eval/samples/review_queue.jsonl

{"item_id": "review:cxd_58647:all_correct:F1", "item_type": "debrief", "case_id": "cxd_58647", "image_path": "images/cxd_58647.png", "behaviour": "all_correct", "target": "F1", "learner": {"marks": [{"mark_id": "M1", "x": 696.5, "y": 814.5, "label": "effusion", "confidence": 4}, {"mark_id": "M2", "x": 281.5, "y": 650.5, "label": "atelectasis", "confidence": 4}], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_58647", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "atelectasis", "display": "Atelectasis", "kind": "focal", "side": "right", "primary_zone": "right_lower_zone", "zones": ["right_lower_zone", "right_periphery", "right_hilum"], "relative_location": "right lower zone, central third, just above the diaphragm", "size": "large (about 2.5% of the image)", "difficulty": "easy", "zones_approximate": false, "ctr": null}, {"id": "F2", "label": "effusion", "display": "Pleural effusion", "kind": "focal", "side": "left", "primary_zone": "left_lower_zone", "zones": ["left_lower_zone", "retrocardiac", "cardiac_silhouette"], "relative_location": "left lower zone, central third, middle part, extending into the retrocardiac region (behind the heart)", "size": "large (about 7.3% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 5.3, "marks": [{"id": "M1", "label": "effusion", "confidence": 4, "zone": "left_lower_zone"}, {"id": "M2", "label": "atelectasis", "confidence": 4, "zone": "right_lower_zone"}], "pattern_selections": []}, "outcomes": [{"target": "F1", "result": "found", "dwell_ms": 1367.0, "zone": "right_lower_zone", "matched": "M2", "learner_label": null}, {"target": "F2", "result": "found", "dwell_ms": 1367.0, "zone": "left_lower_zone", "matched": "M1", "learner_label": null}, {"target": "M1", "result": "true_positive", "dwell_ms": null, "zone": "left_lower_zone", "matched": "F2", "learner_label": "effusion"}, {"target": "M2", "result": "true_positive", "dwell_ms": null, "zone": "right_lower_zone", "matched": "F1", "learner_label": "atelectasis"}], "spatial_relations": [], "search": {"lung_coverage_pct": 5.7, "unvisited_review_areas": ["right_apex", "left_apex", "right_hilum", "left_hilum", "right_costophrenic_angle", "left_costophrenic_angle", "subdiaphragmatic", "mediastinum"], "first_visits": ["right_upper_zone", "right_clavicle", "left_upper_zone", "cardiac_silhouette", "left_lower_zone", "retrocardiac"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["atelectasis", "effusion"]}, "debrief": {"headline": "Both findings found, quickly and confidently", "verdict": "all_found", "findings": [{"finding_id": "F1", "result": "found", "where_to_look": "Right lower zone, just above the diaphragm", "what_it_looks_like": ["White area with volume loss"], "why": "You marked this right lower zone area with the correct label."}, {"finding_id": "F2", "result": "found", "where_to_look": "Left lower zone, extending behind the heart", "what_it_looks_like": ["White lower zone hiding the diaphragm outline"], "why": "You spotted this subtle left-sided effusion and labeled it correctly."}], "overcalls": [], "search_coaching": "Your coverage was small; next time check apices, hila, costophrenic angles and below the diaphragm.", "calibration_note": "", "next_step": "Before submitting, sweep every unvisited zone with the magnifier.", "fact_ids": ["F1", "F2"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 77, "latency_ms": 3726.0, "output_tokens": 311, "cache_read_input_tokens": 0}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 6030.3, "score": 100.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_40421:all_correct:F1", "item_type": "debrief", "case_id": "cxd_40421", "image_path": "images/cxd_40421.png", "behaviour": "all_correct", "target": "F1", "learner": {"marks": [{"mark_id": "M1", "x": 615.5, "y": 497.5, "label": "consolidation", "confidence": 4}, {"mark_id": "M2", "x": 753.5, "y": 461.5, "label": "fracture", "confidence": 4}], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_40421", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "fracture", "display": "Fracture", "kind": "focal", "side": "left", "primary_zone": "left_lower_zone", "zones": ["left_lower_zone", "left_mid_zone"], "relative_location": "left lower zone, lateral third, just above the left costophrenic angle", "size": "medium (about 0.36% of the image)", "difficulty": "moderate", "zones_approximate": false, "ctr": null}, {"id": "F2", "label": "consolidation", "display": "Consolidation", "kind": "focal", "side": "left", "primary_zone": "retrocardiac", "zones": ["retrocardiac", "cardiac_silhouette", "left_lower_zone"], "relative_location": "retrocardiac region (behind the heart)", "size": "medium (about 0.75% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 5.3, "marks": [{"id": "M1", "label": "consolidation", "confidence": 4, "zone": "left_lower_zone"}, {"id": "M2", "label": "fracture", "confidence": 4, "zone": "left_lower_zone"}], "pattern_selections": []}, "outcomes": [{"target": "F1", "result": "found", "dwell_ms": 