data/final_result/add_info.json

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 {
        "doc_id":1,
        "health_literacy_label":"intermediate_health_literacy",
        "num_annotations":12,
        "mean_rating":2.3333333333,
        "consensus_rating":2,
        "modify": true,
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    {
        "doc_id":2,
        "health_literacy_label":"low_health_literacy",
        "num_annotations":6,
        "mean_rating":3.3333333333,
        "consensus_rating":3,
        "modified_info":"A 22-year-old woman had painful mouth sores that made it hard to eat and drink. It started with a fever and bumps on her lips. She had been vaping for about a year. She had scabs and cracks on her lips that could bleed, and sores inside her mouth. A test did not show a cold sore virus. The doctor diagnosed oral erythema multiforme. Treatment was salty-water compresses, a medicated mouth rinse, cream for the cracked corners, and petroleum jelly for dry lips. She was told to stop vaping. Her mouth improved after one week.",
        "rating_distribution":[
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     {
        "doc_id":3,
        "health_literacy_label":"intermediate_health_literacy",
        "num_annotations":6,
        "mean_rating":3.0,
        "consensus_rating":4,
        "modified_info":"A fetal echocardiogram at 32 weeks of pregnancy found an isolated intra-cardiac mass consistent with a cardiac rhabdomyoma. The fetus was otherwise well, and the pregnancy was followed as an outpatient until 39 weeks plus 1 day, when a cesarean section was performed.\n\nAfter delivery, the infant was evaluated on day 1, day 7, day 30, at 7 months, and at 12 months to monitor the cardiac mass and to watch for features of tuberous sclerosis complex (TSC), which is often associated with rhabdomyomas. Across follow-up, the child’s growth (anthropometrics) and neurobehavioral development were normal. The cardiac tumor did not show meaningful change in size and did not cause obstruction, and no other clinical diagnostic criteria for TSC were identified up to 1 year of age.",
        "rating_distribution":[
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     {
        "doc_id":4,
        "health_literacy_label":"intermediate_health_literacy",
        "num_annotations":8,
        "mean_rating":3.25,
        "consensus_rating":4,
        "modified_info":"A 13-year-old boy with laryngeal papillomatosis since age 2 came in with breathing distress. Doctors found multiple narrowing (stenosing) nodules in his larynx and trachea, and a chest CT showed several pulmonary cysts. Because his airway was becoming blocked, he had surgery to remove the papillomatosis lesions and he received a tracheostomy. He was also given a single 400 mg intravenous dose of bevacizumab and received respiratory therapy. He improved and had no recurrence during follow-up.",
        "rating_distribution":[
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    {
        "doc_id":5,
        "health_literacy_label":"intermediate_health_literacy",
        "num_annotations":4,
        "mean_rating":4.0,
        "consensus_rating":5,
        "modified_info":"A 54-year-old man with chronic kidney disease (membranous nephropathy) had been on long-term corticosteroids and other immunosuppressants. He was admitted to respiratory medicine with fever, cough with sputum, and worsening shortness of breath. Imaging of the lungs showed multiple bilateral ground-glass opacities. Lab tests showed elevated inflammatory markers, suggesting an infectious process that could involve bacteria, viruses, and/or fungi. Among pathogen testing, he was positive for RSV antibodies, without positive results for other organisms. He was also immunocompromised from chronic steroid/immunosuppressant use, supported by low total IgG and reduced CD4 and CD8 T-lymphocyte counts. Despite intensive anti-infective therapy and respiratory support, his condition progressed rapidly and he died from respiratory failure.",
        "rating_distribution":[
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    {
        "doc_id":6,
        "health_literacy_label":"intermediate_health_literacy",
        "num_annotations":6,
        "mean_rating":2.6666666667,
        "consensus_rating":2,
