FAILURE MAP
← Case archive

FA-64486 / Clinical triage scoring / Open access

Embolism pretest probability and rule-out pathway: rule-out exclusion list · case 01

A patient using estrogen is ruled out without testing.

Verified by executionVariant 1 · 10 checks per implementationDownload source bundle ↓JSON ↗

ROOT CAUSE

Estrogen use is missing from the rule-out exclusions.

VERIFIED REPAIR

Exclude haemoptysis, estrogen, prior VTE and recent surgery from rule-out.

Unsuccessful approach: Adding estrogen back while dropping prior VTE rules out patients with previous clots.

Case contract

Input {dvt_signs, pe_most_likely, hr, immobile_days, surgery_weeks_ago (or null), prior_vte, hemoptysis, malignancy, age, spo2, estrogen}. Toy points: DVT signs 3, alternative less likely 3, hr > 100 1.5, immobilisation >= 3 days OR surgery within 4 weeks 1.5 (counted once), prior VTE 1.5, haemoptysis 1, malignancy 1. Score > 4 is LIKELY (next IMAGING). UNLIKELY patients are RULED_OUT when age < 50, hr < 100, spo2 >= 95 and none of haemoptysis, estrogen, prior VTE or surgery within 4 weeks; otherwise next D_DIMER. Return {score, category, next}.

Why this case matters

Pretest scoring feeds a rule-out gate; half-point arithmetic, the either/or item and exclusion lists are separate defect sites.

1 / The failure

Exit 1
"""Failure Map reference implementation. Python standard library only."""
import json
import math
from fractions import Fraction
N = 1
observations = []
def solve(x):
    h = 0
    h += 6 if x['dvt_signs'] else 0
    h += 6 if x['pe_most_likely'] else 0
    h += 3 if x['hr'] > 100 else 0
    h += 3 if x['immobile_days'] >= 3 or (x['surgery_weeks_ago'] is not None and x['surgery_weeks_ago'] <= 4) else 0
    h += 3 if x['prior_vte'] else 0
    h += 2 if x['hemoptysis'] else 0
    h += 2 if x['malignancy'] else 0
    likely = h > 8
    recent_surg = x['surgery_weeks_ago'] is not None and x['surgery_weeks_ago'] <= 4
    if likely:
        nxt = 'IMAGING'
    elif x['age'] < 50 and x['hr'] < 100 and x['spo2'] >= 95 and not (x['hemoptysis'] or x['prior_vte'] or recent_surg):
        nxt = 'RULED_OUT'
    else:
        nxt = 'D_DIMER'
    return {'score': h / 2, 'category': 'LIKELY' if likely else 'UNLIKELY', 'next': nxt}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 26,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 4,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 31,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 61,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 102,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 31,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 6,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 29,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 41,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 27,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 5,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': True,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 5.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 32,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 62,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 103,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 32,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 7,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 30,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 42,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 28,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 6,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 33,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 63,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 104,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 33,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 8,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 31,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 43,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 29,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 7,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': True,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 5.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 34,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 64,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 105,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 34,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 9,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 32,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 44,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 30,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 8,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 65,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 106,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 10,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 33,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 45,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})]]
for label, args, expected in fixtures[N-1]:
    check(label, solve(args), expected)
print(json.dumps({"observations": observations, "passed": all(x["passed"] for x in observations)}, ensure_ascii=False))
raise SystemExit(0 if all(x["passed"] for x in observations) else 1)
Boundary fixtureActualExpectedOutcome
low risk young patient{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}Passed
immobilised after surgery counted once{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}Passed
surgery on the day counts{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}Passed
score 4.5 is likely{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}Passed
score 4.0 unlikely{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 4.0}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 4.0}Passed
half point score reported{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}Passed
surgery exactly 4 weeks ago excludes rule-out{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}Passed
remote surgery allows rule-out{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}Passed
estrogen use blocks rule-out{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 0.0}Failed
prior VTE blocks rule-out{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}Passed