1367.0, "zone": "left_lower_zone", "matched": "M2", "learner_label": null}, {"target": "F2", "result": "found", "dwell_ms": 1367.0, "zone": "retrocardiac", "matched": "M1", "learner_label": null}, {"target": "M1", "result": "true_positive", "dwell_ms": null, "zone": "left_lower_zone", "matched": "F2", "learner_label": "consolidation"}, {"target": "M2", "result": "true_positive", "dwell_ms": null, "zone": "left_lower_zone", "matched": "F1", "learner_label": "fracture"}], "spatial_relations": [], "search": {"lung_coverage_pct": 7.1, "unvisited_review_areas": ["right_apex", "right_hilum", "left_hilum", "right_costophrenic_angle", "left_costophrenic_angle", "subdiaphragmatic", "mediastinum"], "first_visits": ["right_upper_zone", "left_apex", "left_upper_zone", "cardiac_silhouette", "left_lower_zone", "retrocardiac"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["fracture", "consolidation"]}, "debrief": {"headline": "Both findings found: fracture and consolidation", "verdict": "all_found", "findings": [{"finding_id": "F1", "result": "found", "where_to_look": "Left lower zone, lateral third, above costophrenic angle", "what_it_looks_like": ["A break or step in a rib outline"], "why": "You marked this rib finding with the correct label and spot."}, {"finding_id": "F2", "result": "found", "where_to_look": "Retrocardiac region, behind the heart", "what_it_looks_like": ["Fluffy, ill-defined white area in lung"], "why": "You spotted this hard, hidden area behind the heart and labeled it correctly."}], "overcalls": [], "search_coaching": "Strong hits, but coverage was low; next time also sweep the hila, angles and mediastinum.", "calibration_note": "", "next_step": "Sweep every unvisited area before submitting the next film.", "fact_ids": ["F1", "F2"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 81, "latency_ms": 3409.5, "output_tokens": 318, "cache_read_input_tokens": 8016}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 3474.9, "score": 100.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_45480:missed_search:F2", "item_type": "debrief", "case_id": "cxd_45480", "image_path": "images/cxd_45480.png", "behaviour": "missed_search", "target": "F2", "learner": {"marks": [], "patterns": [{"label": "fibrosis", "confidence": 4}], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_45480", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "fibrosis", "display": "Fibrosis", "kind": "pattern", "side": "right", "primary_zone": "right_lower_zone", "zones": ["right_lower_zone", "right_costophrenic_angle", "right_periphery"], "relative_location": "right lung, mainly the lower zone, including the costophrenic angle and periphery", "size": null, "difficulty": null, "zones_approximate": false, "ctr": null}, {"id": "F2", "label": "calcification", "display": "Calcification", "kind": "focal", "side": "right", "primary_zone": "right_mid_zone", "zones": ["right_mid_zone"], "relative_location": "right mid zone, lateral third, middle part", "size": "small (about 0.011% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 1.9, "marks": [], "pattern_selections": [{"label": "fibrosis", "confidence": 4}]}, "outcomes": [{"target": "F2", "result": "missed_search", "dwell_ms": 0.0, "zone": "right_mid_zone", "matched": null, "learner_label": null}, {"target": "F1", "result": "pattern_found", "dwell_ms": null, "zone": null, "matched": null, "learner_label": null}], "spatial_relations": [], "search": {"lung_coverage_pct": 2.3, "unvisited_review_areas": ["right_apex", "left_apex", "right_hilum", "left_hilum", "retrocardiac", "right_costophrenic_angle", "left_costophrenic_angle", "subdiaphragmatic", "mediastinum"], "first_visits": ["right_upper_zone", "left_upper_zone"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["fibrosis", "calcification"]}, "debrief": {"headline": "Fibrosis pattern found; small calcification missed", "verdict": "partly_found", "findings": [{"finding_id": "F1", "result": "pattern_found", "where_to_look": "Right lung, mainly lower zone, costophrenic angle, periphery", "what_it_looks_like": ["Fine lines, densest at the lung bases"], "why": "You correctly picked out the fibrosis pattern in the right lower lung."}, {"finding_id": "F2", "result": "missed_search", "where_to_look": "Right mid zone, lateral third", "what_it_looks_like": ["A tiny, very dense spot as bright as bone", "Sharp edges"], "why": "Your search never reached the right mid zone, so this spot went unseen."}], "overcalls": [], "search_coaching": "Sweep every zone, right to left, upper to lower, before submitting; only two upper zones were visited.", "calibration_note": "", "next_step": "Zoom the magnifier through each lung zone, including mid zones.", "fact_ids": ["F1", "F2"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 89, "latency_ms": 4468.0, "output_tokens": 348, "cache_read_input_tokens": 8016}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 4541.8, "score": 10.