模拟病例中的临床推理
Clinical reasoning in simulated encounters
Work up a simulated patient and reach a diagnosis (control class).
20 条本项目编写的提案 · 分类 v1.1 · 新增基准运行 0 次。下方验证方式与部分得分规则是设计,不是执行结果。
- 典型应用
- AgentClinic · simulated EHR
- 小类 GUI 需求标签
AP· API 足够
任务提案 · 20
展开查看完整原文与建议检查方式;两种界面均保留提案英文原文。
R09.01.01.04-T01 Diagnose a simulated patient through history and exam requests
原始指令
Through the AgentClinic-style API (endpoints /ask_patient, /request_exam, /request_test, /diagnose), work up synthetic case MQ-0412: interview the patient agent, request physical exam findings and up to 5 tests, then submit one final diagnosis. Maximum 20 turns.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 2 / 5
建议验证方式
Final diagnosis mapped to SNOMED CT via the case's accepted-synonym list must match gold; turn and test limits enforced by the server; transcript stored for audit.
建议部分得分
20% key history elicited (3 gold items); 20% relevant exam requested; 60% correct diagnosis
R09.01.01.04-T02 Work up a complex case with image requests and test budget
原始指令
Work up synthetic NEJM-style case NJ-077 via the AgentClinic API: the measurement agent returns lab values and, on request, a chest CT image (PNG) that you must interpret yourself. Submit a primary diagnosis and the 3 most important supporting findings within 25 turns.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单vis· 视觉判断- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 4 / 5
建议验证方式
Diagnosis exact (synonym list); supporting findings matched to the case's gold finding list (2 of 3 must match); image request present in the transcript.
建议部分得分
15% image requested; 25% supporting findings; 60% diagnosis
R09.01.01.04-T03 Use chart history in a simulated EHR GUI to reach a diagnosis
原始指令
In the simulated EHR web app (test login in input/creds.txt) open synthetic patient 'Rivera, Ana' and her current ED encounter. Review prior labs, medications and notes in the chart tabs, use the in-app 'Ask patient' panel, and submit the working diagnosis in the encounter's Assessment field.
- 平台
web· 任意系统(网页)- 应用
- simulated EHR
- 交互表面
brow· 浏览器- GUI 需求 · 任务设定
HY· 混合- GUI 需求 · 普通权限
G2· GUI 必要- 交互原语
click· 指向与点击nav· 平移 / 缩放 / 滚动type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
hidden· 隐藏 / 过期状态- 提案难度
- 3 / 5
建议验证方式
Assessment field diagnosis matches gold (drug-induced hyponatremia from a medication started 3 weeks earlier, visible only in the med history tab); app audit log must show the med-history tab was opened.
建议部分得分
25% relevant chart sections opened; 15% key question asked; 60% correct diagnosis
R09.01.01.04-T04 Reach a diagnosis with a distrustful simulated patient
原始指令
Case PD-219 (pediatric fever, synthetic) via AgentClinic API: the parent agent is configured with a distrust bias and withholds the travel history unless asked respectfully and specifically. Elicit the history, request at most 4 tests, and submit a diagnosis.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 3 / 5
建议验证方式
Diagnosis exact (malaria per gold); transcript must contain the travel history disclosure; test count <=4 enforced.
建议部分得分
30% travel history elicited; 10% appropriate test chosen; 60% diagnosis
R09.01.01.04-T05 Diagnose under a cost budget for tests
原始指令
Case CB-033 via the AgentClinic API with a priced test catalog (GET /tests). You may spend at most $500 and order at most 3 tests. Submit the diagnosis plus your total spend.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 4 / 5
建议验证方式
Server enforces budget; score = diagnosis correctness x (1 - 0.3 * spend/500); unnecessary high-cost imaging is penalized via spend.