SHA-256 / f8310e2b8e3a9729fe1bd4e68847b5ea716892bc91d010e9364c07681847b159

2 / The unsuccessful fix

Exit 1
"""Failure Map reference implementation. Python standard library only."""
import json
import math
from fractions import Fraction
N = 1
observations = []
def solve(x):
    h = 0
    h += 6 if x['dvt_signs'] else 0
    h += 6 if x['pe_most_likely'] else 0
    h += 3 if x['hr'] > 100 else 0
    h += 3 if x['immobile_days'] >= 3 or (x['surgery_weeks_ago'] is not None and x['surgery_weeks_ago'] <= 4) else 0
    h += 3 if x['prior_vte'] else 0
    h += 2 if x['hemoptysis'] else 0
    h += 2 if x['malignancy'] else 0
    likely = h > 8
    recent_surg = x['surgery_weeks_ago'] is not None and x['surgery_weeks_ago'] <= 4
    if likely:
        nxt = 'IMAGING'
    elif x['age'] < 50 and x['hr'] < 100 and x['spo2'] >= 95 and not (x['hemoptysis'] or x['estrogen'] or recent_surg):
        nxt = 'RULED_OUT'
    else:
        nxt = 'D_DIMER'
    return {'score': h / 2, 'category': 'LIKELY' if likely else 'UNLIKELY', 'next': nxt}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 26,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 4,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 31,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 61,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 102,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 31,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 6,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 29,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 41,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 27,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 5,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': True,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 5.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 32,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 62,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 103,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 32,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 7,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 30,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 42,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 28,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 6,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 33,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 63,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 104,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 33,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 8,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 31,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 43,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 29,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 7,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': True,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 5.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 34,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 64,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 105,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 34,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 9,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 32,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 44,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 30,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 8,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 65,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 106,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 10,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 33,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 45,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})]]
for label, args, expected in fixtures[N-1]:
    check(label, solve(args), expected)
print(json.dumps({"observations": observations, "passed": all(x["passed"] for x in observations)}, ensure_ascii=False))
raise SystemExit(0 if all(x["passed"] for x in observations) else 1)
Boundary fixtureActualExpectedOutcome
low risk young patient{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}Passed
immobilised after surgery counted once{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}Passed
surgery on the day counts{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}Passed
score 4.5 is likely{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}Passed
score 4.0 unlikely{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 4.0}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 4.0}Passed
half point score reported{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}Passed
surgery exactly 4 weeks ago excludes rule-out{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}Passed
remote surgery allows rule-out{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}Passed
estrogen use blocks rule-out{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 0.0}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 0.0}Passed
prior VTE blocks rule-out{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 1.5}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}Failed