        "modified_info":"A 54-year-old man with chronic kidney disease (membranous nephropathy) had been on long-term corticosteroids and other immunosuppressants. He was admitted to respiratory medicine with fever, cough with sputum, and worsening shortness of breath. Imaging of the lungs showed multiple bilateral ground-glass opacities. Lab tests showed elevated inflammatory markers, suggesting an infectious process that could involve bacteria, viruses, and/or fungi. Among pathogen testing, he was positive for RSV antibodies, without positive results for other organisms. He was also immunocompromised from chronic steroid/immunosuppressant use, supported by low total IgG and reduced CD4 and CD8 T-lymphocyte counts. Despite intensive anti-infective therapy and respiratory support, his condition progressed rapidly and he died from respiratory failure.",
        "rating_distribution":[
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     {
        "doc_id":8,
        "health_literacy_label":"intermediate_health_literacy",
        "num_annotations":5,
        "mean_rating":3.4,
        "consensus_rating":4,
        "rating_distribution":[
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     {
        "doc_id":12,
        "health_literacy_label":"intermediate_health_literacy",
        "num_annotations":11,
        "mean_rating":1.6363636364,
        "consensus_rating":1,
        "modified_info":"A 52-year-old woman came to a urology clinic with ongoing urinary symptoms, including burning with urination (dysuria) and frequent urination, despite multiple treatments for suspected urinary tract infections.On cystoscopy (a camera exam of the bladder), doctors saw redness/irritation of the bladder lining (erythema) and debris. However, imaging and routine lab tests were unremarkable. The diagnosis was confirmed when a live larva was found during urine analysis.Management focused on practical measures: improving personal hygiene and increasing hydration (drinking more water).",
        "rating_distribution":[
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     {
        "doc_id":15,
        "health_literacy_label":"proficient_health_literacy",
        "num_annotations":5,
        "mean_rating":3.8,
        "consensus_rating":3,
        "modified_info": "A 62-year-old Tunisian Arab postmenopausal woman with Von Hippel–Lindau (VHL) disease diagnosed in 2021 had multisystem involvement and a complex oncologic–surgical history; she was gynecologically asymptomatic, with headaches being her main complaint earlier in the course before neurosurgical management of a brain lesion, and she reported no notable family or psychosocial history. In 2021, she was treated with radiotherapy for a non-operable 6 cm left petrous bone endolymphatic sac tumor, underwent left adrenalectomy for a 6 cm pheochromocytoma (pathology confirming pheochromocytoma), and had a left nephrectomy for a ruptured renal tumor with microscopy demonstrating multifocal clear-cell renal cell carcinoma, nuclear grade 2; in 2022, she underwent cephalic duodenopancreatectomy for a pancreatic mass with histology showing three serous cystadenomas and two well-differentiated neuroendocrine tumors. In January 2021, during postoperative surveillance, abdominopelvic CT incidentally identified a 4 cm solid–cystic left adnexal mass suspicious for malignancy, confirmed by transvaginal ultrasound and pelvic MRI and classified O-RADS 5; physical and speculum examinations were unremarkable (no palpable abdominopelvic mass and a healthy cervix), and prior surgical scars from the nephrectomy and duodenopancreatectomy were noted. After multidisciplinary discussion, exploratory surgery via a midline infraumbilical laparotomy revealed a well-circumscribed solid–cystic left adnexal mass without ascites or peritoneal carcinomatosis; the right adnexa appeared grossly normal with no macroscopic signs of malignancy, including absence of exocystic vegetations. Peritoneal cytology was obtained, left adnexectomy was performed, and frozen section was inconclusive, raising the differential of a borderline tumor versus a VHL-associated adnexal lesion; given her postmenopausal status, total hysterectomy with right adnexectomy was completed. Final histology demonstrated bilateral clear-cell papillary cystadenomas of the Fallopian tubes/mesosalpinx and broad ligament (0.5 cm right; 4 cm left), composed of tightly packed papillae with fibrous cores lined by monolayered epithelium, consistent with VHL-associated lesions. The postoperative course was uneventful with a normal 1-month evaluation, and she has been followed every 4 months with normal pelvic ultrasound for 2 years; she was recently readmitted to neurosurgery for recurrence of a brain tumor.",
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    {
        "doc_id":17,
        "health_literacy_label":"low_health_literacy",
        "num_annotations":12,
        "mean_rating":2.4166666667,
        "consensus_rating":3,
