FA-64586 / Clinical triage scoring / Open access
Upper gastrointestinal bleed risk score and disposition: urea lowest band edge · case 01
A urea of exactly 6.5 mmol/L scores 0.
ROOT CAUSE
The first urea band includes 6.5.
THE FAILURE
The first urea band includes 6.5.
Unsuccessful approach: Truncating urea to whole mmol/L scores 6.5-6.9 as normal.
Case contract
Input {urea (mmol/L), hb (g/dL), sex, sbp, hr, melena, syncope, hepatic, cardiac}. Toy points: urea < 6.5:0, 6.5-7.9:2, 8.0-9.9:3, 10.0-24.9:4, >=25:6. Hb male >=13:0, 12-12.9:1, 10-11.9:3, <10:6; female >=12:0, 10-11.9:1, <10:6. SBP >=110:0, 100-109:1, 90-99:2, <90:3. hr >= 100:1, melena 1, syncope 2, hepatic disease 2, cardiac failure 2. Disposition: 0 DISCHARGE, 1-6 ADMIT, >= 7 URGENT. Return {score, disposition}.
Why this case matters
Bleeding risk scores combine sex-specific laboratory tables with haemodynamic bands; each table edge is a separable defect.
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):
u = Fraction(str(x['urea'])) * 10
hb = Fraction(str(x['hb'])) * 10
p_u = 0 if u <= 65 else 2 if u < 80 else 3 if u < 100 else 4 if u < 250 else 6
if x['sex'] == 'M':
p_hb = 0 if hb >= 130 else 1 if hb >= 120 else 3 if hb >= 100 else 6
else:
p_hb = 0 if hb >= 120 else 1 if hb >= 100 else 6
bp = x['sbp']
p_bp = 0 if bp >= 110 else 1 if bp >= 100 else 2 if bp >= 90 else 3
s = p_u + p_hb + p_bp
s += 1 if x['hr'] >= 100 else 0
s += 1 if x['melena'] else 0
s += 2 if x['syncope'] else 0
s += 2 if x['hepatic'] else 0
s += 2 if x['cardiac'] else 0
disp = 'DISCHARGE' if s == 0 else 'ADMIT' if s < 7 else 'URGENT'
return {'score': s, 'disposition': disp}
def check(label, actual, expected):
observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 121,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 111,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.1',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.1',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.3',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 91,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 84,
'hr': 101,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.1',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.1',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.1',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})],
[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 122,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.6',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 112,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.2',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.2',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.4',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 92,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 83,
'hr': 102,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.2',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.2',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.2',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})],
[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 123,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.7',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 113,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.3',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.3',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.5',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 93,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 82,
'hr': 103,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.3',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.3',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.3',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})],
[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 124,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.8',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 114,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.4',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.4',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.6',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 94,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 81,
'hr': 104,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.4',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.4',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.4',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})],
[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.9',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 115,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.5',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.5',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.7',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 95,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 80,
'hr': 105,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.5',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.5',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.5',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})]]
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 fixture | Actual | Expected | Outcome |
|---|---|---|---|
| all normal discharge | {'disposition': 'DISCHARGE', 'score': 0} | {'disposition': 'DISCHARGE', 'score': 0} | Passed |
| urea 6.5 to 6.9 | {'disposition': 'DISCHARGE', 'score': 0} | {'disposition': 'ADMIT', 'score': 2} | Failed |
| urea exactly 6.5 | {'disposition': 'DISCHARGE', 'score': 0} | {'disposition': 'ADMIT', 'score': 2} | Failed |
| female haemoglobin 11 | {'disposition': 'ADMIT', 'score': 1} | {'disposition': 'ADMIT', 'score': 1} | Passed |
| female haemoglobin below 10 | {'disposition': 'ADMIT', 'score': 6} | {'disposition': 'ADMIT', 'score': 6} | Passed |
| male haemoglobin 12.5 | {'disposition': 'ADMIT', 'score': 1} | {'disposition': 'ADMIT', 'score': 1} | Passed |
| systolic exactly 90 | {'disposition': 'ADMIT', 'score': 4} | {'disposition': 'ADMIT', 'score': 4} | Passed |
| systolic below 90 with tachycardia | {'disposition': 'URGENT', 'score': 7} | {'disposition': 'URGENT', 'score': 7} | Passed |
| tachycardia alone | {'disposition': 'ADMIT', 'score': 1} | {'disposition': 'ADMIT', 'score': 1} | Passed |
| melena with tachycardia | {'disposition': 'ADMIT', 'score': 2} | {'disposition': 'ADMIT', 'score': 2} | Passed |
| high risk bleed | {'disposition': 'URGENT', 'score': 17} | {'disposition': 'URGENT', 'score': 17} | Passed |
SHA-256 / 73b5c5c2116d7786980184210ef10d1c21011406b60a3f5435738a76cd4644d1
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):
u = Fraction(str(x['urea'])) * 10
hb = Fraction(str(x['hb'])) * 10
p_u = 0 if math.floor(u / 10) < 7 else 2 if u < 80 else 3 if u < 100 else 4 if u < 250 else 6
if x['sex'] == 'M':
p_hb = 0 if hb >= 130 else 1 if hb >= 120 else 3 if hb >= 100 else 6
else:
p_hb = 0 if hb >= 120 else 1 if hb >= 100 else 6
bp = x['sbp']
p_bp = 0 if bp >= 110 else 1 if bp >= 100 else 2 if bp >= 90 else 3
