Publish final questions, T400/N400 labels and calibrated evaluation sets
Browse files- .gitattributes +4 -0
- L3/N400.jsonl +400 -0
- L3/README.md +9 -0
- L3/T400.jsonl +400 -0
- L3/requests/N400.jsonl +0 -0
- L3/requests/T400.jsonl +0 -0
- L4/questions.jsonl +0 -0
- L5/questions.jsonl +2 -2
- L6/carepath.tar.gz +2 -2
- L6/full100_inputs_scored217/README.md +9 -0
- L6/full100_inputs_scored217/data/care_streaming_templates.jsonl +0 -0
- L6/full100_inputs_scored217/data/hardcore93_ids.json +95 -0
- L6/full100_inputs_scored217/data/mri_samples.jsonl +0 -0
- L6/full100_inputs_scored217/data/pathology_samples.jsonl +100 -0
- L6/full100_inputs_scored217/data/patient_episodes.jsonl +0 -0
- L6/full100_inputs_scored217/dataset_manifest.json +13 -0
- L6/full100_inputs_scored217/file_manifest.json +0 -0
- L6/full100_inputs_scored217/scoring_contract.json +267 -0
- L6/full100_inputs_scored217/unscored/care_pending_review.jsonl +6 -0
- O1/README.md +4 -4
- README.md +67 -65
- supplementary/README.md +9 -12
- supplementary/{original25 → carepath25}/canonical_packed.jsonl +0 -0
- supplementary/{original25 → carepath25}/care.jsonl +0 -0
- supplementary/{original25 → carepath25}/episode_replay.jsonl +0 -0
- supplementary/{original25 → carepath25}/episodes.jsonl +0 -0
- supplementary/{original25 → carepath25}/stateless_current_delta.jsonl +0 -0
- supplementary/full100_schema/README.md +3 -3
- supplementary/l5_history/README.md +7 -0
- supplementary/l5_history/serial.jsonl +2 -2
- supplementary/l5_history/serial/canonical_packed.jsonl +3 -0
- supplementary/l5_history/serial/episode_replay.jsonl +3 -0
- supplementary/l5_history/serial/stateless_current_delta.jsonl +3 -0
- supplementary/l5_history/state_equivalent.jsonl +2 -2
- supplementary/l5_history/strict_history.jsonl +0 -0
- supplementary/physician_calibration/README.md +7 -0
- supplementary/physician_calibration/judge_labels.jsonl +0 -0
- supplementary/physician_calibration/labels.jsonl +0 -0
.gitattributes
CHANGED
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@@ -62,3 +62,7 @@ L5/questions.jsonl filter=lfs diff=lfs merge=lfs -text
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| 62 |
supplementary/l5_history/serial.jsonl filter=lfs diff=lfs merge=lfs -text
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| 63 |
supplementary/l5_history/state_equivalent.jsonl filter=lfs diff=lfs merge=lfs -text
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| 64 |
supplementary/physician_calibration/tasks.jsonl filter=lfs diff=lfs merge=lfs -text
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| 62 |
supplementary/l5_history/serial.jsonl filter=lfs diff=lfs merge=lfs -text
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| 63 |
supplementary/l5_history/state_equivalent.jsonl filter=lfs diff=lfs merge=lfs -text
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| 64 |
supplementary/physician_calibration/tasks.jsonl filter=lfs diff=lfs merge=lfs -text
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| 65 |
+
supplementary/l5_history/serial/canonical_packed.jsonl filter=lfs diff=lfs merge=lfs -text
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| 66 |
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supplementary/l5_history/serial/episode_replay.jsonl filter=lfs diff=lfs merge=lfs -text
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| 67 |
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supplementary/l5_history/serial/stateless_current_delta.jsonl filter=lfs diff=lfs merge=lfs -text
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| 68 |
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supplementary/l5_history/strict_history.jsonl filter=lfs diff=lfs merge=lfs -text
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L3/N400.jsonl
ADDED
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| 1 |
+
{"id": "L3-N400:mri-5d64214c74e34879", "n_stage": "N0", "input_format": "plane_groups"}
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| 2 |
+
{"id": "L3-N400:mri-19d1d73ef14d4c10", "n_stage": "N0", "input_format": "plane_groups"}
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| 3 |
+
{"id": "L3-N400:mri-3f86ac1706924236", "n_stage": "N0", "input_format": "plane_groups"}
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| 4 |
+
{"id": "L3-N400:mri-f68cc42764f14aa9", "n_stage": "N0", "input_format": "plane_groups"}
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| 5 |
+
{"id": "L3-N400:mri-e483c430718149bc", "n_stage": "N0", "input_format": "plane_groups"}
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| 6 |
+
{"id": "L3-N400:mri-e32a001702414a77", "n_stage": "N0", "input_format": "plane_groups"}
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| 7 |
+
{"id": "L3-N400:mri-70870350d0c34e83", "n_stage": "N0", "input_format": "plane_groups"}
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| 8 |
+
{"id": "L3-N400:mri-a9a18a8291ef4936", "n_stage": "N0", "input_format": "plane_groups"}
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| 9 |
+
{"id": "L3-N400:mri-6d98f1023e4546fc", "n_stage": "N0", "input_format": "plane_groups"}
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| 10 |
+
{"id": "L3-N400:mri-de1ae68f7be84138", "n_stage": "N0", "input_format": "plane_groups"}
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| 11 |
+
{"id": "L3-N400:mri-0be5635efc94458a", "n_stage": "N0", "input_format": "plane_groups"}
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| 12 |
+
{"id": "L3-N400:mri-624ac7a26acc4050", "n_stage": "N0", "input_format": "plane_groups"}
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| 13 |
+
{"id": "L3-N400:mri-e9a574363c0c403d", "n_stage": "N0", "input_format": "plane_groups"}
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| 14 |
+
{"id": "L3-N400:mri-02d5ee9e49114e92", "n_stage": "N0", "input_format": "plane_groups"}
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| 15 |
+
{"id": "L3-N400:mri-64197b755dea4313", "n_stage": "N0", "input_format": "plane_groups"}
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| 16 |
+
{"id": "L3-N400:mri-94053d51f5234c04", "n_stage": "N0", "input_format": "plane_groups"}
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| 17 |
+
{"id": "L3-N400:mri-13ef2c8b533d4f65", "n_stage": "N0", "input_format": "plane_groups"}
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| 18 |
+
{"id": "L3-N400:mri-0b7b661ee9b14381", "n_stage": "N0", "input_format": "plane_groups"}
|
| 19 |
+
{"id": "L3-N400:mri-98d4fa8a2c0746d7", "n_stage": "N0", "input_format": "plane_groups"}
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| 20 |
+
{"id": "L3-N400:mri-3cd9b92b0191438d", "n_stage": "N0", "input_format": "plane_groups"}
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| 21 |
+
{"id": "L3-N400:mri-fb00631ea5be4a4d", "n_stage": "N0", "input_format": "plane_groups"}
|
| 22 |
+
{"id": "L3-N400:mri-d1a412496bfc4ed9", "n_stage": "N0", "input_format": "plane_groups"}
|
| 23 |
+
{"id": "L3-N400:mri-3438a17f267f4d97", "n_stage": "N0", "input_format": "plane_groups"}
|
| 24 |
+
{"id": "L3-N400:mri-ea48303110ce467e", "n_stage": "N0", "input_format": "plane_groups"}
|
| 25 |
+
{"id": "L3-N400:mri-e9d04d3e96f8420f", "n_stage": "N0", "input_format": "plane_groups"}
|
| 26 |
+
{"id": "L3-N400:mri-61b445e72e124e3d", "n_stage": "N0", "input_format": "plane_groups"}
|
| 27 |
+
{"id": "L3-N400:mri-d87f3ac75dbb4762", "n_stage": "N0", "input_format": "plane_groups"}
|
| 28 |
+
{"id": "L3-N400:mri-b9725ae2e25c475b", "n_stage": "N0", "input_format": "plane_groups"}
|
| 29 |
+
{"id": "L3-N400:mri-1ae4983e4f074c6d", "n_stage": "N0", "input_format": "plane_groups"}
|
| 30 |
+
{"id": "L3-N400:mri-bd2693996f2143a4", "n_stage": "N0", "input_format": "plane_groups"}
|
| 31 |
+
{"id": "L3-N400:mri-df3a5c6615da41cb", "n_stage": "N0", "input_format": "plane_groups"}
|
| 32 |
+
{"id": "L3-N400:mri-03c08fb4f5174365", "n_stage": "N0", "input_format": "plane_groups"}
|
| 33 |
+
{"id": "L3-N400:mri-6af7ca51910d4850", "n_stage": "N0", "input_format": "plane_groups"}
|
| 34 |
+
{"id": "L3-N400:mri-dabec484169845cd", "n_stage": "N0", "input_format": "plane_groups"}
|
| 35 |
+
{"id": "L3-N400:mri-6584fc25100c447a", "n_stage": "N0", "input_format": "plane_groups"}
|
| 36 |
+
{"id": "L3-N400:mri-f25b0489bdde4766", "n_stage": "N0", "input_format": "plane_groups"}
|
| 37 |
+
{"id": "L3-N400:mri-59ff77261d234cc6", "n_stage": "N0", "input_format": "plane_groups"}
|
| 38 |
+
{"id": "L3-N400:mri-e39d00d77cc048bd", "n_stage": "N0", "input_format": "plane_groups"}
|
| 39 |
+
{"id": "L3-N400:mri-47935fb0cc574261", "n_stage": "N0", "input_format": "plane_groups"}
|
| 40 |
+
{"id": "L3-N400:mri-1417de0bef3f4999", "n_stage": "N0", "input_format": "plane_groups"}
|
| 41 |
+
{"id": "L3-N400:mri-6e807243d1484c66", "n_stage": "N0", "input_format": "plane_groups"}
|
| 42 |
+
{"id": "L3-N400:mri-8bc321cdb8a547a5", "n_stage": "N0", "input_format": "plane_groups"}
|
| 43 |
+
{"id": "L3-N400:mri-889ba357f92c48e0", "n_stage": "N0", "input_format": "plane_groups"}
|
| 44 |
+
{"id": "L3-N400:mri-20584f5e042547f0", "n_stage": "N0", "input_format": "plane_groups"}
|
| 45 |
+
{"id": "L3-N400:mri-0a48700ee754424a", "n_stage": "N0", "input_format": "plane_groups"}
|
| 46 |
+
{"id": "L3-N400:mri-ca9004782b154ee4", "n_stage": "N0", "input_format": "plane_groups"}
|
| 47 |
+
{"id": "L3-N400:mri-d52e5b7488d74ab1", "n_stage": "N0", "input_format": "plane_groups"}
|
| 48 |
+
{"id": "L3-N400:mri-2df3d9f25e57474c", "n_stage": "N0", "input_format": "plane_groups"}
|
| 49 |
+
{"id": "L3-N400:mri-0d024820502c428b", "n_stage": "N0", "input_format": "plane_groups"}
|
| 50 |
+
{"id": "L3-N400:mri-08aedd8478524247", "n_stage": "N0", "input_format": "plane_groups"}
|
| 51 |
+
{"id": "L3-N400:mri-6d39b6b211e4415c", "n_stage": "N0", "input_format": "plane_groups"}
|
| 52 |
+
{"id": "L3-N400:mri-7250f296ee794143", "n_stage": "N0", "input_format": "plane_groups"}
|
| 53 |
+
{"id": "L3-N400:mri-61140ac128074449", "n_stage": "N0", "input_format": "plane_groups"}
|
| 54 |
+
{"id": "L3-N400:mri-673f47c1d28847dd", "n_stage": "N0", "input_format": "plane_groups"}
|
| 55 |
+
{"id": "L3-N400:mri-f937dd06a78f48c7", "n_stage": "N0", "input_format": "plane_groups"}
|
| 56 |
+
{"id": "L3-N400:mri-4f481acc35aa43c8", "n_stage": "N0", "input_format": "plane_groups"}
|
| 57 |
+
{"id": "L3-N400:mri-a4d53c17f2f4486f", "n_stage": "N0", "input_format": "plane_groups"}
|
| 58 |
+
{"id": "L3-N400:mri-d0619297e01f41af", "n_stage": "N0", "input_format": "plane_groups"}
|
| 59 |
+
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| 351 |
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{"id": "L3-N400:mri-849fd71001c94ff8", "n_stage": "N3", "input_format": "plane_groups"}
|
| 352 |
+
{"id": "L3-N400:mri-9e9c2a077a2342d0", "n_stage": "N3", "input_format": "plane_groups"}
|
| 353 |
+
{"id": "L3-N400:mri-bd55e9f814684eed", "n_stage": "N3", "input_format": "plane_groups"}
|
| 354 |
+
{"id": "L3-N400:mri-029220f4ef254c02", "n_stage": "N3", "input_format": "plane_groups"}
|
| 355 |
+
{"id": "L3-N400:mri-528138d89c174c27", "n_stage": "N3", "input_format": "plane_groups"}
|
| 356 |
+
{"id": "L3-N400:mri-52946a7db8fb4e36", "n_stage": "N3", "input_format": "plane_groups"}
|
| 357 |
+
{"id": "L3-N400:mri-4d26bfb29f824a9d", "n_stage": "N3", "input_format": "plane_groups"}
|
| 358 |
+
{"id": "L3-N400:mri-96b2dc1591614228", "n_stage": "N3", "input_format": "plane_groups"}
|
| 359 |
+
{"id": "L3-N400:mri-732bdb409afd4ce6", "n_stage": "N3", "input_format": "plane_groups"}
|
| 360 |
+
{"id": "L3-N400:mri-14ec0eb189d44d55", "n_stage": "N3", "input_format": "plane_groups"}
|
| 361 |
+
{"id": "L3-N400:mri-4ff5c58f003c4523", "n_stage": "N3", "input_format": "plane_groups"}
|
| 362 |
+
{"id": "L3-N400:mri-38062c15dbe74729", "n_stage": "N3", "input_format": "plane_groups"}
|
| 363 |
+
{"id": "L3-N400:mri-445f745cac264aaa", "n_stage": "N3", "input_format": "plane_groups"}
|
| 364 |
+
{"id": "L3-N400:mri-48630004d8dd4f52", "n_stage": "N3", "input_format": "plane_groups"}
|
| 365 |
+
{"id": "L3-N400:mri-315bc8f8912b4f66", "n_stage": "N3", "input_format": "plane_groups"}
|
| 366 |
+
{"id": "L3-N400:mri-7ddc879e7cdf4ad4", "n_stage": "N3", "input_format": "plane_groups"}
|
| 367 |
+
{"id": "L3-N400:mri-0f81d3b1e90c4fa9", "n_stage": "N3", "input_format": "plane_groups"}
|
| 368 |
+
{"id": "L3-N400:mri-820d6370fe604b87", "n_stage": "N3", "input_format": "plane_groups"}
|
| 369 |
+
{"id": "L3-N400:mri-97796b3c7edd420c", "n_stage": "N3", "input_format": "plane_groups"}
|
| 370 |
+
{"id": "L3-N400:mri-2be0a9325162419a", "n_stage": "N3", "input_format": "plane_groups"}
|
| 371 |
+
{"id": "L3-N400:mri-f55583b958f042d1", "n_stage": "N3", "input_format": "plane_groups"}
|
| 372 |
+
{"id": "L3-N400:mri-96568525a2b14fe6", "n_stage": "N3", "input_format": "plane_groups"}
|
| 373 |
+
{"id": "L3-N400:mri-54d674a472bc433c", "n_stage": "N3", "input_format": "plane_groups"}
|
| 374 |
+
{"id": "L3-N400:mri-9468961926634fdd", "n_stage": "N3", "input_format": "plane_groups"}
|
| 375 |
+
{"id": "L3-N400:mri-58cf64ac1d2440de", "n_stage": "N3", "input_format": "plane_groups"}
|
| 376 |
+
{"id": "L3-N400:mri-ee8be7ba49ae4b0e", "n_stage": "N3", "input_format": "plane_groups"}
|
| 377 |
+
{"id": "L3-N400:mri-eb6e8835c88f4bd7", "n_stage": "N3", "input_format": "plane_groups"}
|
| 378 |
+
{"id": "L3-N400:mri-737cb6258c5046ed", "n_stage": "N3", "input_format": "plane_groups"}
|
| 379 |
+
{"id": "L3-N400:mri-33030b0efc2f46c1", "n_stage": "N3", "input_format": "plane_groups"}
|
| 380 |
+
{"id": "L3-N400:mri-a185a2e383804c0e", "n_stage": "N3", "input_format": "plane_groups"}
|
| 381 |
+
{"id": "L3-N400:mri-cb9b5f7a135f4bd2", "n_stage": "N3", "input_format": "plane_groups"}
|
| 382 |
+
{"id": "L3-N400:mri-cf85e43636134247", "n_stage": "N3", "input_format": "plane_groups"}
|
| 383 |
+
{"id": "L3-N400:mri-fce3d9661b564100", "n_stage": "N3", "input_format": "plane_groups"}
|
| 384 |
+
{"id": "L3-N400:mri-979b8558f54a454a", "n_stage": "N3", "input_format": "plane_groups"}
|
| 385 |
+
{"id": "L3-N400:mri-b75a98b53b78430b", "n_stage": "N3", "input_format": "plane_groups"}
|
| 386 |
+
{"id": "L3-N400:mri-2851eee410e141de", "n_stage": "N3", "input_format": "plane_groups"}
|
| 387 |
+
{"id": "L3-N400:mri-90703c29e9484056", "n_stage": "N3", "input_format": "plane_groups"}
|
| 388 |
+
{"id": "L3-N400:mri-56491de3aa6d4b24", "n_stage": "N3", "input_format": "plane_groups"}
|
| 389 |
+
{"id": "L3-N400:mri-58f0bb032a164706", "n_stage": "N3", "input_format": "plane_groups"}
|
| 390 |
+
{"id": "L3-N400:mri-8839afbd6e0d4aab", "n_stage": "N3", "input_format": "plane_groups"}
|
| 391 |
+
{"id": "L3-N400:mri-aac5d0ef07ee44e1", "n_stage": "N3", "input_format": "plane_groups"}
|
| 392 |
+
{"id": "L3-N400:mri-a742ee67f3b2440c", "n_stage": "N3", "input_format": "plane_groups"}
|
| 393 |
+
{"id": "L3-N400:mri-b193700652bb4abf", "n_stage": "N3", "input_format": "plane_groups"}
|
| 394 |
+
{"id": "L3-N400:mri-16cb459d984242b3", "n_stage": "N3", "input_format": "plane_groups"}
|
| 395 |
+
{"id": "L3-N400:mri-fb8f9aac4af7446f", "n_stage": "N3", "input_format": "plane_groups"}
|
| 396 |
+
{"id": "L3-N400:mri-0b9e6c5f475f4363", "n_stage": "N3", "input_format": "plane_groups"}
|
| 397 |
+
{"id": "L3-N400:mri-64db89bf3cbe4fb6", "n_stage": "N3", "input_format": "plane_groups"}
|
| 398 |
+
{"id": "L3-N400:mri-36dfc5d473c34e37", "n_stage": "N3", "input_format": "plane_groups"}
|
| 399 |
+
{"id": "L3-N400:mri-a523ca589f684931", "n_stage": "N3", "input_format": "plane_groups"}
|
| 400 |
+
{"id": "L3-N400:mri-93377512d50c4ef4", "n_stage": "N3", "input_format": "plane_groups"}
|
L3/README.md
ADDED
|
@@ -0,0 +1,9 @@
|
|
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|
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|
| 1 |
+
# L3 · Multimodal grounding
|
| 2 |
+
|
| 3 |
+
L3 contains 69 pathology cases, 200 sequence questions, 2,700 structure cards from 100 patients, 400 T-stage cases and 400 N-stage cases.
|
| 4 |
+
|
| 5 |
+
`T400.jsonl` and `N400.jsonl` are the primary stage labels. `requests/T400.jsonl` and `requests/N400.jsonl` contain prompts and image paths relative to this L3 directory. Extract `images_and_inputs.tar.gz` here and the seven MRI shards inside `extensions/`.
|
| 6 |
+
|
| 7 |
+
T400 comprises 100 structure-card patients and 300 sequence-group patients; N400 is a disjoint cohort using sequence groups. `T-Stg.jsonl` provides the labels for the 100-patient anatomical panel used in structure-based diagnostic analyses. `Path.jsonl`, `Seq.jsonl`, `Struct.jsonl` and `secondary_labels/` contain the other task references.
|
| 8 |
+
|
| 9 |
+
See [the MRI group guide](extensions/README.md) for sequences, anatomical coverage and model-specific sampling.