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_70029:missed_search:F1", "item_type": "debrief", "case_id": "cxd_70029", "image_path": "images/cxd_70029.png", "behaviour": "missed_search", "target": "F1", "learner": {"marks": [{"mark_id": "M1", "x": 729.5, "y": 310.5, "label": "nodule", "confidence": 4}, {"mark_id": "M2", "x": 648.5, "y": 305.5, "label": "nodule", "confidence": 4}], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_70029", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "pleural_thickening", "display": "Pleural thickening", "kind": "focal", "side": "left", "primary_zone": "left_costophrenic_angle", "zones": ["left_costophrenic_angle", "left_lower_zone", "left_periphery"], "relative_location": "left costophrenic angle", "size": "small (about 0.14% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}, {"id": "F2", "label": "nodule", "display": "Nodule", "kind": "focal", "side": "left", "primary_zone": "left_upper_zone", "zones": ["left_upper_zone", "left_apex"], "relative_location": "left upper zone, central third, middle part, extending into the left apex", "size": "small (about 0.038% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}, {"id": "F3", "label": "nodule", "display": "Nodule", "kind": "focal", "side": "left", "primary_zone": "left_upper_zone", "zones": ["left_upper_zone", "left_apex"], "relative_location": "left upper zone, medial third, middle part, extending into the left apex", "size": "small (about 0.029% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 5.3, "marks": [{"id": "M1", "label": "nodule", "confidence": 4, "zone": "left_upper_zone"}, {"id": "M2", "label": "nodule", "confidence": 4, "zone": "left_upper_zone"}], "pattern_selections": []}, "outcomes": [{"target": "F1", "result": "missed_search", "dwell_ms": 0.0, "zone": "left_costophrenic_angle", "matched": null, "learner_label": null}, {"target": "F2", "result": "found", "dwell_ms": 1367.0, "zone": "left_upper_zone", "matched": "M1", "learner_label": null}, {"target": "F3", "result": "found", "dwell_ms": 1367.0, "zone": "left_upper_zone", "matched": "M2", "learner_label": null}, {"target": "M1", "result": "true_positive", "dwell_ms": null, "zone": "left_upper_zone", "matched": "F2", "learner_label": "nodule"}, {"target": "M2", "result": "true_positive", "dwell_ms": null, "zone": "left_upper_zone", "matched": "F3", "learner_label": "nodule"}], "spatial_relations": [], "search": {"lung_coverage_pct": 6.2, "unvisited_review_areas": ["left_apex", "right_hilum", "left_hilum", "retrocardiac", "right_costophrenic_angle", "left_costophrenic_angle", "subdiaphragmatic", "mediastinum"], "first_visits": ["right_apex", "right_clavicle", "right_upper_zone", "left_upper_zone"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["pleural_thickening", "nodule"]}, "debrief": {"headline": "Both nodules found; left costophrenic angle never searched", "verdict": "partly_found", "findings": [{"finding_id": "F1", "result": "missed_search", "where_to_look": "Left costophrenic angle, along the chest wall", "what_it_looks_like": ["Smooth white band along inner chest wall", "Blunted angle without a curved fluid edge"], "why": "Your search never reached the left costophrenic angle, so this band went unseen."}, {"finding_id": "F2", "result": "found", "where_to_look": "Left upper zone, central third, into left apex", "what_it_looks_like": ["Small round white spot in normal lung"], "why": "You spotted this small nodule and labeled it correctly."}, {"finding_id": "F3", "result": "found", "where_to_look": "Left upper zone, medial third, into left apex", "what_it_looks_like": ["Round, well-defined spot, brighter than vessels"], "why": "You also caught this second nodule and labeled it correctly."}], "overcalls": [], "search_coaching": "Coverage was 6.2%. After the upper zones, sweep both lower zones and costophrenic angles.", "calibration_note": "", "next_step": "Finish by checking both costophrenic angles and diaphragm domes.", "fact_ids": ["F1", "F2", "F3", "M1", "M2"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 113, "latency_ms": 4031.6, "output_tokens": 443, "cache_read_input_tokens": 8016}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 4122.6, "score": 70.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_69979:missed_recognition:F2", "item_type": "debrief", "case_id": "cxd_69979", "image_path": "images/cxd_69979.png", "behaviour": "missed_recognition", "target": "F2", "learner": {"marks": [{"mark_id": "M1", "x": 273.5, "y": 532.5, "label": "consolidation", "confidence": 4}], "patterns": [{"label": "cardiomegaly", "confidence": 4}], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_69979", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "cardiomegaly", "display": "Cardiomegaly", "kind": "pattern", "side": "midline", "primary_zone": "cardiac_silhouette", "zones": ["cardiac_silhouette", "retrocardiac", "left_lower_zone"], "relative_location": "cardiac silhouette, enlarged (CTR 0.58, measured automatically)", "size": null, "difficulty": null, "zones_approximate": false, "ctr": 