s = p_u + p_hb + p_bp
s += 1 if x['hr'] >= 100 else 0
s += 1 if x['melena'] else 0
s += 2 if x['syncope'] else 0
s += 2 if x['hepatic'] else 0
s += 2 if x['cardiac'] else 0
disp = 'DISCHARGE' if s == 0 else 'ADMIT' if s < 7 else 'URGENT'
return {'score': s, 'disposition': disp}
def check(label, actual, expected):
observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 121,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 111,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.1',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.1',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.3',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 91,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 84,
'hr': 101,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.1',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.1',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.1',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})],
[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 122,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.6',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 112,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.2',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.2',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.4',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 92,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 83,
'hr': 102,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.2',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.2',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.2',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})],
[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 123,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.7',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 113,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.3',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.3',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.5',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 93,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 82,
'hr': 103,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.3',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.3',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.3',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})],
[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 124,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.8',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 114,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.4',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.4',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.6',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 94,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 81,
'hr': 104,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.4',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.4',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.4',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})],
[('all normal discharge',
{'urea': '5.0',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 0, 'disposition': 'DISCHARGE'}),
('urea 6.5 to 6.9',
{'urea': '6.9',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('urea exactly 6.5',
{'urea': '6.5',
'hb': '14.0',
'sex': 'M',
'sbp': 115,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('female haemoglobin 11',
{'urea': '5.0',
'hb': '11.5',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('female haemoglobin below 10',
{'urea': '5.0',
'hb': '9.5',
'sex': 'F',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 6, 'disposition': 'ADMIT'}),
('male haemoglobin 12.5',
{'urea': '5.0',
'hb': '12.7',
'sex': 'M',
'sbp': 125,
'hr': 80,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('systolic exactly 90',
{'urea': '7.0',
'hb': '14.0',
'sex': 'M',
'sbp': 90,
'hr': 95,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 4, 'disposition': 'ADMIT'}),
('systolic below 90 with tachycardia',
{'urea': '9.0',
'hb': '14.0',
'sex': 'M',
'sbp': 80,
'hr': 105,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 7, 'disposition': 'URGENT'}),
('tachycardia alone',
{'urea': '5.0',
'hb': '13.5',
'sex': 'M',
'sbp': 125,
'hr': 100,
'melena': False,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 1, 'disposition': 'ADMIT'}),
('melena with tachycardia',
{'urea': '5.5',
'hb': '14.0',
'sex': 'M',
'sbp': 125,
'hr': 105,
'melena': True,
'syncope': False,
'hepatic': False,
'cardiac': False},
{'score': 2, 'disposition': 'ADMIT'}),
('high risk bleed',
{'urea': '26',
'hb': '8.5',
'sex': 'M',
'sbp': 85,
'hr': 80,
'melena': False,
'syncope': True,
'hepatic': False,
'cardiac': False},
{'score': 17, 'disposition': 'URGENT'})]]
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 fixture | Actual | Expected | Outcome |
|---|---|---|---|
| all normal discharge | {'disposition': 'DISCHARGE', 'score': 0} | {'disposition': 'DISCHARGE', 'score': 0} | Passed |
| urea 6.5 to 6.9 | {'disposition': 'DISCHARGE', 'score': 0} | {'disposition': 'ADMIT', 'score': 2} | Failed |
| urea exactly 6.5 | {'disposition': 'DISCHARGE', 'score': 0} | {'disposition': 'ADMIT', 'score': 2} | Failed |
| female haemoglobin 11 | {'disposition': 'ADMIT', 'score': 1} | {'disposition': 'ADMIT', 'score': 1} | Passed |
| female haemoglobin below 10 | {'disposition': 'ADMIT', 'score': 6} | {'disposition': 'ADMIT', 'score': 6} | Passed |
| male haemoglobin 12.5 | {'disposition': 'ADMIT', 'score': 1} | {'disposition': 'ADMIT', 'score': 1} | Passed |
| systolic exactly 90 | {'disposition': 'ADMIT', 'score': 4} | {'disposition': 'ADMIT', 'score': 4} | Passed |
| systolic below 90 with tachycardia | {'disposition': 'URGENT', 'score': 7} | {'disposition': 'URGENT', 'score': 7} | Passed |
| tachycardia alone | {'disposition': 'ADMIT', 'score': 1} | {'disposition': 'ADMIT', 'score': 1} | Passed |
| melena with tachycardia | {'disposition': 'ADMIT', 'score': 2} | {'disposition': 'ADMIT', 'score': 2} | Passed |
| high risk bleed | {'disposition': 'URGENT', 'score': 17} | {'disposition': 'URGENT', 'score': 17} | Passed |
SHA-256 / 15b278dd86446820133c52dab1840e167a7fe5823e95eeab8a32646808585c02
HELD IN THE MEMBER ARCHIVE
The verified repair and its recorded checks are member-only.
This mechanism has 11 recorded checks per implementation. The open-access tier publishes the failure and the unsuccessful fix; the repaired source that passes every check, and the observations that prove it, are available to members.
Every case sharing this mechanism uses the same contract and the same repair, so this one record is held back for all of them.
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Sign in to the archive ↗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 2026-09-29T14:47:26.072116+00:00.
Case digest / 1c178f3fc63a7d8b23634b0a21795153447697400037110e6823c238838a601a