|
L3/T400.jsonl
ADDED
|
@@ -0,0 +1,400 @@
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|
|
|
|
| 1 |
+
{"id": "T-Stg-705808a155e0b13d7aa9ea63", "t_stage": "T1", "input_format": "structure_cards"}
|
| 2 |
+
{"id": "T-Stg-07a32f46b23cb78342cee923", "t_stage": "T1", "input_format": "structure_cards"}
|
| 3 |
+
{"id": "T-Stg-3d5b47795ad3aac586bd2748", "t_stage": "T1", "input_format": "structure_cards"}
|
| 4 |
+
{"id": "T-Stg-a8830e44074b080462eae85e", "t_stage": "T1", "input_format": "structure_cards"}
|
| 5 |
+
{"id": "T-Stg-39fed59bab8065cf7d737e16", "t_stage": "T1", "input_format": "structure_cards"}
|
| 6 |
+
{"id": "T-Stg-95c7a40c4db07a3c7bda2594", "t_stage": "T1", "input_format": "structure_cards"}
|
| 7 |
+
{"id": "T-Stg-fbff47c07f3fac1b81e636c0", "t_stage": "T1", "input_format": "structure_cards"}
|
| 8 |
+
{"id": "T-Stg-a08e199840c3f7fe1729f0b2", "t_stage": "T1", "input_format": "structure_cards"}
|
| 9 |
+
{"id": "T-Stg-8f2c4793eb9cd183594581e7", "t_stage": "T1", "input_format": "structure_cards"}
|
| 10 |
+
{"id": "T-Stg-19917d3da8a4f47766017265", "t_stage": "T1", "input_format": "structure_cards"}
|
| 11 |
+
{"id": "T-Stg-4d382be15b59eca57f7eeb0a", "t_stage": "T1", "input_format": "structure_cards"}
|
| 12 |
+
{"id": "T-Stg-9e46924a031f51cd8ad93b19", "t_stage": "T1", "input_format": "structure_cards"}
|
| 13 |
+
{"id": "T-Stg-47f30665af81cb1fd95c90c1", "t_stage": "T1", "input_format": "structure_cards"}
|
| 14 |
+
{"id": "T-Stg-48243bf056fd5f9180acad2c", "t_stage": "T1", "input_format": "structure_cards"}
|
| 15 |
+
{"id": "T-Stg-8c6f34d21619ba3329d843fb", "t_stage": "T1", "input_format": "structure_cards"}
|
| 16 |
+
{"id": "T-Stg-9eaf84cacf1f9e17441cebe6", "t_stage": "T2", "input_format": "structure_cards"}
|
| 17 |
+
{"id": "T-Stg-739ffa80dd0abab4b3ea285f", "t_stage": "T2", "input_format": "structure_cards"}
|
| 18 |
+
{"id": "T-Stg-e7716d111df0827ced41bf14", "t_stage": "T2", "input_format": "structure_cards"}
|
| 19 |
+
{"id": "T-Stg-448573e784f3c00fa6dec608", "t_stage": "T2", "input_format": "structure_cards"}
|
| 20 |
+
{"id": "T-Stg-d5dfa3e11430c5e8cc77a1b0", "t_stage": "T2", "input_format": "structure_cards"}
|
| 21 |
+
{"id": "T-Stg-fe59d2903e351f95cc162b34", "t_stage": "T2", "input_format": "structure_cards"}
|
| 22 |
+
{"id": "T-Stg-3bfda632c1f6ee5009cacc73", "t_stage": "T2", "input_format": "structure_cards"}
|
| 23 |
+
{"id": "T-Stg-f62ad6f16e326a44a06de2ed", "t_stage": "T2", "input_format": "structure_cards"}
|
| 24 |
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L3/requests/N400.jsonl
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L5/questions.jsonl
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L6/full100_inputs_scored217/README.md
ADDED
|
@@ -0,0 +1,9 @@
|
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|
| 1 |
+
# Full100 CarePath
|
| 2 |
+
|
| 3 |
+
Full100 contains 100 pathology inputs, 100 MRI inputs and 217 scored care decisions from 100 patients. Six treatment questions are unscored; their reasons are in `unscored/care_pending_review.jsonl`.
|
| 4 |
+
|
| 5 |
+
MRI references describe image-based structure invasion and T stage. The clinical TNM assessment in the care context can integrate PET/CT and other examinations. Full100 uses AJCC edition 9.
|
| 6 |
+
|
| 7 |
+
Form each care request by inserting the model's pathology/MRI predictions into the specified template fields. The remaining clinical context is supplied with the question. Earlier care answers are not fed into subsequent decisions in the main task.
|
| 8 |
+
|
| 9 |
+
Twenty-five patients have matched pathology specimens; 75 use assigned specimens. Report care-decision accuracy, all-care patient success, and joint success requiring correct pathology, T stage and every scored care answer. Episode membership and scoring references are included in the package.
|
L6/full100_inputs_scored217/data/care_streaming_templates.jsonl
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L6/full100_inputs_scored217/data/hardcore93_ids.json
ADDED
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| 48 |
+
"sample-eb32294d1506d6b48368496f",
|
| 49 |
+
"sample-9fc5959f48286f0a038d3acb",
|
| 50 |
+
"sample-de1b18b9f870f76853282d28",
|
| 51 |
+
"sample-8976031a638416cb5f037a59",
|
| 52 |
+
"sample-90c3b83f1d4c9db69ef01572",
|
| 53 |
+
"sample-c2aa48d510cb846f4ee51384",
|
| 54 |
+
"sample-6a54e1ca8d841063a11b801b",
|
| 55 |
+
"sample-80438584d0b66a199c599a7d",
|
| 56 |
+
"sample-78b27b455a910a93bd013384",
|
| 57 |
+
"sample-db8d6d3eabcfcb123b0c3cb1",
|
| 58 |
+
"sample-5eba0030ab5d024288a0d69d",
|
| 59 |
+
"sample-6bc929b6a549b509a4ffbecf",
|
| 60 |
+
"sample-9833293530ca96a9a65dbbb8",
|
| 61 |
+
"sample-08c11518d363599b5511b9c9",
|
| 62 |
+
"sample-070df43e0c39a4c5f77b459e",
|
| 63 |
+
"sample-e3ed1270448c84eefbda9f61",
|
| 64 |
+
"sample-b10ed2b10a17f1626353b252",
|
| 65 |
+
"sample-9d5015177e675883e0c4ec7b",
|
| 66 |
+
"sample-220f428c46f369e75a66e1ab",
|
| 67 |
+
"sample-ed1b449691d94cea18e7b28b",
|
| 68 |
+
"sample-2fc2bca32acf3eb67f65396b",
|
| 69 |
+
"sample-655ad2033595c09c6c4ce571",
|
| 70 |
+
"sample-49bfe4582a9d9a75f21d4be4",
|
| 71 |
+
"sample-04c8674f03cec4de991fcf32",
|
| 72 |
+
"sample-7fddfe1b2a584f133c3b89f7",
|
| 73 |
+
"sample-49519c2b08d621c382f2a093",
|
| 74 |
+
"sample-deb84ffb5f7c209f58040b0d",
|
| 75 |
+
"sample-76e183c8ae4202bcecbc9d87",
|
| 76 |
+
"sample-9549c3c98f10ace802cbb08b",
|
| 77 |
+
"sample-5acaafa7f13a3c4be08160aa",
|
| 78 |
+
"sample-fd63f0707132f4eb9174ab3e",
|
| 79 |
+
"sample-95b51d663e429afb86c572e7",
|
| 80 |
+
"sample-ac55ce5273aeb2587f3051e7",
|
| 81 |
+
"sample-6cb68b4fe11abd5f5e27ea88",
|
| 82 |
+
"sample-31164fa636b978a86d54f0c9",
|
| 83 |
+
"sample-6d0ec36f585feac9ee8c0aa5",
|
| 84 |
+
"sample-4caf9a9989bff46283725cce",
|
| 85 |
+
"sample-00fdb85efc65b944f8959fc3",
|
| 86 |
+
"sample-72b57dbdb0633da918062d61",
|
| 87 |
+
"sample-3ed269e9b5e894b444089bf3",
|
| 88 |
+
"sample-40b7a6f655350cf46e9ce33c",
|
| 89 |
+
"sample-58cbc880ddd38089d56cda8c",
|
| 90 |
+
"sample-cc72c6bbde9abe2a112ce0fc",
|
| 91 |
+
"sample-38fe8a3260ea673c5c5ddb90",
|
| 92 |
+
"sample-06aacdbb23f806198bd0b70c",
|
| 93 |
+
"sample-5ae78b6dca4ce8a61a44d0ca",
|
| 94 |
+
"sample-057bee25fe3533856610d5c8"
|
| 95 |
+
]
|
L6/full100_inputs_scored217/data/mri_samples.jsonl
ADDED
|
The diff for this file is too large to render.
See raw diff
|
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|
L6/full100_inputs_scored217/data/pathology_samples.jsonl
ADDED
|
@@ -0,0 +1,100 @@
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| 1 |
+
{"sample_id": "sample-e4cdc6e57d3d2abcf1f2d4b6", "patient_id": "patient-5fa48522b2703f35ead0224b", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/9ab8ce08101342bfbe7c4db6e9495dd9b426264e67722c569ea0914c52c25eba.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 2 |
+
{"sample_id": "sample-49e66b1ba0221a39c00aa767", "patient_id": "patient-5ee5dba6116030961a7a97b5", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/4c0e16e18582e977f7ef9436f51d31af22eaf2233c7cd7ab9bd3aa3248a38480.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 3 |
+
{"sample_id": "sample-c3fe2d73681610beec27dd74", "patient_id": "patient-867f2373fc1b04e0b8b80452", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/5d5c2f8b499a691297003604dc6e7679b4619d37b0d8c5e89d9f48d71f976c2d.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 4 |
+
{"sample_id": "sample-1bb43e39142ea1753e756ceb", "patient_id": "patient-9149023ec8599161ec3e5cfd", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/822181b81a298803011d41145940daefd4057805c98122a036224c49f8b010df.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 5 |
+
{"sample_id": "sample-b47beb4c0df45b5d61a9144b", "patient_id": "patient-4e3ac84b9e1451cea981f98e", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/67b6a8a7abca9a4d17cef851eff0c41d5a6519eaadabd4d210b6d1e15096233d.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 6 |
+
{"sample_id": "sample-82d3d16424a96abf08406d23", "patient_id": "patient-e45c55cc63c050892e6b2467", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/d21d674064c8d20e49eded27cb5099133833201827a433e865651dacfc990a38.jpg"], "answer": "0", "modality_source": "patient_matched"}
|
| 7 |
+
{"sample_id": "sample-9d959165696f45b3a22bc3ca", "patient_id": "patient-a48d1d72efa6c4217cf5b79c", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/8ebf66b7b48f0f8b3106210297d6e01ed6769a40784afc75c9155bc546b5662b.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 8 |
+
{"sample_id": "sample-0c456ef161d0951b6f098ab6", "patient_id": "patient-e90c2443e271b2e927262653", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/ea4e13ae332107c19347ee94107e6d993a66a5346ea91d4c736bb62c3f8b9b33.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 9 |
+
{"sample_id": "sample-4cef78a24fff80c88ed756ae", "patient_id": "patient-7c0941dbdd4694260fd4de38", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/7f8a6824f71eb93b170642f6298726a4ce647c8fedcbb96690372dbbdc1b1e50.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 10 |
+
{"sample_id": "sample-62b5ed36444890c1199772d5", "patient_id": "patient-36d433557e63f939b878347d", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/02370e073f45f9689242e6932b9b58863ec90167969249b2df80fdd580b3a84d.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 11 |
+
{"sample_id": "sample-654596d529403b99ffb12ccc", "patient_id": "patient-79fa00752e4405e2980f6292", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/0588c57f7086bd3bef0f82c5eac990e4b7175c4f3232a94dc238c52bd147d47f.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 12 |
+
{"sample_id": "sample-071c3fc1fb941e7478b4b5ea", "patient_id": "patient-e7eec542502a097814d58d8a", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/36ad2a03449e673320e83064479e62e1ca24e642597ffc3ffca6e909567c5498.jpg"], "answer": "1", "modality_source": "patient_matched"}
|
| 13 |
+
{"sample_id": "sample-35df8cf0a70a274b5a62cb28", "patient_id": "patient-4912d2bc95150726fba7d603", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/e83284c8957d4d6ed4cc7725b18fee60b288911e8206f3c4d369184d7aea8fd7.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 14 |
+
{"sample_id": "sample-9081d5db01ff2c6088906e33", "patient_id": "patient-658c901d241197123d75230c", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/e00cda4041ffb1971108c7bd04794faf916464497b9a9aa78654595cce760708.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 15 |
+
{"sample_id": "sample-ae7cfb42da3f6217673ee929", "patient_id": "patient-817588890ea7d1df0cf353ab", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/51c9477296b160c01f065cf8412280bf0b445ebde10b1bdc575ee88c1178a72f.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 16 |
+
{"sample_id": "sample-2f5ed65dad5a903371fbf1e7", "patient_id": "patient-eefab65cf080ff1d932d6946", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/175feb816e1d943d637d0f2f30aa6f88400731fbb418009facdade68e378e773.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 17 |
+
{"sample_id": "sample-a39f52e687cbb3496d7392e3", "patient_id": "patient-f229dd9bf4b869b8294dd81a", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/81b4622e3c032cc4fed53dda2678c8130ff091a59e3fe895808af70ebb327675.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 18 |
+
{"sample_id": "sample-cbb692d8c5ea462dbc99eb95", "patient_id": "patient-2904f892de88d1d694b3a4f3", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/b58f4be5aa5db0d5bd537b1405e70be20e7304db786b8f20fe07073682c73326.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 19 |
+
{"sample_id": "sample-9d9834e78279434ccaa3d258", "patient_id": "patient-9eee365a9ef54e00d4f99666", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/e31090638ec40e2a05be8f0cfdc4f448682111cfb2f5035a794a7a1397bdf454.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 20 |
+
{"sample_id": "sample-d70a114be7e94ac18a86eaa5", "patient_id": "patient-2636abbed83572883f5aa8f0", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说��：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/fa23ebfac5675cbbf06663e7a1d2d1ed8bb5edd105cc793cce2027c5c4c81657.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 21 |
+
{"sample_id": "sample-4c831764428f750963a878b5", "patient_id": "patient-a1f42fd798b22a2ae5c5a7bc", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/9acbb159da1332e6bd571308bb316ee411b8f648a2c54bb96688e6b7df2f1578.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 22 |
+