SHA-256 / f7e2d1d4751dffbe59ed9fcf30b6f7723ce5cd20d85e757a8406504bf013bccc

3 / The verified repair

Exit 0
"""Failure Map reference implementation. Python standard library only."""
import json
import math
from fractions import Fraction
N = 1
observations = []
def solve(x):
    h = 0
    h += 6 if x['dvt_signs'] else 0
    h += 6 if x['pe_most_likely'] else 0
    h += 3 if x['hr'] > 100 else 0
    h += 3 if x['immobile_days'] >= 3 or (x['surgery_weeks_ago'] is not None and x['surgery_weeks_ago'] <= 4) else 0
    h += 3 if x['prior_vte'] else 0
    h += 2 if x['hemoptysis'] else 0
    h += 2 if x['malignancy'] else 0
    likely = h > 8
    recent_surg = x['surgery_weeks_ago'] is not None and x['surgery_weeks_ago'] <= 4
    if likely:
        nxt = 'IMAGING'
    elif x['age'] < 50 and x['hr'] < 100 and x['spo2'] >= 95 and not (x['hemoptysis'] or x['estrogen'] or x['prior_vte'] or recent_surg):
        nxt = 'RULED_OUT'
    else:
        nxt = 'D_DIMER'
    return {'score': h / 2, 'category': 'LIKELY' if likely else 'UNLIKELY', 'next': nxt}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 26,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 4,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 31,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 61,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 102,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 31,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 6,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 29,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 41,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 27,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 5,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': True,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 5.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 32,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 62,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 103,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 32,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 7,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 30,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 42,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 28,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 6,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 33,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 63,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 104,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 33,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 8,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 31,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 43,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 29,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 7,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': True,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 5.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 34,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 64,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 105,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 34,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 9,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 32,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 44,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})],
 [('low risk young patient',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 30,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('immobilised after surgery counted once',
   {'dvt_signs': True,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 8,
    'surgery_weeks_ago': 2,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('surgery on the day counts',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 0,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 40,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.5 is likely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.5, 'category': 'LIKELY', 'next': 'IMAGING'}),
  ('score 4.0 unlikely',
   {'dvt_signs': False,
    'pe_most_likely': True,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': True,
    'age': 65,
    'spo2': 98,
    'estrogen': False},
   {'score': 4.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('half point score reported',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 106,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 55,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('surgery exactly 4 weeks ago excludes rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 4,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('remote surgery allows rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': 10,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 35,
    'spo2': 98,
    'estrogen': False},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'RULED_OUT'}),
  ('estrogen use blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': False,
    'hemoptysis': False,
    'malignancy': False,
    'age': 33,
    'spo2': 98,
    'estrogen': True},
   {'score': 0.0, 'category': 'UNLIKELY', 'next': 'D_DIMER'}),
  ('prior VTE blocks rule-out',
   {'dvt_signs': False,
    'pe_most_likely': False,
    'hr': 80,
    'immobile_days': 0,
    'surgery_weeks_ago': None,
    'prior_vte': True,
    'hemoptysis': False,
    'malignancy': False,
    'age': 45,
    'spo2': 98,
    'estrogen': False},
   {'score': 1.5, 'category': 'UNLIKELY', 'next': 'D_DIMER'})]]
for label, args, expected in fixtures[N-1]:
    check(label, solve(args), expected)
print(json.dumps({"observations": observations, "passed": all(x["passed"] for x in observations)}, ensure_ascii=False))
raise SystemExit(0 if all(x["passed"] for x in observations) else 1)
Boundary fixtureActualExpectedOutcome
low risk young patient{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}Passed
immobilised after surgery counted once{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}Passed
surgery on the day counts{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}Passed
score 4.5 is likely{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}{'category': 'LIKELY', 'next': 'IMAGING', 'score': 4.5}Passed
score 4.0 unlikely{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 4.0}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 4.0}Passed
half point score reported{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}Passed
surgery exactly 4 weeks ago excludes rule-out{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}Passed
remote surgery allows rule-out{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}{'category': 'UNLIKELY', 'next': 'RULED_OUT', 'score': 0.0}Passed
estrogen use blocks rule-out{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 0.0}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 0.0}Passed
prior VTE blocks rule-out{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}{'category': 'UNLIKELY', 'next': 'D_DIMER', 'score': 1.5}Passed

SHA-256 / 78c970b53bb27ecc987497bd852ca81a7dcc07e9e3cc936e91a56ecd715191e6

Verification & scope

A deterministic toy software model with explicitly stipulated thresholds and formulas; it is not clinical guidance, not a validated medical calculator, and makes no claim of conformance to any published protocol. Numbered variants vary patient and order inputs. This reproducer isolates one failure mechanism. Results cover the supplied fixtures. Variants within a family share a test contract and should remain grouped when constructing evaluation splits. Related mechanisms with a shared evaluation_group must also remain together; these controlled models are not independent production incidents.

Observations recorded using Python 3.12.14 at 2026-09-29T14:47:24.840054+00:00.

Case digest / febf1156c485926251fd64aae726bf46021f1b51156fd88d0ea69298a9e53f55