0.58}, {"id": "F2", "label": "effusion", "display": "Pleural effusion", "kind": "focal", "side": "left", "primary_zone": "left_costophrenic_angle", "zones": ["left_costophrenic_angle", "left_lower_zone", "left_periphery"], "relative_location": "left costophrenic angle, just above the diaphragm", "size": "medium (about 1.5% of the image)", "difficulty": "moderate", "zones_approximate": false, "ctr": null}, {"id": "F3", "label": "consolidation", "display": "Consolidation", "kind": "focal", "side": "right", "primary_zone": "right_lower_zone", "zones": ["right_lower_zone", "right_periphery", "right_hilum"], "relative_location": "right lower zone, central third, just above the diaphragm", "size": "medium (about 1% of the image)", "difficulty": "moderate", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 4.4, "marks": [{"id": "M1", "label": "consolidation", "confidence": 4, "zone": "right_lower_zone"}], "pattern_selections": [{"label": "cardiomegaly", "confidence": 4}]}, "outcomes": [{"target": "F2", "result": "missed_recognition", "dwell_ms": 495.0, "zone": "left_costophrenic_angle", "matched": null, "learner_label": null}, {"target": "F3", "result": "found", "dwell_ms": 1367.0, "zone": "right_lower_zone", "matched": "M1", "learner_label": null}, {"target": "F1", "result": "pattern_found", "dwell_ms": null, "zone": null, "matched": null, "learner_label": null}, {"target": "M1", "result": "true_positive", "dwell_ms": null, "zone": "right_lower_zone", "matched": "F3", "learner_label": "consolidation"}], "spatial_relations": [], "search": {"lung_coverage_pct": 10.7, "unvisited_review_areas": ["right_hilum", "left_hilum", "right_costophrenic_angle", "left_costophrenic_angle", "subdiaphragmatic", "mediastinum"], "first_visits": ["right_apex", "right_upper_zone", "left_apex", "left_clavicle", "left_upper_zone", "right_lower_zone"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["cardiomegaly", "effusion", "consolidation"]}, "debrief": {"headline": "Two of three found; left effusion slipped past", "verdict": "partly_found", "findings": [{"finding_id": "F1", "result": "pattern_found", "where_to_look": "Cardiac silhouette: compare heart width with inner chest width (CTR 0.58).", "what_it_looks_like": ["Heart width more than half the chest width"], "why": "You picked out the enlarged heart pattern with good confidence."}, {"finding_id": "F2", "result": "missed_recognition", "where_to_look": "Left costophrenic angle, just above the diaphragm.", "what_it_looks_like": ["Rounded or filled-in costophrenic angle", "Curved fluid edge rising along the chest wall"], "why": "Your gaze passed over this corner briefly without registering the blunted angle."}, {"finding_id": "F3", "result": "found", "where_to_look": "Right lower zone, just above the diaphragm.", "what_it_looks_like": ["Fluffy, ill-defined white area in the lung"], "why": "You marked this consolidation in the correct spot with the correct label."}], "overcalls": [], "search_coaching": "Finish each film by checking both costophrenic angles and diaphragm domes, which you never visited.", "calibration_note": "", "next_step": "Check both lower corners for sharp angles before submitting.", "fact_ids": ["F1", "F2", "F3"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 119, "latency_ms": 4213.8, "output_tokens": 458, "cache_read_input_tokens": 8016}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 4287.3, "score": 55.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_60742:missed_recognition:F1", "item_type": "debrief", "case_id": "cxd_60742", "image_path": "images/cxd_60742.png", "behaviour": "missed_recognition", "target": "F1", "learner": {"marks": [], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_60742", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "consolidation", "display": "Consolidation", "kind": "focal", "side": "right", "primary_zone": "right_upper_zone", "zones": ["right_upper_zone", "right_apex", "right_clavicle"], "relative_location": "right upper zone, central third, middle part, extending into the right apex", "size": "medium (about 1.1% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 2.8, "marks": [], "pattern_selections": []}, "outcomes": [{"target": "F1", "result": "missed_recognition", "dwell_ms": 495.0, "zone": "right_upper_zone", "matched": null, "learner_label": null}], "spatial_relations": [], "search": {"lung_coverage_pct": 7.5, "unvisited_review_areas": ["right_hilum", "left_hilum", "retrocardiac", "right_costophrenic_angle", "left_costophrenic_angle", "subdiaphragmatic"], "first_visits": ["mediastinum", "right_periphery", "right_upper_zone", "left_apex", "left_upper_zone", "right_apex"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["consolidation"]}, "debrief": {"headline": "Consolidation in the right upper zone slipped past you", "verdict": "missed", "findings": [{"finding_id": "F1", "result": "missed_recognition", "where_to_look": "Right upper zone, central third, reaching into right apex", "what_it_looks_like": ["Fluffy, ill-defined white area in the lung"], "why": "Your gaze passed over this area briefly without recognizing the hazy whiteness."