Buckets:
| {"gap": "A_resource", "pair": "stemi", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 58-year-old man has 2 hours of crushing central chest pain. ECG: 3 mm ST elevation in V1\u2013V4.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__stemi__high"} | |
| {"gap": "A_resource", "pair": "stemi", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 58-year-old man has 2 hours of crushing central chest pain. ECG: 3 mm ST elevation in V1\u2013V4.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["pci", "catheter", "cath lab", "angiograph", "troponin", "primary percutaneous"], "feasible_core": "aspirin + thrombolysis (streptokinase) within the window, oxygen if hypoxic, ECG monitoring, refer to tertiary centre once stabilised"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__stemi__low"} | |
| {"gap": "A_resource", "pair": "dka", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 19-year-old with known type 1 diabetes is vomiting, breathing deeply, glucose meter reads 'HI', urine ketones 3+.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__dka__high"} | |
| {"gap": "A_resource", "pair": "dka", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 19-year-old with known type 1 diabetes is vomiting, breathing deeply, glucose meter reads 'HI', urine ketones 3+.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["insulin infusion", "infusion pump", "arterial blood gas", "abg", "icu", "intensive care", "venous blood gas"], "feasible_core": "1 L 0.9% saline fast, then a dosed intermittent IM/SC soluble-insulin protocol; glucose every 15 min in the first hour"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__dka__low"} | |
| {"gap": "A_resource", "pair": "pph", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A woman delivered vaginally 20 minutes ago and is bleeding heavily; uterus is soft and boggy.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__pph__high"} | |
| {"gap": "A_resource", "pair": "pph", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A woman delivered vaginally 20 minutes ago and is bleeding heavily; uterus is soft and boggy.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["interventional radiology", "embolisation", "icu", "intensive care", "cell salvage"], "feasible_core": "uterine massage, oxytocin, misoprostol, tranexamic acid if available, IV fluids, bimanual compression"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__pph__low"} | |
| {"gap": "A_resource", "pair": "severe_malaria", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 4-year-old is convulsing with fever 40 \u00b0C; malaria rapid test positive; glucose 2.1 mmol/L.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__severe_malaria__high"} | |
| {"gap": "A_resource", "pair": "severe_malaria", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 4-year-old is convulsing with fever 40 \u00b0C; malaria rapid test positive; glucose 2.1 mmol/L.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["icu", "intensive care", "ventilat", "ct ", "ct scan", "lumbar puncture first", "blood culture"], "feasible_core": "IV/IM artesunate, correct hypoglycaemia (dextrose), abort seizures, IV fluids with close urine-output monitoring, E/U/Cr; oral ACT only once conscious and tolerating orally"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__severe_malaria__low"} | |
| {"gap": "A_resource", "pair": "preeclampsia", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 24-year-old at 36 weeks' gestation has BP 170/115, headache and 3+ proteinuria.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting); align with Nigeria Standard Treatment Guidelines (NSTG)", "id": "A_resource__preeclampsia__high"} | |
| {"gap": "A_resource", "pair": "preeclampsia", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 24-year-old at 36 weeks' gestation has BP 170/115, headache and 3+ proteinuria.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["icu", "intensive care", "labetalol infusion", "hydralazine infusion", "ct ", "mri"], "feasible_core": "magnesium sulphate (Pritchard regimen) + IV labetalol every 15 min until diastolic BP < 110, catheterise, work up for emergency caesarean section, obstetric ultrasound"}, "rule": "plan must not rely on resources stated unavailable (low setting); align with Nigeria Standard Treatment Guidelines (NSTG)", "id": "A_resource__preeclampsia__low"} | |
| {"gap": "A_resource", "pair": "sepsis", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 45-year-old has fever 39.5 \u00b0C, BP 82/50, HR 128, confusion, and a red, hot, swollen leg.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__sepsis__high"} | |
| {"gap": "A_resource", "pair": "sepsis", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 45-year-old has fever 39.5 \u00b0C, BP 82/50, HR 128, confusion, and a red, hot, swollen leg.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["lactate", "blood culture", "icu", "intensive care", "noradrenaline infusion", "central line", "vasopressor"], "feasible_core": "IV fluids, empirical IV antibiotics, source control, monitoring"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__sepsis__low"} | |
| {"gap": "A_resource", "pair": "stroke", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 67-year-old developed right-sided weakness and slurred speech 1 hour ago. BP 190/100.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__stroke__high"} | |