        "modified_info":"A 27-year-old woman had many cancers in her large intestine and rectum. She also had an inherited condition that causes many polyps. She had robot-assisted surgery to remove the entire colon and rectum, and the team also removed lymph nodes from the whole area using a surgical robot called Hugo RAS. The robot work had three steps: first, her head was tilted down and the team removed the right side of the colon with nearby tissue up to the bend near the liver; next, they removed the left side of the colon with nearby tissue, removed the rectum with the tissue around it, and took deeper lymph nodes; last, her body was kept flat and the team tied off the main blood vessels along the main artery that feeds the intestines. After the robot part was finished, they took the removed bowel out through the anus. Through a small cut at the belly button, they made a pouch from the small intestine and connected this pouch to the anus. The surgery took about 10 and a half hours, blood loss was very small, and recovery after surgery went smoothly.",
        "rating_distribution":[
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     {
        "doc_id":17,
        "health_literacy_label":"proficient_health_literacy",
        "num_annotations":11,
        "mean_rating":3.3636363636,
        "consensus_rating":3,
        "modified_info":"A 27-year-old woman with multiple colorectal cancers on a background of familial adenomatous polyposis (FAP) underwent robot-assisted total proctocolectomy (TPC) with lymph node dissection of the entire colorectal region using the Hugo RAS system. Preoperative evaluation identified large lesions in the ascending, transverse, and sigmoid colon and upper rectum; pathology confirmed adenocarcinoma in some lesions. Preoperative CT demonstrated multiple lymph node swellings along the inferior mesenteric artery (IMA) and middle colic artery, without evidence of distant metastases. Following multidisciplinary cancer board review, robot-assisted TPC was selected (Hugo RAS system; approved by the Evaluating Committee for Highly Difficult New Medical Technologies [H-0051] and the Kyoto University IRB).\n\nUnder general anesthesia, the patient was positioned in lithotomy with arms tucked. A 5-cm vertical umbilical incision was made with a wound protector; pneumoperitoneum was established; 4 robotic trocars and 2 assistant trocars were placed. Instrumentation included a camera, monopolar curved shears (right hand), bipolar fenestrated forceps (left hand), and Cadiere/double fenestrated forceps (reserve arm). The procedure consisted of three steps with two table positions (Trendelenburg and flat) and docking tilts, maintaining the same arm cart angles throughout.\n\nStep 1: Ascending colon complete mesocolic excision (CME) via a caudal approach to completion of hepatic flexure mobilization.\n\nStep 2: Central vessel ligation (CVL) of the IMA, descending colon CME to completion of splenic flexure mobilization, followed by total mesorectal excision (TME) until the intersphincteric space was fully exposed; D3 lymph node dissection was performed.\n\nStep 3: After undocking all robotic arms and repositioning the patient flat, CVL along the superior mesenteric artery (SMA) was performed with ligation of the ileocolic, right colic, and middle colic vessels; the inferior mesenteric vein (IMV) was ligated at its root (exposed during Step 2).\n\nAfter transection of the terminal ileum, the specimen was extracted transanally following complete excision of rectal mucosa from just below the dentate line due to multiple adenomas in the anal canal. An ileal pouch was constructed through the small umbilical incision and confirmed to reach the bottom of the anal canal; transanal hand-sewn ileal pouch–anal anastomosis (IPAA) was performed without a diverting ileostomy. No conversion to open surgery was required. Following undocking, laparoscopy confirmed hemostasis, specimen extraction, and anastomosis integrity.\n\nOperative time was 632 minutes (Step 1: 36 min; Step 2: 160 min; Step 3: 188 min; other procedures including positioning, docking, specimen extraction, and anastomosis: 248 min). Estimated blood loss was minimal (20 mL). Postoperative recovery was uneventful with flatus and initiation of liquid nutrition on POD 1 and solid diet on POD 3, with a functional ileal pouch and satisfactory anal function.\n\nFinal pathology demonstrated two sigmoid colon cancers (S1: Type 0-Ip, 55 × 50 mm, tub1, pT1b, ly0, v0; S2: Type 0-Isp, 55 × 50 mm, tub1, pTis, ly0, v0) and one rectal cancer (R1: Type 0-Ip, 40 × 35 mm, tub1, pTis, ly0, v0). Nodal evaluation showed 18/89 positive lymph nodes, all associated with sigmoid/rectosigmoid lesions (stations #241, #242, #251), yielding UICC pT1bN2b stage.",
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]