discussed?",
+      "retrieved_pmids": [
+        "39230543",
+        "30079702",
+        "29920547",
+        "27132702",
+        "37310921",
+        "23800552",
+        "37310921",
+        "33984191",
+        "23690262",
+        "21594591",
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+      ],
+      "contradictions_flagged": 0,
+      "anchors_count": 0,
+      "latency": 43.89
+    },
+    {
+      "query_num": 5,
+      "query": "Summarize the treatment plan for this patient considering all the information from our discussion.",
+      "retrieved_pmids": [
+        "28858981",
+        "37804690",
+        "35287530",
+        "40164095",
+        "37381745",
+        "32497632",
+        "8874843",
+        "28869766",
+        "19521237",
+        "31630071",
+        "34240393",
+        "30086073"
+      ],
+      "contradictions_flagged": 0,
+      "anchors_count": 0,
+      "latency": 49.2
+    }
+  ]
+}