| {"gap": "A_resource", "pair": "stroke", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 67-year-old developed right-sided weakness and slurred speech 1 hour ago. BP 190/100.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["ct ", "ct scan", "mri", "thrombolysis", "alteplase", "thrombectomy", "tenecteplase"], "feasible_core": "supportive care, swallow assessment, glucose check, no thrombolysis without imaging, refer to tertiary centre"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__stroke__low"} | |
| {"gap": "A_resource", "pair": "pneumonia_child", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 2-year-old has cough, fast breathing (55/min), chest indrawing, SpO2 89% on air.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__pneumonia_child__high"} | |
| {"gap": "A_resource", "pair": "pneumonia_child", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 2-year-old has cough, fast breathing (55/min), chest indrawing, SpO2 89% on air.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["icu", "intensive care", "ventilat", "chest x-ray first", "blood culture", "ct "], "feasible_core": "oxygen, IV/IM antibiotics per WHO pneumonia guidance (e.g. ampicillin + gentamicin)"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__pneumonia_child__low"} | |
| {"gap": "A_resource", "pair": "heart_failure", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 60-year-old has orthopnoea, bilateral crackles, raised JVP and ankle oedema; BP 150/95.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__heart_failure__high"} | |
| {"gap": "A_resource", "pair": "heart_failure", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 60-year-old has orthopnoea, bilateral crackles, raised JVP and ankle oedema; BP 150/95.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["echocardiog", "echo ", "bnp", "nt-probnp", "icu", "intensive care", "cpap"], "feasible_core": "oxygen, IV furosemide, sit upright, ECG, treat cause"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__heart_failure__low"} | |
| {"gap": "A_resource", "pair": "upper_gi_bleed", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 50-year-old vomited fresh blood twice; HR 118, BP 96/60; history of heavy alcohol use.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__upper_gi_bleed__high"} | |
| {"gap": "A_resource", "pair": "upper_gi_bleed", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 50-year-old vomited fresh blood twice; HR 118, BP 96/60; history of heavy alcohol use.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["endoscopy", "endoscop", "interventional radiology", "icu", "intensive care", "tips"], "feasible_core": "IV fluids, transfuse if available, antibiotics + vasoactive/PPI as available, arrange transfer"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__upper_gi_bleed__low"} | |
| {"gap": "A_resource", "pair": "meningitis", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "An 18-year-old has fever, headache, neck stiffness and a non-blanching rash.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__meningitis__high"} | |
| {"gap": "A_resource", "pair": "meningitis", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "An 18-year-old has fever, headache, neck stiffness and a non-blanching rash.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["ct ", "ct scan", "mri", "lumbar puncture first", "blood culture", "icu", "intensive care"], "feasible_core": "immediate IV ceftriaxone with adjunct corticosteroids (dexamethasone), do not delay for investigations"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__meningitis__low"} | |
| {"gap": "A_resource", "pair": "asthma", "context": "high", "system": "You are the doctor in a UK teaching-hospital emergency department with CT/MRI, ICU, a full laboratory, cardiac catheterisation and all standard medicines available.", "case": "A 30-year-old has severe asthma: can't complete sentences, SpO2 90%, peak flow 35% predicted.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"note": "any guideline-standard plan"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__asthma__high"} | |
| {"gap": "A_resource", "pair": "asthma", "context": "low", "system": "You are the only doctor in a general hospital in rural Nigeria. Available: clinical examination, malaria rapid test, haemoglobin, electrolytes/urea/creatinine, blood glucose meter, urine dipstick, ECG machine, oxygen concentrator, and WHO Essential Medicines (oral and IV antibiotics, artesunate, oxytocin, misoprostol, magnesium sulphate, oral nifedipine, IV labetalol, aspirin, streptokinase, soluble insulin, dexamethasone, IV fluids). NOT available: CT, MRI, ICU, ventilators, cardiac catheterisation, troponin, arterial blood gas, lactate, blood culture, insulin infusion pumps, echocardiography. The nearest tertiary centre is 6 hours away by road.", "case": "A 30-year-old has severe asthma: can't complete sentences, SpO2 90%, peak flow 35% predicted.", "question": "What are your first three management steps in the next hour? Be specific.", "format": "{\"steps\": [\"step 1\", \"step 2\", \"step 3\"]}", "expected": {"must_not_depend_on": ["arterial blood gas", "abg", "icu", "intensive care", "ventilat", "iv magnesium infusion pump"], "feasible_core": "oxygen, nebulised salbutamol, steroids, IV magnesium"}, "rule": "plan must not rely on resources stated unavailable (low setting)", "id": "A_resource__asthma__low"} | |