}], "overcalls": [], "search_coaching": "Your visits touched the right upper zone; next time, compare both upper zones side by side before moving on.", "calibration_note": "", "next_step": "Pause on any hazy patch and compare it with the other side.", "fact_ids": ["F1"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 68, "latency_ms": 3122.7, "output_tokens": 239, "cache_read_input_tokens": 8016}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 3189.6, "score": 0.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_45197:missed_decision:F1", "item_type": "debrief", "case_id": "cxd_45197", "image_path": "images/cxd_45197.png", "behaviour": "missed_decision", "target": "F1", "learner": {"marks": [], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_45197", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "nodule", "display": "Nodule", "kind": "focal", "side": "right", "primary_zone": "right_hilum", "zones": ["right_hilum", "right_mid_zone", "right_lower_zone"], "relative_location": "right hilum, just below the mediastinum", "size": "medium (about 0.55% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 4.1, "marks": [], "pattern_selections": []}, "outcomes": [{"target": "F1", "result": "missed_decision", "dwell_ms": 2046.0, "zone": "right_hilum", "matched": null, "learner_label": null}], "spatial_relations": [], "search": {"lung_coverage_pct": 3.8, "unvisited_review_areas": ["right_apex", "left_apex", "left_hilum", "retrocardiac", "right_costophrenic_angle", "left_costophrenic_angle", "subdiaphragmatic", "mediastinum"], "first_visits": ["right_upper_zone", "left_clavicle", "left_upper_zone", "right_hilum", "right_mid_zone"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["nodule"]}, "debrief": {"headline": "Nodule at the right hilum: seen, but judged normal", "verdict": "missed", "findings": [{"finding_id": "F1", "result": "missed_decision", "where_to_look": "Right hilum, just below the mediastinum", "what_it_looks_like": ["Round white spot, rounder and brighter than nearby vessels", "Edges smooth, lobulated or spiky"], "why": "You lingered here with the magnifier but judged it normal."}], "overcalls": [], "search_coaching": "Coverage was small; the apices, left hilum and behind the heart went unvisited. Sweep them all.", "calibration_note": "", "next_step": "Compare each hilum with the other, and check round spots against nearby vessels.", "fact_ids": ["F1"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": false, "errors": ["R1: finding F1 appears 2 times; include it exactly once", "R8 F1.where_to_look is empty"], "trimmed": false, "words": 86, "latency_ms": 3750.5, "output_tokens": 323, "cache_read_input_tokens": 8016}, {"attempt": 2, "ok": true, "errors": [], "trimmed": false, "words": 68, "latency_ms": 5530.4, "output_tokens": 254, "cache_read_input_tokens": 8016}], "first_try_ok": false, "trimmed": false, "regenerated": true}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 9342.8, "score": 0.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_48950:missed_decision:F1", "item_type": "debrief", "case_id": "cxd_48950", "image_path": "images/cxd_48950.png", "behaviour": "missed_decision", "target": "F1", "learner": {"marks": [{"mark_id": "M1", "x": 244.5, "y": 798.5, "label": "pneumothorax", "confidence": 4}, {"mark_id": "M2", "x": 827.5, "y": 805.5, "label": "pleural_thickening", "confidence": 4}], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_48950", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "pneumothorax", "display": "Pneumothorax", "kind": "focal", "side": "right", "primary_zone": "right_upper_zone", "zones": ["right_upper_zone", "right_apex", "right_periphery"], "relative_location": "right upper zone, central third, middle part, extending into the right apex", "size": "medium (about 1.9% of the image)", "difficulty": "easy", "zones_approximate": false, "ctr": null}, {"id": "F2", "label": "pneumothorax", "display": "Pneumothorax", "kind": "focal", "side": "right", "primary_zone": "right_costophrenic_angle", "zones": ["right_costophrenic_angle", "right_lower_zone", "right_periphery"], "relative_location": "right costophrenic angle, just above the diaphragm", "size": "small (about 0.19% of the image)", "difficulty": "moderate", "zones_approximate": false, "ctr": null}, {"id": "F3", "label": "pleural_thickening", "display": "Pleural thickening", "kind": "focal", "side": "left", "primary_zone": "left_costophrenic_angle", "zones": ["left_costophrenic_angle", "left_lower_zone", "left_periphery"], "relative_location": "left costophrenic angle, just above the diaphragm", "size": "small (about 0.12% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 7.5, "marks": [{"id": "M1", "label": "pneumothorax", "confidence": 4, "zone": "right_lower_zone"}, {"id": "M2", "label": "pleural_thickening", "confidence": 4, "zone": "left_lower_zone"}], "pattern_selections": []}, "outcomes": [{"target": "F1", "result": "missed_decision", "dwell_ms": 