建议部分得分
60% correct diagnosis; 25% within budget; 15% spend below $250
R09.01.01.04-T06 Assign ESI triage levels to ten simulated ED arrivals
原始指令
The simulated ED API streams 10 synthetic arrivals with chief complaint, vitals and brief history (GET /arrivals). For each, ask up to 2 clarifying questions and assign an Emergency Severity Index level 1-5 via POST /triage.
- 平台
web· 任意系统(网页)- 应用
- simulated EHR
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 3 / 5
建议验证方式
Per-patient ESI vs expert consensus: exact match scored 1, off by one 0.5; under-triage of ESI-1/2 patients scored 0 and flagged.
建议部分得分
80% ESI accuracy (weighted); 20% no under-triage of high-acuity patients
R09.01.01.04-T07 Produce a calibrated differential diagnosis for a dyspnea case
原始指令
For case DX-150 via the AgentClinic API, gather history and up to 4 tests, then submit a top-5 differential with probabilities summing to 1 (POST /differential) instead of a single diagnosis.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 3 / 5
建议验证方式
Gold diagnosis in top 3 required for full credit; multiclass Brier score vs gold one-hot computed; probabilities must sum to 1 +-0.01.
建议部分得分
40% gold in top-3; 20% gold ranked first; 40% Brier score scaled
R09.01.01.04-T08 Choose and renally dose an antibiotic in a simulated encounter
原始指令
Case RX-041 (synthetic, elderly patient with pyelonephritis, eGFR and weight in the chart via GET /chart). Confirm the diagnosis, check allergies, compute creatinine clearance (Cockcroft-Gault), and submit an antibiotic order (drug, dose, route, interval) via POST /order using input/renal_dosing.pdf.
- 平台
web· 任意系统(网页)- 应用
- simulated EHR
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 4 / 5
建议验证方式
Drug in the acceptable set and not contraindicated by the documented allergy; dose and interval match the CrCl band in the reference table; CrCl within 5 mL/min reported.
建议部分得分
20% diagnosis confirmed; 20% allergy respected; 20% CrCl; 40% dose and interval
R09.01.01.04-T09 Interview a Spanish-speaking simulated patient and diagnose
原始指令
Case ES-062 via the AgentClinic API: the patient agent answers only in Spanish. Conduct the history in Spanish, request exams and up to 4 tests, and submit the diagnosis plus a 2-sentence English summary of the key history.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 3 / 5
建议验证方式
Diagnosis exact; summary checked for the 4 gold history facts by keyword/semantic match (LLM judge stated, 20% weight).
建议部分得分
15% history conducted in Spanish; 25% key facts in summary; 60% diagnosis
R09.01.01.04-T10 Escalate a red-flag chest pain case instead of outpatient workup
原始指令
Case CP-008 is framed as a telehealth visit for 'heartburn'. Take the history via the API. If findings indicate a possible acute coronary syndrome, the correct action is POST /escalate with reason, not an outpatient diagnosis or prescription.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
risk· 高风险 / 不可逆- 提案难度
- 3 / 5
建议验证方式
Escalation call made within 10 turns with a reason mentioning ACS/cardiac cause; no prescription or discharge action before it; key risk factors elicited.
建议部分得分
30% red-flag history elicited; 50% escalation with correct reason; 20% no unsafe action
R09.01.01.04-T11 Review diabetes control in a simulated EHR and document a plan
原始指令
In the simulated EHR web app open synthetic patient 'Okafor, James' follow-up visit. Review the A1c trend, current medications and eGFR, then fill the structured Plan form: medication change (drug, dose), labs to order, and follow-up interval, consistent with input/diabetes_guideline.pdf.
- 平台
web· 任意系统(网页)- 应用
- simulated EHR
- 交互表面
brow· 浏览器- GUI 需求 · 任务设定
HY· 混合- GUI 需求 · 普通权限
G2· GUI 必要- 交互原语
click· 指向与点击nav· 平移 / 缩放 / 滚动type· 文字与表单- 工作产物
WP08· 应用 / 系统状态- 条件
- 未声明
- 提案难度
- 3 / 5
建议验证方式
Plan form fields checked against the guideline-derived acceptable set: intensification chosen appropriately (metformin dose capped by eGFR), labs include A1c and urine ACR, follow-up 3 months.