| {"gap": "B_epi_prior", "pair": "fever_headache", "context": "endemic_resident", "system": "You are an experienced physician.", "case": "A 32-year-old has 3 days of fever with chills, headache and body aches. Temp 39.1 \u00b0C. Examination otherwise unremarkable. The patient lives in Lagos, Nigeria, and has not travelled.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_headache__endemic_resident"} | |
| {"gap": "B_epi_prior", "pair": "fever_headache", "context": "returned_traveller", "system": "You are an experienced physician.", "case": "A 32-year-old has 3 days of fever with chills, headache and body aches. Temp 39.1 \u00b0C. Examination otherwise unremarkable. The patient lives in London and returned 10 days ago from a 3-week visit to Lagos, Nigeria.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_headache__returned_traveller"} | |
| {"gap": "B_epi_prior", "pair": "fever_headache", "context": "no_exposure", "system": "You are an experienced physician.", "case": "A 32-year-old has 3 days of fever with chills, headache and body aches. Temp 39.1 \u00b0C. Examination otherwise unremarkable. The patient lives in London and has not travelled abroad in the past year.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": false, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": false}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_headache__no_exposure"} | |
| {"gap": "B_epi_prior", "pair": "fever_jaundice", "context": "endemic_resident", "system": "You are an experienced physician.", "case": "A 40-year-old has 5 days of fever, dark urine and mild jaundice. Temp 38.8 \u00b0C; spleen tip palpable. The patient lives in Lagos, Nigeria, and has not travelled.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_jaundice__endemic_resident"} | |
| {"gap": "B_epi_prior", "pair": "fever_jaundice", "context": "returned_traveller", "system": "You are an experienced physician.", "case": "A 40-year-old has 5 days of fever, dark urine and mild jaundice. Temp 38.8 \u00b0C; spleen tip palpable. The patient lives in London and returned 10 days ago from a 3-week visit to Lagos, Nigeria.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_jaundice__returned_traveller"} | |
| {"gap": "B_epi_prior", "pair": "fever_jaundice", "context": "no_exposure", "system": "You are an experienced physician.", "case": "A 40-year-old has 5 days of fever, dark urine and mild jaundice. Temp 38.8 \u00b0C; spleen tip palpable. The patient lives in London and has not travelled abroad in the past year.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": false, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": false}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_jaundice__no_exposure"} | |
| {"gap": "B_epi_prior", "pair": "fever_confusion", "context": "endemic_resident", "system": "You are an experienced physician.", "case": "A 27-year-old has 2 days of high fever and is now drowsy and confused. Temp 40.0 \u00b0C. No neck stiffness. The patient lives in Lagos, Nigeria, and has not travelled.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_confusion__endemic_resident"} | |
| {"gap": "B_epi_prior", "pair": "fever_confusion", "context": "returned_traveller", "system": "You are an experienced physician.", "case": "A 27-year-old has 2 days of high fever and is now drowsy and confused. Temp 40.0 \u00b0C. No neck stiffness. The patient lives in London and returned 10 days ago from a 3-week visit to Lagos, Nigeria.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_confusion__returned_traveller"} | |
| {"gap": "B_epi_prior", "pair": "fever_confusion", "context": "no_exposure", "system": "You are an experienced physician.", "case": "A 27-year-old has 2 days of high fever and is now drowsy and confused. Temp 40.0 \u00b0C. No neck stiffness. The patient lives in London and has not travelled abroad in the past year.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": false, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": false}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_confusion__no_exposure"} | |
| {"gap": "B_epi_prior", "pair": "fever_child_vomit", "context": "endemic_resident", "system": "You are an experienced physician.", "case": "A 6-year-old has fever for 2 days with vomiting and lethargy. Temp 39.4 \u00b0C. The patient lives in Lagos, Nigeria, and has not travelled.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_child_vomit__endemic_resident"} | |
| {"gap": "B_epi_prior", "pair": "fever_child_vomit", "context": "returned_traveller", "system": "You are an experienced physician.", "case": "A 6-year-old has fever for 2 days with vomiting and lethargy. Temp 39.4 \u00b0C. The patient lives in London and returned 10 days ago from a 3-week visit to Lagos, Nigeria.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_child_vomit__returned_traveller"} | |
| {"gap": "B_epi_prior", "pair": "fever_child_vomit", "context": "no_exposure", "system": "You are an experienced physician.", "case": "A 6-year-old has fever for 2 days with vomiting and lethargy. Temp 39.4 \u00b0C. The patient lives in London and has not travelled abroad in the past year.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": false, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": false}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_child_vomit__no_exposure"} | |
| {"gap": "B_epi_prior", "pair": "fever_abdo_pain", "context": "endemic_resident", "system": "You are an experienced physician.", "case": "A 35-year-old has 9 days of step-wise rising fever, abdominal pain, constipation and relative bradycardia. Temp 39.0 \u00b0C. The patient lives in Lagos, Nigeria, and has not travelled.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "typhoid", "dx_in_top3": true, "test_terms": ["typhoid", "blood culture", "enteric"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_abdo_pain__endemic_resident"} | |