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{"sample_id": "sample-ac5379a611bf5bcf126d2bcf", "patient_id": "patient-e84ab9973716353b1e20d968", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/31d23de71f67880772a639abcc6e370de866a6f2a9b6a760b96f00b22e19d646.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-558f9c54f0ed8f8d6d6ceecb", "patient_id": "patient-f509f093a998dace3479c00a", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/3bad2a005eb7ee9c05115dbd3eddeb8643368b45c56419264c59bae182f7ddb3.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-a2771ca75fb3cf995910644a", "patient_id": "patient-48b354132fb0421b229210e0", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/706f322da86cd8a4f64c57f9322479a568450346782ca850bb9f1ef9e0ea0374.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-5c94ba259faf6c7fec8ced41", "patient_id": "patient-641b087096be76a631a78061", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/e9047a5794c1a19590e06981cda2437a44ab3c543cedef9b3d8c1ce01f34f6a0.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-ebbcb11aa095ddd00cfc4f23", "patient_id": "patient-30c44ba207e66a3175f648ed", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/aeadec94e48a4ad815db0a097b6d8d68d9e9160ff281287f26e77ab29c0aa554.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-fb6c2ce066a7eba52b28e361", "patient_id": "patient-d35b8662b9cf177265f9f63d", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/21f1555b61c31ad5962776720bae2f2b68fe6d122a1432162bd3c56b4a071c25.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-4693f78178513cbc6bbd0f01", "patient_id": "patient-8b32cb25120a42a552884380", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/29423a94b0660b07e987e6bd99544ed8988d0355667cd38143e1d77625a93db4.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-bb0f41813d721d1ada8b8dc4", "patient_id": "patient-5990e6fe34e7e300b080c17a", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/ffd09ce14aaa081b329bb1329eac055720970a5db4cb5fa084bb48a3da3060c5.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-dd83e58d5230034df145fb21", "patient_id": "patient-5c77cf118819bdf31fcf8f42", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的���理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/c5ce431a866ba99f1e0b0f80f34ca5ae56a8e811c91e6141200e4f51d13507e6.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-9269b76601259f07f725679f", "patient_id": "patient-91e3c16145c17bad01196479", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/403249431dcadd0e5a7019497f61b11db937d79aed9290420f3cc16c127f29aa.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-8b89294aa44e5dd773e3ebc5", "patient_id": "patient-772412c07d2776f303790dfa", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/77ddab6094a09c1a3f99f94a0a6a92ee3f8843d1ff700ff066da64adb7920445.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-76751483f6e246265c6689c2", "patient_id": "patient-8977b4b1d24f1a473b242981", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/752709e6d5787330a28e79e880a3b93ff1b321a432d372445589a18c929528f4.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-d73d646803fe2780c9ef61d8", "patient_id": "patient-476cb2a0d6afea80b42088a3", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/1402c4816f2344c4bf7975eb23e3597ced03f8b62a11ece384cd3895ef48edde.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-48511067ecb23612c79b9685", "patient_id": "patient-f81cca3c5327e5165d731767", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/a16b44ab197874ea3c249b38b1cd83330a672d96431e9b7545aff2ed4725d47e.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-90417dbe5ad9052ef71764ff", "patient_id": "patient-84fa3d6098d10a1d14b6b19e", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/d55e81fcbb7387e7de99fa3d0c7fdcc2ba670472950d59592dbbe7e81271c737.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-7cd9bfaf95a31767ea22e7a9", "patient_id": "patient-34616c327ce5d69194ca7f4d", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/b67f35c7b3358480ffef384e42eb056281fbd2aea11743b8404995e9f1307b1e.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-77b632ac2f14b07cede03c5d", "patient_id": "patient-9bf5c8c03860cdf61108611d", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/ea9bdde32287f7faf9aba95ad9fd7e820faac820e101ab561b34f238749f8ce3.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-c9e5bf8aab19632fb9105469", "patient_id": "patient-f402aced5926698da3194c37", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/1b45d81045f38b2358a24e2faceb37d2b910db88acd318c4aca82a6e703eb8a2.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-25054b21769a83c4cc1ef883", "patient_id": "patient-51e6f99c527367bbd97aebd8", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/9dbd197cfeb6834c27f840345a64372ada1c4845e57d0ddd6ef9df3da7577c6d.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-8711fd42e78381df61ea6558", "patient_id": "patient-5731cc38ced94b2ee39c442a", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/8f5824aac2b814ae249dbbb484e620a39cd6c30e8ef6d1bfa89abe2b5d5f9e00.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-c7cc381ceb35f31cc42432f6", "patient_id": "patient-e5fcd31b4b8b85194b146991", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/efce9a3185bbb96c9472a44972e20eb059c6f67b818b5d627da64abc0efc7850.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-e58f6bf18eeb02a852a96c41", "patient_id": "patient-d6812a1c46ed21fda9ebb9f8", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/fc0582424f288acd66b7f0feee104a48a16676d110e856ef0eebba95822bbb08.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-5937c5e9598ae837a9c05589", "patient_id": "patient-eecadcdf172a1efe8947b052", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/e0dbb185bba5a7e129fbb94151fa19ba4abac9dd85157f24fd38bd55b37edcfe.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-0b87b72851fcd4d2ad2b9250", "patient_id": "patient-290a042206ccfe67e72f9a19", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/cd23ae68c8e540bd273c2c32b0f5d65a21e53570594ffd912ef67cbd477d1240.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-621c843ee9d124224e1da39b", "patient_id": "patient-02ca51eed4fedbb13e4db76d", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/437beb054587485e9dae1638d0f959e615cd585b22efeb5b753face9f50266b0.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-7ab9fdfdcc661ba0e31820cc", "patient_id": "patient-f25e20b1e5c6eea840d4cc21", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/3a889b576af93a50c79053ae58137f8580813d8eb7b0cce38f477f18ee539a7c.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-4a50857a0fd27bee87c69197", "patient_id": "patient-9fcde7a95f4d57501ecbf7b2", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该病例是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。", "images": ["assets/d1ec39ecf9dcdb0133110f8a481533542430b1bc0f8bd279fd8172248db2f1b0.jpg"], "answer": "1", "modality_source": "patient_matched"}
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{"sample_id": "sample-d234b95fb2de53245ede8db0", "patient_id": "patient-1189badad5e7374b82a3cc86", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/c56ccd160b4d71af90e18e91a10601b64a24adb28cf99d2521614b42a5645d0f.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-c6121779161575ccab860ca8", "patient_id": "patient-283ba4356f86fb9f68ac5c06", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/26e6259d67b89cceb2762a44e8a82f2e6e6ef8098e3e2b833b976cb6e5872ac9.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-881058e5b7d99965fc907cb1", "patient_id": "patient-f89d81ee7716a74d2854d920", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/e7d88545a5a4874c995dc04f1b5b5d49af098b2a83fb56f14263b5de7011921b.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-15b6123c0a002d964023bda5", "patient_id": "patient-01cb4effba96aca19ec352ef", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/cec51e62f4eaa30748e245367b5f82cfb46c63009d44002a79c1aa660ab5d28f.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-e347505c42af02c863dadd7c", "patient_id": "patient-8e2d677e2677ad4a75d70dcb", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/830c731a6925e42c7aac3fe35b8dee90a3fddd8b30f3c163abbdc863328041ed.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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| 69 |
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{"sample_id": "sample-3d51f6b821b98015663e6c26", "patient_id": "patient-9eaf0b40aec7a0f326916f11", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/8f57bc69074a14d6e239d9b9d07aef17ebc94fd309813e55b75e714d837f3c8a.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-3463302dea6383b89a4a6035", "patient_id": "patient-c37f6b32f02ac91bd1ae7799", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/95d0d1c51668bbd40e2f5e602cf223f3c2fef5c386be517f2a781ac0530422fc.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-7e34ca99d985ca20b525e717", "patient_id": "patient-4aef168669533556a36bc39e", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/5ea1f1a69e10628fbaf813b56b305ba01267beb07e1ad83bc56de3390c254834.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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| 72 |
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{"sample_id": "sample-23a5f20abca02343f2c2e1fb", "patient_id": "patient-e675eddb370b74337da96684", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/9bd8da32a866b30d62a7d1ef7160262b07c40536caedea6f85b24f81582e6ab4.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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{"sample_id": "sample-78aae0af4d7af5ab466870c2", "patient_id": "patient-174236bff64528c2f91d7aa7", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答��", "images": ["assets/5d42f60fd27aa0191f22dddd3b095963d9db3e5b6d98ee4865e6208ed0e15e6b.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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| 74 |
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{"sample_id": "sample-e1cf5481f4ccf0715929d6df", "patient_id": "patient-b933c2f377b80fd439ace547", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/63b652ada085b7f3fca8b3202b2f38ee80e20d35c302d6cae4c2e0eee2bced4e.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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| 75 |
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{"sample_id": "sample-192eb3378440710983dcd9ff", "patient_id": "patient-640515b141269ff2b238a29f", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/0c2f18a97936221d52cd71c05855ab1528b3dc7513634a9e450f2b1f316c7c62.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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| 76 |
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{"sample_id": "sample-0278d9b594ab64311c906474", "patient_id": "patient-b574ac1f42cd6a06d5a529d9", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/5fbb7295670fcd4ae87b8f59146387db42ebfd1137727a96aaf4909db22140de.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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| 77 |
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{"sample_id": "sample-fe7baaa836aa5c9c2de2922d", "patient_id": "patient-cdb749e199be2356a7040391", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/d9442f37bd7d2f33beec83cb1d3a94bb8153a5ccf4e46889df699a1a3a7cd349.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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| 78 |
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{"sample_id": "sample-717477a6d1ac8cf7e2134aee", "patient_id": "patient-8711d6dac046e543146e43a2", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/9acf2ee5191c00ab3c8862d681e4b2cf2511d011e0443b880c3bb5228a23ea90.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
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| 79 |
+
{"sample_id": "sample-dceb28cbf1b0d34886b61cc7", "patient_id": "patient-f5101794bd0a287128017a19", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/cf874c85e863dfbc4f7ca3c77cb33d949e3b1eeb406cd748ee92483798409b39.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 80 |
+
{"sample_id": "sample-62318e408b687aaa2f03ff0f", "patient_id": "patient-45e4c46d921f3565452c0d71", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/a4557c77c59a0e8a313fe1d9404489cc86c868bdf88f2b1234b1f59224a1bfe8.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 81 |
+
{"sample_id": "sample-abe272edb4b02b9d74f4697f", "patient_id": "patient-5d0c932da06a8cecf1430be4", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/06a283503ddaea9aa36f251425accfbec129b2845f1211d4b449b5be819b34ed.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 82 |
+
{"sample_id": "sample-2a6be15fea99ad7ceb24c27f", "patient_id": "patient-684941835dbbdf1c83ea8f14", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/5cdef496f330890378a66187ded2fbb8a081393261d7b91f08321db6fd7a8168.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 83 |
+
{"sample_id": "sample-3cdfa6a1aa03b53d1d5b1e07", "patient_id": "patient-cd8d5017ed5c739576ddc3c8", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/7984e36dcb89c6bbff9f78b7085a775f81fd361f05ee6b989001c48a332767a3.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 84 |
+
{"sample_id": "sample-6558a2113ef4d3086adcf14e", "patient_id": "patient-ea6494e889c7facfd6a5b961", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/0533c92c5b0b15a579b200e11bc82c7a113c021b6eaee230f78bba0012f8043f.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 85 |
+
{"sample_id": "sample-6f7cf601bfad6ece95957cb9", "patient_id": "patient-393a69d1a905e05600212d51", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/d996c8f619c68c03f957b3c7cf8431194955d0e2248d19c2f6b5113b7551f6eb.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 86 |
+
{"sample_id": "sample-0758c9c47a947d1c41fe0969", "patient_id": "patient-b65cb84467c638c61d55d3fd", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/7f015bf1e61cec916166a5312b5508caa36ff9d592db564d12d4c42e76da3a8f.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 87 |
+
{"sample_id": "sample-e00bee6732ce6e1cf929b4dc", "patient_id": "patient-2cf7bbf9c878504492560fe8", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/08998cdb9f6d30885b2bc8a68a7ce763089d3700482673e001e6cf6fae5bd985.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 88 |
+
{"sample_id": "sample-d19ff47311205976d5e540d2", "patient_id": "patient-960f6ab1e16dbdd23090f492", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/73cff672d670829673d08a04de603046c62cd232eb0cfe08d98fbef2cf4fc8b6.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 89 |