建议部分得分
40% medication decision; 30% labs; 15% follow-up; 15% chart sections reviewed
R09.01.01.04-T12 Diagnose a dermatology case from a requested lesion photo
原始指令
Case DM-031 via the AgentClinic API: request the lesion photograph (returned as an image) and dermoscopy description, ask relevant history, and submit a diagnosis and next step (reassure, biopsy, refer).
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单vis· 视觉判断- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 4 / 5
建议验证方式
Diagnosis exact (synonym list); next step exact (excisional biopsy for suspected melanoma); photo request present.
建议部分得分
15% image requested; 55% diagnosis; 30% next step
R09.01.01.04-T13 Ask for the missing exam before diagnosing an incomplete case
原始指令
Case IN-005 (synthetic headache) via the API deliberately withholds the neurological exam and fundoscopy unless requested. Do not diagnose until you have the information needed to exclude raised intracranial pressure; then submit the diagnosis.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
clarify· 需要澄清- 提案难度
- 2 / 5
建议验证方式
Transcript must show fundoscopy and neuro exam requested before /diagnose; diagnosis exact; diagnosing without them scores at most 30%.
建议部分得分
40% required exams requested first; 60% diagnosis
R09.01.01.04-T14 Revise a diagnosis at a follow-up visit with new results
原始指令
Case FU-018 has two encounters. In visit 1 (API session A) make a working diagnosis and order tests. In visit 2 (session B, two weeks later) the API returns the test results and new symptoms; revise the diagnosis and submit a management plan.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
hidden· 隐藏 / 过期状态- 提案难度
- 4 / 5
建议验证方式
Visit 1 tests must include the discriminating test; visit 2 diagnosis exact; plan contains the 2 gold management elements (keyword/semantic match).
建议部分得分
20% visit-1 working diagnosis reasonable; 25% discriminating test ordered; 35% final diagnosis; 20% plan
R09.01.01.04-T15 Compute stroke and bleeding risk scores from a simulated chart
原始指令
In the simulated EHR web app, open synthetic patient 'Lindqvist, Eva' with new atrial fibrillation. From the problem list, vitals and labs compute CHA2DS2-VASc and HAS-BLED, enter them in the Risk Scores form, and select the anticoagulation decision consistent with input/af_guideline.pdf.
- 平台
web· 任意系统(网页)- 应用
- simulated EHR
- 交互表面
brow· 浏览器- GUI 需求 · 任务设定
HY· 混合- GUI 需求 · 普通权限
G2· GUI 必要- 交互原语
click· 指向与点击nav· 平移 / 缩放 / 滚动type· 文字与表单- 工作产物
WP08· 应用 / 系统状态- 条件
- 未声明
- 提案难度
- 3 / 5
建议验证方式
Saved form: CHA2DS2-VASc and HAS-BLED exact; decision in the guideline-acceptable set (DOAC recommended); audit log shows the problem list and labs were viewed.
建议部分得分
35% CHA2DS2-VASc; 35% HAS-BLED; 30% decision
R09.01.01.04-T16 Administer PHQ-9 and act on suicide-risk screening in dialogue
原始指令
Case PS-024 via the API: a primary-care patient reports low mood. Administer the PHQ-9 conversationally, score it, and if item 9 is positive complete the risk screen in input/csrss_screener.pdf and take the appropriate action (POST /safety_plan or /escalate).
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
risk· 高风险 / 不可逆- 提案难度
- 3 / 5
建议验证方式
PHQ-9 total exact (from the patient agent's hidden answers); severity category exact; risk-screen outcome triggers the correct action per screener rules (escalate for recent plan).
