FA-64701 / Clinical triage scoring / Open access
Chest pain composite risk score: moderate band upper range · case 01
A score of 4 is reported as low risk.
ROOT CAUSE
The moderate band excludes its lower edge.
VERIFIED REPAIR
Treat 4-6 as moderate.
Unsuccessful approach: An exclusive upper limit of 6 drops scores of 6 to low.
Case contract
Input {history 0-2, ecg 0-2, age, risk_factors (count), known_athero, troponin (ng/L), uln (ng/L)}. Toy points: age < 45:0, 45-64:1, >=65:2; risk factors 0:0, 1-2:1, >=3 or known atherosclerosis:2; troponin as a multiple of the upper limit (troponin/uln) <= 1:0, <= 3:1, > 3:2. Risk: 0-3 LOW, 4-6 MODERATE, 7-10 HIGH. Return {score, risk}.
Why this case matters
Composite chest pain scores sum banded components; age, override and troponin edges each fail on their own.
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):
a = x['age']
p_age = 2 if a >= 65 else 1 if a >= 45 else 0
rf = x['risk_factors']
p_rf = 2 if rf >= 3 or x['known_athero'] else 1 if rf >= 1 else 0
t = Fraction(x['troponin'], x['uln'])
p_t = 0 if t <= 1 else 1 if t <= 3 else 2
s = x['history'] + x['ecg'] + p_age + p_rf + p_t
risk = 'HIGH' if s >= 7 else 'MODERATE' if s > 4 else 'LOW'
return {'score': s, 'risk': risk}
def check(label, actual, expected):
observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('low risk control',
{'history': 1, 'ecg': 0, 'age': 31, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 31, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 1, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 3, 'risk': 'LOW'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 41, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 51, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 2, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 44, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 16, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 1, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 32, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 32, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 2, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 42, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 52, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 2, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 1, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 45, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 17, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 2, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 33, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 33, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 0, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 43, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 53, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 0, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 2, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 46, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 18, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 3, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 34, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 34, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 1, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 3, 'risk': 'LOW'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 54, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 1, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 47, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 19, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 4, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 35, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 35, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 2, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 41, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 55, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 2, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 2, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 48, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 20, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 5, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})]]
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 |
|---|---|---|---|
| low risk control | {'risk': 'LOW', 'score': 1} | {'risk': 'LOW', 'score': 1} | Passed |
| troponin just over limit with other assay limit | {'risk': 'LOW', 'score': 2} | {'risk': 'LOW', 'score': 2} | Passed |
| age exactly 45 | {'risk': 'LOW', 'score': 3} | {'risk': 'LOW', 'score': 3} | Passed |
| age 42 | {'risk': 'LOW', 'score': 4} | {'risk': 'MODERATE', 'score': 4} | Failed |
| known atherosclerosis without risk factors | {'risk': 'LOW', 'score': 4} | {'risk': 'MODERATE', 'score': 4} | Failed |
| troponin exactly at limit | {'risk': 'MODERATE', 'score': 5} | {'risk': 'MODERATE', 'score': 5} | Passed |
| troponin exactly three times limit | {'risk': 'MODERATE', 'score': 6} | {'risk': 'MODERATE', 'score': 6} | Passed |
| troponin above three times limit | {'risk': 'LOW', 'score': 2} | {'risk': 'LOW', 'score': 2} | Passed |
| score exactly 6 | {'risk': 'MODERATE', 'score': 6} | {'risk': 'MODERATE', 'score': 6} | Passed |
| score exactly 7 | {'risk': 'HIGH', 'score': 7} | {'risk': 'HIGH', 'score': 7} | Passed |
SHA-256 / 1d3ab82e75007ae85be37cbc78534a62c2fde924513b5de13606d634a62ee1de
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):
a = x['age']
p_age = 2 if a >= 65 else 1 if a >= 45 else 0
rf = x['risk_factors']
p_rf = 2 if rf >= 3 or x['known_athero'] else 1 if rf >= 1 else 0
t = Fraction(x['troponin'], x['uln'])
p_t = 0 if t <= 1 else 1 if t <= 3 else 2
s = x['history'] + x['ecg'] + p_age + p_rf + p_t
risk = 'HIGH' if s >= 7 else 'MODERATE' if 4 <= s < 6 else 'LOW'
return {'score': s, 'risk': risk}
def check(label, actual, expected):
observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('low risk control',
{'history': 1, 'ecg': 0, 'age': 31, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 31, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 1, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 3, 'risk': 'LOW'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 41, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 51, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 2, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 44, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 16, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 1, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 32, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 32, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 2, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 42, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 52, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 2, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 1, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 45, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 17, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 2, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 33, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 33, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 0, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 43, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 53, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 0, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 2, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 46, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 18, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 3, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 34, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 34, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 1, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 3, 'risk': 'LOW'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 54, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 1, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 47, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 19, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 4, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 35, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 35, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 2, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 41, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 55, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 2, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 2, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 48, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 20, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 5, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})]]