+
{"sample_id": "sample-c287a9a97c2cff7b7171ec42", "patient_id": "patient-16c0f88f348c8b36a4e0ba3d", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/b59a4407beaffb6867da564ecb7092100a51dbf600d00f48c92b413b0050f5e6.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 90 |
+
{"sample_id": "sample-92e0b7699cbe4ae29fa6935e", "patient_id": "patient-23d7450690ac27c41cf2d08a", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻��癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/b43cd4568b88e1ab5b5f6f605f0f4619e543da513179cbdd0703b9d19cadb04e.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 91 |
+
{"sample_id": "sample-0aa5ecf5a58e921997c007a7", "patient_id": "patient-d0d7ee4ee410114ceb96522e", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/527e5cd50198944f7b407a5cd6867c6143ad4573708ed3f1f9bbe1d80214f956.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 92 |
+
{"sample_id": "sample-1823f1031d3286497784decb", "patient_id": "patient-1f701280917a20dc32022e52", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/af4cf2952f655c6140699d4db5c47dd7e114bf687a7dba0e76bc41fb562bc7fe.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 93 |
+
{"sample_id": "sample-6f08ba6dece1d8bb3759e0ac", "patient_id": "patient-49de37b11211aa728bd7cf39", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/a53293d4d36d8710d0afa7e305649e268543b54ac1bc9d44a4d188b213eaec4b.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 94 |
+
{"sample_id": "sample-3865dbbab3ecfb72316eaa79", "patient_id": "patient-aa7bbd78f73aee5acf2a27c4", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/3d75e932f6f20a49e2df94f7d3754ddf4766e0b027d84b0259f1e3bb760308c6.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 95 |
+
{"sample_id": "sample-4f7cd4952161ebbb98a7b51b", "patient_id": "patient-9aa3715525d6a6720ad66982", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/66d6998b345e8c1c837bef1bbb1836a04b3cb113485f797559b34fab02d1d00a.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 96 |
+
{"sample_id": "sample-94502e2b9a6bf109eca7bc49", "patient_id": "patient-412a1cb9536aabf4688e2144", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/7032422d444b62ed31ae264661e265a3c8d8f4f747dd2272450ba82689add7e9.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 97 |
+
{"sample_id": "sample-5b8a30336e51723d263344a7", "patient_id": "patient-003420d0da40426e1c7e0974", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/9ff65a0773ed0676690c76253277c442d0eba67540b8c678fb043b3c950aedec.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 98 |
+
{"sample_id": "sample-a4d2d1b7719bd1fb8ea89063", "patient_id": "patient-5800309a4e814fbcbd295754", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/3d5c498f4c14e0462e6f7c45157a58a697bac7948fd0f2622b5a80fa1d462c71.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 99 |
+
{"sample_id": "sample-063450cc1804626553e4d45e", "patient_id": "patient-a578b52d91765d2dc023e7ca", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/a400cfe7e5da75f0d42c4fb14d47de073c68969c2e58c01327bccf131beda83b.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
| 100 |
+
{"sample_id": "sample-63a8f970b69efacf1c1fe156", "patient_id": "patient-0adb245ab94b19ab3ec93940", "task": "pathology_binary_npc_support", "prompt": "根据提供的病理图像，判断该图像是否支持鼻咽癌诊断。\n请仅输出 0 或 1。\n0 表示不支持鼻咽癌诊断；1 表示支持鼻咽癌诊断。\n说明：本图像为非患者特异的病理判别图像，不代表该患者本人的病理切片；请仅依据图像内容作答。", "images": ["assets/9991e6713757453cd022cabac88d1c09028f08c43b63ab6d823b83376f3200dc.jpg"], "answer": "1", "modality_source": "pathology_specimen_proxy"}
|
L6/full100_inputs_scored217/data/patient_episodes.jsonl
ADDED
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L6/full100_inputs_scored217/dataset_manifest.json
ADDED
|
@@ -0,0 +1,13 @@
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| 1 |
+
{
|
| 2 |
+
"schema_version": "npcbench-full100-public-input-v2",
|
| 3 |
+
"dataset_version": "full100_scored217_20261103",
|
| 4 |
+
"data_revision": "2026-11-03",
|
| 5 |
+
"patients": 100,
|
| 6 |
+
"pathology_samples": 100,
|
| 7 |
+
"mri_samples": 100,
|
| 8 |
+
"care_nodes": 217,
|
| 9 |
+
"unscored_pending_review_nodes": 6,
|
| 10 |
+
"assets": 1100,
|
| 11 |
+
"pathology_proxy_samples": 75,
|
| 12 |
+
"scoring_contract_sha256": "68add94878b40f4d17f3dc5d412f2b55412a4df29a6083caa8f32961705a0eca"
|
| 13 |
+
}
|
L6/full100_inputs_scored217/file_manifest.json
ADDED
|
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L6/full100_inputs_scored217/scoring_contract.json
ADDED
|
@@ -0,0 +1,267 @@
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| 1 |
+
{
|
| 2 |
+
"schema": "npcbench-l6-membership-v1",
|
| 3 |
+
"version": "full100_scored217_v1_20261026",
|
| 4 |
+
"decision_date": "2026-10-26",
|
| 5 |
+
"decision_timezone": "Asia/Shanghai",
|
| 6 |
+
"decision_source": "explicit_author_instruction",
|
| 7 |
+
"membership_status": "confirmed",
|
| 8 |
+
"patients": 100,
|
| 9 |
+
"scored_care_nodes": 217,
|
| 10 |
+
"unscored_pending_review_nodes": 6,
|
| 11 |
+
"previous_care_nodes": 223,
|
| 12 |
+
"hardcore_nodes": 93,
|
| 13 |
+
"all_patients_have_scored_care": true,
|
| 14 |
+
"selection_basis": "documented_clinical_source_quality_findings",
|
| 15 |
+
"exclusion_not_preregistered": true,
|
| 16 |
+
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|
| 17 |
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|
| 219 |
+
"sample-5737526b7d92f1b3d5423663",
|
| 220 |
+
"sample-84b4eab1f1613c7517fd613a",
|
| 221 |
+
"sample-9895c4d0f7c600fd0c046a50",
|
| 222 |
+
"sample-46fc2f7bd9dd0872ef1b356e",
|
| 223 |
+
"sample-7c52866e0776802e0c94516f",
|
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+
"sample-ce21ad4c82d0349356f5fbb9",
|
| 225 |
+
"sample-c47048c6a3961cfb24a6bb12",
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+
"sample-40b7a6f655350cf46e9ce33c",
|
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+
"sample-58cbc880ddd38089d56cda8c",
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+
"sample-cc72c6bbde9abe2a112ce0fc",
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+
"sample-38fe8a3260ea673c5c5ddb90",
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+
"sample-06aacdbb23f806198bd0b70c",
|
| 231 |
+
"sample-9713cef7ba61651ea6a5f02e",
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+
"sample-e0f912ad55b7b1f092a1b468",
|
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+
"sample-67a2318574aada2f5af690c0",
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+
"sample-5549469386bb20d944ce932b",
|
| 235 |
+
"sample-cef4654d5f291c72b760bfcf",
|
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+
"sample-5ae78b6dca4ce8a61a44d0ca",
|
| 237 |
+
"sample-b03a0a9310651ef3f13754f1",
|
| 238 |
+
"sample-057bee25fe3533856610d5c8",
|
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+
"sample-ea63b7a358722be15870f84c",
|
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+
"sample-6fc96ea65282f416f15f852e",
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+
"sample-08d32abcf26a92c62d1dc762"
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+
],
|
| 243 |
+
"exclusion_reason_definitions": {
|
| 244 |
+
"unique_treatment_gold_unresolved": "The archived source does not establish a unique treatment decision at the stated checkpoint.",
|
| 245 |
+
"ordered_vs_administered_unresolved": "Ordered and administered medicines were combined without establishing the same executed treatment regimen.",
|
| 246 |
+
"stopped_order_in_gold_action": "The proposed action includes a medicine associated with a stopped order in the source excerpt.",
|
| 247 |
+
"staging_source_disagreement": "The checkpoint staging condition and later source staging statement disagree and have not been adjudicated.",
|
| 248 |
+
"radiotherapy_omitted_from_gold_action": "Radiotherapy appears in the source while the generated gold action represents medicines only.",
|
| 249 |
+
"decision_time_boundary_unresolved": "The later treatment record does not establish a unique decision at the earlier checkpoint."
|
| 250 |
+
},
|
| 251 |
+
"metric_denominators": {
|
| 252 |
+
"care_micro": 217,
|
| 253 |
+
"patient_all_care": 100,
|
| 254 |
+
"strict_episode": 100,
|
| 255 |
+
"pathology": 100,
|
| 256 |
+
"MRI_T": 100,
|
| 257 |
+
"hardcore_care": 93
|
| 258 |
+
},
|
| 259 |
+
"strict_episode_definition": "pathology_correct AND MRI_T_correct AND all retained scored care_turns correct",
|
| 260 |
+
"excluded_nodes_count_as": "neither_correct_nor_incorrect; absent_from_all_scoring_masks",
|
| 261 |
+
"separate_safety_endpoint_measured": false,
|
| 262 |
+
"answer_parser_status": "revision_required; membership_confirmation_does_not_validate_parser",
|
| 263 |
+
"parent_care_sha256": "1bec4c712ffa55702a6b815af6ad5cfae7da4cb75f62f86826b63c7e531cad62",
|
| 264 |
+
"care_sha256": "9069d4b9b434e93d5ed6b79413c7429560bb6cc428a69acdb11bb9f9dcef1be4",
|
| 265 |
+
"episodes_sha256": "3a970221b99ee2c252ac5ece30b8e14311e9191e9fc1c36413b26ee4ed69096f",
|
| 266 |
+
"hardcore_sha256": "c415f31808ed22b579039f6983c22671dd79e499be729d33992c50b71c62dbf8"
|
| 267 |
+
}
|
L6/full100_inputs_scored217/unscored/care_pending_review.jsonl
ADDED
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@@ -0,0 +1,6 @@
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{"sample_id": "sample-12f314190f742e35d1b0beb6", "patient_id": "patient-30c44ba207e66a3175f648ed", "episode_id": "episode-4d56ed64ec75115988b7cbac", "turn_id": "P4_01", "phase": "P4", "question": "实际治疗尚未开始；按AJCC第9版，已知分期为T2N3cM0，III期，治疗前最新安全性或计划信息为：入院日期: 既往时点；诊疗过程描述: 入院完善相关检查：既往时点 病理号：[编号已隐藏]检查结果： （鼻咽部）镜检为未分化型非角化性癌。 既往时点 PET/CT全身显像:鼻咽右侧咽隐窝粘膜增厚代谢活跃，符合鼻咽癌；右咽后、右颈II-III多发淋巴结代谢活跃， 考虑转移；右颈IV区小淋巴结代谢略活跃，转移待排。 胃体部胃壁结节代谢略活跃，恶性待排(GIST?)，请结合胃镜检查。 双肺多发小结节代谢未见异常，疑增殖灶。 盆腔少量积液。 结合检查结果，明确诊断鼻咽未分化型非角化性癌 T3N3M0 IVa期 AJCC8th，拟行3周期诱导化疗后行同期放化疗，将病情及下一步诊疗计划告知患者A，其表示了解病情，决定放弃治疗，已充分告知其放弃治疗可能出现肿瘤未控并很快出现转移等不良后果，其仍坚持出院，予今日签字出院。；出院情况: 患者无鼻塞、涕血、面麻、复视及听力下降、头痛等，精神、饮食、睡眠可，大小便正常。 查体同入院。；出院医嘱: 1、外院进一步治疗鼻咽癌。 2、胃肠外科门诊咨询胃肠间质瘤相关治疗。结合患者当前意愿，下一步诊疗安排最合理的是？", "prompt": "你正在参与一名鼻咽癌相关患者的纵向诊疗模拟。\n资料按临床时间逐步提供。请只根据当前节点可见证据作答，不要使用未来记录。\n\n【历史辅助诊断节点】\n病理图像判断：{{PATHOLOGY_RESULT}}。\nMRI影像判断：{{MRI_T_STAGE}}；受侵结构：{{MRI_INVOLVED_STRUCTURES}}。\n文本分期：{{N_STAGE}}，{{M_STAGE}}。\n综合TNM：{{TNM_STATUS}}；总分期：{{OVERALL_STAGE}}。\n\n【截至当前节点可见证据】\n【初诊资料1】入院时间: 既往时点；现为进一步治疗入本院。自起病以来，患者精神、睡眠可，食欲如常，大小便正常，体重无下降。；鼻症状: 无；耳症状: 无；眼症状: 无；头部症状: 无；是否有颈部肿物: 是；阳性症状体征: 右颈部肿物；体重改变性质: 未变 【病理资料1】（鼻咽部）镜检为未分化型非角化性癌。；活检部位: 鼻咽；肿瘤部位: 鼻咽；组织学分型: 未分化型非角化性癌；组织学分级: 未分化；是否鼻咽癌: 是 【影像与分期资料1】鼻咽右侧咽隐窝粘膜增厚代谢活跃，符合鼻咽癌；右咽后、右颈II-III多发淋巴结代谢活跃， 考虑转移；右颈IV区小淋巴结代谢略活跃，转移待排。 胃体部胃壁结节代谢略活跃，恶性待排(GIST?)，请结合胃镜检查。 双肺多发小结节代谢未见异常，疑增殖灶。 盆腔少量积液。 ；鼻咽病变，考虑鼻咽癌。 右侧咽旁间隙受侵。 颅底骨质未见明显骨质破坏。 右侧咽后数个肿大淋巴结，考虑转移。 颈部右侧II、III、IV区多个肿大淋巴结，考虑转移。 副鼻窦炎。 【治疗经过1】入院日期: 既往时点；诊疗过程描述: 入院完善相关检查：既往时点 病理号：[编号已隐藏]检查结果： （鼻咽部）镜检为未分化型非角化性癌。 既往时点 PET/CT全身显像:鼻咽右侧咽隐窝粘膜增厚代谢活跃，符合鼻咽癌；右咽后、右颈II-III多发淋巴结代谢活跃， 考虑转移；右颈IV区小淋巴结代谢略活跃，转移待排。 胃体部胃壁结节代谢略活跃，恶性待排(GIST?)，请结合胃镜检查。 双肺多发小结节代谢未见异常，疑增殖灶。 盆腔少量积液。 结合检查结果，明确诊断鼻咽未分化型非角化性癌 T3N3M0 IVa期 AJCC8th，拟行3周期诱导化疗后行同期放化疗，将病情及下一步诊疗计划告知患者A，其表示了解病情，决定放弃治疗，已充分告知其放弃治疗可能出现肿瘤未控并很快出现转移等不良后果，其仍坚持出院，予今日签字出院。；出院情况: 患者无鼻塞、涕血、面麻、复视及听力下降、头痛等，精神、饮食、睡眠可，大小便正常。 查体同入院。；出院医嘱: 1、外院进一步治疗鼻咽癌。 2、胃肠外科门诊咨询胃肠间质瘤相关治疗。\n\n【当前需要决策的问题】\n实际治疗尚未开始；按AJCC第9版，已知分期为T2N3cM0，III期，治疗前最新安全性或计划信息为：入院日期: 既往时点；诊疗过程描述: 入院完善相关检查：既往时点 病理号：[编号已隐藏]检查结果： （鼻咽部）镜检为未分化型非角化性癌。 既往时点 PET/CT全身显像:鼻咽右侧咽隐窝粘膜增厚代谢活跃，符合鼻咽癌；右咽后、右颈II-III多发淋巴结代谢活跃， 考虑转移；右颈IV区小淋巴结代谢略活跃��转移待排。 胃体部胃壁结节代谢略活跃，恶性待排(GIST?)，请结合胃镜检查。 双肺多发小结节代谢未见异常，疑增殖灶。 盆腔少量积液。 结合检查结果，明确诊断鼻咽未分化型非角化性癌 T3N3M0 IVa期 AJCC8th，拟行3周期诱导化疗后行同期放化疗，将病情及下一步诊疗计划告知患者A，其表示了解病情，决定放弃治疗，已充分告知其放弃治疗可能出现肿瘤未控并很快出现转移等不良后果，其仍坚持出院，予今日签字出院。；出院情况: 患者无鼻塞、涕血、面麻、复视及听力下降、头痛等，精神、饮食、睡眠可，大小便正常。 查体同入院。；出院医嘱: 1、外院进一步治疗鼻咽癌。 2、胃肠外科门诊咨询胃肠间质瘤相关治疗。结合患者当前意愿，下一步诊疗安排最合理的是？\n\n【历史辅助决策节点】\n- 暂无可展示的历史辅助决策节点。\n\n请在以下 A-L 选项中选择唯一最合适的答案。\nA. 仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗\nB. 仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围\nC. 仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗\nD. 直接永久停止所有治疗，以避免后续出现任何毒性\nE. 仅行免疫单药治疗，忽略当前分期和既定局部治疗目标\nF. 仅行局部放疗，已存在的系统性疾病范围不纳入方案选择\nG. 仅行口服维持治疗，不进行诱导、同期或系统治疗评估\nH. 先进行三个月中药治疗，影像进展后再决定是否规范治疗\nI. 重复进行病理活检，直至所有免疫组化指标完全一致后才治疗\nJ. 无论肾功能、听力和体能状态如何均使用足量高剂量顺铂\nK. 直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径\nL. 充分沟通并记录拒治决定，安排肿瘤专科转诊和复诊；患者同意后再评估并实施诱导化疗衔接同步放化疗\n\n请仅输出一个选项字母（A-L）。", "context_placeholders": ["PATHOLOGY_RESULT", "MRI_T_STAGE", "MRI_INVOLVED_STRUCTURES", "N_STAGE", "M_STAGE", "TNM_STATUS", "OVERALL_STAGE"], "options": {"A": "仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗", "B": "仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围", "C": "仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗", "D": "直接永久停止所有治疗，以避免后续出现任何毒性", "E": "仅行免疫单药治疗，忽略当前分期和既定局部治疗目标", "F": "仅行局部放疗，已存在的系统性疾病范围不纳入方案选择", "G": "仅行口服维持治疗，不进行诱导、同期或系统治疗评估", "H": "先进行三个月中药治疗，影像进展后再决定是否规范治疗", "I": "重复进行病理活检，直至所有免疫组化指标完全一致后才治疗", "J": "无论肾功能、听力和体能状态如何均使用足量高剂量顺铂", "K": "直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径", "L": "充分沟通并记录拒治决定，安排肿瘤专科转诊和复诊；患者同意后再评估并实施诱导化疗衔接同步放化疗"}, "status": "unscored_pending_item_review", "reason_codes": [], "quality_exclusion_reason": "The physician has approved the complete current item after final item-level clinical review, including the full question, available evidence, all A-L options, and option L as the uniquely best answer. The item remains in the unscored review package pending scoring eligibility checks and controlled release integration. The clinical approval, approved content hash, and earlier exclusion concerns are retained in the local audit trail."}