2046.0, "zone": "right_upper_zone", "matched": null, "learner_label": null}, {"target": "F2", "result": "found", "dwell_ms": 1367.0, "zone": "right_costophrenic_angle", "matched": "M1", "learner_label": null}, {"target": "F3", "result": "found", "dwell_ms": 1367.0, "zone": "left_costophrenic_angle", "matched": "M2", "learner_label": null}, {"target": "M1", "result": "true_positive", "dwell_ms": null, "zone": "right_lower_zone", "matched": "F2", "learner_label": "pneumothorax"}, {"target": "M2", "result": "true_positive", "dwell_ms": null, "zone": "left_lower_zone", "matched": "F3", "learner_label": "pleural_thickening"}], "spatial_relations": [], "search": {"lung_coverage_pct": 5.5, "unvisited_review_areas": ["left_apex", "right_hilum", "left_hilum", "retrocardiac", "subdiaphragmatic", "mediastinum"], "first_visits": ["right_upper_zone", "left_upper_zone", "right_costophrenic_angle", "right_lower_zone", "right_periphery", "left_costophrenic_angle"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["pneumothorax", "pleural_thickening"]}, "debrief": {"headline": "Two of three found; right upper pneumothorax judged normal", "verdict": "partly_found", "findings": [{"finding_id": "F1", "result": "missed_decision", "where_to_look": "Right upper zone, central third, into right apex", "what_it_looks_like": ["Thin white line parallel to chest wall", "No lung markings beyond that line"], "why": "You looked here for a while but judged it normal."}, {"finding_id": "F2", "result": "found", "where_to_look": "Right costophrenic angle, just above diaphragm", "what_it_looks_like": ["Deep, dark angle with a fine pleural line"], "why": "You marked this small pneumothorax and labeled it correctly."}, {"finding_id": "F3", "result": "found", "where_to_look": "Left costophrenic angle, just above diaphragm", "what_it_looks_like": ["Smooth white band along inner chest wall"], "why": "You spotted this hard, subtle thickening and named it correctly."}], "overcalls": [], "search_coaching": "After the bases, trace each apex edge for a fine line with no vessels beyond.", "calibration_note": "Both confident marks were correct, yet the larger finding slipped past.", "next_step": "Trace both lung edges from apex downward before submitting.", "fact_ids": ["F1", "F2", "F3"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 121, "latency_ms": 3938.7, "output_tokens": 441, "cache_read_input_tokens": 8016}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 4004.2, "score": 70.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_46049:mislabeled:F1", "item_type": "debrief", "case_id": "cxd_46049", "image_path": "images/cxd_46049.png", "behaviour": "mislabeled", "target": "F1", "learner": {"marks": [{"mark_id": "M1", "x": 865.5, "y": 781.5, "label": "pleural_thickening", "confidence": 4}, {"mark_id": "M2", "x": 726.5, "y": 411.5, "label": "consolidation", "confidence": 4}, {"mark_id": "M3", "x": 268.5, "y": 616.5, "label": "nodule", "confidence": 4}], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_46049", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "mass", "display": "Mass", "kind": "focal", "side": "right", "primary_zone": "right_mid_zone", "zones": ["right_mid_zone", "right_lower_zone", "right_periphery"], "relative_location": "right mid zone, lateral third, lower part", "size": "medium (about 0.99% of the image)", "difficulty": "moderate", "zones_approximate": false, "ctr": null}, {"id": "F2", "label": "pleural_thickening", "display": "Pleural thickening", "kind": "focal", "side": "left", "primary_zone": "left_costophrenic_angle", "zones": ["left_costophrenic_angle", "left_lower_zone", "left_periphery"], "relative_location": "left costophrenic angle, just above the diaphragm", "size": "medium (about 0.38% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}, {"id": "F3", "label": "consolidation", "display": "Consolidation", "kind": "focal", "side": "left", "primary_zone": "left_upper_zone", "zones": ["left_upper_zone", "left_clavicle", "left_mid_zone"], "relative_location": "left upper zone, central third, just above the left hilum", "size": "medium (about 0.83% of the image)", "difficulty": "moderate", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 7.0, "marks": [{"id": "M1", "label": "pleural_thickening", "confidence": 4, "zone": "left_lower_zone"}, {"id": "M2", "label": "consolidation", "confidence": 4, "zone": "left_upper_zone"}, {"id": "M3", "label": "nodule", "confidence": 4, "zone": "right_mid_zone"}], "pattern_selections": []}, "outcomes": [{"target": "F1", "result": "mislabeled", "dwell_ms": 1367.0, "zone": "right_mid_zone", "matched": "M3", "learner_label": "nodule"}, {"target": "F2", "result": "found", "dwell_ms": 1367.0, "zone": "left_costophrenic_angle", "matched": "M1", "learner_label": null}, {"target": "F3", "result": "found", "dwell_ms": 