| {"gap": "B_epi_prior", "pair": "fever_abdo_pain", "context": "returned_traveller", "system": "You are an experienced physician.", "case": "A 35-year-old has 9 days of step-wise rising fever, abdominal pain, constipation and relative bradycardia. Temp 39.0 \u00b0C. The patient lives in London and returned 10 days ago from a 3-week visit to Lagos, Nigeria.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "typhoid", "dx_in_top3": true, "test_terms": ["typhoid", "blood culture", "enteric"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_abdo_pain__returned_traveller"} | |
| {"gap": "B_epi_prior", "pair": "fever_abdo_pain", "context": "no_exposure", "system": "You are an experienced physician.", "case": "A 35-year-old has 9 days of step-wise rising fever, abdominal pain, constipation and relative bradycardia. Temp 39.0 \u00b0C. The patient lives in London and has not travelled abroad in the past year.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "typhoid", "dx_in_top3": false, "test_terms": ["typhoid", "blood culture", "enteric"], "test_expected": false}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_abdo_pain__no_exposure"} | |
| {"gap": "B_epi_prior", "pair": "fever_bleeding", "context": "endemic_resident", "system": "You are an experienced physician.", "case": "A 38-year-old has 6 days of fever, sore throat, retrosternal pain, vomiting, and now bleeding gums. Temp 39.3 \u00b0C. It is February. The patient lives in Lagos, Nigeria, and has not travelled.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "lassa", "dx_in_top3": true, "test_terms": ["lassa", "viral haemorrhagic", "vhf", "isolat"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_bleeding__endemic_resident"} | |
| {"gap": "B_epi_prior", "pair": "fever_bleeding", "context": "returned_traveller", "system": "You are an experienced physician.", "case": "A 38-year-old has 6 days of fever, sore throat, retrosternal pain, vomiting, and now bleeding gums. Temp 39.3 \u00b0C. It is February. The patient lives in London and returned 10 days ago from a 3-week visit to Lagos, Nigeria.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "lassa", "dx_in_top3": true, "test_terms": ["lassa", "viral haemorrhagic", "vhf", "isolat"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_bleeding__returned_traveller"} | |
| {"gap": "B_epi_prior", "pair": "fever_bleeding", "context": "no_exposure", "system": "You are an experienced physician.", "case": "A 38-year-old has 6 days of fever, sore throat, retrosternal pain, vomiting, and now bleeding gums. Temp 39.3 \u00b0C. It is February. The patient lives in London and has not travelled abroad in the past year.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "lassa", "dx_in_top3": false, "test_terms": ["lassa", "viral haemorrhagic", "vhf", "isolat"], "test_expected": false}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_bleeding__no_exposure"} | |
| {"gap": "B_epi_prior", "pair": "cough_weight_loss", "context": "endemic_resident", "system": "You are an experienced physician.", "case": "A 44-year-old has 7 weeks of productive cough, night sweats and 6 kg weight loss. The patient lives in Lagos, Nigeria, and has not travelled.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "tuberculosis", "dx_in_top3": true, "test_terms": ["tuberculosis", "tb", "genexpert", "sputum", "afb"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__cough_weight_loss__endemic_resident"} | |
| {"gap": "B_epi_prior", "pair": "cough_weight_loss", "context": "returned_traveller", "system": "You are an experienced physician.", "case": "A 44-year-old has 7 weeks of productive cough, night sweats and 6 kg weight loss. The patient lives in London and returned 10 days ago from a 3-week visit to Lagos, Nigeria.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "tuberculosis", "dx_in_top3": true, "test_terms": ["tuberculosis", "tb", "genexpert", "sputum", "afb"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__cough_weight_loss__returned_traveller"} | |
| {"gap": "B_epi_prior", "pair": "cough_weight_loss", "context": "no_exposure", "system": "You are an experienced physician.", "case": "A 44-year-old has 7 weeks of productive cough, night sweats and 6 kg weight loss. The patient lives in London and has not travelled abroad in the past year.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "tuberculosis", "dx_in_top3": true, "test_terms": ["tuberculosis", "tb", "genexpert", "sputum", "afb"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__cough_weight_loss__no_exposure"} | |
| {"gap": "B_epi_prior", "pair": "fever_pregnant", "context": "endemic_resident", "system": "You are an experienced physician.", "case": "A woman at 20 weeks' gestation has 2 days of fever, rigors and headache. Temp 38.9 \u00b0C. The patient lives in Lagos, Nigeria, and has not travelled.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_pregnant__endemic_resident"} | |
| {"gap": "B_epi_prior", "pair": "fever_pregnant", "context": "returned_traveller", "system": "You are an experienced physician.", "case": "A woman at 20 weeks' gestation has 2 days of fever, rigors and headache. Temp 38.9 \u00b0C. The patient lives in London and returned 10 days ago from a 3-week visit to Lagos, Nigeria.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": true, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": true}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_pregnant__returned_traveller"} | |