|
| 2 |
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{"sample_id": "sample-7b65ce668408f9ea66544af8", "patient_id": "patient-4912d2bc95150726fba7d603", "episode_id": "episode-73bafcd2d14697159b5d1b7b", "turn_id": "P4_01", "phase": "P4", "question": "实际治疗尚未开始；按AJCC第9版，已知分期为T3N1cM0，II期，治疗前最新安全性或计划信息为：记录时间: 既往时点；病程主题: 上级查房记录；病程内容: 既往时点 上级医生A查房记录 今日查房，患者回吸性血涕，无头晕、头痛，无复视、视力模糊，无面麻等不适，精神、睡眠、饮食可，大小便正常。 查体同入院。 上级医生A查房后指示：继续完善检查。 医嘱内容。结合疾病范围、治疗目标与耐受性，首个抗肿瘤治疗策略应如何安排？", "prompt": "你正在参与一名鼻咽癌相关患者的纵向诊疗模拟。\n资料按临床时间逐步提供。请只根据当前节点可见证据作答，不要使用未来记录。\n\n【历史辅助诊断节点】\n病理图像判断：{{PATHOLOGY_RESULT}}。\nMRI影像判断：{{MRI_T_STAGE}}；受侵结构：{{MRI_INVOLVED_STRUCTURES}}。\n文本分期：{{N_STAGE}}，{{M_STAGE}}。\n综合TNM：{{TNM_STATUS}}；总分期：{{OVERALL_STAGE}}。\n\n【截至当前节点可见证据】\n【初诊资料1】���录时间: 既往时点；一.病例特点: 1、患者31岁 女性。2、现病史:患者诉缘于1年前无明显诱因出现间断性回吸性血涕，无头晕、头痛，无复视、视力模糊，无面麻等不适，当时未治疗。遂为求进一步治疗，遂来本院就诊，现为求进一步治疗入院，患者A，精神可，饮食睡眠一般，大小便正常，体重无明显变化。 3、体格检查: T:36.70℃ P:89次/分 R:20次/分 BP:97 / 70mmHg Ht:165 Cm Wt:54.50 Kg BSA: 1.5922 m2 kps:90 神智清楚，表情自然，发育良好，营养良好。 自主体位，检查合作。 皮肤粘膜正常，无水肿，无出血，无溃疡，无皮疹、肝掌、蜘蛛痣。 全身浅表淋巴结未及明显肿大。 头颅五官端正，无畸形，眼睑无浮肿，无下垂。巩膜无黄染，结膜无充血，无苍白，眼球活动正常，角膜透明，双侧瞳孔等大等圆，直径3mm，直接、间接对光反射正常。耳廓无畸形，外耳道无溢脓溢液，乳突区无压痛。 听力正常，鼓膜正常。 鼻无畸形，鼻中隔居中，副鼻窦无压痛、扣痛。 口腔粘膜正常。 齿龈无红肿，扁桃体无肿大。 颈静脉无怒张，甲状腺未扪及肿大，颈无抵抗。 胸廓对称，胸壁静脉无曲张，双肺触觉语颤对称，扣诊呈清音，双肺呼吸音清，未闻及干湿啰音。 心前区无隆起，未触及震颤。 心率89次/分，心律整齐，各瓣膜听诊区未闻及病理性杂音。 腹部平软，未见胃型、肠型、蠕动波，全腹无压痛，反跳痛，未扪及包块。 肝脾未扪及，Murphy's sign 阴性，肝肾区无扣痛，移动性浊音阴性，肠鸣音正常。 肛门、外生殖器未查。 脊柱四肢无畸形，肌力、肌张力正常。 生理反射存在，病理反射未引出。 4. 【病理资料1】（鼻咽顶壁肿物）镜检为未分化型非角化性癌。 免疫组化：标本06：CK(AE1/AE3)（+），EGFR（+）。 原位杂交：标本06：EBERs（+）。；活检部位: 顶壁,鼻咽；肿瘤部位: 顶壁,鼻咽；组织学分型: 未分化型非角化性癌；组织学分级: 未分化；是否鼻咽癌: 是 【影像与分期资料1】鼻咽病变，考虑鼻咽癌。 颅底骨质破坏。 颈部双侧II-III区见数个小淋巴结，性质待定。 副鼻窦炎。；检查部位: 鼻咽部；肿瘤部位: 鼻咽；是否区域复发: 否 ；鼻咽病灶，考虑鼻咽癌；右侧咽后淋巴结代谢略活跃，考虑转移。 双侧颈部Ⅱ区淋巴结代谢略活跃，疑炎性病变。 鼻窦炎。 双肺纤维增殖灶。 【治疗经过1】记录时间: 既往时点；病程主题: 上级查房记录；病程内容: 既往时点 上级医生A查房记录 今日查房，患者回吸性血涕，无头晕、头痛，无复视、视力模糊，无面麻等不适，精神、睡眠、饮食可，大小便正常。 查体同入院。 上级医生A查房后指示：继续完善检查。 医嘱内容\n\n【当前需要决策的问题】\n实际治疗尚未开始；按AJCC第9版，已知分期为T3N1cM0，II期，治疗前最新安全性或计划信息为：记录时间: 既往时点；病程主题: 上级查房记录；病程内容: 既往时点 上级医生A查房记录 今日查房，患者回吸性血涕，无头晕、头痛，无复视、视力模糊，无面麻等不适，精神、睡眠、饮食可，大小便正常。 查体同入院。 上级医生A查房后指示：继续完善检查。 医嘱内容。结合疾病范围、治疗目标与耐受性，首个抗肿瘤治疗策略应如何安排？\n\n【历史辅助决策节点】\n- 暂无可展示的历史辅助决策节点。\n\n请在以下 A-L 选项中选择唯一最合适的答案。\nA. 仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗\nB. 仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围\nC. 仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗\nD. 直接永久停止所有治疗，以避免后续出现任何毒性\nE. 仅行免疫单药治疗，忽略当前分期和既定局部治疗目标\nF. 仅行局部放疗，已存在的系统性疾病范围不纳入方案选择\nG. 仅行口服维持治疗，不进行诱导、同期或系统治疗评估\nH. 先进行三个月中药治疗，影像进展后再决定是否规范治疗\nI. 完成治疗前评估，以根治性放疗为基础制定综合治疗方案，结合分期及耐受性确定化疗安排\nJ. 重复进行病理活检，直至所有免疫组化指标完全一致后才治疗\nK. 无论肾功能、听力和体能状态如何均使用足量高剂量顺铂\nL. 直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径\n\n请仅输出一个选项字母（A-L）。", "context_placeholders": ["PATHOLOGY_RESULT", "MRI_T_STAGE", "MRI_INVOLVED_STRUCTURES", "N_STAGE", "M_STAGE", "TNM_STATUS", "OVERALL_STAGE"], "options": {"A": "仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗", "B": "仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围", "C": "仅使用止��、止吐和营养支持，不安排肿瘤专科治疗", "D": "直接永久停止所有治疗，以避免后续出现任何毒性", "E": "仅行免疫单药治疗，忽略当前分期和既定局部治疗目标", "F": "仅行局部放疗，已存在的系统性疾病范围不纳入方案选择", "G": "仅行口服维持治疗，不进行诱导、同期或系统治疗评估", "H": "先进行三个月中药治疗，影像进展后再决定是否规范治疗", "I": "完成治疗前评估，以根治性放疗为基础制定综合治疗方案，结合分期及耐受性确定化疗安排", "J": "重复进行病理活检，直至所有免疫组化指标完全一致后才治疗", "K": "无论肾功能、听力和体能状态如何均使用足量高剂量顺铂", "L": "直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径"}, "status": "unscored_pending_item_review", "reason_codes": [], "quality_exclusion_reason": "The physician has approved the complete current item after final item-level clinical review, including the full question, available evidence, all A-L options, and option I as the uniquely best answer. The item remains in the unscored review package pending scoring eligibility checks and controlled release integration. The clinical approval, approved content hash, and earlier exclusion concerns are retained in the local audit trail."}
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| 3 |
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{"sample_id": "sample-79529e369270dc3a5c7c0a67", "patient_id": "patient-641b087096be76a631a78061", "episode_id": "episode-ebfee8142953531864f40945", "turn_id": "P4_01", "phase": "P4", "question": "实际治疗尚未开始；按AJCC第9版，已知分期为T3N1cM0，II期，治疗前最新安全性或计划信息为：记录时间: 既往时点；病历特点: 患者A，女，72岁，因\"发现左颈肿物1月余\"于既往时点，步行入院。 一、病例特点: 1、患者A，女性，72岁，[详细地址已隐藏]。2、现病史：患者及家属诉既往时点无意间发现左颈部无痛性肿物，约鹌鹑蛋大小，质地韧，活动度差，偶伴太阳穴及顶部一过性头部刺痛，不影响睡眠，偶伴左耳鸣，既往时点月有1次晨起痰中带血丝，无复视、视力模糊，无听力下降，无鼻塞，无面麻等不适，未予重视，逐渐加重，遂至外院A就诊，外院A，病理号:[编号已隐藏]）示：鼻咽未分化型非角化性癌，未行治疗，遂至本院进一步诊治，完善检查后，经科室会诊，考虑患者肿物侵及左侧翼突基底部，拟修改原诊断为：鼻咽未分化型非角化性癌 T3N1M0 III期 AJCC第八版，患者发病以来，精神可，饮食睡眠一般，大小便正常，体重无明显变化。 3、肿瘤专科检查:张口门齿距4.0cm；鼻咽顶壁及顶后壁黏膜粗糙；左侧颈部II区可扪及1个淋巴结，最大径1×1cm，无融合，质地硬，边界清，活动度好，无压痛，无皮肤浸润，无溃疡；颅神经检查:阴性。 4、辅助检查:（1）既往时点在外院A（病理号:[编号已隐藏]）鼻咽活检病理示:未分化型非角化癌 （2）既往时点 甲状腺及颈部淋巴结彩超：双侧颈部II区、III区淋巴结，考虑转移性淋巴结声像。 甲状腺双侧叶多发囊实性结节，考虑结节性甲状腺肿声像。 （3）既往时点 电子鼻咽镜：鼻中隔居中，双下甲不大，鼻咽顶壁及顶后壁黏膜粗糙，表面覆分泌物。 （4）既往时点 PET/CT 全身显像：鼻咽顶壁、顶后壁及双侧壁粘膜稍增厚放射性浓密，以右侧壁为著，SUV约6.1，累及颅底骨（斜坡、双侧岩尖、蝶骨基底部及双侧翼突基底部）。 双侧咽隐窝变浅。 双侧咽后未见明显肿大淋巴结及异常放射性分布。 颅底骨质未见明显破坏。 双侧海绵窦放射性分布未见明显异常。 左颈II区肿大淋巴结放射性分布浓密，SUV约6.8，大小约1.4×1.5cm；余双颈多个小淋巴结放射性分布未见明显异常。 鼻咽病灶代谢活跃，结合病史，考虑鼻咽癌，累及颅底骨；左颈II区肿大淋巴结代谢活跃，考虑转移。 疑甲状腺左叶结节性肿。 双肺散在纤维增殖灶；疑双肺下叶炎症；纵隔及双肺门多发淋巴结代谢活跃，疑炎性改变，建议随诊。 双侧肾上腺增粗代谢略活跃，考虑良性增生性病变；双肾小结石；左肾囊肿。 多发脊柱退行性变；腰椎侧弯。 （5）既往时点 心脏彩超(套)：心脏结构及运动未见异常，各房室腔及大血管未探及异常血流信号，左心收缩功能正常。 （6）既往时点 鼻咽+颈部磁共振平扫＋增强：鼻咽腔未见狭窄，鼻咽双侧顶壁、顶后壁增厚，增强扫描明显强化。 双侧咽隐窝未见变浅。 双侧咽旁脂肪间隙清晰，双侧颈动脉鞘结构清晰，未见明确肿物影。 双侧腭帆提肌、腭帆张肌、头长肌形态正常。 双侧咀嚼肌间隙未见异常；口咽双侧壁未见增厚。 颅底骨质未见异常。 双侧海绵窦形态正常，信号均匀，颈内动脉位置正常。 双侧上��窦、筛窦、蝶窦、乳突充气良好，骨壁完整。 双眼大小、形态、位置、信号均未见异常；球后未见占位性病变。 双侧咽后见数个小淋巴结，大者短径约4mm，明显强化。 颈部左侧II区、III区见数个淋巴结，大者短径约12mm，明显强化。 ：鼻咽病变，考虑鼻咽癌。 双侧咽后数个小淋巴结，性质待定。 颈部左侧II区、双侧III区数个淋巴结，考虑转移。 （7）既往时点 本院病理：鼻咽顶后壁）镜下：形态结合免疫组化结果，符合未分化型非角化性癌。 ：CK(AE1/AE3)（+），EGFR（+）。 原位杂交：EBERs（+）。 （7）既往时点：EBV-DNA定量检测: 0 copy/mL；诊疗计划: 1、完善各项检查，做好治疗前准备。 2、予以放化综合治疗。结合疾病范围、治疗目标与耐受性，首个抗肿瘤治疗策略应如何安排？", "prompt": "你正在参与一名鼻咽癌相关患者的纵向诊疗模拟。\n资料按临床时间逐步提供。请只根据当前节点可见证据作答，不要使用未来记录。\n\n【历史辅助诊断节点】\n病理图像判断：{{PATHOLOGY_RESULT}}。\nMRI影像判断：{{MRI_T_STAGE}}；受侵结构：{{MRI_INVOLVED_STRUCTURES}}。\n文本分期：{{N_STAGE}}，{{M_STAGE}}。\n综合TNM：{{TNM_STATUS}}；总分期：{{OVERALL_STAGE}}。\n\n【截至当前节点可见证据】\n【初诊资料1】入院时间: 既往时点；患者A，精神可，饮食睡眠一般，大小便正常，体重无明显变化。；鼻症状: 无；耳症状: 耳鸣；眼症状: 无；口咽症状: 血痰；头部症状: 头痛；是否有颈部肿物: 是；阳性症状体征: 左耳鸣,太阳穴刺痛,头部刺痛,痰中带血,左颈部无痛性肿物；体重改变性质: 未变 【病理资料1】（鼻咽顶后壁）镜下：形态结合免疫组化结果，符合未分化型非角化性癌。 免疫组化：标本86：CK(AE1/AE3)（+），EGFR（+）。 原位杂交：EBERs（+）。；活检部位: 顶后壁,鼻咽；肿瘤部位: 顶后壁,鼻咽；组织学分型: 未分化型非角化性癌；组织学分级: 未分化；是否鼻咽癌: 是 【影像与分期资料1】鼻咽病灶代谢活跃，结合病史，考虑鼻咽癌，累及颅底骨；左颈II区肿大淋巴结代谢活跃，考虑转移。 疑甲状腺左叶结节性肿。 双肺散在纤维增殖灶；疑双肺下叶炎症；纵隔及双肺门多发淋巴结代谢活跃，疑炎性改变，建议随诊。 双侧肾上腺增粗代谢略活跃，考虑良性增生性病变；双肾小结石；左肾囊肿。 多发脊柱退行性变；腰椎侧弯。 ；鼻咽病变，考虑鼻咽癌。 双侧咽后数个小淋巴结，性质待定。 颈部左侧II区、双侧III区数个淋巴结，考虑转移。；检查部位: 颈部；肿瘤部位: 鼻咽；是否区域淋巴结转移: 是；区域转移淋巴结最大径(mm): 12.0；区域淋巴结转移部位: 双侧III区淋巴结,左侧II区淋巴结；是否区域复发: 否 【治疗经过1】记录时间: 既往时点；病历特点: 患者A，女，72岁，因\"发现左颈肿物1月余\"于既往时点，步行入院。 一、病例特点: 1、患者A，女性，72岁，[详细地址已隐藏]。2、现病史：患者及家属诉既往时点无意间发现左颈部无痛性肿物，约鹌鹑蛋大小，质地韧，活动度差，偶伴太阳穴及顶部一过性头部刺痛，不影响睡眠，偶伴左耳鸣，既往时点月有1次晨起痰中带血丝，无复视、视力模糊，无听力下降，无鼻塞，无面麻等不适，未予重视，逐渐加重，遂至外院A就诊，外院A，病理号:[编号已隐藏]）示：鼻咽未分化型非角化性癌，未行治疗，遂至本院进一步诊治，完善检查后，经科室会诊，考虑患者肿物侵及左侧翼突基底部，拟修改原诊断为：鼻咽未分化型非角化性癌 T3N1M0 III期 AJCC第八版，患者发病以来，精神可，饮食睡眠一般，大小便正常，体重无明显变化。 3、肿瘤专科检查:张口门齿距4.0cm；鼻咽顶壁及顶后壁黏膜粗糙；左侧颈部II区可扪及1个淋巴结，最大径1×1cm，无融合，质地硬，边界清，活动度好，无压痛，无皮肤浸润，无溃疡；颅神经检查:阴性。 4、辅助检查:（1）既往时点在外院A（病理号:[编号已隐藏]）鼻咽活检病理示:未分化型非角化癌 （2）既往时点 甲状腺及颈部淋巴结彩超：双侧颈部II区、III区淋巴结，考虑转移性淋巴结声像。 甲状腺双侧叶多发囊实性结节，考虑结节性甲状腺肿声像。 （3）既往时点 电子鼻咽镜：鼻中隔居中，双下甲不大，鼻咽顶壁及顶后壁黏膜粗糙，表面覆分泌物。 （4）既往时点 PET/CT 全身显像：鼻咽顶壁、顶后壁及双侧壁粘膜稍增厚放射性浓密，以右侧壁为著，SUV约6.1，累及颅底骨（斜坡、双侧岩尖、蝶骨基底部及双侧翼突基底部）。 双侧咽隐窝变浅。 双侧咽后未见明显肿大淋巴结及异常放射性分布。 颅底骨质未见明显破坏。 双侧海绵窦放射性分布未见明显异常。 左颈II区肿大淋巴结放射性分布浓密，SUV约6.8，大小约1.4×1.5cm；余双颈多个小淋巴结放射性分布未见明显异常。 鼻咽病灶代谢活跃，结合病史，考虑鼻咽癌，累及颅底骨；左颈II区肿大淋巴结代谢活跃，考虑转移。 疑甲状腺左叶结节性肿。 双肺散在纤维增殖灶；疑双肺下叶炎症；纵隔及双肺门多发淋巴结代谢活跃，疑炎性改变，建议随诊。 双侧肾上腺增粗代谢略活跃，考虑良性增生性病变；双肾小结石；左肾囊肿。 多发脊柱退行性变；腰椎侧弯。 （5）既往时点 心脏彩超(套)：心脏结构及运动未见异常，各房室腔及大血管未探及异常血流信号，左心收缩功能正常。 （6）既往时点 鼻咽+颈部磁共振平扫＋增强：鼻咽腔未见狭窄，鼻咽双侧顶壁、顶后壁增厚，增强扫描明显强化。 双侧咽隐窝未见变浅。 双侧咽旁脂肪间隙清晰，双侧颈动脉鞘结构清晰，未见明确肿物影。 双侧腭帆提肌、腭帆张肌、头长肌形态正常。 双侧咀嚼肌间隙未见异常；口咽双侧壁未见增厚。 颅底骨质未见异常。 双侧海绵窦形态正常，信号均匀，颈内动脉位置正常。 双侧上颌窦、筛窦、蝶窦、乳突充气良好，骨壁完整。 双眼大小、形态、位置、信号均未见异常；球后未见占位性病变。 双侧咽后见数个小淋巴结，大者短径约4mm，明显强化。 颈部左侧II区、III区见数个淋巴结，大者短径约12mm，明显强化。 ：鼻咽病变，考虑鼻咽癌。 双侧咽后数个小淋巴结，性质待定。 颈部左侧II区、双侧III区数个淋巴结，考虑转移。 （7）既往时点 本院病理：鼻咽顶后壁）镜下：形态结合免疫组化结果，符合未分化型非角化性癌。 ：CK(AE1/AE3)（+），EGFR（+）。 原位杂交：EBERs（+）。 （7）既往时点：EBV-DNA定量检测: 0 copy/mL；诊疗计划: 1、完善各项检查，做好治疗前准备。 2、予以放化综合治疗\n\n【当前需要决策的问题】\n实际治疗尚未开始；按AJCC第9版，已知分期为T3N1cM0，II期，治疗前最新安全性或计划信息为：记录时间: 既往时点；病历特点: 患者A，女，72岁，因\"发现左颈肿物1月余\"于既往时点，步行入院。 一、病例特点: 1、患者A，女性，72岁，[详细地址已隐藏]。2、现病史：患者及家属诉既往时点无意间发现左颈部无痛性肿物，约鹌鹑蛋大小，质地韧，活动度差，偶伴太阳穴及顶部一过性头部刺痛，不影响睡眠，偶伴左耳鸣，既往时点月有1次晨起痰中带血丝，无复视、视力模糊，无听力下降，无鼻塞，无面麻等不适，未予重视，逐渐加重，遂至外院A就诊，外院A，病理号:[编号已隐藏]）示：鼻咽未分化型非角化性癌，未行治疗，遂至本院进一步诊治，完善检查后，经科室会诊，考虑患者肿物侵及左侧翼突基底部，拟修改原诊断为：鼻咽未分化型非角化性癌 T3N1M0 III期 AJCC第八版，患者发病以来，精神可，饮食睡眠一般，大小便正常，体重无明显变化。 3、肿瘤专科检查:张口门齿距4.0cm；鼻咽顶壁及顶后壁黏膜粗糙；左侧颈部II区可扪及1个淋巴结，最大径1×1cm，无融合，质地硬，边界清，活动度好，无压痛，无皮肤浸润，无溃疡；颅神经检查:阴性。 4、辅助检查:（1）既往时点在外院A（病理号:[编号已隐藏]）鼻咽活检病理示:未分化型非角化癌 （2）既往时点 甲状腺及颈部淋巴结彩超：双侧颈部II区、III区淋巴结，考虑转移性淋巴结声像。 甲状腺双侧叶多发囊实性结节，考虑结节性甲状腺肿声像。 （3）既往时点 电子鼻咽镜：鼻中隔居中，双下甲不大，鼻咽顶壁及顶后壁黏膜粗糙，表面覆分泌物。 （4）既往时点 PET/CT 全身显像：鼻咽顶壁、顶后壁及双侧壁粘膜稍增厚放射性浓密，以右侧壁为著，SUV约6.1，累及颅底骨（斜坡、双侧岩尖、蝶骨基底部及双侧翼突基底部）。 双侧咽隐窝变浅。 双侧咽后未见明显肿大淋巴结及异常放射性分布。 颅底骨质未见明显破坏。 双侧海绵窦放射性分布未见明显异常。 左颈II区肿大淋巴结放射性分布浓密，SUV约6.8，大小约1.4×1.5cm；余双颈多个小淋巴结放射性分布未见明显异常。 鼻咽病灶代谢活跃，结合病史，考虑鼻咽癌，累及颅底骨；左颈II区肿大淋巴结代谢活跃，考虑转移。 疑甲状腺左叶结节性肿。 双肺散在纤维增殖灶；疑双肺下叶炎症；纵隔及双肺门多发淋巴结代谢活跃，疑炎性改变，建议随诊。 双侧肾上腺增粗代谢略活跃，考虑良性增生性病变；双肾小结石；左肾囊肿。 多发脊柱退行性变；腰椎侧弯。 （5）既往时点 心脏彩超(套)：心脏结构及运动��见异常，各房室腔及大血管未探及异常血流信号，左心收缩功能正常。 （6）既往时点 鼻咽+颈部磁共振平扫＋增强：鼻咽腔未见狭窄，鼻咽双侧顶壁、顶后壁增厚，增强扫描明显强化。 双侧咽隐窝未见变浅。 双侧咽旁脂肪间隙清晰，双侧颈动脉鞘结构清晰，未见明确肿物影。 双侧腭帆提肌、腭帆张肌、头长肌形态正常。 双侧咀嚼肌间隙未见异常；口咽双侧壁未见增厚。 颅底骨质未见异常。 双侧海绵窦形态正常，信号均匀，颈内动脉位置正常。 双侧上颌窦、筛窦、蝶窦、乳突充气良好，骨壁完整。 双眼大小、形态、位置、信号均未见异常；球后未见占位性病变。 双侧咽后见数个小淋巴结，大者短径约4mm，明显强化。 颈部左侧II区、III区见数个淋巴结，大者短径约12mm，明显强化。 ：鼻咽病变，考虑鼻咽癌。 双侧咽后数个小淋巴结，性质待定。 颈部左侧II区、双侧III区数个淋巴结，考虑转移。 （7）既往时点 本院病理：鼻咽顶后壁）镜下：形态结合免疫组化结果，符合未分化型非角化性癌。 ：CK(AE1/AE3)（+），EGFR（+）。 原位杂交：EBERs（+）。 （7）既往时点：EBV-DNA定量检测: 0 copy/mL；诊疗计划: 1、完善各项检查，做好治疗前准备。 2、予以放化综合治疗。结合疾病范围、治疗目标与耐受性，首个抗肿瘤治疗策略应如何安排？\n\n【历史辅助决策节点】\n- 暂无可展示的历史辅助决策节点。\n\n请在以下 A-L 选项中选择唯一最合适的答案。\nA. 仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗\nB. 仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围\nC. 仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗\nD. 直接永久停止所有治疗，以避免后续出现任何毒性\nE. 仅行免疫单药治疗，忽略当前分期和既定局部治疗目标\nF. 仅行局部放疗，已存在的系统性疾病范围不纳入方案选择\nG. 仅行口服维持治疗，不进行诱导、同期或系统治疗评估\nH. 完成治疗前评估，以根治性放疗为基础制定综合治疗方案，结合分期及耐受性确定化疗安排\nI. 先进行三个月中药治疗，影像进展后再决定是否规范治疗\nJ. 重复进行病理活检，直至所有免疫组化指标完全一致后才治疗\nK. 无论肾功能、听力和体能状态如何均使用足量高剂量顺铂\nL. 直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径\n\n请仅输出一个选项字母（A-L）。", "context_placeholders": ["PATHOLOGY_RESULT", "MRI_T_STAGE", "MRI_INVOLVED_STRUCTURES", "N_STAGE", "M_STAGE", "TNM_STATUS", "OVERALL_STAGE"], "options": {"A": "仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗", "B": "仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围", "C": "仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗", "D": "直接永久停止所有治疗，以避免后续出现任何毒性", "E": "仅行免疫单药治疗，忽略当前分期和既定局部治疗目标", "F": "仅行局部放疗，已存在的系统性疾病范围不纳入方案选择", "G": "仅行口服维持治疗，不进行诱导、同期或系统治疗评估", "H": "完成治疗前评估，以根治性放疗为基础制定综合治疗方案，结合分期及耐受性确定化疗安排", "I": "先进行三个月中药治疗，影像进展后再决定是否规范治疗", "J": "重复进行病理活检，直至所有免疫组化指标完全一致后才治疗", "K": "无论肾功能、听力和体能状态如何均使用足量高剂量顺铂", "L": "直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径"}, "status": "unscored_pending_item_review", "reason_codes": [], "quality_exclusion_reason": "The physician has approved the complete current item after final item-level clinical review, including the full question, available evidence, all A-L options, and option H as the uniquely best answer. The item remains in the unscored review package pending scoring eligibility checks and controlled release integration. The clinical approval, approved content hash, and earlier exclusion concerns are retained in the local audit trail."}