1367.0, "zone": "left_upper_zone", "matched": "M2", "learner_label": null}, {"target": "M1", "result": "true_positive", "dwell_ms": null, "zone": "left_lower_zone", "matched": "F2", "learner_label": "pleural_thickening"}, {"target": "M2", "result": "true_positive", "dwell_ms": null, "zone": "left_upper_zone", "matched": "F3", "learner_label": "consolidation"}, {"target": "M3", "result": "true_positive", "dwell_ms": null, "zone": "right_mid_zone", "matched": "F1", "learner_label": "nodule"}], "spatial_relations": [], "search": {"lung_coverage_pct": 7.2, "unvisited_review_areas": ["right_hilum", "left_hilum", "retrocardiac", "right_costophrenic_angle", "subdiaphragmatic", "mediastinum"], "first_visits": ["right_apex", "right_upper_zone", "left_apex", "left_upper_zone", "left_costophrenic_angle", "left_lower_zone"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["mass", "pleural_thickening", "consolidation", "nodule"]}, "debrief": {"headline": "Two of three found; right mid zone spot mislabeled", "verdict": "partly_found", "findings": [{"finding_id": "F1", "result": "mislabeled", "where_to_look": "Right mid zone, lateral third, lower part", "what_it_looks_like": ["Large rounded white area with visible edge"], "why": "You marked the correct spot but called it a nodule; this is larger, so mass."}, {"finding_id": "F2", "result": "found", "where_to_look": "Left costophrenic angle, just above diaphragm", "what_it_looks_like": ["Blunted angle without a curved fluid edge"], "why": "You spotted this hard, subtle finding and labeled it correctly."}, {"finding_id": "F3", "result": "found", "where_to_look": "Left upper zone, just above left hilum", "what_it_looks_like": ["Fluffy, ill-defined white area in lung"], "why": "You found this and labeled it correctly on your first pass."}], "overcalls": [], "search_coaching": "Your search skipped both hila, behind the heart, mediastinum and right costophrenic angle; sweep those next.", "calibration_note": "Your confident nodule label was wrong; check size before choosing nodule versus mass.", "next_step": "Before labeling a round white spot, judge its size.", "fact_ids": ["F1", "F2", "F3"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 123, "latency_ms": 4022.9, "output_tokens": 450, "cache_read_input_tokens": 8016}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 4095.9, "score": 98.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_56632:mislabeled:F1", "item_type": "debrief", "case_id": "cxd_56632", "image_path": "images/cxd_56632.png", "behaviour": "mislabeled", "target": "F1", "learner": {"marks": [{"mark_id": "M1", "x": 811.5, "y": 692.5, "label": "effusion", "confidence": 4}], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_56632", "is_normal": false, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": [{"id": "F1", "label": "pleural_thickening", "display": "Pleural thickening", "kind": "focal", "side": "left", "primary_zone": "left_lower_zone", "zones": ["left_lower_zone", "left_periphery"], "relative_location": "left lower zone, lateral third, just above the diaphragm", "size": "large (about 2.1% of the image)", "difficulty": "hard", "zones_approximate": false, "ctr": null}]}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 3.6, "marks": [{"id": "M1", "label": "effusion", "confidence": 4, "zone": "subdiaphragmatic"}], "pattern_selections": []}, "outcomes": [{"target": "F1", "result": "mislabeled", "dwell_ms": 1367.0, "zone": "left_lower_zone", "matched": "M1", "learner_label": "effusion"}, {"target": "M1", "result": "true_positive", "dwell_ms": null, "zone": "subdiaphragmatic", "matched": "F1", "learner_label": "effusion"}], "spatial_relations": [], "search": {"lung_coverage_pct": 2.6, "unvisited_review_areas": ["right_hilum", "left_hilum", "retrocardiac", "right_costophrenic_angle", "left_costophrenic_angle", "mediastinum"], "first_visits": ["right_apex", "right_upper_zone", "left_apex", "left_clavicle", "left_upper_zone", "subdiaphragmatic"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["pleural_thickening", "effusion"]}, "debrief": {"headline": "Correct spot, wrong label: pleural thickening, not effusion", "verdict": "partly_found", "findings": [{"finding_id": "F1", "result": "mislabeled", "where_to_look": "Left lower zone, lateral third, just above the diaphragm", "what_it_looks_like": ["Smooth white band along inner chest wall", "Blunted angle without a curved fluid edge"], "why": "You marked the correct spot but called it effusion, which would show a meniscus."}], "overcalls": [], "search_coaching": "You covered little lung and skipped both hila and costophrenic angles; sweep every zone before settling.", "calibration_note": "Confidence 4 on the wrong label; check for a meniscus first.", "next_step": "Ask whether a curved fluid edge is present before choosing effusion.", "fact_ids": ["F1", "M1"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": false, "errors": ["R3 headline: says 'right' about the pleural_thickening, but FACTS put it on the patient's left", "R3 headline: 'Right spot' uses \"right\" to mean correct; \"right\" and \"left\" are read as the patient's side, so write \"correct\""], "trimmed": false, "words": 83, "latency_ms": 3768.2, "output_tokens": 287, "cache_read_input_tokens": 8016}, {"attempt": 2, "ok": true, "errors": [], "trimmed": false, "words": 83, "latency_ms": 2855.2, "output_tokens": 288, "cache_read_input_tokens": 8016}], "first_try_ok": false, "trimmed": false, "regenerated": true}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 6692.9, "score": 94.