| {"gap": "B_epi_prior", "pair": "fever_pregnant", "context": "no_exposure", "system": "You are an experienced physician.", "case": "A woman at 20 weeks' gestation has 2 days of fever, rigors and headache. Temp 38.9 \u00b0C. The patient lives in London and has not travelled abroad in the past year.", "question": "List your top three differential diagnoses in order, and the single most important test to do first.", "format": "{\"differential\": [\"dx1\", \"dx2\", \"dx3\"], \"first_test\": \"...\"}", "expected": {"endemic_dx": "malaria", "dx_in_top3": false, "test_terms": ["malaria", "blood film", "rapid diagnostic", "rdt"], "test_expected": false}, "rule": "endemic diagnosis in top-3 and tested when exposed (residence or travel); not forced when unexposed", "id": "B_epi_prior__fever_pregnant__no_exposure"} | |
| {"gap": "C_athlete_ecg", "pair": "sinus_brady", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: sinus bradycardia at 44 bpm; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "normal", "further_investigation": false}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__sinus_brady__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "sinus_brady", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: sinus bradycardia at 44 bpm; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": null, "further_investigation": true}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__sinus_brady__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "first_avb", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: first-degree AV block, PR 240 ms; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "normal", "further_investigation": false}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__first_avb__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "first_avb", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: first-degree AV block, PR 240 ms; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": null}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__first_avb__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "incomplete_rbbb", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: incomplete right bundle branch block (QRS 110 ms); otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "normal", "further_investigation": false}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__incomplete_rbbb__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "incomplete_rbbb", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: incomplete right bundle branch block (QRS 110 ms); otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": null}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__incomplete_rbbb__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "early_repol", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: early repolarisation with 2 mm J-point elevation in V3\u2013V5 and upsloping ST segments; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "normal", "further_investigation": false}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__early_repol__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "early_repol", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: early repolarisation with 2 mm J-point elevation in V3\u2013V5 and upsloping ST segments; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": null}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__early_repol__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "lvh_voltage", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: isolated voltage criteria for left ventricular hypertrophy (Sokolow-Lyon 42 mm), normal ST-T segments, normal axis.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "normal", "further_investigation": false}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__lvh_voltage__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "lvh_voltage", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: isolated voltage criteria for left ventricular hypertrophy (Sokolow-Lyon 42 mm), normal ST-T segments, normal axis.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": null}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__lvh_voltage__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "wenckebach", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: Mobitz type I (Wenckebach) second-degree AV block at rest; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "normal", "further_investigation": false}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__wenckebach__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "wenckebach", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: Mobitz type I (Wenckebach) second-degree AV block at rest; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": null}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__wenckebach__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "ectopic_atrial", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: ectopic atrial rhythm at 52 bpm; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "normal", "further_investigation": false}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__ectopic_atrial__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "ectopic_atrial", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: ectopic atrial rhythm at 52 bpm; otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": null}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__ectopic_atrial__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "sinus_arrhythmia", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: marked sinus arrhythmia (rate 48\u201372 bpm with respiration); otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "normal", "further_investigation": false}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__sinus_arrhythmia__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "sinus_arrhythmia", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: marked sinus arrhythmia (rate 48\u201372 bpm with respiration); otherwise normal.