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 |
|---|---|---|---|
| low risk control | {'risk': 'LOW', 'score': 1} | {'risk': 'LOW', 'score': 1} | Passed |
| troponin just over limit with other assay limit | {'risk': 'LOW', 'score': 2} | {'risk': 'LOW', 'score': 2} | Passed |
| age exactly 45 | {'risk': 'LOW', 'score': 3} | {'risk': 'LOW', 'score': 3} | Passed |
| age 42 | {'risk': 'MODERATE', 'score': 4} | {'risk': 'MODERATE', 'score': 4} | Passed |
| known atherosclerosis without risk factors | {'risk': 'MODERATE', 'score': 4} | {'risk': 'MODERATE', 'score': 4} | Passed |
| troponin exactly at limit | {'risk': 'MODERATE', 'score': 5} | {'risk': 'MODERATE', 'score': 5} | Passed |
| troponin exactly three times limit | {'risk': 'LOW', 'score': 6} | {'risk': 'MODERATE', 'score': 6} | Failed |
| troponin above three times limit | {'risk': 'LOW', 'score': 2} | {'risk': 'LOW', 'score': 2} | Passed |
| score exactly 6 | {'risk': 'LOW', 'score': 6} | {'risk': 'MODERATE', 'score': 6} | Failed |
| score exactly 7 | {'risk': 'HIGH', 'score': 7} | {'risk': 'HIGH', 'score': 7} | Passed |
SHA-256 / 1f87d864a38b4ad3674039beb662892f27cbe1ab9aa65e182819003a726778d7
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):
a = x['age']
p_age = 2 if a >= 65 else 1 if a >= 45 else 0
rf = x['risk_factors']
p_rf = 2 if rf >= 3 or x['known_athero'] else 1 if rf >= 1 else 0
t = Fraction(x['troponin'], x['uln'])
p_t = 0 if t <= 1 else 1 if t <= 3 else 2
s = x['history'] + x['ecg'] + p_age + p_rf + p_t
risk = 'HIGH' if s >= 7 else 'MODERATE' if s >= 4 else 'LOW'
return {'score': s, 'risk': risk}
def check(label, actual, expected):
observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('low risk control',
{'history': 1, 'ecg': 0, 'age': 31, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 31, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 1, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 3, 'risk': 'LOW'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 41, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 51, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 2, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 44, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 16, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 1, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 32, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 32, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 2, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 42, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 52, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 2, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 1, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 45, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 17, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 2, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 33, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 33, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 0, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 43, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 53, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 0, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 2, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 46, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 18, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 3, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 34, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 34, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 1, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 3, 'risk': 'LOW'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 54, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 1, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 5, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 47, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 19, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 4, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})],
[('low risk control',
{'history': 1, 'ecg': 0, 'age': 35, 'risk_factors': 0, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 1, 'risk': 'LOW'}),
('troponin just over limit with other assay limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 1, 'known_athero': False, 'troponin': 35, 'uln': 26},
{'score': 2, 'risk': 'LOW'}),
('age exactly 45',
{'history': 2, 'ecg': 0, 'age': 45, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('age 42',
{'history': 2, 'ecg': 1, 'age': 41, 'risk_factors': 1, 'known_athero': False, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('known atherosclerosis without risk factors',
{'history': 1, 'ecg': 0, 'age': 55, 'risk_factors': 0, 'known_athero': True, 'troponin': 7, 'uln': 14},
{'score': 4, 'risk': 'MODERATE'}),
('troponin exactly at limit',
{'history': 2, 'ecg': 2, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 14, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin exactly three times limit',
{'history': 1, 'ecg': 2, 'age': 60, 'risk_factors': 1, 'known_athero': False, 'troponin': 42, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('troponin above three times limit',
{'history': 0, 'ecg': 0, 'age': 40, 'risk_factors': 0, 'known_athero': False, 'troponin': 48, 'uln': 14},
{'score': 2, 'risk': 'LOW'}),
('score exactly 6',
{'history': 2, 'ecg': 1, 'age': 50, 'risk_factors': 1, 'known_athero': False, 'troponin': 20, 'uln': 14},
{'score': 6, 'risk': 'MODERATE'}),
('score exactly 7',
{'history': 2, 'ecg': 2, 'age': 70, 'risk_factors': 1, 'known_athero': False, 'troponin': 5, 'uln': 14},
{'score': 7, 'risk': 'HIGH'})]]
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 |
|---|---|---|---|
| low risk control | {'risk': 'LOW', 'score': 1} | {'risk': 'LOW', 'score': 1} | Passed |
| troponin just over limit with other assay limit | {'risk': 'LOW', 'score': 2} | {'risk': 'LOW', 'score': 2} | Passed |
| age exactly 45 | {'risk': 'LOW', 'score': 3} | {'risk': 'LOW', 'score': 3} | Passed |
| age 42 | {'risk': 'MODERATE', 'score': 4} | {'risk': 'MODERATE', 'score': 4} | Passed |
| known atherosclerosis without risk factors | {'risk': 'MODERATE', 'score': 4} | {'risk': 'MODERATE', 'score': 4} | Passed |
| troponin exactly at limit | {'risk': 'MODERATE', 'score': 5} | {'risk': 'MODERATE', 'score': 5} | Passed |
| troponin exactly three times limit | {'risk': 'MODERATE', 'score': 6} | {'risk': 'MODERATE', 'score': 6} | Passed |
| troponin above three times limit | {'risk': 'LOW', 'score': 2} | {'risk': 'LOW', 'score': 2} | Passed |
| score exactly 6 | {'risk': 'MODERATE', 'score': 6} | {'risk': 'MODERATE', 'score': 6} | Passed |
| score exactly 7 | {'risk': 'HIGH', 'score': 7} | {'risk': 'HIGH', 'score': 7} | Passed |
SHA-256 / 9b012933d10304f035711fc423da6e020edefb31424e631c19a6e5650c75f75f
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 2026-09-29T14:47:26.913733+00:00.
Case digest / 070c696b4916e0b3644574bb552636e7bd19936989a6f0f6c5a68cab78281fbc