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_69522:overcall_normal", "item_type": "debrief", "case_id": "cxd_69522", "image_path": "images/cxd_69522.png", "behaviour": "overcall_normal", "target": null, "learner": {"marks": [{"mark_id": "M1", "x": 380.5, "y": 224.5, "label": "nodule", "confidence": 4}], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_69522", "is_normal": true, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": []}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 3.6, "marks": [{"id": "M1", "label": "nodule", "confidence": 4, "zone": "right_upper_zone"}], "pattern_selections": []}, "outcomes": [{"target": "M1", "result": "false_positive", "dwell_ms": null, "zone": "right_upper_zone", "matched": null, "learner_label": "nodule"}], "spatial_relations": [], "search": {"lung_coverage_pct": 3.3, "unvisited_review_areas": ["right_apex", "left_apex", "right_hilum", "left_hilum", "retrocardiac", "right_costophrenic_angle", "left_costophrenic_angle", "subdiaphragmatic", "mediastinum"], "first_visits": ["left_upper_zone", "right_mid_zone", "right_upper_zone"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["nodule"]}, "debrief": {"headline": "Normal film, but one nodule mark was placed", "verdict": "overcall", "findings": [], "overcalls": [{"mark_id": "M1", "explanation": "Radiologists marked nothing here; this film has no abnormality.", "possible_mimics": ["Overlap of first rib and clavicle", "Crossing points of the upper ribs"]}], "search_coaching": "Coverage was small; sweep every zone, including apices, hila, behind the heart and below the diaphragm.", "calibration_note": "Confidence 4 on a normal area; hold high confidence until a spot passes the mimic checks.", "next_step": "Before marking a spot, check whether ribs or vessels explain it.", "fact_ids": ["M1"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 72, "latency_ms": 3026.2, "output_tokens": 245, "cache_read_input_tokens": 8016}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 3094.1, "score": 75.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}
{"item_id": "review:cxd_45725:overcall_normal", "item_type": "debrief", "case_id": "cxd_45725", "image_path": "images/cxd_45725.png", "behaviour": "overcall_normal", "target": null, "learner": {"marks": [{"mark_id": "M1", "x": 335.5, "y": 301.5, "label": "nodule", "confidence": 4}], "patterns": [], "declared_normal": false}, "facts": {"schema": "debrief_facts.v1", "case": {"case_id": "cxd_45725", "is_normal": true, "projection": "frontal; PA vs AP not recorded", "pixel_spacing_mm": null, "findings": []}, "learner": {"level": "other", "declared_normal": false, "normal_confidence": null, "hints_used": 0, "time_to_submit_s": 3.6, "marks": [{"id": "M1", "label": "nodule", "confidence": 4, "zone": "right_upper_zone"}], "pattern_selections": []}, "outcomes": [{"target": "M1", "result": "false_positive", "dwell_ms": null, "zone": "right_upper_zone", "matched": null, "learner_label": "nodule"}], "spatial_relations": [], "search": {"lung_coverage_pct": 3.7, "unvisited_review_areas": ["right_apex", "right_hilum", "left_hilum", "retrocardiac", "right_costophrenic_angle", "left_costophrenic_angle", "subdiaphragmatic", "mediastinum"], "first_visits": ["left_upper_zone", "left_apex", "right_mid_zone", "right_upper_zone"], "zoom_used": false, "loupe_used": true}, "history": {}, "teaching_cards": ["nodule"]}, "debrief": {"headline": "Normal film: your nodule mark had no matching finding", "verdict": "overcall", "findings": [], "overcalls": [{"mark_id": "M1", "explanation": "Radiologists marked nothing in the right upper zone; this region is normal.", "possible_mimics": ["Overlap of the first rib and clavicle", "Crossing points of the upper ribs"]}], "search_coaching": "You covered little lung in 3.6 seconds; sweep apices, hila, angles, and behind the heart.", "calibration_note": "Confidence 4 on a mark that was normal; slow down before committing.", "next_step": "Compare both sides, and check each spot against a rib crossing.", "fact_ids": ["M1"]}, "source": "live", "provenance": "ai_draft", "validator": {"ok": true, "errors": [], "n_errors": 0, "attempts": [{"attempt": 1, "ok": true, "errors": [], "trimmed": false, "words": 72, "latency_ms": 2907.1, "output_tokens": 240, "cache_read_input_tokens": 8016}], "first_try_ok": true, "trimmed": false, "regenerated": false}, "validator_ok": true, "model": "claude-sonnet-5-5", "prompt_version": "v3+899f119a", "latency_ms": 2974.6, "score": 75.0, "dry_run": false, "synthetic_learner": true, "split": "bench", "generated_by": "backend/app/tutor/review_queue.py"}