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{"sample_id": "sample-609d2981b7532ea640d0fd4b", "patient_id": "patient-16c0f88f348c8b36a4e0ba3d", "episode_id": "episode-dab7f4ebfe3b20b0503fd7e4", "turn_id": "P4_01", "phase": "P4", "question": "实际治疗尚未开始；已知分期为T3N1cM0，II期（AJCC第9版），治疗前最新安全性或计划信息为：报告日期: 既往时点；检查名称: 颈部磁共振平扫＋增强(1.5T以上)(套)；检查所见: 鼻咽腔狭窄，鼻咽双侧顶壁、双侧顶后壁、双侧后壁、左侧壁增厚，明显强化。双侧咽隐窝受侵。双侧后鼻道受侵； 左侧咽旁间隙受侵。双侧腭帆提肌、双侧腭帆张肌、双侧头长肌受侵。余咽旁肌未见明显异常。 左侧翼突基底部受侵，余颅底骨质未见明显异常。 双侧咽后见数个肿大淋巴结，大者短径6mm↑(0-5mm)，明显强化。 颈部双侧II区见多个小淋巴结，大者短径4mm(0-10mm)，明显强化。 右侧上颌窦粘膜增厚。左侧乳突见较多分泌物。双侧腮腺、颌下腺、甲状腺、喉部、所见脑实质未见明显异常。；检查结论: 鼻咽病变，考虑鼻咽癌。 左侧翼突基底部可疑受侵。 双侧咽后数个肿大淋巴结，可疑转移。 颈部双侧II区多个小淋巴结，性质待定。 副鼻窦炎；左侧乳突炎。；检查部位: 颈部；肿瘤部位: 鼻咽；是否区域淋巴结转移: 不确定；是否区域复发: 否\n报告日期: 既往时点；检查名称: PET/CT全身显像（套）；检查所见: 空腹6h以上，静脉注射18F-FDG，静息60min后行全身PET/CT断层显像，影像清晰。 鼻咽顶壁、顶后壁及双侧壁粘膜增厚放射性浓聚，SUV约18.5，病灶侵犯颅底骨（蝶骨基底部左份、左翼突基底部）、鼻中隔后份、双腭帆肌群、左头长肌及左咽旁咽后脂肪间隙，局部与双侧破裂孔分界欠清。左侧咽隐窝消失；右侧咽隐窝变浅。双侧海绵窦结构及放射性分布未见明显异常。双咽后及双颈Ⅱ区多个小淋巴结放射性分布略浓密，SUV约2.7，最大约1.0×0.5cm；余双颈小淋巴结放射性分布未见明显异常。 双侧脑实质密度、形态正常，放射性分布均匀、对称，诸脑室、脑池、脑沟、脑裂未见异常，中线结构居中。口咽、喉咽未见异常。鼻窦炎。左乳突炎。甲状腺放射性分布未见异常。 左上肺上舌段小斑片影放射性分布未见明显异常；余双肺未见确切病灶和异常放射性分布。气管、支气管通畅。前纵隔见胸腺组织放射性分布略浓密。心脏及大血管放射性分布未见异常。食管放射性分布未见明显异常。双侧乳腺未见确切病灶和异常放射性分布。纵隔、双肺门及双侧腋窝未见肿大淋巴结及异常放射性分布。 肝脏S6包膜下稍低密度结节影放射性分布未见明显异常，大小约2.0×1.5cm；余肝脏形态、结构及放射性分布未见明显异常。肝门结构及放射性分布未见明显异常。肝内、外胆管及胆总管未见扩张。胆囊、胃及十二指肠放射性分布未见异常。右肾囊肿。脾脏、胰腺、左肾及双侧肾上腺形态、结构及放射性分布未见异常。腹腔及腹膜后未见肿大淋巴结及异常放射性分布。 子宫内膜区局部放射性分布较浓密，SUV约4.1（生理性摄取）。膀胱、肠管等形态、结构及放射性分布未见明显异常。双侧髂血管旁及双侧腹股沟未见明显肿大淋巴结及异常放射性分布。盆腔少量积液。 双侧致密性髂骨炎。L5椎体良性病变。所见颅盖骨、各躯干骨、四肢骨放射性分布未见明显异常。；检查结论: 鼻咽病灶代谢活跃，符合鼻咽癌，病灶侵犯颅底骨等，余侵犯范围如上述；双咽后小淋巴结代谢略活跃，转移待排。 双颈Ⅱ区小淋巴结代谢略活跃，疑炎性病变。 鼻窦炎。左乳突炎。 左上肺小增殖灶。 肝脏S6包膜下结节影代谢未见明显异常，考虑良性病变（海绵状血管瘤？）。 右肾囊肿。 双侧致密性髂骨炎。L5椎体良性病变。 盆腔少量积液。；检查部位: 全身；肿瘤部位: 鼻咽；是否区域淋巴结转移: 不确定\n拟先行顺铂、白蛋白紫杉醇联合卡培他滨诱导治疗，随后衔接同期放化疗；治疗前完成器官功能及耐受性评估。\n在完成治疗前评估、可按上述既定计划实施治疗的前提下，下一步应如何安排治疗及监测？", "prompt": "你正在参与一名鼻咽癌相关患者的纵向诊疗模拟。\n资料按临床时间逐步提供。请只根据当前节点可见证据作答，不要使用未来记录。\n\n【历史辅助诊断节点】\n病理图像判断：{{PATHOLOGY_RESULT}}。\nMRI影像判断：{{MRI_T_STAGE}}；受侵结构：{{MRI_INVOLVED_STRUCTURES}}。\n文本分期：{{N_STAGE}}，{{M_STAGE}}。\n综合TNM：{{TNM_STATUS}}；总分期：{{OVERALL_STAGE}}。\n\n【截至当前节点可见证据】\n【初诊资料1】记录时间: 既往时点；主诉: 听力下降1月；门诊既往史；既往疾病史: 既往史:是否有过敏史无过敏史。是否有吸烟史吸烟史详情月经史月经史: 【病理资料1】（鼻咽部）送检少量粘膜组织及较多坏死物，粘膜内见小巢异型细胞，形态较符合未分化型非角化性癌。 本院免疫组化结果：EGFR（+）。；活检部位: 鼻咽；肿瘤部位: 鼻咽；组织学分型: 未分化型非角化性癌；组织学分级: 未分化；是否鼻咽癌: 是 【影像与分期资料1】报告日期: 既往时点；检查名称: 颈部磁共振平扫＋增强(1.5T以上)(套)；检查所见: 鼻咽腔狭窄，鼻咽双侧顶壁、双侧顶后壁、双侧后壁、左侧壁增厚，明显强化。双侧咽隐窝受侵。双侧后鼻道受侵； 左侧咽旁间隙受侵。双侧腭帆提肌、双侧腭帆张肌、双侧头长肌受侵。余咽旁肌未见明显异常。 左侧翼突基底部受侵，余颅底骨质未见明显异常。 双侧咽后见数个肿大淋巴结，大者短径6mm↑(0-5mm)，明显强化。 颈部双侧II区见多个小淋巴结，大者短径4mm(0-10mm)，明显强化。 右侧上颌窦粘膜增厚。左侧乳突见较多分泌物。双侧腮腺、颌下腺、甲状腺、喉部、所见脑实质未见明显异常。；检查结论: 鼻咽病变，考虑鼻咽癌。 左侧翼突基底部可疑受侵。 双侧咽后数个肿大淋巴结，可疑转移。 颈部双侧II区多个小淋巴结，性质待定。 副鼻窦炎；左侧乳突炎。；检查部位: 颈部；肿瘤部位: 鼻咽；是否区域淋巴结转移: 不确定；是否区域复发: 否 ；报告日期: 既往时点；检查名称: PET/CT全身显像（套）；检查所见: 空腹6h以上，静脉注射18F-FDG，静息60min后行全身PET/CT断层显像，影像清晰。 鼻咽顶壁、顶后壁及双侧壁粘膜增厚放射性浓聚，SUV约18.5，病灶侵犯颅底骨（蝶骨基底部左份、左翼突基底部）、鼻中隔后份、双腭帆肌群、左头长肌及左咽旁咽后脂肪间隙，局部与双侧破裂孔分界欠清。左侧咽隐窝消失；右侧咽隐窝变浅。双侧海绵窦结构及放射性分布未见明显异常。双咽后及双颈Ⅱ区多个小淋巴结放射性分布略浓密，SUV约2.7，最大约1.0×0.5cm；余双颈小淋巴结放射性分布未见明显异常。 双侧脑实质密度、形态正常，放射性分布均匀、对称，诸脑室、脑池、脑沟、脑裂未见异常，中线结构居中。口咽、喉咽未见异常。鼻窦炎。左乳突炎。甲状腺放射性分布未见异常。 左上肺上舌段小斑片影放射性分布未见明显异常；余双肺未见确切病灶和异常放射性分布。气管、支气管通畅。前纵隔见胸腺组织放射性分布略浓密。心脏及大血管放射性分布未见异常。食管放射性分布未见明显异常。双侧乳腺未见确切病灶和异常放射性分布。纵隔、双肺门及双侧腋窝未见肿大淋巴结及异常放射性分布。 肝脏S6包膜下稍低密度结节影放射性分布未见明显异常，大小约2.0×1.5cm；余肝脏形态、结构及放射性分布未见明显异常。肝门结构及放射性分布未见明显异常。肝内、外胆管及胆总管未见扩张。胆囊、胃及十二指肠放射性分布未见异常。右肾囊肿。脾脏、胰腺、左肾及双侧肾上腺形态、结构及放射性分布未见异常。腹腔及腹膜后未见肿大淋巴结及异常放射性分布。 子宫内膜区局部放射性分布较浓密，SUV约4.1（生理性摄取）。膀胱、肠管等形态、结构及放射性分布未见明显异常。双侧髂血管旁及双侧腹股沟未见明显肿大淋巴结及异常放射性分布。盆腔少量积液。 双侧致密性髂骨炎。L5椎体良性病变。所见颅盖骨、各躯干骨、四肢骨放射性分布未见明显异常。；检查结论: 鼻咽病灶代谢活跃，符合鼻咽癌，病灶侵犯颅底骨等，余侵犯范围如上述；双咽后小淋巴结代谢略活跃，转移待排。 双颈Ⅱ区小淋巴结代谢略活跃，疑炎性病变。 鼻窦炎。左乳突炎。 左上肺小增殖灶。 肝脏S6包膜下结节影代谢未见明显异常，考虑良性病变（海绵状血管瘤？）。 右肾囊肿。 双侧致密性髂骨炎。L5椎体良性病变。 盆腔少量积液。；检查部位: 全身；肿瘤部位: 鼻咽；是否区域淋巴结转移: 不确定 【治疗经过1】报告日期: 既往时点；检查名称: 颈部磁共振平扫＋增强(1.5T以上)(套)；检查所见: 鼻咽腔狭窄，鼻咽双侧顶壁、双侧顶后壁、双侧后壁、左侧壁增厚，明显强化。双侧咽隐窝受侵。双侧后鼻道受侵； 左侧咽旁间隙受侵。双侧腭帆提肌、双侧腭帆张肌、双侧头长肌受侵。余咽旁肌未见明显异常。 左侧翼突基底部受侵，余颅底骨质未见明显异常。 双侧咽后见数个肿大淋巴结，大者短径6mm↑(0-5mm)，明显强化。 颈部双侧II区见多个小淋巴结，大者短径4mm(0-10mm)，明显强化。 右侧上颌窦粘膜增厚。左侧乳突见较多分泌物。双侧腮腺、颌下腺、甲状腺、喉部、所见脑实质未见明显异常。；检查结论: 鼻咽病变，考虑鼻咽癌。 左侧翼突基底部可疑受侵。 双侧咽后数个肿大淋巴结，可疑转移。 颈部双侧II区多个小淋巴结，性质待定。 副鼻窦炎；左侧乳突炎。；检查部位: 颈部；肿瘤部位: 鼻咽；是否区域淋巴结转移: 不确定；是否区域复发: 否\n报告日期: 既往时点；检查名称: PET/CT全身显像（套）；检查所见: 空腹6h以上，静脉注射18F-FDG，静息60min后行全身PET/CT断层显像，影像清晰。 鼻咽顶壁、顶后壁及双侧壁粘膜增厚放射性浓聚，SUV约18.5，病灶侵犯颅底骨（蝶骨基底部左份、左翼突基底部）、鼻中隔后份、双腭帆肌群、左头长肌及左咽旁咽后脂肪间隙，局部与双侧破裂孔分界欠清。左侧咽隐窝消失；右侧咽隐窝变浅。双侧海绵窦结构及放射性分布未见明显异常。双咽后及双颈Ⅱ区多个小淋巴结放射性分布略浓密，SUV约2.7，最大约1.0×0.5cm；余双颈小淋巴结放射性分布未见明显异常。 双侧脑实质密度、形态正常，放射性分布均匀、对称，诸脑室、脑池、脑沟、脑裂未见异常，中线结构居中。口咽、喉咽未见异常。鼻窦炎。左乳突炎。甲状腺放射性分布未见异常。 左上肺上舌段小斑片影放射性分布未见明显异常；余双肺未见确切病灶和异常放射性分布。气管、支气管通畅。前纵隔见胸腺组织放射性分布略浓密。心脏及大血管放射性分布未见异常。食管放射性分布未见明显异常。双侧乳腺未见确切病灶和异常放射性分布。纵隔、双肺门及双侧腋窝未见肿大淋巴结及异常放射性分布。 肝脏S6包膜下稍低密度结节影放射性分布未见明显异常，大小约2.0×1.5cm；余肝脏形态、结构及放射性分布未见明显异常。肝门结构及放射性分布未见明显异常。肝内、外胆管及胆总管未见扩张。胆囊、胃及十二指肠放射性分布未见异常。右肾囊肿。脾脏、胰腺、左肾及双侧肾上腺形态、结构及放射性分布未见异常。腹腔及腹膜后未见肿大淋巴结及异常放射性分布。 子宫内膜区局部放射性分布较浓密，SUV约4.1（生理性摄取）。膀胱、肠管等形态、结构及放射性分布未见明显异常。双侧髂血管旁及双侧腹股沟未见明显肿大淋巴结及异常放射性分布。盆腔少量积液。 双侧致密性髂骨炎。L5椎体良性病变。所见颅盖骨、各躯干骨、四肢骨放射性分布未见明显异常。；检查结论: 鼻咽病灶代谢活跃，符合鼻咽癌，病灶侵犯颅底骨等，余侵犯范围如上述；双咽后小淋巴结代谢略活跃，转移待排。 双颈Ⅱ区小淋巴结代谢略活跃，疑炎性病变。 鼻窦炎。左乳突炎。 左上肺小增殖灶。 肝脏S6包膜下结节影代谢未见明显异常，考虑良性病变（海绵状血管瘤？）。 右肾囊肿。 双侧致密性髂骨炎。L5椎体良性病变。 盆腔少量积液。；检查部位: 全身；肿瘤部位: 鼻咽；是否区域淋巴结转移: 不确定\n拟先行顺铂、白蛋白紫杉醇联合卡培他滨诱导治疗，随后衔接同期放化疗；治疗前完成器官功能及耐受性评估。\n\n【当前需要决策的问题】\n实际治疗尚未开始；已知分期为T3N1cM0，II期（AJCC第9版），治疗前最新安全性或计划信息为：报告日期: 既往时点；检查名称: 颈部磁共振平扫＋增强(1.5T以上)(套)；检查所见: 鼻咽腔狭窄，鼻咽双侧顶壁、双侧顶后壁、双侧后壁、左侧壁增厚，明显强化。双侧咽隐窝受侵。双侧后鼻道受侵； 左侧咽旁间隙受侵。双侧腭帆提肌、双侧腭帆张肌、双侧头长肌受侵。余咽旁肌未见明显异常。 左侧翼突基底部受侵，余颅底骨质未见明显异常。 双侧咽后见数个肿大淋巴结，大者短径6mm↑(0-5mm)，明显强化。 颈部双侧II区见多个小淋巴结，大者短径4mm(0-10mm)，明显强化。 右侧上颌窦粘膜增厚。左侧乳突见较多分泌物。双侧腮腺、颌下腺、甲状腺、喉部、所见脑实质未见明显异常。；检查结论: 鼻咽病变，考虑鼻咽癌。 左侧翼突基底部可疑受侵。 双侧咽后数个肿大淋巴结，可疑转移。 颈部双侧II区多个小淋巴结，性质待定。 副鼻窦炎；左侧乳突炎。；检查部位: 颈部；肿瘤部位: 鼻咽；是否区域淋巴结转移: 不确定；是否区域复发: 否\n报告日期: 既往时点；检查名称: PET/CT全身显像（套）；检查所见: 空腹6h以上，静脉注射18F-FDG，静息60min后行全身PET/CT断层显像，影像清晰。 鼻咽顶壁、顶后壁及双侧壁粘膜增厚放射性浓聚，SUV约18.5，病灶侵犯颅底骨（蝶骨基底部左份、左翼突基底部）、鼻中隔后份、双腭帆肌群、左头长肌及左咽旁咽后脂肪间隙，局部与双侧破裂孔分界欠清。左侧咽隐窝消失；右侧咽隐窝变浅。双侧海绵窦结构及放射性分布未见明显异常。双咽后及双颈Ⅱ区多个小淋巴结放射性分布略浓密，SUV约2.7，最大约1.0×0.5cm；余双颈小淋巴结放射性分布未见明显异常。 双侧脑实质密度、形态正常，放射性分布均匀、对称，诸脑室、脑池、脑沟、脑裂未见异常，中线结构居中。口咽、喉咽未见异常。鼻窦炎。左乳突炎。甲状腺放射性分布未见异常。 左上肺上舌段小斑片影放射性分布未见明显异常；余双肺未见确切病灶和异常放射性分布。气管、支气管通畅。前纵隔见���腺组织放射性分布略浓密。心脏及大血管放射性分布未见异常。食管放射性分布未见明显异常。双侧乳腺未见确切病灶和异常放射性分布。纵隔、双肺门及双侧腋窝未见肿大淋巴结及异常放射性分布。 肝脏S6包膜下稍低密度结节影放射性分布未见明显异常，大小约2.0×1.5cm；余肝脏形态、结构及放射性分布未见明显异常。肝门结构及放射性分布未见明显异常。肝内、外胆管及胆总管未见扩张。胆囊、胃及十二指肠放射性分布未见异常。右肾囊肿。脾脏、胰腺、左肾及双侧肾上腺形态、结构及放射性分布未见异常。腹腔及腹膜后未见肿大淋巴结及异常放射性分布。 子宫内膜区局部放射性分布较浓密，SUV约4.1（生理性摄取）。膀胱、肠管等形态、结构及放射性分布未见明显异常。双侧髂血管旁及双侧腹股沟未见明显肿大淋巴结及异常放射性分布。盆腔少量积液。 双侧致密性髂骨炎。L5椎体良性病变。所见颅盖骨、各躯干骨、四肢骨放射性分布未见明显异常。；检查结论: 鼻咽病灶代谢活跃，符合鼻咽癌，病灶侵犯颅底骨等，余侵犯范围如上述；双咽后小淋巴结代谢略活跃，转移待排。 双颈Ⅱ区小淋巴结代谢略活跃，疑炎性病变。 鼻窦炎。左乳突炎。 左上肺小增殖灶。 肝脏S6包膜下结节影代谢未见明显异常，考虑良性病变（海绵状血管瘤？）。 右肾囊肿。 双侧致密性髂骨炎。L5椎体良性病变。 盆腔少量积液。；检查部位: 全身；肿瘤部位: 鼻咽；是否区域淋巴结转移: 不确定\n拟先行顺铂、白蛋白紫杉醇联合卡培他滨诱导治疗，随后衔接同期放化疗；治疗前完成器官功能及耐受性评估。\n在完成治疗前评估、可按上述既定计划实施治疗的前提下，下一步应如何安排治疗及监测？\n\n【历史辅助决策节点】\n- 暂无可展示的历史辅助决策节点。\n\n请在以下 A-L 选项中选择唯一最合适的答案。\nA. 仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗\nB. 仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围\nC. 按既定计划启动顺铂、白蛋白紫杉醇联合卡培他滨诱导治疗，随后衔接同期放化疗，并进行治疗前评估及安全性监测\nD. 仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗\nE. 直接永久停止所有治疗，以避免后续出现任何毒性\nF. 仅行免疫单药治疗，忽略当前分期和既定局部治疗目标\nG. 仅行局部放疗，已存在的系统性疾病范围不纳入方案选择\nH. 仅行口服维持治疗，不进行诱导、同期或系统治疗评估\nI. 先进行三个月中药治疗，影像进展后再决定是否规范治疗\nJ. 重复进行病理活检，直至所有免疫组化指标完全一致后才治疗\nK. 无论肾功能、听力和体能状态如何均使用足量高剂量顺铂\nL. 直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径\n\n请仅输出一个选项字母（A-L）。", "context_placeholders": ["PATHOLOGY_RESULT", "MRI_T_STAGE", "MRI_INVOLVED_STRUCTURES", "N_STAGE", "M_STAGE", "TNM_STATUS", "OVERALL_STAGE"], "options": {"A": "仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗", "B": "仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围", "C": "按既定计划启动顺铂、白蛋白紫杉醇联合卡培他滨诱导治疗，随后衔接同期放化疗，并进行治疗前评估及安全性监测", "D": "仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗", "E": "直接永久停止所有治疗，以避免后续出现任何毒性", "F": "仅行免疫单药治疗，忽略当前分期和既定局部治疗目标", "G": "仅行局部放疗，已存在的系统性疾病范围不纳入方案选择", "H": "仅行口服维持治疗，不进行诱导、同期或系统治疗评估", "I": "先进行三个月中药治疗，影像进展后再决定是否规范治疗", "J": "重复进行病理活检，直至所有免疫组化指标完全一致后才治疗", "K": "无论肾功能、听力和体能状态如何均使用足量高剂量顺铂", "L": "直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径"}, "status": "unscored_pending_item_review", "reason_codes": ["unique_treatment_gold_unresolved", "revised_treatment_plan_pending_scoring_review"], "quality_exclusion_reason": "The item has been locally revised to implement an explicitly confirmed case treatment plan. It remains unscored pending formal treatment-gold and scoring-reinstatement review. Original source uncertainties and temporal limitations are preserved in the external revision record."}
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{"sample_id": "sample-c696f0a618cfe7777e966bd2", "patient_id": "patient-393a69d1a905e05600212d51", "episode_id": "episode-316ca44099c55186ce6cf1ad", "turn_id": "P4_01", "phase": "P4", "question": "实际治疗尚未开始；已知分期为T3N2cM0，II期���AJCC第9版），治疗前最新安全性或计划信息为：记录时间: 既往时点；病历特点: 患者A，男，36岁，因\"涕血6月，发现鼻咽癌4天\"于既往时点，步行入院。 一、病例特点： 1、患者A，男性，36岁。 2、现病史:缘于既往时点月患者无意中出现涕血 ，未予重视，逐渐加重，未行鼻咽镜及活检（前次住院因患者口述有误）。 遂就诊于本院既往时点PET/CT全身显像检查诊断： 鼻咽病灶代谢活跃，考虑鼻咽癌，病灶侵犯颅底骨、蝶窦及双翼腭窝，具体范围如上所述；右颈II-III区多发肿大淋巴结代谢活跃，考虑转移；左颈II区肿大淋巴结代谢稍活跃，疑转移。 鼻窦炎。 既往时点鼻咽部磁共振平扫＋增强（3.0T及以上）： 鼻咽病变，考虑鼻咽癌。 颅底骨质破坏。 双侧咽后小淋巴结，转移待排。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区数个淋巴结，考虑转移。 副鼻窦炎；右侧乳突炎。 既往时点行右侧颈部肿大淋巴结穿刺活检。 病理检查结果： （右颈淋巴结）镜下：结合免疫组化及原位杂交结果，病变诊断为转移性淋巴上皮瘤样癌，请检查鼻咽及肺等部位。 免疫组化：[标本05]-0：CK(AE1/AE3)（+），p40（+），CK5/6（+），CK7（-）。 原位杂交：EBERs（+）。 综合患者临床及病理结果，诊断为鼻咽癌。 今为求进一步诊治来本院。 患者发病以来，精神佳，饮食睡眠佳，大小便正常，体重无减轻。 3、体格检查: 张口门齿距5cm；颈部未见淋巴结，无压痛，无皮肤浸润，无溃疡；颅神经检查：阴性 4、辅助检查:既往时点 鼻咽部磁共振平扫＋增强（3.0T及以上）： 鼻咽腔狭窄，鼻咽双侧顶壁、双侧顶后壁、双侧后壁、双侧壁增厚，明显强化。 双侧咽隐窝受侵。 口咽、双侧后鼻孔未见明显异常。 右侧咽旁间隙受侵。 双侧腭帆提肌、双侧腭帆张肌、右侧翼内肌、双侧头长肌受侵。 余咽旁肌未见明显异常。 双侧翼突基底部、双侧翼突内板、蝶骨基底部、斜坡、双侧岩尖、双侧枕骨基底部受侵，余颅底骨质未见明显异常。 双侧破裂孔受侵。 双侧咽后见小淋巴结，大者短径4mm，明显强化。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区见数个肿大淋巴结，大者短径18mm，明显强化，部分可见中央坏死。 双侧上颌窦、双侧筛窦、双侧蝶窦粘膜增厚。 右侧乳突见较多分泌物。 检查诊断： 鼻咽病变，考虑鼻咽癌。 颅底骨质破坏。 双侧咽后小淋巴结，转移待排。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区数个淋巴结，考虑转移。 副鼻窦炎；右侧乳突炎。 既往时点 PET/CT全身显像（套）： 鼻咽病灶代谢活跃，考虑鼻咽癌，病灶侵犯颅底骨、蝶窦及双翼腭窝，具体范围如上所述；右颈II-III区多发肿大淋巴结代谢活跃，考虑转移；左颈II区肿大淋巴结代谢稍活跃，疑转移。 既往时点 病理： （右颈淋巴结）镜下：结合免疫组化及原位杂交结果，病变诊断为转移性淋巴上皮瘤样癌，请检查鼻咽及肺等部位。 免疫组化：[标本05]-0：CK(AE1/AE3)（+），p40（+），CK5/6（+），CK7（-）。 原位杂交：EBERs（+）。\n拟行白蛋白紫杉醇、奈达铂联合替雷利珠单抗及尼妥珠单抗诱导治疗，随后评估并衔接放疗及后续全身治疗；治疗前完成器官功能及耐受性评估。\n在完成治疗前评估、可按上述既定计划实施治疗的前提下，下一步应如何安排治疗及监测？", "prompt": "你正在参与一名鼻咽癌相关患者的纵向诊疗模拟。\n资料按临床时间逐步提供。请只根据当前节点可见证据作答，不要使用未来记录。\n\n【历史辅助诊断节点】\n病理图像判断：{{PATHOLOGY_RESULT}}。\nMRI影像判断：{{MRI_T_STAGE}}；受侵结构：{{MRI_INVOLVED_STRUCTURES}}。\n文本分期：{{N_STAGE}}，{{M_STAGE}}。\n综合TNM：{{TNM_STATUS}}；总分期：{{OVERALL_STAGE}}。\n\n【截至当前节点可见证据】\n【初诊资料1】记录时间: 既往时点；病历特点: 患者A，男，36岁，因\"反复涕血6月。\"于既往时点，步行入院。一、病例特点： 1、患者A，男性，36岁。今为求进一步诊治来本院。患者A，精神佳，饮食睡眠佳，大小便正常，体重无减轻。3、体格检查: 张口门齿距cm；鼻咽双侧顶后壁结节状肿物；双侧颈部未扪及肿大淋巴结，双侧颈部IIa区可扪及1个淋巴结，最大径×cm，无融合，质地硬，边界清，活动度好，无压痛，无皮肤浸润，无溃疡；颅神经检查： 【病理资料1】（右颈淋巴结）镜下：结合免疫组化及原位杂交结果，病变诊断为转移性淋巴上皮瘤样癌，请检查鼻咽及肺等部位。 免疫组化：[标本05]-0：CK(AE1/AE3)（+），p40（+），CK5/6（+），CK7（-）。 原位杂交：EBERs（+）。；颈部转移淋巴结部位: 右侧颈部淋巴结；是否鼻咽癌: 否 【影像与分期资料1】报告日期: 既往时点；检查名称: 鼻咽部磁共振平扫＋增强（3.0T及以上）(套)；检查所见: 鼻咽腔狭窄，鼻咽双侧顶壁、双侧顶后壁、双侧后壁、双侧壁增厚，明显强化。双侧咽隐窝受侵。口咽、双侧后鼻孔未见明显异常。 右侧咽旁间隙受侵。双侧腭帆提肌、双侧腭帆张肌、右侧翼内肌、双侧头长肌受侵。余咽旁肌未见明显异常。 双侧翼突基底部、双侧翼突内板、蝶骨基底部、斜坡、双侧岩尖、双侧枕骨基底部受侵，余颅底骨质未见明显异常。 双侧破裂孔受侵。 双侧咽后见小淋巴结，大者短径4mm，明显强化。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区见数个肿大淋巴结，大者短径18mm，明显强化，部分可见中央坏死。 双侧上颌窦、双侧筛窦、双侧蝶窦粘膜增厚。右侧乳突见较多分泌物。；检查结论: 鼻咽病变，考虑鼻咽癌。 颅底骨质破坏。 双侧咽后小淋巴结，转移待排。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区数个淋巴结，考虑转移。 副鼻窦炎；右侧乳突炎。；检查部位: 鼻咽部；肿瘤部位: 鼻咽；是否区域淋巴结转移: 是；区域转移淋巴结最大径(mm): 18.0；是否区域复发: 否 ；报告日期: 既往时点；检查名称: PET/CT全身显像（套）；检查所见: 空腹6h以上，静脉注射18F-FDG，静息60min后行全身PET/CT断层显像，影像清晰。 鼻咽顶壁、顶后壁、双侧壁粘膜明显增厚放射性分布浓聚，SUV约12.1，病灶侵犯双侧头长肌、双侧翼腭肌群、右侧翼内肌、颅底骨（蝶骨基底部、双侧翼突基底部及内侧板、枕骨斜坡及髁部、右侧岩尖）、蝶窦、鼻中隔、双侧翼腭窝、双侧破裂孔。双侧咽隐窝消失。双侧海绵窦结构及放射性分布未见异常。筛窦及双侧上颌窦部分低密度影放射性分布稀疏；额窦及蝶窦结构及放射性分布未见明显异常。双侧乳突结构及放射性分布未见异常。口咽、喉咽未见明显异常。甲状腺放射性分布未见异常。右颈II-III区多发肿大淋巴结放射性分布浓聚，SUV约8.0，大者约1.6×2.2cm；左颈II区肿大淋巴结放射性分布浓密，SUV约4.7，大小约0.8×1.3cm；余双侧颈部小淋巴结放射性分布未见明显异常。 所见双侧脑实质密度、形态正常，放射性分布均匀、对称，诸脑室、脑池、脑沟、脑裂未见异常，中线结构居中。 双肺纹理清晰，双侧肺野未见确切病灶和异常放射性分布。气管、支气管通畅。心脏及大血管放射性分布未见异常。食管放射性分布未见明显异常。胸壁未见确切病灶和异常放射性分布。纵隔、双肺门及双侧腋窝未见肿大淋巴结及异常放射性分布。 肝脏形态、结构及放射性分布未见明显异常。肝门结构及放射性分布未见明显异常。肝内、外胆管及胆总管未见扩张。胆囊、胃及十二指肠放射性分布未见异常。脾脏、胰腺、双肾及双侧肾上腺形态、结构及放射性分布未见异常。腹腔及腹膜后未见肿大淋巴结及异常放射性分布。 盆腔放射性分布均匀，膀胱、肠管、前列腺等形态、结构及放射性分布未见明显异常。双侧髂血管旁及双侧腹股沟未见明显肿大淋巴结及异常放射性分布。 右侧第6肋骨皮质连续性中断放射性分布浓聚，SUV约8.5；左侧肩关节放射性分布浓聚，SUV约3.4；余所见颅骨、各躯干骨、四肢骨放射性分布未见明显异常。；检查结论: 鼻咽病灶代谢活跃，考虑鼻咽癌，病灶侵犯颅底骨、蝶窦及双翼腭窝，具体范围如上所述；右颈II-III区多发肿大淋巴结代谢活跃，考虑转移；左颈II区肿大淋巴结代谢稍活跃，疑转移。 鼻窦炎。 右侧第6肋骨折改变；左侧肩关节炎症。；检查部位: 全身；肿瘤部位: 鼻咽；是否区域淋巴结转移: 是；区域转移淋巴结最大径(mm): 22.0\n治疗前颈部超声检查结论：双侧颈部II区、右侧颈部III、Va区淋巴结，考虑转移性淋巴结，建议超声引导下穿刺活检。 双侧颈部Ib区淋巴结，考虑反应性淋巴结可能性大。 【治疗经过1】记录时间: 既往时点；病历特点: 患者A，男，36岁，因\"涕血6月，发现鼻咽癌4天\"于既往时点，步行入院。 一、病例特点： 1、患者A，男性，36岁。 2、现病史:缘于既往时点月患者无意中出现涕血 ，未予重视，逐渐加重，未行鼻咽镜及活检（前次住院因患者口述有误）。 遂就诊于本院既往时点PET/CT全身显像检查诊断： 鼻咽病灶代谢活跃，考虑鼻咽癌，病灶侵犯颅底骨、蝶窦及双翼腭窝，具体范围如上所述；右颈II-III区多发肿大淋巴结代谢活跃，考虑转移；��颈II区肿大淋巴结代谢稍活跃，疑转移。 鼻窦炎。 既往时点鼻咽部磁共振平扫＋增强（3.0T及以上）： 鼻咽病变，考虑鼻咽癌。 颅底骨质破坏。 双侧咽后小淋巴结，转移待排。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区数个淋巴结，考虑转移。 副鼻窦炎；右侧乳突炎。 既往时点行右侧颈部肿大淋巴结穿刺活检。 病理检查结果： （右颈淋巴结）镜下：结合免疫组化及原位杂交结果，病变诊断为转移性淋巴上皮瘤样癌，请检查鼻咽及肺等部位。 免疫组化：[标本05]-0：CK(AE1/AE3)（+），p40（+），CK5/6（+），CK7（-）。 原位杂交：EBERs（+）。 综合患者临床及病理结果，诊断为鼻咽癌。 今为求进一步诊治来本院。 患者发病以来，精神佳，饮食睡眠佳，大小便正常，体重无减轻。 3、体格检查: 张口门齿距5cm；颈部未见淋巴结，无压痛，无皮肤浸润，无溃疡；颅神经检查：阴性 4、辅助检查:既往时点 鼻咽部磁共振平扫＋增强（3.0T及以上）： 鼻咽腔狭窄，鼻咽双侧顶壁、双侧顶后壁、双侧后壁、双侧壁增厚，明显强化。 双侧咽隐窝受侵。 口咽、双侧后鼻孔未见明显异常。 右侧咽旁间隙受侵。 双侧腭帆提肌、双侧腭帆张肌、右侧翼内肌、双侧头长肌受侵。 余咽旁肌未见明显异常。 双侧翼突基底部、双侧翼突内板、蝶骨基底部、斜坡、双侧岩尖、双侧枕骨基底部受侵，余颅底骨质未见明显异常。 双侧破裂孔受侵。 双侧咽后见小淋巴结，大者短径4mm，明显强化。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区见数个肿大淋巴结，大者短径18mm，明显强化，部分可见中央坏死。 双侧上颌窦、双侧筛窦、双侧蝶窦粘膜增厚。 右侧乳突见较多分泌物。 检查诊断： 鼻咽病变，考虑鼻咽癌。 颅底骨质破坏。 双侧咽后小淋巴结，转移待排。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区数个淋巴结，考虑转移。 副鼻窦炎；右侧乳突炎。 既往时点 PET/CT全身显像（套）： 鼻咽病灶代谢活跃，考虑鼻咽癌，病灶侵犯颅底骨、蝶窦及双翼腭窝，具体范围如上所述；右颈II-III区多发肿大淋巴结代谢活跃，考虑转移；左颈II区肿大淋巴结代谢稍活跃，疑转移。 既往时点 病理： （右颈淋巴结）镜下：结合免疫组化及原位杂交结果，病变诊断为转移性淋巴上皮瘤样癌，请检查鼻咽及肺等部位。 免疫组化：[标本05]-0：CK(AE1/AE3)（+），p40（+），CK5/6（+），CK7（-）。 原位杂交：EBERs（+）。\n拟行白蛋白紫杉醇、奈达铂联合替雷利珠单抗及尼妥珠单抗诱导治疗，随后评估并衔接放疗及后续全身治疗；治疗前完成器官功能及耐受性评估。\n\n【当前需要决策的问题】\n实际治疗尚未开始；已知分期为T3N2cM0，II期（AJCC第9版），治疗前最新安全性或计划信息为：记录时间: 既往时点；病历特点: 患者A，男，36岁，因\"涕血6月，发现鼻咽癌4天\"于既往时点，步行入院。 一、病例特点： 1、患者A，男性，36岁。 2、现病史:缘于既往时点月患者无意中出现涕血 ，未予重视，逐渐加重，未行鼻咽镜及活检（前次住院因患者口述有误）。 遂就诊于本院既往时点PET/CT全身显像检查诊断： 鼻咽病灶代谢活跃，考虑鼻咽癌，病灶侵犯颅底骨、蝶窦及双翼腭窝，具体范围如上所述；右颈II-III区多发肿大淋巴结代谢活跃，考虑转移；左颈II区肿大淋巴结代谢稍活跃，疑转移。 鼻窦炎。 既往时点鼻咽部磁共振平扫＋增强（3.0T及以上）： 鼻咽病变，考虑鼻咽癌。 颅底骨质破坏。 双侧咽后小淋巴结，转移待排。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区数个淋巴结，考虑转移。 副鼻窦炎；右侧乳突炎。 既往时点行右侧颈部肿大淋巴结穿刺活检。 病理检查结果： （右颈淋巴结）镜下：结合免疫组化及原位杂交结果，病变诊断为转移性淋巴上皮瘤样癌，请检查鼻咽及肺等部位。 免疫组化：[标本05]-0：CK(AE1/AE3)（+），p40（+），CK5/6（+），CK7（-）。 原位杂交：EBERs（+）。 综合患者临床及病理结果，诊断为鼻咽癌。 今为求进一步诊治来本院。 患者发病以来，精神佳，饮食睡眠佳，大小便正常，体重无减轻。 3、体格检查: 张口门齿距5cm；颈部未见淋巴结，无压痛，无皮肤浸润，无溃疡；颅神经检查：阴性 4、辅助检查:既往时点 鼻咽部磁共振平扫＋增强（3.0T及以上）： 鼻咽腔狭窄，鼻咽双侧顶壁、双侧顶后壁、双侧后壁、双侧壁增厚，明显强化。 双侧咽隐窝受侵。 口咽、双侧后鼻孔未见明显异常。 右侧咽旁间隙受侵。 双侧腭帆提肌、双侧腭帆张肌、右侧��内肌、双侧头长肌受侵。 余咽旁肌未见明显异常。 双侧翼突基底部、双侧翼突内板、蝶骨基底部、斜坡、双侧岩尖、双侧枕骨基底部受侵，余颅底骨质未见明显异常。 双侧破裂孔受侵。 双侧咽后见小淋巴结，大者短径4mm，明显强化。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区见数个肿大淋巴结，大者短径18mm，明显强化，部分可见中央坏死。 双侧上颌窦、双侧筛窦、双侧蝶窦粘膜增厚。 右侧乳突见较多分泌物。 检查诊断： 鼻咽病变，考虑鼻咽癌。 颅底骨质破坏。 双侧咽后小淋巴结，转移待排。 颈部双侧II A区、右侧II B区、右侧III区、右侧V A区数个淋巴结，考虑转移。 副鼻窦炎；右侧乳突炎。 