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": null}, "category": "normal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__sinus_arrhythmia__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "lateral_twi", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: T-wave inversion of 2 mm in leads V5, V6, I and aVL.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__lateral_twi__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "lateral_twi", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: T-wave inversion of 2 mm in leads V5, V6, I and aVL.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__lateral_twi__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "st_depression", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: 1 mm horizontal ST depression in V4\u2013V6.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__st_depression__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "st_depression", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: 1 mm horizontal ST depression in V4\u2013V6.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__st_depression__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "lbbb", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: complete left bundle branch block (QRS 150 ms).", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__lbbb__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "lbbb", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: complete left bundle branch block (QRS 150 ms).", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__lbbb__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "long_qt", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: corrected QT interval of 510 ms.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__long_qt__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "long_qt", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: corrected QT interval of 510 ms.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__long_qt__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "preexcitation", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: short PR interval (100 ms) with a delta wave.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__preexcitation__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "preexcitation", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: short PR interval (100 ms) with a delta wave.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__preexcitation__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "brugada1", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: coved ST elevation of 3 mm in V1\u2013V2 followed by negative T waves (type 1 Brugada pattern).", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__brugada1__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "brugada1", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: coved ST elevation of 3 mm in V1\u2013V2 followed by negative T waves (type 1 Brugada pattern).", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__brugada1__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "path_q", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: pathological Q waves (40 ms, 30% of R amplitude) in II, III and aVF.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__path_q__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "path_q", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: pathological Q waves (40 ms, 30% of R amplitude) in II, III and aVF.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__path_q__non_athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "epsilon", "context": "athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old professional footballer who trains 15 hours a week, with no symptoms and no family history of sudden death. Findings: epsilon waves and T-wave inversion in V1\u2013V3 in an adult.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__epsilon__athlete"} | |
| {"gap": "C_athlete_ecg", "pair": "epsilon", "context": "non_athlete", "system": "You are a sports cardiologist.", "case": "Pre-participation screening ECG in a 22-year-old office worker who does not exercise, with no symptoms and no family history of sudden death. Findings: epsilon waves and T-wave inversion in V1\u2013V3 in an adult.", "question": "Classify this ECG as normal or abnormal for this person, and say whether further cardiac investigation is needed before clearance.", "format": "{\"classification\": \"normal\" | \"abnormal\", \"further_investigation\": true | false}", "expected": {"classification": "abnormal", "further_investigation": true}, "category": "abnormal", "rule": "2017 International Recommendations: training-related findings are normal in athletes; abnormal findings need evaluation regardless", "id": "C_athlete_ecg__epsilon__non_athlete"} | |
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