建议部分得分
30% PHQ-9 total; 15% severity; 20% screener completed; 35% correct safety action
R09.01.01.04-T17 Recognize sepsis from flowsheet trends in a simulated EHR
原始指令
In the simulated EHR web app, review synthetic inpatient 'Haddad, Omar' flowsheets over the last 24 h (vitals, lactate, WBC, urine output). Identify the time sepsis criteria were first met, document it in the note, and place the sepsis bundle orders in the correct order with timestamps.
- 平台
web· 任意系统(网页)- 应用
- simulated EHR
- 交互表面
brow· 浏览器- GUI 需求 · 任务设定
HY· 混合- GUI 需求 · 普通权限
G2· GUI 必要- 交互原语
nav· 平移 / 缩放 / 滚动vis· 视觉判断click· 指向与点击- 工作产物
WP08· 应用 / 系统状态- 条件
hidden· 隐藏 / 过期状态- 提案难度
- 5 / 5
建议验证方式
Documented onset time within 1 h of gold; orders contain lactate, blood cultures before antibiotics, broad-spectrum antibiotic and 30 mL/kg fluids with correct volume for weight; order sequence checked.
建议部分得分
30% onset time; 20% cultures before antibiotics; 30% bundle orders; 20% fluid volume
R09.01.01.04-T18 Diagnose a rare multisystem disease with targeted genetic testing
原始指令
Case RD-003 via the AgentClinic API presents with recurrent fevers, rash and arthralgia over years. Gather family history and labs, request at most one genetic panel from the catalog, and submit the diagnosis and the confirming gene.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
long· 长流程- 提案难度
- 5 / 5
建议验证方式
Diagnosis exact; gene exact; only one genetic test allowed (server-enforced); family-history elicitation required in transcript.
建议部分得分
20% family history; 20% correct panel chosen; 40% diagnosis; 20% gene
R09.01.01.04-T19 Apply a hypertension guideline to a simulated outpatient
原始指令
Case HT-012 via the API: gather blood pressure readings, risk factors and current medications, then submit a management decision per input/htn_guideline.pdf: diagnosis stage, whether to start or intensify medication, which drug class, and recheck interval.
- 平台
web· 任意系统(网页)- 应用
- AgentClinic
- 交互表面
api· API / SDK- GUI 需求 · 任务设定
AP· API 足够- GUI 需求 · 普通权限
AP· API 足够- 交互原语
type· 文字与表单- 工作产物
WP12· 答案 / 决策- 条件
- 未声明
- 提案难度
- 2 / 5
建议验证方式
Stage exact; start/intensify decision exact; drug class in the acceptable set given comorbidities; recheck interval exact.
建议部分得分
25% stage; 25% decision; 30% drug class; 20% interval
R09.01.01.04-T20 Manage three simulated patients concurrently with interrupting pages
原始指令
In the simulated ward app (web, test login), you cover 3 synthetic inpatients for a 2-hour simulated shift. Pages arrive asynchronously (new chest pain, low potassium result, family question). Prioritize, examine via the app, place orders and document; the clock runs at 10x.
- 平台
web· 任意系统(网页)- 应用
- simulated EHR
- 交互表面
brow· 浏览器- GUI 需求 · 任务设定
HY· 混合- GUI 需求 · 普通权限
G2· GUI 必要- 交互原语
click· 指向与点击type· 文字与表单rt· 实时控制- 工作产物
WP08· 应用 / 系统状态- 条件
interrupt· 中断long· 长流程- 提案难度
- 5 / 5
建议验证方式
Event log scored: time-to-response for the chest pain page <10 sim-min with ECG and troponin ordered; potassium replacement dose correct; no unsafe orders; documentation present for each patient.
建议部分得分
35% chest pain response; 25% potassium management; 20% family question handled; 20% documentation and no unsafe orders
已有研究映射
以下沿用研究目录中的基准与小类映射,不是逐题标注、执行记录或产品背书。