既往时点 PET/CT全身显像（套）： 鼻咽病灶代谢活跃，考虑鼻咽癌，病灶侵犯颅底骨、蝶窦及双翼腭窝，具体范围如上所述；右颈II-III区多发肿大淋巴结代谢活跃，考虑转移；左颈II区肿大淋巴结代谢稍活跃，疑转移。 既往时点 病理： （右颈淋巴结）镜下：结合免疫组化及原位杂交结果，病变诊断为转移性淋巴上皮瘤样癌，请检查鼻咽及肺等部位。 免疫组化：[标本05]-0：CK(AE1/AE3)（+），p40（+），CK5/6（+），CK7（-）。 原位杂交：EBERs（+）。\n拟行白蛋白紫杉醇、奈达铂联合替雷利珠单抗及尼妥珠单抗诱导治疗，随后评估并衔接放疗及后续全身治疗；治疗前完成器官功能及耐受性评估。\n在完成治疗前评估、可按上述既定计划实施治疗的前提下，下一步应如何安排治疗及监测？\n\n【历史辅助决策节点】\n- 暂无可展示的历史辅助决策节点。\n\n请在以下 A-L 选项中选择唯一最合适的答案。\nA. 按既定计划启动白蛋白紫杉醇、奈达铂联合替雷利珠单抗及尼妥珠单抗诱导治疗，随后评估并衔接放疗及后续全身治疗，监测安全性\nB. 仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗\nC. 仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围\nD. 仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗\nE. 直接永久停止所有治疗，以避免后续出现任何毒性\nF. 仅行免疫单药治疗，忽略当前分期和既定局部治疗目标\nG. 仅行局部放疗，已存在的系统性疾病范围不纳入方案选择\nH. 仅行口服维持治疗，不进行诱导、同期或系统治疗评估\nI. 先进行三个月中药治疗，影像进展后再决定是否规范治疗\nJ. 重复进行病理活检，直至所有免疫组化指标完全一致后才治疗\nK. 无论肾功能、听力和体能状态如何均使用足量高剂量顺铂\nL. 直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径\n\n请仅输出一个选项字母（A-L）。", "context_placeholders": ["PATHOLOGY_RESULT", "MRI_T_STAGE", "MRI_INVOLVED_STRUCTURES", "N_STAGE", "M_STAGE", "TNM_STATUS", "OVERALL_STAGE"], "options": {"A": "按既定计划启动白蛋白紫杉醇、奈达铂联合替雷利珠单抗及尼妥珠单抗诱导治疗，随后评估并衔接放疗及后续全身治疗，监测安全性", "B": "仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗", "C": "仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围", "D": "仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗", "E": "直接永久停止所有治疗，以避免后续出现任何毒性", "F": "仅行免疫单药治疗，忽略当前分期和既定局部治疗目标", "G": "仅行局部放疗，已存在的系统性疾病范围不纳入方案选择", "H": "仅行口服维持治疗，不进行诱导、同期或系统治疗评估", "I": "先进行三个月中药治疗，影像进展后再决定是否规范治疗", "J": "重复进行病理活检，直至所有免疫组化指标完全一致后才治疗", "K": "无论肾功能、听力和体能状态如何均使用足量高剂量顺铂", "L": "直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径"}, "status": "unscored_pending_item_review", "reason_codes": ["unique_treatment_gold_unresolved", "revised_treatment_plan_pending_scoring_review"], "quality_exclusion_reason": "The item has been locally revised to implement an explicitly confirmed case treatment plan. It remains unscored pending formal treatment-gold and scoring-reinstatement review. Original source uncertainties and temporal limitations are preserved in the external revision record."}
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+
{"sample_id": "sample-53a6f549f066ad1e543508ec", "patient_id": "patient-9aa3715525d6a6720ad66982", "episode_id": "episode-7520d0606065154fbfaf68dc", "turn_id": "P4_01", "phase": "P4", "question": "实际治疗尚未开始；已知分期为T3N0cM0，AJCC第9版II期，治疗前最新安全性或计划信息为：记录时间: 既往时点；病历特点: 患者A，男，43岁，因\"痰中带血近1月。 \"于既往时点，步行入院。 一、病例特点: 1、患者A，男性，43岁，贵州人 2、现病史:缘于既往时点患者无明显诱因出现痰中带血，无头晕、头痛，无复视、视力模糊，无耳鸣、听力下降，无鼻塞、涕血，无面麻等不适，遂至外院A就诊，既往时点行鼻咽活检病理示：疑鼻咽肿瘤，未行治疗，既往时点患者至本院完善相关检查后诊断为：鼻咽未分化型非角化性癌 T3N0M0 III期AJCC第八版分期。 今为求进一步诊治来本院。 患者发病以来，精神可，饮食睡眠一般，大小便正常，体重无明显变化。 3、肿瘤专科检查:张口门齿距5cm；鼻咽双侧顶后壁结节状肿物；双侧颈部IIa区可扪及多个个淋巴结，最大径0.5×0.3cm，无融合，质地硬，边界清，活动度好，无压痛，无皮肤浸润，无溃疡；颅神经检查:阴性。 4、辅助检查:（1）既往时点，外院A，鼻咽MR增强扫描 鼻咽部增多增厚软组织，以顶部及右侧壁为著 双侧颈部多发淋巴结 （2）既往时点，外院A，鼻咽部取材病理 黏膜组织固有层见少许异型细胞团，疑肿瘤。 既往时点 十五导联心电图检查(套) 检查结果： 窦性心律 顺钟向转位 心电图大致正常 检查诊断： 窦性心律 顺钟向转位 心电图大致正常窦性心律 顺钟向转位 心电图大致正常 既往时点 心脏彩超(套) 检查结果： 心脏超声测值： LA 24mm (20mm-38mm) AO 24mm (22mm-35mm) MV E 0.96m/s (<2) EF 70% (50-75%) LV 44mm (35mm-55mm) IVS 10mm (6mm-12mm) A 0.53m/s (<2) FS 39% (25-45%) RA 32mm (25mm-40mm) LVPW 10mm (6mm-12mm) RV 29mm (20mm-30mm) PA 21mm (16mm-26mm) 二维及Ｍ型超声心动图特征： 升主动脉内径正常，管壁光滑，主波幅度正常，重搏波存在；肺动脉内径正常； 各房室腔径正常。 室壁厚度及运动正常。 房、室间隔连续性完好。 各组瓣膜形态、结构及运动正常。 心包及心包腔未见异常。 彩色及频谱多普勒超声心动图未见异常。 检查诊断： 心脏结构及运动未见异常 各房室腔及大血管未探及异常血流信号 左心收缩功能正常 既往时点 PET/CT全身显像（套） 检查诊断： 鼻咽顶壁、顶后壁、右侧壁粘膜增厚代谢活跃，符合鼻咽癌，病灶侵犯右侧咽旁间隙、右侧翼腭窝、右侧破裂孔、颅底骨。 双颈II区小淋巴结炎症。 筛窦炎。 双肾小结石；双肾多发囊肿。 前列腺钙化灶。 既往时点 鼻咽部磁共振平扫＋增强(1.5T以上)(套) 检查诊断： 鼻咽病变，考虑鼻咽癌可能性大。 颅底骨质破坏。 双侧咽后小淋巴结，建议复查。 颈部双侧II区、双侧III区、双侧IV区小淋巴结。 副鼻窦炎。 既往时点 电子鼻咽镜检查(表麻下)(含活检)(套) 检查结果： 双侧鼻腔通畅， 鼻咽可见结节状隆起性肿物 检查诊断： 鼻咽肿物性质待查四个工作日后请凭诊疗卡到一号楼二楼和二号楼一楼自助打印机取病理报告。 既往时点 病理号： PIS 检查结果： （左顶后壁）镜下：送检鼻咽粘膜组织中，局灶可见少量核稍增大、核仁明显细胞小巢团状分布，结合免疫组化及原位杂交结果，符合未分化型非角化性癌。 免疫组化：#A-0：CK(AE1/AE3)（+），EGFR（+）； 原位杂交：#A-0：EBERs（+）。 检查诊断： （左顶后壁）送检组织1块，直径为0.6cm。\n拟行以根治性放疗为基础、联合尼妥珠单抗的治疗；治疗前完成器官功能及耐受性评估。\n在完成治疗前评估、可按上述既定计划实施治疗的前提下，下一步应如何安排治疗及监测？", "prompt": "你正在参与一名鼻咽癌相关患者的纵向诊疗模拟。\n资料按临床时间逐步提供。请只根据当前节点可见证据作答，不要使用未来记录。\n\n【历史辅助诊断节点】\n病理图像判断：{{PATHOLOGY_RESULT}}。\nMRI影像判断：{{MRI_T_STAGE}}；受侵结构：{{MRI_INVOLVED_STRUCTURES}}。\n文本分期：{{N_STAGE}}，{{M_STAGE}}。\n综合TNM：{{TNM_STATUS}}；总分期：{{OVERALL_STAGE}}。\n\n【截至当前节点可见证据】\n【初诊资料1】记录时间: 既往时点；主诉: 回吸性涕血2周；既往疾病史: 既往史:是否有过敏史无过敏史。是否有吸烟史吸烟史详情 【病理资料1】（鼻咽部新生物）镜检为恶性肿瘤，考虑为未分化型非角化性癌，建议交费用已送检的白片行免疫组化（CK、EGFR）及原位杂交检测（EBER）协助进一步诊断。 备注：请带回本次会诊的所有外院病理切片及纸质资料。；活检部位: 鼻咽；肿瘤部位: 鼻咽；组织学分型: 未分化型非角化性癌；组织学分级: 未分化；是否鼻咽癌: 是 【影像与分期资料1】报告日期: 既往时点；检查名称: 鼻咽部磁共振平扫＋增强(1.5T以上)(套)；检查所见: 鼻咽腔狭窄，鼻咽双侧顶壁、右侧顶后壁、右侧后壁、右侧壁增厚，明显强化。右侧咽隐窝受侵。 右侧咽旁间隙受侵。右侧腭帆提肌、右侧腭帆张肌、右侧头长肌受侵。余咽旁肌未见明显异常。 右侧翼突基底部、蝶骨基底部、斜坡、右侧岩尖受侵，余颅底骨质未见明显异常。 右侧破裂孔、右侧翼腭窝受侵。 双侧咽后见数个小淋巴结，大者短径3mm(0-5mm)，明显强化。 颈部双侧II区、双侧III区、双侧IV区见多个小淋巴结，大者短径5mm(0-10mm)，明显强化。 双侧上颌窦、双侧筛窦、右侧蝶窦粘膜增厚。 双侧腮腺、颌下腺、甲状腺、喉部、所见脑实质未见明显异常。；检查结论: 鼻咽病变，考虑鼻咽癌可能性大。 颅底骨质破坏。 双侧咽后小淋巴结，建议复查。 颈部双侧II区、双侧III区、双侧IV区小淋巴结。 副鼻窦炎。；检查部位: 鼻咽部；肿瘤部位: 鼻咽；是否区域复发: 否 ；报告日期: 既往时点；检查名称: PET/CT全身显像（套）；检查所见: 空腹6h以上，静脉注射18F-FDG，静息60min后行全身PET/CT断层显像，影像清晰。 鼻咽顶壁、顶后壁、右侧壁粘膜增厚放射性分布浓聚，SUV约13.6，病灶侵犯右侧腭帆肌群、右侧头长肌、右侧咽旁间隙、右侧翼腭窝、右侧破裂孔、颅底骨（蝶骨基底部、右侧翼突基底部、枕骨斜坡、右侧岩尖）。左侧破裂孔未见明显异常。双侧海绵窦结构及放射性分布未见异常。筛窦低密度影放射性分布未见明显异常。口咽、喉咽未见明显异常。甲状腺放射性分布未见异常。双颈II区小淋巴结放射性分布略浓密，大者约0.8×1.1cm；余双侧颈部小淋巴结放射性分布未见异常。 双侧脑实质密度、形态正常，放射性分布均匀、对称，诸脑室、脑池、脑沟、脑裂未见异常，中线结构居中。 双肺纹理清晰，双侧肺野未见确切病灶和异常放射性分布。气管、支气管通畅。心脏及大血管放射性分布未见异常。食管放射性分布未见明显异常。胸壁未见确切病灶和异常放射性分布。双肺门、纵隔及双侧腋窝未见肿大淋巴结及异常放射性分布。 肝脏形态、结构及放射性分布未见明显异常。肝门结构及放射性分布未见明显异常。肝内、外胆管及胆总管未见扩张。胆囊、胃及十二指肠放射性分布未见异常。双肾盂点状致密影放射性分布缺损；双肾多发囊性密度影放射性分布稀疏，大者约2.0×2.0cm；脾脏、胰腺及双侧肾上腺形态、结构及放射性分布未见异常。腹腔及腹膜后未见肿大淋巴结及异常放射性分布。 前列腺点状致密影放射性分布缺损；膀胱、肠管等形态、结构及放射性分布未见明显异常。双侧髂血管旁及双侧腹股沟未见明显肿大淋巴结及异常放射性分布。 所见颅盖骨、各躯干骨、四肢骨放射性分布未见明显异常。；检查结论: 鼻咽顶壁、顶后壁、右侧壁粘膜增厚代谢活跃，符合鼻咽癌，病灶侵犯右侧咽旁间隙、右侧翼腭窝、右侧破裂孔、颅底骨。 双颈II区小淋巴结炎症。 筛窦炎。 双肾小结石；双肾多发囊肿。 前列腺钙化灶。；检查部位: 全身；肿瘤部位: 鼻咽 【治疗经过1】记录时间: 既往时点；病历特点: 患者A，男，43岁，因\"痰中带血近1月。 \"于既往时点，步行入院。 一、病例特点: 1、患者A，男性，43岁，贵州人 2、现病史:缘于既往时点患者无明显诱因出现痰中带血，无头晕、头痛，无复视、视力模糊，无耳鸣、听力下降，无鼻塞、涕血，无面麻等不适，遂至外院A就诊，既往时点行鼻咽活检病理示：疑鼻咽肿瘤，未行治疗，既往时点患者至本院完善相关检查后诊断为：鼻咽未分化型非角化性癌 T3N0M0 III期AJCC第八版分期。 今为求进一步诊治来本院。 患者发病以来，精神可，饮食睡眠一般，大小便正常，体重无明显变化。 3、肿瘤专科检查:张口门齿距5cm；鼻咽双侧顶后壁结节状肿物；双侧颈部IIa区可扪及多个个淋巴结，最大径0.5×0.3cm，无融合，质地硬，边界清，活动度好，无压痛，无皮肤浸润，无溃疡；颅神经检查:阴性。 4、辅助检查:（1）既往时点，外院A，鼻咽MR增强扫描 鼻咽部增多增厚软组织，以顶部及右侧壁为著 双侧颈部多发淋巴结 （2）既往时点，外院A，鼻咽部取材病理 黏膜组织固有层见少许异型细胞团，疑肿瘤。 既往时点 十五导联心电图检查(套) 检查结果： 窦性心律 顺钟向转位 心电图大致正常 检查诊断： 窦性心律 顺钟向转位 心电图大致正常窦性心律 顺钟向转位 心电图大致正常 既往时点 心脏彩超(套) 检查结果： 心脏超声测值： LA 24mm (20mm-38mm) AO 24mm (22mm-35mm) MV E 0.96m/s (<2) EF 70% (50-75%) LV 44mm (35mm-55mm) IVS 10mm (6mm-12mm) A 0.53m/s (<2) FS 39% (25-45%) RA 32mm (25mm-40mm) LVPW 10mm (6mm-12mm) RV 29mm (20mm-30mm) PA 21mm (16mm-26mm) 二维及Ｍ型超声心动图特征： 升主���脉内径正常，管壁光滑，主波幅度正常，重搏波存在；肺动脉内径正常； 各房室腔径正常。 室壁厚度及运动正常。 房、室间隔连续性完好。 各组瓣膜形态、结构及运动正常。 心包及心包腔未见异常。 彩色及频谱多普勒超声心动图未见异常。 检查诊断： 心脏结构及运动未见异常 各房室腔及大血管未探及异常血流信号 左心收缩功能正常 既往时点 PET/CT全身显像（套） 检查诊断： 鼻咽顶壁、顶后壁、右侧壁粘膜增厚代谢活跃，符合鼻咽癌，病灶侵犯右侧咽旁间隙、右侧翼腭窝、右侧破裂孔、颅底骨。 双颈II区小淋巴结炎症。 筛窦炎。 双肾小结石；双肾多发囊肿。 前列腺钙化灶。 既往时点 鼻咽部磁共振平扫＋增强(1.5T以上)(套) 检查诊断： 鼻咽病变，考虑鼻咽癌可能性大。 颅底骨质破坏。 双侧咽后小淋巴结，建议复查。 颈部双侧II区、双侧III区、双侧IV区小淋巴结。 副鼻窦炎。 既往时点 电子鼻咽镜检查(表麻下)(含活检)(套) 检查结果： 双侧鼻腔通畅， 鼻咽可见结节状隆起性肿物 检查诊断： 鼻咽肿物性质待查四个工作日后请凭诊疗卡到一号楼二楼和二号楼一楼自助打印机取病理报告。 既往时点 病理号： PIS 检查结果： （左顶后壁）镜下：送检鼻咽粘膜组织中，局灶可见少量核稍增大、核仁明显细胞小巢团状分布，结合免疫组化及原位杂交结果，符合未分化型非角化性癌。 免疫组化：#A-0：CK(AE1/AE3)（+），EGFR（+）； 原位杂交：#A-0：EBERs（+）。 检查诊断： （左顶后壁）送检组织1块，直径为0.6cm。\n拟行以根治性放疗为基础、联合尼妥珠单抗的治疗；治疗前完成器官功能及耐受性评估。\n\n【当前需要决策的问题】\n实际治疗尚未开始；已知分期为T3N0cM0，AJCC第9版II期，治疗前最新安全性或计划信息为：记录时间: 既往时点；病历特点: 患者A，男，43岁，因\"痰中带血近1月。 \"于既往时点，步行入院。 一、病例特点: 1、患者A，男性，43岁，贵州人 2、现病史:缘于既往时点患者无明显诱因出现痰中带血，无头晕、头痛，无复视、视力模糊，无耳鸣、听力下降，无鼻塞、涕血，无面麻等不适，遂至外院A就诊，既往时点行鼻咽活检病理示：疑鼻咽肿瘤，未行治疗，既往时点患者至本院完善相关检查后诊断为：鼻咽未分化型非角化性癌 T3N0M0 III期AJCC第八版分期。 今为求进一步诊治来本院。 患者发病以来，精神可，饮食睡眠一般，大小便正常，体重无明显变化。 3、肿瘤专科检查:张口门齿距5cm；鼻咽双侧顶后壁结节状肿物；双侧颈部IIa区可扪及多个个淋巴结，最大径0.5×0.3cm，无融合，质地硬，边界清，活动度好，无压痛，无皮肤浸润，无溃疡；颅神经检查:阴性。 4、辅助检查:（1）既往时点，外院A，鼻咽MR增强扫描 鼻咽部增多增厚软组织，以顶部及右侧壁为著 双侧颈部多发淋巴结 （2）既往时点，外院A，鼻咽部取材病理 黏膜组织固有层见少许异型细胞团，疑肿瘤。 既往时点 十五导联心电图检查(套) 检查结果： 窦性心律 顺钟向转位 心电图大致正常 检查诊断： 窦性心律 顺钟向转位 心电图大致正常窦性心律 顺钟向转位 心电图大致正常 既往时点 心脏彩超(套) 检查结果： 心脏超声测值： LA 24mm (20mm-38mm) AO 24mm (22mm-35mm) MV E 0.96m/s (<2) EF 70% (50-75%) LV 44mm (35mm-55mm) IVS 10mm (6mm-12mm) A 0.53m/s (<2) FS 39% (25-45%) RA 32mm (25mm-40mm) LVPW 10mm (6mm-12mm) RV 29mm (20mm-30mm) PA 21mm (16mm-26mm) 二维及Ｍ型超声心动图特征： 升主动脉内径正常，管壁光滑，主波幅度正常，重搏波存在；肺动脉内径正常； 各房室腔径正常。 室壁厚度及运动正常。 房、室间隔连续性完好。 各组瓣膜形态、结构及运动正常。 心包及心包腔未见异常。 彩色及频谱多普勒超声心动图未见异常。 检查诊断： 心脏结构及运动未见异常 各房室腔及大血管未探及异常血流信号 左心收缩功能正常 既往时点 PET/CT全身显像（套） 检查诊断： 鼻咽顶壁、顶后壁、右侧壁粘膜增厚代谢活跃，符合鼻咽癌，病灶侵犯右侧咽旁间隙、右侧翼腭窝、右侧破裂孔、颅底骨。 双颈II区小淋巴结炎症。 筛窦炎。 双肾小结石；双肾多发囊肿。 前列腺钙化灶。 既往时点 鼻咽部磁共振平扫＋增强(1.5T以上)(套) 检查诊断： 鼻咽病变，考虑鼻咽癌可能性大。 颅底骨质破坏。 双侧咽后小淋巴结，建议复查。 颈部双侧II区、双侧III区、双侧IV区小淋巴结。 副鼻窦炎。 既往时点 电子鼻咽镜检查(表麻下)(含活检)(套) 检查结果： 双侧鼻腔通畅， 鼻咽可见结节状隆起性肿物 检查诊断： 鼻咽肿物性质待查四个工作��后请凭诊疗卡到一号楼二楼和二号楼一楼自助打印机取病理报告。 既往时点 病理号： PIS 检查结果： （左顶后壁）镜下：送检鼻咽粘膜组织中，局灶可见少量核稍增大、核仁明显细胞小巢团状分布，结合免疫组化及原位杂交结果，符合未分化型非角化性癌。 免疫组化：#A-0：CK(AE1/AE3)（+），EGFR（+）； 原位杂交：#A-0：EBERs（+）。 检查诊断： （左顶后壁）送检组织1块，直径为0.6cm。\n拟行以根治性放疗为基础、联合尼妥珠单抗的治疗；治疗前完成器官功能及耐受性评估。\n在完成治疗前评估、可按上述既定计划实施治疗的前提下，下一步应如何安排治疗及监测？\n\n【历史辅助决策节点】\n- 暂无可展示的历史辅助决策节点。\n\n请在以下 A-L 选项中选择唯一最合适的答案。\nA. 仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗\nB. 仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围\nC. 仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗\nD. 直接永久停止所有治疗，以避免后续出现任何毒性\nE. 仅行免疫单药治疗，忽略当前分期和既定局部治疗目标\nF. 仅行局部放疗，已存在的系统性疾病范围不纳入方案选择\nG. 按既定计划开展以根治性放疗为基础、联合尼妥珠单抗的治疗，并进行治疗前评估及安全性监测\nH. 仅行口服维持治疗，不进行诱导、同期或系统治疗评估\nI. 先进行三个月中药治疗，影像进展后再决定是否规范治疗\nJ. 重复进行病理活检，直至所有免疫组化指标完全一致后才治疗\nK. 无论肾功能、听力和体能状态如何均使用足量高剂量顺铂\nL. 直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径\n\n请仅输出一个选项字母（A-L）。", "context_placeholders": ["PATHOLOGY_RESULT", "MRI_T_STAGE", "MRI_INVOLVED_STRUCTURES", "N_STAGE", "M_STAGE", "TNM_STATUS", "OVERALL_STAGE"], "options": {"A": "仅观察并每3个月复查MRI，暂不启动任何抗肿瘤治疗", "B": "仅行鼻咽原发灶手术切除，不结合区域和远处疾病范围", "C": "仅使用止痛、止吐和营养支持，不安排肿瘤专科治疗", "D": "直接永久停止所有治疗，以避免后续出现任何毒性", "E": "仅行免疫单药治疗，忽略当前分期和既定局部治疗目标", "F": "仅行局部放疗，已存在的系统性疾病范围不纳入方案选择", "G": "按既定计划开展以根治性放疗为基础、联合尼妥珠单抗的治疗，并进行治疗前评估及安全性监测", "H": "仅行口服维持治疗，不进行诱导、同期或系统治疗评估", "I": "先进行三个月中药治疗，影像进展后再决定是否规范治疗", "J": "重复进行病理活检，直至所有免疫组化指标完全一致后才治疗", "K": "无论肾功能、听力和体能状态如何均使用足量高剂量顺铂", "L": "直接采用后线挽救方案，不考虑患者尚未接受的一线治疗路径"}, "status": "unscored_pending_item_review", "reason_codes": ["unique_treatment_gold_unresolved", "revised_treatment_plan_pending_scoring_review"], "quality_exclusion_reason": "The item has been locally revised to implement an explicitly confirmed case treatment plan. It remains unscored pending formal treatment-gold and scoring-reinstatement review. Original source uncertainties and temporal limitations are preserved in the external revision record."}
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# O1
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103 questions from 42
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# O1 · Specialist consultation
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O1 contains 103 questions from 42 cases. `questions.jsonl` provides case information and consultation questions; `rubrics.jsonl` provides 1,726 weighted criteria.
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The 1,069 positive criteria cover core conclusions, supporting evidence and conditional recommendations. The 657 negative criteria cover 337 major and 320 minor errors. A true positive criterion earns credit; a true negative criterion incurs its specified deduction.
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Generate one answer per question, then judge each criterion against that answer. The paper uses GPT-OSS-120B as its default judge. Scores average questions equally; case-weighted results are reported separately.
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data_files:
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path: L3/Struct.jsonl
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path: O1/questions.jsonl
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language:
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- multimodal
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---
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# NPCBench
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NPCBench is a medical benchmark for guideline knowledge, multimodal evidence,
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longitudinal decisions, care-path reasoning and specialist consultation in
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nasopharyngeal carcinoma.
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[Paper](https://openreview.net/forum?id=AVTJEREEah) · [Evaluation code](https://github.com/pidneuralode/NPCBench)
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| `L1/` | Guideline knowledge | 250 questions |
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| `L2/` | Guideline application | 185 questions |
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| `L3/` | Multimodal grounding | 69 pathology cases, 200 sequence questions, 2,700 structure cards, 100 T-stage cases |
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| `L4/` | Case-level planning | 165 questions from 84 patients |
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| `L5/` | Longitudinal revision | 305 turns from 100 patients |
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| `L6/` | CarePath | 100 patients, 217 scored care decisions |
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| `O1/` | Open-ended consultation | 103 questions, 1,726 rubric criteria |
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file provides the current prompts, options, references and grouping fields. O1 provides its
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criteria separately. For L3, `Path`, `Seq`, `Struct` and `T-Stg` identify the four
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image tasks; `secondary_labels/` provides additional MRI evidence labels.
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```sh
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tar -xzf L3/images_and_inputs.tar.gz -C L3
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```
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evaluation, not clinical care. Single-institution, retrospective and disease-specific
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sampling limits generalization.
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Original data and annotations are licensed under [CC BY 4.0](LICENSE-DATA.md).
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paper when using the dataset.
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data_files:
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path: L3/Struct.jsonl
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- config_name: L3-T100-anatomical
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path: L3/T-Stg.jsonl
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data_files:
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path: O1/questions.jsonl
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- config_name: L3-T400
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path: L3/T400.jsonl
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path: L3/N400.jsonl
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language:
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- en
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- multimodal
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---
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# NPCBench
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[Paper](https://openreview.net/forum?id=AVTJEREEah) · [Evaluation code](https://github.com/pidneuralode/NPCBench)
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NPCBench evaluates guideline knowledge, image interpretation, clinical planning,
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longitudinal decisions, full-care episodes and specialist consultation in
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nasopharyngeal carcinoma.
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+
| Task | Contents |
|
| 67 |
+
|---|---|
|
| 68 |
+
| L1 | 250 guideline questions |
|
| 69 |
+
| L2 | 185 application questions |
|
| 70 |
+
| L3 | 69 pathology cases; 200 sequence questions; 2,700 structure cards from 100 patients; T400 and N400 |
|
| 71 |
+
| L4 | 165 planning questions from 84 patients |
|
| 72 |
+
| L5 | 305 decisions from 100 patients |
|
| 73 |
+
| L6 | 100 patients, 217 scored care decisions |
|
| 74 |
+
| O1 | 103 consultations from 42 cases, 1,726 scoring criteria |
|
| 75 |
|
| 76 |
+
## Files and inputs
|
|
|
|
|
|
|
|
|
|
| 77 |
|
| 78 |
+
Question files are JSONL. They contain anonymous IDs, prompts, options and
|
| 79 |
+
reference answers, with grouping fields needed for scoring. O1 criteria are in
|
| 80 |
+
`O1/rubrics.jsonl`. Image paths are relative to their extracted data directory.
|
| 81 |
|
| 82 |
```sh
|
| 83 |
+
hf download pengkaiScience/NPCBench --repo-type dataset --local-dir NPCBench
|
| 84 |
+
cd NPCBench
|
| 85 |
tar -xzf L3/images_and_inputs.tar.gz -C L3
|
| 86 |
tar -xzf L6/carepath.tar.gz -C L6
|
| 87 |
+
for shard in L3/extensions/images-*.tar; do
|
| 88 |
+
tar -xf "$shard" -C L3/extensions
|
| 89 |
+
done
|
| 90 |
```
|
| 91 |
|
| 92 |
+
T-stage labels are in `L3/T400.jsonl`; N-stage labels are in `L3/N400.jsonl`.
|
| 93 |
+
Both use AJCC/UICC edition 8. T400 contains 50/50/150/150 T1/T2/T3/T4 cases;
|
| 94 |
+
N400 contains 80/160/80/80 N0/N1/N2/N3 cases. The two cohorts are patient-disjoint.
|
| 95 |
+
T staging uses boxed structure cards for 100 patients and aligned sequence groups
|
| 96 |
+
for 300 patients. N staging uses sequence groups for 400 patients. The group
|
| 97 |
+
images retain 512×512 display tiles and enter one multi-image request per patient.
|
| 98 |
+
[The MRI data guide](L3/extensions/README.md) describes layouts and sampling.
|
| 99 |
+
|
| 100 |
+
Full100 uses AJCC edition 9 for MRI. Its archive contains pathology, MRI and care
|
| 101 |
+
inputs, labels, and episode membership. Six treatment questions have no scored
|
| 102 |
+
reference answer; their exclusion reasons are provided. Twenty-five patients
|
| 103 |
+
have matched pathology, while 75 use assigned pathology specimens. The separate
|
| 104 |
+
25-case control in `supplementary/carepath25/` tests specified evidence and history
|
| 105 |
+
interventions. Its decision set differs from Full100.
|
| 106 |
+
|
| 107 |
+
`supplementary/` also contains answer-format, longitudinal-history, MRI cine and
|
| 108 |
+
physician-calibration material. Calibration labels describe sampled consultation
|
| 109 |
+
responses; they are not physician labels for every Full100 patient.
|
| 110 |
+
|
| 111 |
+
## Patients and privacy
|
| 112 |
+
|
| 113 |
+
The main L3 MRI tasks use 874 unique patients. T400 and N400 account for 800;
|
| 114 |
+
the sequence task includes 74 further patients and overlaps both staging cohorts.
|
| 115 |
+
Other task cohorts overlap and should not be summed as unique patient counts.
|
| 116 |
+
T400 examinations span March 2021–June 2024; N400 spans the same period.
|
| 117 |
+
The second-centre MRI analysis uses 53 cases with definite T-stage labels.
|
| 118 |
+
|
| 119 |
+
Names, contact details, addresses and source record identifiers are removed.
|
| 120 |
+
Longitudinal text uses relative dates where appropriate. L4 retains consultation
|
| 121 |
+
and treatment timing needed to determine the applicable guideline edition.
|
| 122 |
+
Clinical ages and intervals are preserved. The data are authorized benchmark
|
| 123 |
+
derivatives under IRB B2026-465-01, rather than original hospital exports.
|
| 124 |
+
|
| 125 |
+
NPCBench is intended for research evaluation. Retrospective, disease-specific
|
| 126 |
+
sampling and differences in image formats and cohort composition should be
|
| 127 |
+
considered when interpreting scores.
|
|
|
|
|
|
|
| 128 |
|
| 129 |
Original data and annotations are licensed under [CC BY 4.0](LICENSE-DATA.md).
|
| 130 |
+
Third-party materials retain their terms. Please cite the NPCBench paper.
|
|
|
supplementary/README.md
CHANGED
|
@@ -1,14 +1,11 @@
|
|
| 1 |
-
#
|
| 2 |
|
| 3 |
-
|
| 4 |
-
|
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
| 5 |
|
| 6 |
-
|
| 7 |
-
- `option_free/`: matched short-answer prompts and reference answers.
|
| 8 |
-
- `l5_history/`: full-history, state-equivalent and serial decision inputs.
|
| 9 |
-
- `original25/`: the historical 25-patient control with 146 decisions; distinct from the current Full100 decision set.
|
| 10 |
-
- `carepath_history/`: episode inputs for the separate history intervention.
|
| 11 |
-
- `physician_calibration/`: the 1,017-label physician calibration set and the responses being assessed. Model-generated responses here are the objects of human annotation, not a leaderboard output archive.
|
| 12 |
-
|
| 13 |
-
Each file retains its own task and condition identifiers. Follow the corresponding
|
| 14 |
-
protocol when grouping records or comparing conditions.
|
|
|
|
| 1 |
+
# Supplementary evaluation data
|
| 2 |
|
| 3 |
+
- `option_free/`: 71 matched guideline questions with and without answer options.
|
| 4 |
+
- `l5_history/`: full-history, time-stripped snapshot, order-only and strict-history inputs. The serial directory contains packed, current-delta and episode-replay inputs for 87 patients and 292 decisions.
|
| 5 |
+
- `carepath25/`: the 25-case evidence-replacement and interaction controls, with 146 selected care decisions.
|
| 6 |
+
- `carepath_history/`: episode definitions for care-history comparisons.
|
| 7 |
+
- `full100_schema/`: the explicit MRI response-format control.
|
| 8 |
+
- `mri_cine/`: cine inputs and correspondence with static image frames.
|
| 9 |
+
- `physician_calibration/`: specialist labels and paired judge labels on consultation criteria.
|
| 10 |
|
| 11 |
+
Each control uses its own fixed patients, questions and input condition. These samples overlap the main tasks and are not additional independent patient cohorts.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
supplementary/{original25 → carepath25}/canonical_packed.jsonl
RENAMED
|
File without changes
|
supplementary/{original25 → carepath25}/care.jsonl
RENAMED
|
File without changes
|
supplementary/{original25 → carepath25}/episode_replay.jsonl
RENAMED
|
File without changes
|
supplementary/{original25 → carepath25}/episodes.jsonl
RENAMED
|
File without changes
|
supplementary/{original25 → carepath25}/stateless_current_delta.jsonl
RENAMED
|
File without changes
|
supplementary/full100_schema/README.md
CHANGED
|
@@ -1,5 +1,5 @@
|
|
| 1 |
-
# Full100 MRI
|
| 2 |
|
| 3 |
-
This
|
| 4 |
|
| 5 |
-
|
|
|
|
| 1 |
+
# Full100 MRI response-format control
|
| 2 |
|
| 3 |
+
This 100-patient prompt set explicitly lists the JSON response fields for structure invasion, involved structures, T stage and imaging evidence. It uses the Full100 MRI images and AJCC ninth-edition reference labels.
|
| 4 |
|
| 5 |
+
The control changes response-format instructions for 75 patients. The remaining 25 prompts already contain the full schema. Compare care answers only when the actual image-derived input fields differ.
|
supplementary/l5_history/README.md
ADDED
|
@@ -0,0 +1,7 @@
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1 |
+
# L5 history controls
|
| 2 |
+
|
| 3 |
+
`state_equivalent.jsonl` contains the same 305 questions under full history, a time-stripped and regrouped snapshot, and an order-only shuffle. Each row identifies its condition and paired question. The snapshot changes temporal information; the shuffle retains time markers and changes line order.
|
| 4 |
+
|
| 5 |
+
`strict_history.jsonl` contains full-history and current-only inputs with the prespecified review mask `in_hr_core`. Report the broader and core subsets separately.
|
| 6 |
+
|
| 7 |
+
`serial.jsonl` contains the three interaction conditions on 292 questions from 87 patients. The `serial/` directory additionally provides episode replay messages; persistent interaction inserts that model's preceding answers in chronological order.
|
supplementary/l5_history/serial.jsonl
CHANGED
|
@@ -1,3 +1,3 @@
|
|
| 1 |
version https://git-lfs.github.com/spec/v1
|
| 2 |
-
oid sha256:
|
| 3 |
-
size
|
|
|
|
| 1 |
version https://git-lfs.github.com/spec/v1
|
| 2 |
+
oid sha256:661d4909682aecccd63ca1329df0e590572da6008211d1e637c0ca387fde68fd
|
| 3 |
+
size 59090875
|
supplementary/l5_history/serial/canonical_packed.jsonl
ADDED
|
@@ -0,0 +1,3 @@
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1 |
+
version https://git-lfs.github.com/spec/v1
|
| 2 |
+
oid sha256:42d28793fa177330e2ef4d1473c28d43cb0e452c27952c58e3c2af9cd876426d
|
| 3 |
+
size 24455299
|
supplementary/l5_history/serial/episode_replay.jsonl
ADDED
|
@@ -0,0 +1,3 @@
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1 |
+
version https://git-lfs.github.com/spec/v1
|
| 2 |
+
oid sha256:0aa43fa40e8459b666bbb887a0f2685f3033a32a514ba2157a240951c5e03e66
|
| 3 |
+
size 23243209
|
supplementary/l5_history/serial/stateless_current_delta.jsonl
ADDED
|
@@ -0,0 +1,3 @@
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1 |
+
version https://git-lfs.github.com/spec/v1
|
| 2 |
+
oid sha256:a2c365afdf1f7e70467e12c571545d426c238415d99ebeeb0711cc863035f740
|
| 3 |
+
size 11343247
|
supplementary/l5_history/state_equivalent.jsonl
CHANGED
|
@@ -1,3 +1,3 @@
|
|
| 1 |
version https://git-lfs.github.com/spec/v1
|
| 2 |
-
oid sha256:
|
| 3 |
-
size
|
|
|
|
| 1 |
version https://git-lfs.github.com/spec/v1
|
| 2 |
+
oid sha256:a9b08daadc2e58cbe90267e8a10e36a0d75e1fde5eb9f915d89562cd63e80add
|
| 3 |
+
size 32455369
|
supplementary/l5_history/strict_history.jsonl
CHANGED
|
The diff for this file is too large to render.
See raw diff
|
|
|
supplementary/physician_calibration/README.md
ADDED
|
@@ -0,0 +1,7 @@
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 1 |
+
# Physician calibration
|
| 2 |
+
|
| 3 |
+
Physicians annotated 1,017 criteria from 54 consultation responses generated by nine models on six cases. `tasks.jsonl` contains the evaluated case, question, response and criterion; `labels.jsonl` contains the physician labels.
|
| 4 |
+
|
| 5 |
+
`comparison_included` selects the 1,013 criteria with native judgments from all four compared judges. Four criteria lack a native Qwen3.6-27B judgment and are excluded from every judge comparison. The physician labels themselves remain available.
|
| 6 |
+
|
| 7 |
+
`judge_labels.jsonl` provides the four sets of criterion judgments on this common panel. A true label means that the criterion holds, including the presence of an error for a negative criterion. Compute sensitivity and specificity with physician labels as the reference, and resample complete responses or cases for clustered intervals.
|
supplementary/physician_calibration/judge_labels.jsonl
ADDED
|
The diff for this file is too large to render.
See raw diff
|
|
|
supplementary/physician_calibration/labels.jsonl
CHANGED
|
The diff for this file is too large to render.
See raw diff
|
|
|